TRANSLATIONAL PHYSIOLOGY Increased sensitivity of the ryanodine receptor to halothane-induced oligomerization in malignant hyperthermia-susceptible human skeletal muscle

Glover, Louise, James J. A. Heffron, and Kay Ohlendieck. Increased sensitivity of the ryanodine receptor to halothane-induced oligomerization in malignant hyperthermia-susceptible human skeletal muscle. J Appl Physiol 96: 11–18, 2004. First published September 5, 2003; 10.1152/japplphysiol.00537.2003.—Mutations in the skeletal muscle RyR1 isoform of the ryanodine receptor (RyR) Ca -release channel confer susceptibility to malignant hyperthermia, which may be triggered by inhalational anesthetics such as halothane. Using immunoblotting, we show here that the ryanodine receptor, calmodulin, junctin, calsequestrin, sarcalumenin, calreticulin, annexin-VI, sarco(endo)plasmic reticulum Ca -ATPase, and the dihydropyridine receptor exhibit no major changes in their expression level between normal human skeletal muscle and biopsies from individuals susceptible to malignant hyperthermia. In contrast, protein gel-shift studies with halothane-treated sarcoplasmic reticulum vesicles from normal and susceptible specimens showed a clear difference. Although the 2-dihydropyridine receptor and calsequestrin were not affected, clustering of the Ca -ATPase was induced at comparable halothane concentrations. In the concentration range of 0.014–0.35 mM halothane, anesthetic-induced oligomerization of the RyR1 complex was observed at a lower threshold concentration in the sarcoplasmic reticulum from patients with malignant hyperthermia. Thus the previously described decreased Ca -loading ability of the sarcoplasmic reticulum from susceptible muscle fibers is probably not due to a modified expression of Ca -handling elements, but more likely a feature of altered quaternary receptor structure or modified functional dynamics within the Ca -regulatory apparatus. Possibly increased RyR1 complex formation, in conjunction with decreased Ca uptake, is of central importance to the development of a metabolic crisis in malignant hyperthermia.