CASQ1-null Mice Research Articles

Ablation of Calsequestrin-1, Ca2+ unbalance, and susceptibility to heat stroke.

Introduction: Ca2+ levels in adult skeletal muscle fibers are mainly controlled by excitation-contraction (EC) coupling, a mechanism that translates action potentials in release of Ca2+ from the sarcoplasmic reticulum (SR) release channels, i.e. the ryanodine receptors type-1 (RyR1). Calsequestrin (Casq) is a protein that binds large amounts of Ca2+ in the lumen of the SR terminal cisternae, near sites of Ca2+ release. There is general agreement that Casq is not only important for the SR ability to store Ca2+, but also for modulating the opening probability of the RyR Ca2+ release channels. The initial studies: About 20 years ago we generated a mouse model lacking Casq1 (Casq1-null mice), the isoform predominantly expressed in adult fast twitch skeletal muscle. While the knockout was not lethal as expected, lack of Casq1 caused a striking remodeling of membranes of SR and of transverse tubules (TTs), and mitochondrial damage. Functionally, CASQ1-knockout resulted in reduced SR Ca2+ content, smaller Ca2+ transients, and severe SR depletion during repetitive stimulation. The myopathic phenotype of Casq1-null mice: After the initial studies, we discovered that Casq1-null mice were prone to sudden death when exposed to halogenated anaesthetics, heat and even strenuous exercise. These syndromes are similar to human malignant hyperthermia susceptibility (MHS) and environmental-exertional heat stroke (HS). We learned that mechanisms underlying these syndromes involved excessive SR Ca2+ leak and excessive production of oxidative species: indeed, mortality and mitochondrial damage were significantly prevented by administration of antioxidants and reduction of oxidative stress. Though, how Casq1-null mice could survive without the most important SR Ca2+ binding protein was a puzzling issue that was not solved. Unravelling the mystery: The mystery was finally solved in 2020, when we discovered that in Casq1-null mice the SR undergoes adaptations that result in constitutively active store-operated Ca2+ entry (SOCE). SOCE is a mechanism that allows skeletal fibers to use external Ca2+ when SR stores are depleted. The post-natal compensatory mechanism that allows Casq1-null mice to survive involves the assembly of new SR-TT junctions (named Ca2+ entry units) containing Stim1 and Orai1, the two proteins that mediate SOCE.

Constitutive assembly of Ca2+ entry units in soleus muscle from calsequestrin knockout mice.

Calcium (Ca2+) entry units (CEUs) are junctions within the I band of the sarcomere between stacks of sarcoplasmic reticulum (SR) cisternae and extensions of the transverse (T)-tubule. CEUs contain STIM1 and Orai1 proteins, the molecular machinery of store-operated Ca2+ entry (SOCE). In extensor digitorum longus (EDL) fibers of wild-type (WT) mice, CEUs transiently assemble during acute exercise and disassemble several hours thereafter. By contrast, calsequestrin-1 (CASQ1) ablation induces a compensatory constitutive assembly of CEUs in EDL fibers, resulting in enhanced constitutive and maximum SOCE that counteracts SR Ca2+ depletion during repetitive activity. However, whether CEUs form in slow-twitch fibers, which express both the skeletal CASQ1 and the cardiac CASQ2 isoforms, is unknown. Herein, we compared the structure and function of soleus muscles from WT and knockout mice that lack either CASQ1 (CASQ1-null) or both CASQs (dCASQ-null). Ultrastructural analyses showed that SR/T-tubule junctions at the I band, virtually identical to CEUs in EDL muscle, were present and more frequent in CASQ1-null than WT mice, with dCASQ-null exhibiting the highest incidence. The greater incidence of CEUs in soleus from dCASQ-null mice correlated with increased specific force production during repetitive, high-frequency stimulation, which depended on Ca2+ entry. Consistent with this, Orai1 expression was significantly increased in soleus of CASQ1-null mice, but even more in dCASQ-null mice, compared with WT. Together, these results strengthen the concept that CEU assembly strongly depends on CASQ expression and provides an alternative source of Ca2+ needed to refill SR Ca2+ stores to maintain specific force production during sustained muscle activity.

Oxygen Consumption and Basal Metabolic Rate as Markers of Susceptibility to Malignant Hyperthermia and Heat Stroke.

