Myotonic dystrophy (DM) is caused by a CTG expansion in the 3-untranslated region of a protein kinase gene (DMPK). Cardiovascular disease is one of the most prevalent causes of death in DM patients. Electrophysiological studies in cardiac muscles from DM patients and from DMPK ؊/؊ mice suggested that DMPK is critical to the modulation of cardiac contractility and to the maintenance of proper cardiac conduction activity. However, there are no data regarding the molecular signaling pathways involved in DM heart failure. Here we show that DMPK expression in cardiac myocytes is highly enriched in the sarcoplasmic reticulum (SR) where it colocalizes with the ryanodine receptor and phospholamban (PLN), a muscle-specific SR Ca 2؉ -ATPase (SERCA2a) inhibitor. Coimmunoprecipitation studies showed that DMPK and PLN can physically associate. Furthermore, purified wild-type DMPK, but not a kinase-deficient mutant (K110A DMPK), phosphorylates PLN in vitro. Subsequent studies using the DMPK ؊/؊ mice demonstrated that PLN is hypo-phosphorylated in SR vesicles from DMPK ؊/؊ mice compared with wild-type mice both in vitro and in vivo. Finally, we show that Ca 2؉ uptake in SR is impaired in ventricular homogenates from DMPK ؊/؊ mice. Together, our data suggest the existence of a novel regulatory DMPK pathway for cardiac contractility and provide a molecular mechanism for DM heart pathology.
Myotonic muscular dystrophy (DM)1 is an autosomal, dominant inherited, neuromuscular disorder with an incidence of 1 in 8000 in European and North American populations. Clinical expression of DM is extremely variable; patients present with progressive muscular dystrophy associated with the inability to promote normal muscle relaxation (myotonia), cataracts, cardiac arrhythmia, testicular atrophy, and insulin resistance (1).The DM1 mutation has been identified as the expansion of an unstable CTG repeat in the 3Ј-untranslated region of a gene encoding myotonic dystrophy protein kinase (DMPK) at chromosome 19q13.3. The age of onset and the severity of the disease correlate with the extent of expansion (2, 3). The dmpk gene product is a Ser/Thr protein kinase homologous to the MRCK p21-activated kinases (4) and the Rho family of kinases (5). Data obtained by using antibodies that detect specific isoforms of DMPK indicate that the most abundant isoform of DMPK is an 80-kDa protein expressed almost exclusively in smooth, skeletal, and cardiac muscles (6). This kinase exists both as a membrane-associated and as a soluble form in human left ventricular samples (7). The different C termini of DMPK that arise from alternative splicing determine its localization to the endoplasmic reticulum, mitochondria, or cytosol in transfected COS-1 cells (8). Among the substrates for DMPK proposed by in vitro studies are phospholemman, the dihydropyridine receptor, and the myosin phosphatase targeting subunit (9 -11). However, an in vivo demonstration of the phosphorylation of these substrates by DMPK remains to be established, and a link between these substrates an...