BACKGROUND AND PURPOSEWe investigated the hypothesis that elevated glucose increases contractile responses in vascular smooth muscle and that this enhanced constriction occurs due to the glucose-induced PKC-dependent inhibition of voltage-gated potassium channels.
EXPERIMENTAL APPROACHPatch-clamp electrophysiology in rat isolated mesenteric arterial myocytes was performed to investigate the glucose-induced inhibition of voltage-gated potassium (K v ) current. To determine the effects of glucose in whole vessel, wire myography was performed in rat mesenteric, porcine coronary and human internal mammary arteries.
KEY RESULTSGlucose-induced inhibition of K v was PKC-dependent and could be pharmacologically dissected using PKC isoenzyme-specific inhibitors to reveal a PKCβ-dependent component of K v inhibition dominating between 0 and 10 mM glucose with an additional PKCα-dependent component becoming evident at concentrations greater than 10 mM. These findings were supported using wire myography in all artery types used, where contractile responses to vessel depolarization and vasoconstrictors were enhanced by increasing bathing glucose concentration, again with evidence for distinct and complementary PKCα/PKCβ-mediated components.
CONCLUSIONS AND IMPLICATIONSOur results provide compelling evidence that glucose-induced PKCα/PKCβ-mediated inhibition of K v current in vascular smooth muscle causes an enhanced constrictor response. Inhibition of K v current causes a significant depolarization of vascular myocytes leading to marked vasoconstriction. The PKC dependence of this enhanced constrictor response may present a potential therapeutic target for improving microvascular perfusion following percutaneous coronary intervention after myocardial infarction in hyperglycaemic patients. Significant fluctuations in plasma glucose concentration also occur physiologically through the diurnal cycle of feeding and fasting, and such changes can be exaggerated under certain pathophysiological circumstances (e.g. type 1 or type 2 diabetes). According to NICE guidelines, diabetes is often associated with cardiovascular complications, including coronary artery disease (leading to myocardial infarction and angina), peripheral artery disease (leg claudication and gangrene) and carotid artery disease (strokes and dementia). There are also microvascular complications caused by diabetes, such as diabetic retinopathy, kidney and nerve damage (NICE guidelines, 2014). Recent evidence suggests that the plasma concentration of blood glucose may also play a significant role in enhancing vasoconstriction and so have a deleterious effect on microvascular reperfusion following percutaneous coronary intervention (Iwakura et al., 2003). The risk associated with these complications can be minimized by tight glycaemic control, although there is a need for therapies to reduce the risk further. Acute hyperglycaemia (15 mM), in healthy human subjects, increases systolic and diastolic BP and heart rate and decreases leg blood flow and blood viscosity (Gi...