Calsequestrin 1 (CASQ1) and Ryanodine receptor 1 (RYR1) are two of the main players in excitation–contraction (EC) coupling. CASQ1-knockout mice and mice carrying a mutation in RYR1 (Y522S) linked to human malignant hyperthermia susceptibility (MHS) both suffer lethal hypermetabolic episodes when exposed to halothane (MHS crises) and to environmental heat (heat stroke, HS). The phenotype of Y522S is more severe than that of CASQ1-null mice. As MHS and HS are hypermetabolic responses, we studied the metabolism of adult CASQ1-null and Y522S mice using wild-type (WT) mice as controls. We found that CASQ1-null and Y522S mice have increased food consumption and higher core temperature at rest. By indirect calorimetry, we then verified that CASQ1-null and Y522S mice show an increased oxygen consumption and a lower respiratory quotient (RQ). The accelerated metabolism of CASQ1-null and Y522S mice was also accompanied with a reduction in body fat. Moreover, both mouse models displayed increased oxygen consumption and a higher core temperature during heat stress. The results collected suggest that metabolic rate, oxygen consumption, and body temperature at rest, all more elevated in Y522S than in CASQ1-null mice, could possibly be used as predictors of the level of susceptibility to hyperthermic crises of mice (and possibly humans).

Increased basal metabolic rate in mice susceptible to malignant hyperthermia and heat stroke

Ryanodine receptor type-1 (RYR1) and Calsequestrin-1 (CASQ1) proteins, located in the sarcoplasmic reticulum (SR), are two of the main players in skeletal excitation-contraction (EC) coupling. Mutations in the human RYR1 gene (encoding for the SR Ca2+ release channel) and ablation in mice of CASQ1 (a SR Ca2+ binding protein) cause hypersensitivity to halogenated anesthetics (malignant hyperthermia [MH] susceptibility) and to heat (heat stroke; HS). As both MH and HS are characterized by excessive cytosolic Ca2+ levels and hypermetabolic responses, we studied the metabolism of 4-mo-old mice from two different lines that are MH/HS susceptible: knock-in mice carrying a human MH mutation (RYR1YS) and CASQ1-knockout (ko) mice. RYR1YS and, to a lesser degree, CASQ1-null mice show an increased volume of oxygen consumption (VO2) and a lower respiratory quotient (RQ) compared with WT mice (indicative of a metabolism that relies more on lipids). This finding is accompanied by a reduction in total body fat mass in both Y522S and CASQ1-null mice (again, compared with WT). In addition, we found that RYR1YS and CASQ1-null mice have an increased food consumption (+26.04% and +25.58% grams/day, respectively) and higher basal core temperature (+0.57°C and +0.54°C, respectively) compared with WT mice. Finally, Western blots and electron microscopy indicated that, in hyperthermic mice, (1) SERCA (used to remove myoplasmic Ca2+) and UCP3 (responsible for a thermogenic process that dissipates mitochondrial H+ gradient) are overexpressed, and (2) mitochondrial volume and percentage of damaged mitochondria are both increased. In conclusion, the MH/HS phenotype in RYR1YS and CASQ1-null mice is associated with an intrinsically increased basal metabolism.

Discovery of new intracellular junctions: The calcium entry units (CEUs)

In 2017, Boncompagni, Michelucci et al. demonstrated that during exercise the sarcotubular system of extensor digitorum longus (EDL) fibers undergoes a profound remodeling that leads to the assembly of new junctions between T-tubule extensions at the I band and sarcoplasmic reticulum (SR) stacks. As these junctions contain colocalized STIM1 and Orai1 and enhance store-operated Ca2+ entry (SOCE), they have been named Ca2+ entry units (CEUs). In addition, it has been more recently shown that (1) CEUs disassemble following recovery, with T-tubules retraction from the I band faster than SR stacks disassembly, and (2) lack of calsequestrin-1 (CASQ1) induces a constitutive assembly of CEUs, resulting in enhanced SOCE that counteracts the SR Ca2+ depletion. We have now analyzed (1) CEUs during postnatal maturation (at 2 wk of age) and (2) whether CEUs form in slow-twitch fibers (soleus). (a) Compared with adult (4 mo) EDL fibers of resting WT mice, at 2 wk of age we found a greater longitudinal disposition of T-tubules associated to SR membranes forming junctions virtually identical to CEUs in adult EDLs of exercised WT mice, which promote increased STIM1/Orai1-mediated SOCE. (b) We also compared structure and function of soleus (which also express the cardiac isoform CASQ2) from WT mice and from mice lacking either CASQ1 (CASQ1-null) or CASQ1/2 (dCASQ-null). In soleus from both genotypes, CEUs are constitutively assembled although they appear structurally smaller than those described previously in exercised WT or CASQ1-null EDLs. A detailed EM quantitative analysis revealed that CEUs were more abundant in dCASQ-null than CASQ1-null mice. The amount of CEUs strictly correlated with the ability of soleus fibers to recover extracellular Ca2+ via SOCE to support contractility during high-frequency stimulation. These data were supported by molecular analysis of Western blots, showing that Orai1 expression was enhanced following ablation of CASQ.

