Vascular
Smooth Muscle Excitation–Contraction Coupling
Vascular smooth
muscle (VSM) contraction is, like that of cardiac muscle, controlled by the intracellular
Ca2+ concentration [Ca2+]i. Unlike
cardiac muscle cells, however, VSM cells lack troponin and utilize a myosin-based
system to regulate contraction.
Regulation of
contraction by Ca2+ and myosin phosphorylation (see shaded area in left
cell of Figure 15) Vasoconstricting
stimuli initiate VSM cell contraction by increasing [Ca2+]i
from its basal level of ∼100 nmol/L. Force development is
proportional to the increase in [Ca2+]i, with maximal
contraction occurring at ∼1 µmol/L [Ca2+]i.
The rise in [Ca2+]i promotes its binding to the
cytoplasmic regulatory protein calmodulin (CaM). Once a calmodulin
molecule has bound four Ca2+ ions, it can activate the enzyme myosin
light-chain kinase (MLCK). MLCK in turn phosphorylates two 20-kDa subunits
(‘light chains’) contained within the ‘head’ of each myosin molecule.
Phosphorylated myosin then forms
crossbridges with actin, using ATP hydrolysis as an energy source to produce
contraction. Actin–myosin interactions during crossbridge cycling are similar
to those in cardiac myocytes (see Chapter 12).
The degree of myosin light-chain phosphorylation, which determines
crossbridge turnover, is a balance between the activity of MLCK and a myosin
light-chain phosphatase which dephosphorylates the light chains. Once
[Ca2+]i falls, MLCK activity diminishes and relaxation occurs as
light-chain phosphorylation is returned to basal levels by the phosphatase.
VSM cells in vivo maintain a tonic level of partial contraction
that varies with fluctuations in the vasoconstricting and vasodilating
influences to which they are exposed. VSM cells avoid fatigue during prolonged
contractions because their rate of ATP consumption is 300-fold lower than that
of skeletal muscle fibres. This is possible because the crossbridge cycle is
much slower than in striated muscles. The maximum crossbridge cycling rate of
smooth muscle during shortening is
only about one-tenth of that in striated muscles, as a result of differences in
the types of myosin present. In addition, once they have shortened, vascular
cells can maintain contraction with an even lower expenditure of ATP because
the myosin crossbridges remain attached to actin for a longer time, thus
‘locking in’ shortening.
The binding to receptors of noradrenaline and other important
vasoconstrictors such as endothelin, thromboxane A2, angiotensin II and vasopressin stimulates
VSM contraction via common G- protein-mediated pathways (see left
cell).
Binding of vasoconstrictors to receptors activates the G-protein Gq,
which stimulates the enzyme phospholipase C. Phospholipase C splits the
membrane phospholipid phosphatidylinositol 1,4- bisphosphate (PIP2),
generating the second messengers inositol 1,4,5-triphosphate (IP3),
and diacylglycerol (DAG). IP3 binds to and opens Ca2+
channels on the membrane of the sarcoplasmic reticulum (SR). This allows
Ca2+, which is stored in high concentrations within the SR, to flood out into
the cytoplasm and rapidly increase [Ca2+]i. DAG activates
protein kinase C (PKC). This activates the protein CPI-17, which
phosphorylates and inhibits myosin phosphatase, promoting contraction.
Ca2+ influx
mechanisms
Vasoconstrictors also cause membrane depolarization via several
mechanisms. First, the release of SR Ca2+, which they initiate,
opens Ca2+-activated chloride channels in the
plasma membrane. Second, vasoconstrictors may act via DAG and PKC to cause
depolarization by inhibiting the activity of K+ channels.
Third, vasoconstrictors induce both membrane depolarization and Ca2+
entry into VSM cells by opening receptor-gated cation channels, which
allow the influx of both Na+ and Ca2+ ions. The
identities of the proteins making up the Ca2+-activated chloride and
receptorgated cation channels remained elusive for many years, but these
channels have recently been proposed to be formed from anoctamin and TRPC
(transient receptor potential canonical) proteins, respectively.
