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Shrestha, N; Zorn-Pauly, K; Mesirca, P; Koyani, CN; Wölkart, G; Di, Biase, V; Torre, E; Lang, P; Gorischek, A; Schreibmayer, W; Arnold, R; Maechler, H; Mayer, B; von, Lewinski, D; Torrente, AG; Mangoni, ME; Pelzmann, B; Scheruebel, S.
Lipopolysaccharide-induced sepsis impairs M2R-GIRK signaling in the mouse sinoatrial node.
Proc Natl Acad Sci U S A. 2023; 120(28): e2210152120
Doi: 10.1073/pnas.2210152120
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- Führende Autor*innen der Med Uni Graz
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Pelzmann Brigitte
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Scherübel-Posch Susanne
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Shrestha Niroj
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Zorn-Pauly Klaus
- Co-Autor*innen der Med Uni Graz
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Arnold Robert
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Di Biase Valentina
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Gorischek Astrid
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Koyani Chintan Navinchandra
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Lang Petra
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Mächler Heinrich
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Schreibmayer Wolfgang
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von Lewinski Dirk
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- Abstract:
- Sepsis has emerged as a global health burden associated with multiple organ dysfunction and 20% mortality rate in patients. Numerous clinical studies over the past two decades have correlated the disease severity and mortality in septic patients with impaired heart rate variability (HRV), as a consequence of impaired chronotropic response of sinoatrial node (SAN) pacemaker activity to vagal/parasympathetic stimulation. However, the molecular mechanism(s) downstream to parasympathetic inputs have not been investigated yet in sepsis, particularly in the SAN. Based on electrocardiography, fluorescence Ca2+ imaging, electrophysiology, and protein assays from organ to subcellular level, we report that impaired muscarinic receptor subtype 2-G protein-activated inwardly-rectifying potassium channel (M2R-GIRK) signaling in a lipopolysaccharide-induced proxy septic mouse model plays a critical role in SAN pacemaking and HRV. The parasympathetic responses to a muscarinic agonist, namely IKACh activation in SAN cells, reduction in Ca2+ mobilization of SAN tissues, lowering of heart rate and increase in HRV, were profoundly attenuated upon lipopolysaccharide-induced sepsis. These functional alterations manifested as a direct consequence of reduced expression of key ion-channel components (GIRK1, GIRK4, and M2R) in the mouse SAN tissues and cells, which was further evident in the human right atrial appendages of septic patients and likely not mediated by the common proinflammatory cytokines elevated in sepsis.
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