Pre-assembled Ca2+ entry units and constitutively active Ca2+ entry in skeletal muscle of calsequestrin-1 knockout mice.

Store-operated Ca2+ entry (SOCE) is a ubiquitous Ca2+ influx mechanism triggered by depletion of Ca2+ stores from the endoplasmic/sarcoplasmic reticulum (ER/SR). We recently reported that acute exercise in WT mice drives the formation of Ca2+ entry units (CEUs), intracellular junctions that contain STIM1 and Orai1, the two key proteins mediating SOCE. The presence of CEUs correlates with increased constitutive- and store-operated Ca2+ entry, as well as sustained Ca2+ release and force generation during repetitive stimulation. Skeletal muscle from mice lacking calsequestrin-1 (CASQ1-null), the primary Ca2+-binding protein in the lumen of SR terminal cisternae, exhibits significantly reduced total Ca2+ store content and marked SR Ca2+ depletion during high-frequency stimulation. Here, we report that CEUs are constitutively assembled in extensor digitorum longus (EDL) and flexor digitorum brevis (FDB) muscles of sedentary CASQ1-null mice. The higher density of CEUs in EDL (39.6 ± 2.1/100 µm2 versus 2.0 ± 0.3/100 µm2) and FDB (16.7 ± 1.0/100 µm2 versus 2.7 ± 0.5/100 µm2) muscles of CASQ1-null compared with WT mice correlated with enhanced constitutive- and store-operated Ca2+ entry and increased expression of STIM1, Orai1, and SERCA. The higher ability to recover Ca2+ ions via SOCE in CASQ1-null muscle served to promote enhanced maintenance of peak Ca2+ transient amplitude, increased dependence of luminal SR Ca2+ replenishment on BTP-2-sensitive SOCE, and increased maintenance of contractile force during repetitive, high-frequency stimulation. Together, these data suggest that muscles from CASQ1-null mice compensate for the lack of CASQ1 and reduction in total releasable SR Ca2+ content by assembling CEUs to promote constitutive and store-operated Ca2+ entry.

Aerobic Training Prevents Heatstrokes in Calsequestrin-1 Knockout Mice by Reducing Oxidative Stress.

Calsequestrin-1 knockout (CASQ1-null) mice suffer lethal episodes when exposed to strenuous exercise and environmental heat, crises known as exertional/environmental heatstroke (EHS). We previously demonstrated that administration of exogenous antioxidants (N-acetylcysteine and trolox) reduces CASQ1-null mortality during exposure to heat. As aerobic training is known to boost endogenous antioxidant protection, we subjected CASQ1-null mice to treadmill running for 2 months at 60% of their maximal speed for 1 h, 5 times/week. When exposed to heat stress protocol (41°C/1 h), the mortality rate of CASQ1-null mice was significantly reduced compared to untrained animals (86% versus 16%). Protection from heatstrokes was accompanied by a reduced increase in core temperature during the stress protocol and by an increased threshold of response to caffeine of isolated extensor digitorum longus muscles during in vitro contracture test. At cellular and molecular levels, aerobic training (i) improved mitochondrial function while reducing their damage and (ii) lowered calpain activity and lipid peroxidation in membranes isolated from sarcoplasmic reticulum and mitochondria. Based on this evidence, we hypothesize that the protective effect of aerobic training is essentially mediated by a reduction in oxidative stress during exposure of CASQ1-null mice to adverse environmental conditions.

Strenuous exercise triggers a life-threatening response in mice susceptible to malignant hyperthermia.