The membrane depolarization elicited by vasoconstrictors opens L-type
voltage-gated Ca2+ channels (also termed CaV
1.2 channels) similar to those found in cardiac myocytes. With sufficient depolarization,
some blood vessels may fire brief Ca2+ channel-mediated APs that cause
transient contractions. More often, however, vasoconstrictors cause graded
depolarizations, during which sufficient Ca2+ influx occurs to cause
more sustained contractions. Vasoconstrictors further enhance Ca2+
influx through L-type channels by evoking channel phosphorylation.
Furthermore, depletion of Ca2+ from the SR due to the action of IP3
opens store-operated Ca2+ (SOC) channels in the cell
membrane which admit both Na+ and Ca2+ into the cell. The
identities of the proteins forming SOC channels remain in dispute.
As well as raising [Ca2+]i, vasoconstrictors also
promote contraction by a process termed Ca2+ sensitization.
Ca2+ sensitization is caused by the inhibition of myosin phosphatase.
This increases myosin light-chain phosphorylation, and therefore force development,
even with minimal increases in [Ca2+]i and MLCK activity.
Although PKC has this effect (see above), phosphatase inhibition is
primarily caused by RhoA kinase, an enzyme stimulated by the ras type
G-protein RhoA, which is activated by vasoconstrictors by an as yet
unknown mechanism.
The relative importance of the excitatory mechanisms listed above varies
between different vasoconstrictors and vascular beds. In resistance arteries
depolarization and Ca2+ influx through volt- age-gated channels are
probably most important.
Ca2+ removal and vasodilator mechanisms (see right cell of Figure 15) Several mechanisms serve to remove Ca2+ from the
cytoplasm. These are continually active, allowing cells both to recover from
stimulation and to maintain a low basal [Ca2+]i in the
face of the enormous electrochemical gradient tending to drive Ca2+
into cells even when they are not stimulated. The smooth endoplasmic reticulum
Ca2+-ATPase (SERCA) pumps Ca2+ from the
cytoplasm into the SR. This process is referred to as Ca2+ sequestration.
An analogous plasma membrane Ca2+-ATPase (PMCA) pumps
Ca2+ from the cytoplasm into the extracellular space (Ca2+
extrusion). Cells also extrude Ca2+ via a Na+-Ca2+
exchanger (NCX) located in the cell membrane, which is similar to that
found in cardiac cells (see Chapter 12). The NCX may be localized to areas of
the plasma membrane that are approached closely by the SR, allowing any Ca2+
leaking from the SR to be quickly ejected from the cell without causing tension
development. Interestingly, when the intracellular Na+ concentration
near the cell membrane is sufficiently raised due to the opening of
receptor-gated or store-operated channels, the NCX may act in reverse mode, thereby
becoming a pathway for Ca2+ influx
rather than extrusion.
Most vasodilators acting on smooth muscle cells cause relaxation by
activating either the cyclic GMP (e.g. nitric oxide, atrial natriuretic
peptide) or cyclic AMP (e.g. adenosine, prostacyclin, β-receptor
agonists) second messenger systems. Both second mes- sengers activate kinases,
which act by phosphorylating overlap pingsetsofcellularproteins. cGMPactivates
cyclic GMP-dependent protein kinase (protein kinase G, PKG). PKG has
multiple vasodilating effects. It activates K+ channels by
phosphorylating them, leading to a membrane hyperpolarization that inhibits Ca2+
influx by switching off voltage-gated Ca2+ channels, a fraction of
which are open even at the resting membrane potential. PKG also stimulates the
sequestration and extrusion of Ca2+ sequestration by activating the
Ca2+ pumps, and it stimulates myosin phophatase by inhibiting Rho
kinase.
Cyclic AMP exerts its effects via cyclic AMP-dependent protein kinase (protein
kinase A, PKA), although high levels of cAMP have also been shown to
stimulate PKG. PKA lowers [Ca2+]i by stimulating Ca2+
pumps, and also by opening K+ channels (again via phosphorylation).
The stimulation of SERCA by PKA, which loads the SR with Ca2+, may
also indirectly activate Ca2+-activated K+ (BKCa)
channels by increasing the frequency of ‘Ca2+ sparks’. These are
transient elevations of [Ca2+]i near the cell membrane
caused by the opening of ryanodine receptors (RyRs) and the consequent release
of Ca2+ from the SR. PKA can also phosphorylate MLCK, thereby
inhibiting its activity. However, the contribution of this mechanism to
relaxation under physiological conditions
is controversial.