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L-type Ca2+ channel blockers promote vascular remodeling through activation of STIM proteins.


ABSTRACT: Voltage-gated L-type Ca2+ channel (Cav1.2) blockers (LCCBs) are major drugs for treating hypertension, the preeminent risk factor for heart failure. Vascular smooth muscle cell (VSMC) remodeling is a pathological hallmark of chronic hypertension. VSMC remodeling is characterized by molecular rewiring of the cellular Ca2+ signaling machinery, including down-regulation of Cav1.2 channels and up-regulation of the endoplasmic reticulum (ER) stromal-interacting molecule (STIM) Ca2+ sensor proteins and the plasma membrane ORAI Ca2+ channels. STIM/ORAI proteins mediate store-operated Ca2+ entry (SOCE) and drive fibro-proliferative gene programs during cardiovascular remodeling. SOCE is activated by agonists that induce depletion of ER Ca2+, causing STIM to activate ORAI. Here, we show that the three major classes of LCCBs activate STIM/ORAI-mediated Ca2+ entry in VSMCs. LCCBs act on the STIM N terminus to cause STIM relocalization to junctions and subsequent ORAI activation in a Cav1.2-independent and store depletion-independent manner. LCCB-induced promotion of VSMC remodeling requires STIM1, which is up-regulated in VSMCs from hypertensive rats. Epidemiology showed that LCCBs are more associated with heart failure than other antihypertensive drugs in patients. Our findings unravel a mechanism of LCCBs action on Ca2+ signaling and demonstrate that LCCBs promote vascular remodeling through STIM-mediated activation of ORAI. Our data indicate caution against the use of LCCBs in elderly patients or patients with advanced hypertension and/or onset of cardiovascular remodeling, where levels of STIM and ORAI are elevated.

SUBMITTER: Johnson MT 

PROVIDER: S-EPMC7382247 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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L-type Ca<sup>2+</sup> channel blockers promote vascular remodeling through activation of STIM proteins.

Johnson Martin T MT   Gudlur Aparna A   Zhang Xuexin X   Xin Ping P   Emrich Scott M SM   Yoast Ryan E RE   Courjaret Raphael R   Nwokonko Robert M RM   Li Wei W   Hempel Nadine N   Machaca Khaled K   Gill Donald L DL   Hogan Patrick G PG   Trebak Mohamed M  

Proceedings of the National Academy of Sciences of the United States of America 20200708 29


Voltage-gated L-type Ca<sup>2+</sup> channel (Ca<sub>v</sub>1.2) blockers (LCCBs) are major drugs for treating hypertension, the preeminent risk factor for heart failure. Vascular smooth muscle cell (VSMC) remodeling is a pathological hallmark of chronic hypertension. VSMC remodeling is characterized by molecular rewiring of the cellular Ca<sup>2+</sup> signaling machinery, including down-regulation of Ca<sub>v</sub>1.2 channels and up-regulation of the endoplasmic reticulum (ER) stromal-interac  ...[more]

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