In humans, hyperthermic episodes can be triggered by halogenated anesthetics [malignant hyperthermia (MH) susceptibility] and by high temperature [environmental heat stroke (HS)]. Correlation between MH susceptibility and HS is supported by extensive work in mouse models that carry a mutation in ryanodine receptor type-1 (RYR1Y522S/WT) and calsequestrin-1 knockout (CASQ1-null), 2 proteins that control Ca2+ release in skeletal muscle. As overheating episodes in humans have also been described during exertion, here we subjected RYR1Y522S/WT and CASQ1-null mice to an exertional-stress protocol (incremental running on a treadmill at 34°C and 40% humidity). The mortality rate was 80 and 78.6% in RYR1Y522S/WT and CASQ1-null mice, respectively, vs. 0% in wild-type mice. Lethal crises were characterized by hyperthermia and rhabdomyolysis, classic features of MH episodes. Of importance, pretreatment with azumolene, an analog of the drug used in humans to treat MH crises, reduced mortality to 0 and 12.5% in RYR1Y522S/WT and CASQ1-null mice, respectively, thanks to a striking reduction of hyperthermia and rhabdomyolysis. At the molecular level, azumolene strongly prevented Ca2+-dependent activation of calpains and NF-κB by lowering myoplasmic Ca2+ concentration and nitro-oxidative stress, parameters that were elevated in RYR1Y522S/WT and CASQ1-null mice. These results suggest that common molecular mechanisms underlie MH crises and exertional HS in mice.-Michelucci, A., Paolini, C., Boncompagni, S., Canato, M., Reggiani, C., Protasi, F. Strenuous exercise triggers a life-threatening response in mice susceptible to malignant hyperthermia.

Assembly of Calcium Entry Units Improves Muscle Resistance to Fatigue

We discovered that treadmill exercise in-vivo promotes formation in skeletal fibers of new junctions between sarcoplasmic reticulum (SR) and transverse-tubules (TTs) containing STIM1 and Orai1, the two main players in store-operated Ca2+ entry (SOCE). We proposed that these new SR-TT junctions may function as Calcium Entry Units (CEUs) during repetitive muscle activity. Interestingly, in mice lacking Calsequestrin-1 (CASQ1-null) CEUs are constitutively present. In extensor digitorum longus (EDL) of mice, we quantified using electron-microscopy the number of CEUs/100μm2: 2.0±0.3 9.9±0.7; and 39.6±2.1, respectively in control (ctr)WT, exercised (ex)WT (subjected to 1 h of running at increasing speed: from 5 m/min to 25 m/min), and CASQ1-null mice. Higher number of CEUs/area in exWT and CASQ1-null mice correlates with higher expression levels of STIM1 and Orai1 detected by western-blot. We then used a repetitive stimulation protocol (30 x 1s-60Hz pulses every 5 seconds) to compare fatigue resistance in EDL muscles in presence or absence of extracellular Ca2+, or in presence of SOCE inhibitors (BTP-2, 2-APB and SKF-96365). Results of these experiments indicated: a) in 2.5 mM Ca2+ external solution, EDL muscles from exWT and CASQ1-null mice exhibited an increased capability to maintain contractile force compared to ctrWT mice (residual force after 15 tetani: 42.9±3.7%, 69.3±3.1% and 128.8±5.4% respectively for ctrWT, exWT, and CASQ1-null EDL muscles); b) in Ca2+-free external solution, muscles from exWT and CASQ1-null mice showed a greater decay of contractile force than ctrWT (residual force after 15 tetani: 30.4±2.4%, 34.7±3.3% and 63.5±2.2% respectively for ctrWT, exWT, and CASQ1-null EDL muscles); c) virtually identical results were obtained in presence of SOCE inhibitors. These data suggest that CEUs provide a preferential pathway for Ca2+ entry during repetitive muscle activity, likely important to limit muscle fatigue.

Estrogens Protect Calsequestrin-1 Knockout Mice from Lethal Hyperthermic Episodes by Reducing Oxidative Stress in Muscle.

Oxidative stress has been proposed to play a key role in malignant hyperthermia (MH), a syndrome caused by excessive Ca2+ release in skeletal muscle. Incidence of mortality in male calsequestrin-1 knockout (CASQ1-null) mice during exposure to halothane and heat (a syndrome closely resembling human MH) is far greater than that in females. To investigate the possible role of sex hormones in this still unexplained gender difference, we treated male and female CASQ1-null mice for 1 month, respectively, with Premarin (conjugated estrogens) and leuprolide (GnRH analog) and discovered that during exposure to halothane and heat Premarin reduced the mortality rate in males (79–27% and 86–20%), while leuprolide increased the incidence of mortality in females (18–73% and 24–82%). We then evaluated the (a) responsiveness of isolated muscles to temperature and caffeine, (b) sarcoplasmic reticulum (SR) Ca2+ release in single fibers, and (c) oxidative stress and the expression levels of main enzymes involved in the regulation of the redox balance in muscle. Premarin treatment reduced the temperature and caffeine sensitivity of EDL muscles, normalized SR Ca2+ release, and reduced oxidative stress in males, suggesting that female sex hormones may protect mice from lethal hyperthermic episodes by reducing both the SR Ca2+ leak and oxidative stress.

