[Ca 2ϩ ]i, and reduced the amount of Ca 2ϩ release associated with exposure to any given concentration of caffeine or 4-CmC to MHN levels. These results suggest that the differences in the response of MHS skeletal myoballs to caffeine and 4-CmC may be mediated at least in part by the chronic high resting [Ca 2ϩ ]i levels in these cells. calcium homeostasis; 1,2-bis(2-aminophenoxy)ethane-N,N,NЈ,NЈ-tetraacetic acid MALIGNANT HYPERTHERMIA (MH) is a potentially fatal pharmacogenetic myopathy of humans and several large mammals, including swine, dog, and horse. It can be induced by volatile anesthetics and/or depolarizing muscle relaxants (1, 33, 37). While in swine susceptibility to the syndrome has been associated with a single point mutation (Arg615Cys) in the Ca 2ϩ release channel at the sarcoplasmic reticulum (ryanodine receptor 1, RyR1) (13, 32), in humans at least 42 MH mutations have been identified at 34 different RyR1 residues and two MH mutations at one residue in the skeletal dihydropyridine receptor (DHPR) (21,33,37 (17,26). In addition, it was previously shown that skeletal muscle from MHS individuals and animals have a lower pharmacological threshold and an exaggerated response at submaximal concentrations of caffeine (22, 45) and 4-chloro-m-cresol (4-CmC) (44, 48) than do those with MH-nonsusceptible (MHN) muscle. This enhanced sensitivity is widely used as part of the clinical diagnosis of MH susceptibility in humans and has been confirmed experimentally in swine (16,21). The molecular and cellular basis for heightened sensitivity to pharmacological agents in MHS has remained unclear (33, 37). Evidence of chronically elevated resting [Ca 2ϩ ] i has been presented on the basis of direct measurements with Ca 2ϩ -selective electrodes in isolated human and swine skeletal muscle fibers (28, 30). However, the extent to which high [Ca 2ϩ ] i contributes to sensitizing responses to caffeine and 4-CmC is not known.The purpose of the present study was to address the question of whether the enhanced intracellular Ca 2ϩ release at submaximal concentrations of caffeine and 4-CmC (44,45,48) in MHS cells is related to chronic elevation in resting [Ca 2ϩ ] i in affected muscle cells. To do so, resting [Ca 2ϩ ] i of MHS myoballs was decreased nearly to MHN levels by loading them with the Ca 2ϩ chelator 1,2-bis(2-aminophenoxy)ethane-N,N,NЈ,NЈ-tetraacetic acid (BAPTA) and then reexamining the responses to caffeine and 4-CmC. Our results suggest that the enhanced intracellular Ca 2ϩ release at submaximal concentrations of caffeine and 4-CmC was closely associated with the high resting [Ca 2ϩ ] i observed in these cells.
MATERIALS AND METHODSMuscle cell preparations. Muscle biopsies were obtained from the hindlimb muscles of newborn (4 -8 days) Yorkshire (MHN; n ϭ 4) and Poland China (MHS; n ϭ 5) swine. Susceptibility to MH was determined using polymerase chain reaction genotyping as previously described (33, 37). Hindlimb muscle was removed while the animals were anesthetized with the nontriggering age...