Antioxidants protect calsequestrin-1 knockout mice from halothane- and heat-induced sudden death.

Mice lacking calsequestrin-1 (CASQ1-null), a Ca-binding protein that modulates the activity of Ca release in the skeletal muscle, exhibit lethal hypermetabolic episodes that resemble malignant hyperthermia in humans when exposed to halothane or heat stress. Because oxidative species may play a critical role in malignant hyperthermia crises, we treated CASQ1-null mice with two antioxidants, N-acetylcysteine (NAC, Sigma-Aldrich, Italy; provided ad libitum in drinking water) and (±)-6-hydroxy-2,5,7,8-tetramethylchromane-2-carboxylic acid (Trolox, Sigma-Aldrich; administered by intraperitoneal injection), before exposure to halothane (2%, 1 h) or heat (41°C, 1 h). NAC and Trolox significantly protected CASQ1-null mice from lethal episodes, with mortality being 79% (n = 14), 25% (n = 16), and 20% (n = 5) during halothane exposure and 86% (n = 21), 29% (n = 21), and 33% (n = 6) during heat stress in untreated, NAC-treated, and Trolox-treated mice, respectively. During heat challenge, an increase in core temperature in CASQ1-null mice (42.3° ± 0.1°C, n=10) was significantly reduced by both NAC and Trolox (40.6° ± 0.3°C, n = 6 and 40.5° ± 0.2°C, n = 6). NAC treatment of CASQ1-null muscles/mice normalized caffeine sensitivity during in vitro contracture tests, Ca transients in single fibers, and significantly reduced the percentage of fibers undergoing rhabdomyolysis (37.6 ± 2.5%, 38/101 fibers in 3 mice; 11.6 ± 1.1%, 21/186 fibers in 5 mice). The protective effect of antioxidant treatment likely resulted from mitigation of oxidative stress, because NAC reduced mitochondrial superoxide production, superoxide dismutase type-1 expression, and 3-nitrotyrosine expression, and increased both reduced glutathione and reduced glutathione/oxidized glutathione ratio. These studies provide a deeper understanding of the mechanisms that underlie hyperthermic crises in CASQ1-deficient muscle and demonstrate that antioxidant pretreatment may prevent them.

Oxidative stress, mitochondrial damage, and cores in muscle from calsequestrin-1 knockout mice

BackgroundMutations in the gene encoding ryanodine receptor type-1 (RYR1), the calcium ion (Ca2+) release channel in the sarcoplasmic reticulum (SR) of skeletal muscle, are linked to central core disease (CCD) and malignant hyperthermia (MH) susceptibility. We recently reported that mice lacking the skeletal isoform of calsequestrin (CASQ1-null), the primary Ca2+ buffer in the SR of skeletal muscle and a modulator of RYR1 activity, exhibit lethal heat- and anesthetic-induced hypermetabolic episodes that resemble MH events in humans.MethodsWe compared ultrastructure, oxidative status, and contractile function in skeletal fibers of extensor digitorum longus (EDL) muscles in wild type (WT) and CASQ1-null mice at different ages (from 4 to 27 months) using structural, biochemical, and functional assays.ResultsAbout 25% of fibers in EDL muscles from CASQ1-null mice of 14 to 27 months of age exhibited large areas of structural disarray (named core-like regions), which were rarely observed in muscle from age-matched WT mice. To determine early events that may lead to the formation of cores, we analyzed EDL muscles from adult mice: at 4 to 6 months of age, CASQ1-null mice (compared to WT) displayed significantly reduced grip strength (40 ± 1 vs. 86 ± 1 mN/gr) and exhibited an increase in the percentage of damaged mitochondria (15.1% vs. 2.6%) and a decrease in average cross-sectional fiber area (approximately 37%) in EDL fibers. Finally, oxidative stress was also significantly increased (25% reduction in ratio between reduced and oxidized glutathione, or GSH/GSSG, and 35% increase in production of mitochondrial superoxide flashes). Providing ad libitum access to N-acetylcysteine in the drinking water for 2 months normalized GSH/GSSG ratio, reduced mitochondrial damage (down to 8.9%), and improved grip strength (from 46 ± 3 to 59 ± 2 mN/gr) in CASQ1-null mice.ConclusionsOur findings: 1) demonstrate that ablation of CASQ1 leads to enhanced oxidative stress, mitochondrial damage, and the formation of structural cores in skeletal muscle; 2) provide new insights in the pathogenic mechanisms that lead to damage/disappearance of mitochondria in cores; and 3) suggest that antioxidants may provide some therapeutic benefit in reducing mitochondrial damage, limiting the development of cores, and improving muscle function.Electronic supplementary materialThe online version of this article (doi:10.1186/s13395-015-0035-9) contains supplementary material, which is available to authorized users.

Lethal Exertional Strokes in RYR1Y522S/WT and CASQ1-Null Mice are Prevented by Drugs used to Treat Malignant Hyperthermia in Humans

In humans, lethal over-heating episodes are triggered by administration of halogenated anesthetics (a disorder known as Malignant Hyperthermia Susceptibility, MHS) and by high temperature and/or strenuous exercise (crises identified as Environmental/Exertional Heat Strokes, EHSs). Whereas MH crises are successfully treated by intravenous administration of dantrolene, to date no pharmacological interventions are available to prevent or reverse EHS.We previously demonstrated that ryanodine receptor type-1 (RYR1) Y522S/WT (carrying a mutation linked to MHS in humans) and Calsequestrin-1 knockout (CASQ1-null) mice trigger lethal crises when exposed to both halothane and heat. Here we tested the following hypotheses: a) strenuous exercise in challenging environmental conditions is a stress capable of triggering EHS-lethal episodes in both mouse models; b) drugs used to treat MH crises in humans (dantrolene or its analog azumolene) can prevent such exertion-induced strokes. When RYR1Y522S/WT (n=10) and CASQ1-null (n=14) mice were subjected to an exertional-stress protocol (executed on a treadmill at 34°C, 30-40% of humidity) which was tolerated by WT animals (n=10), their mortality was dramatically increased (80% and 79%, respectively). During the exertional protocol RYR1Y522S/WT and CASQ1-null mice showed: a) rise in core temperature (respectively 5.35±0.25°C and 4.92±0.26°C) significantly higher than WT mice (2.57±0.2°C); b) high percentage of skeletal fibers presenting severe structural damage (respectively 99% and ∼64%); and c) elevated blood levels of creatine-kinase, K+, and Ca2+ (suggestive of rhabdomyolysis). Interestingly, pre-treatment of animals with dantrolene or azumolene prevented completely exertional-strokes in both RYR1Y522S/WT (n=7) and CASQ1-null (n=8) mice, strongly suggesting that: a) exertional-crises may share common molecular mechanisms with anesthetic-induced MH; b) drugs used in the operating room to treat acutely MH crises should be considered for treatment of environmental/exertional heat strokes.

CASQ1 Gene Is an Unlikely Candidate for Malignant Hyperthermia Susceptibility in the North American Population

Malignant hyperthermia (MH, MIM# 145600) is a complex pharmacogenetic disorder that is manifested in predisposed individuals as a potentially lethal reaction to volatile anesthetics and depolarizing muscle relaxants. Studies of CASQ1-null mice have shown that CASQ1, encoding calsequestrin 1, the major Ca2+ binding protein in the lumen of the sarcoplasmic reticulum, is a candidate gene for MH in mice. The aim of this study was to establish whether the CASQ1 gene is associated with MH in the North American population. The entire coding region of CASQ1 in 75 unrelated patients diagnosed by caffeine-halothane contracture test as MH susceptible (MHS) was analyzed by DNA sequencing. Subsequently, three groups of unrelated individuals (130 MHS, 100 MH negative, and 192 normal controls) were genotyped for a variant that was identified by sequencing. Levels of CASQ1 expression in the muscle from unrelated MHS and MH negative individuals were estimated by Western blotting. Screening of the entire coding sequence of the CASQ1 gene in 75 MHS patients revealed a single variant c.260T > C (p.Met87Thr) in exon 1. This variant is unlikely to be pathogenic, because its allele frequency in the MHS group was not significantly different from that of controls. There was also no difference in calsequestrin 1 protein levels between muscle samples from MHS and controls, including those carrying the p.Met87Thr variant. This study revealed a low level of protein coding sequence variability within the human CASQ1 gene, indicating that CASQ1 is not a major MHS locus in the North American population.

N-Acetylcysteine, a Potent Anti-Oxidant, Rescues the Malignant Hyperthermia and Environmental Heat Stroke Phenotype of Calsequestrin-1 Knockout Mice

Calsequestrin type 1 (CASQ1) is both the major Ca2+ binding protein in the sarcoplasmic reticulum (SR) in skeletal muscle and a direct modulator of type 1 ryanodine receptor (RYR1) Ca2+-release channel activity. Mice lacking CASQ1 (CASQ1-null) exhibit increased susceptibility for Malignant Hyperthermia (MH) and Environmental Heat Stroke (EHS), life-threatening disorders triggered by volatile anaesthetics and high temperature, respectively. Excessive oxidative stress during MH/EHS crises are proposed to result in increased RYR1 nitrosylation, and subsequently, enhanced SR Ca2+ leak that leads to hypercontractures and rhabdomyolysis. Here, we treated CASQ1-null mice for 2 months (from 2-to-4 months of age) with N-acetylcysteine (NAC, a potent anti-oxidant) provided ad libitum in their drinking water (1% w/v). NAC treatment significantly protected CASQ1-null mice from lethal episodes induced by both halothane (2%, 1h at 32°C) and heat challenge (41°C, 1h) with the rate of mortality being 79 vs 25% and 86 vs 30% in control vs NAC-treated mice, respectively. This protection resulted from several factors including: a) reduced oxidative stress measured as both GSH/GSSG ratio and the frequency of mitochondrial superoxide flash activity (P<0.05); b) decreased maximum core temperature during heat challenge (from 42.1 to 40.8°C); and c) reduced number of fibers undergoingrhabdomyolysis (from 37.6 to 11.6 %). Furthermore, in-vitro contracture test (IVCT) showed that the threshold for caffeine-induced contracture is back to normal values. These results support the hypothesis that excessive production of reactive oxygen species plays a critical role in the onset of MH/EHS crises. Therefore, anti-oxidants may be useful for the treatment and prevention of oxidative stress related skeletal muscle disorders.

Lessons from calsequestrin-1 ablation in vivo: much more than a Ca2+ buffer after all

Calsequestrin type-1 (CASQ1), the main sarcoplasmic reticulum (SR) Ca(2+) binding protein, plays a dual role in skeletal fibers: a) it provides a large pool of rapidly-releasable Ca(2+) during excitation-contraction (EC) coupling; and b) it modulates the activity of ryanodine receptors (RYRs), the SR Ca(2+) release channels. We have generated a mouse lacking CASQ1 in order to further characterize the role of CASQ1 in skeletal muscle. Contrary to initial expectations, CASQ1 ablation is compatible with normal motor activity, in spite of moderate muscle atrophy. However, CASQ1 deficiency results in profound remodeling of the EC coupling apparatus: shrinkage of junctional SR lumen; proliferation of SR/transverse-tubule contacts; and increased density of RYRs. While force development during a twitch is preserved, it is nevertheless characterized by a prolonged time course, likely reflecting impaired Ca(2+) re-uptake by the SR. Finally, lack of CASQ1 also results in increased rate of SR Ca(2+) depletion and inability of muscle to sustain tension during a prolonged tetani. All modifications are more pronounced (or only found) in fast-twitch extensor digitorum longus muscle compared to slow-twitch soleus muscle, likely because the latter expresses higher amounts of calsequestrin type-2 (CASQ2). Surprisingly, male CASQ1-null mice also exhibit a marked increased rate of spontaneous mortality suggestive of a stress-induced phenotype. Consistent with this idea, CASQ1-null mice exhibit an increased susceptibility to undergo a hypermetabolic syndrome characterized by whole body contractures, rhabdomyolysis, hyperthermia and sudden death in response to halothane- and heat-exposure, a phenotype remarkably similar to human malignant hyperthermia and environmental heat-stroke. The latter findings validate the CASQ1 gene as a candidate for linkage analysis in human muscle disorders.

Measurement of Intra-SR [Ca 2+] Reveals Changes in SR Ca 2+ Permeability During Intracellular Ca 2+ Release in Skeletal Muscle

In skeletal muscle, Ca2+ release from the SR is under strong regulation. While this regulation has well known Ca2+-dependent components acting from the cytosolic side of the channels (CICR and CDI), putative effects of luminal calcium are not well defined. Combining imaging of [Ca2+]SR by the cameleon D4cpV targeted with calsequestrin 1 or its Ca2+-impaired variant “Delta-Asp”, with measurements of cytosolic [Ca2+] (X-rhod 1) in single mouse FDB fibers, we directly monitored the evolution of Ca2+ permeability (P) of the SR membrane during long-lasting voltage clamp depolarizations. These depolarizations were intended to both elicit the release response and substantially deplete the SR of calcium, so that P could be evaluated as the SR calcium decreased. Against our expectations (Royer 2007; 2010) P was found to decrease significantly during depolarization. Consequently, depletion was never complete, and [Ca2+]SR reached on average 40% of the resting content after long pulses. This gating effect of depletion is similar to that which in cardiomyocytes is believed to terminate Ca2+ release and be associated with the presence of calsequestrin. Similar measurements in cells from casq1-null mice showed instead > 90% depletion during long-lasting pulses. Permeability remained essentially constant, at a high value, for the duration of the pulses. This was confirmed under various compositions of cytosolic and external solutions, with different calsequestrin-derived targeting sequences and widely varying biosensor expression densities. An inhibitory effect on Ca2+ release is evidently lost in the casq1-null mouse. Whether this reflects allosteric gating by calsequestrin remains to be established. The observation goes a long way towards explaining the modest effect of calsequestrin KO in the maximal amount of SR calcium that can be released by depolarization (Royer, 2010). Funded by NIAMS (NIH) and MDA.

Initial Characterization of CASQ1/CASQ2 Knockout (double CASQ-Null) Mice

In muscle, Calsequestrin (CASQ), the major Ca2+-binding protein of the sarcoplasmic reticulum (SR) terminal cisternae, is expressed as two different isoforms. CASQ1 is the only isoform present in adult fast-twitch fibers. On the other hand, CASQ2 expression, abundant in all fibers before birth, decreases progressively after birth and in the adult is only found in slow twitch fibers, co-expressed with CASQ1. Lack of CASQ1 results in: a) significant structural and functional alterations to the excitation-contraction coupling machinery (Paolini et al., 2007. J Physiol 583:767); b) higher rate of spontaneous mortality in males; and c) malignant hyperthermia (MH)-like phenotype (Dainese et al., 2009. Faseb J 23:1710). However, in CASQ1-null mice CASQ2 is still expressed in slow twitch fibers. We have now generated a mouse lacking both CASQ isoforms (double CASQ-null), by cross-breeding our mice with CASQ2-knockout animals (Knollmann et al., 2006. J Clin Invest 116:2510). Lack of both CASQ isoforms was confirmed by western blot. The double-null mice are viable and breed normally, however the rate of spontaneous mortality of male animals is higher than CASQ1-null animals. Whereas the overall phenotype of mice is similar to that of CASQ1-null mice, significant differences are found in Soleus. From the structural point of view, in Soleus muscle we find many fibers (about 30%) with severe structural damage that were not found in CASQ1-null animals. Functional studies indicate significant prolongation in twitch time parameters, increased twitch tension and impaired tension generation during prolonged tetani both in EDL and Soleus, likely related to abnormal calcium release kinetics. These findings suggest that: a) expression of CASQ2 is essential for the maintenance of a subpopulation of Soleus fibers; and b) lack of both CASQ1 and 2 exacerbates the overall phenotype of CASQ1-null mice.

Store overload‐induced Ca2+ release as a triggering mechanism for CPVT and MH episodes caused by mutations in RYR and CASQ genes

Store overload‐induced Ca²⁺ release as a triggering mechanism for CPVT and MH episodes caused by mutations in <i>RYR</i> and <i>CASQ</i> genes

Anesthetic‐and heat‐induced sudden death in calsequestrin‐1‐knockout mice

Calsequestrin-1 (CASQ1) is a moderate-affinity, high-capacity Ca(2+)-binding protein in the sarcoplasmic reticulum (SR) terminal cisternae of skeletal muscle. CASQ1 functions as both a Ca(2+)-binding protein and a luminal regulator of ryanodine receptor (RYR1)-mediated Ca(2+) release. Mice lacking skeletal CASQ1 are viable but exhibit reduced levels of releasable Ca(2+) and altered contractile properties. Here we report that CASQ1-null mice exhibit increased spontaneous mortality and susceptibility to heat- and anesthetic-induced sudden death. Exposure of CASQ1-null mice to either 2% halothane or heat stress triggers lethal episodes characterized by whole-body contractures, elevated core temperature, and severe rhabdomyolysis, which are prevented by prior dantrolene administration. The characteristics of these events are remarkably similar to analogous episodes observed in humans with malignant hyperthermia (MH) and animal models of MH and environmental heat stroke (EHS). In vitro studies indicate that CASQ1-null muscle exhibits increased contractile sensitivity to temperature and caffeine, temperature-dependent increases in resting Ca(2+), and an increase in the magnitude of depolarization-induced Ca(2+) release. These results demonstrate that CASQ1 deficiency alters proper control of RYR1 function and suggest CASQ1 as a potential candidate gene for linkage analysis in families with MH/EHS where mutations in the RYR1 gene are excluded.