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Permanent link (DOI): https://doi.org/10.7939/R3NP45

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Ion transport pharmacology in heart disease and type-2 diabetes. Open Access

Descriptions

Other title
Subject/Keyword
type-2 diabetes
ATP-sensitive potassium channel
ranolazine
sodium-calcium exchanger
heart disease
pharmacology
sulfonylureas
reactive oxygen species
patch clamping
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Soliman, Daniel
Supervisor and department
Light, Peter E. (Pharmacology)
Examining committee member and department
Clanachan, Alexander S. (Pharmacology)
Fliegel, Larry (Biochemistry)
Seubert, John M. (Pharmacy and Pharmaceutical Sciences)
Pierce, Grant N. (Physiology & Pharmacology, University of Manitoba, Winnipeg, MB)
Department
Department of Pharmacology
Specialization

Date accepted
2010-11-26T21:03:29Z
Graduation date
2011-06
Degree
Doctor of Philosophy
Degree level
Doctoral
Abstract
The cardiac sodium-calcium exchanger (NCX) is an important membrane protein which regulates cellular calcium necessary for the optimal contractile function of the heart. NCX has become a focal point in ischemic heart disease (IHD) research as evidence suggests that reactive oxygen species (ROS) produced during IHD can cause NCX to malfunction resulting in an intracellular calcium overload leading to cardiac contractile abnormalities. Therefore, I hypothesized that NCX function is mediated by ROS increasing NCX1 activity during cardiac ischemia-reperfusion. To research this hypothesis, I investigated cellular mechanisms which may play a role in NCX dysfunction and also examined methods to correct NCX function. I found that reactive oxygen species directly and irreversibly modify NCX protein, increasing its activity, thereby worsening the calcium overload which is deleterious to cardiac function. I also elucidated the molecular means by which NCX protein modification occurs. Exploring pharmacological means by which to decrease NCX function to relieve the calcium overload and reduce the damage to the heart, I discovered that ranolazine (Ranexa™), indicated for the treatment of angina pectoris inhibits NCX activity directly, thereby further reducing the calcium overload-induced injury to the heart. Furthermore, many IHD patients are also co-morbid for type-2 diabetes. These patients are prescribed sulfonylurea (SU) agents which act at the ATP sensitive K+ channel (KATP). One agent such as glibenclamide is known to have cardiotoxic side effects. Therefore, SUs devoid of any cardiac side effects would beneficial. Interestingly, patients possessing the genetic variant E23K-S1369A KATP channel have improved blood glucose levels with the use of the SU gliclazide. Therefore, I determined the functional mechanism by which gliclazide has increased inhibition at the KATP channel. These findings have implications for type-2 diabetes therapy, in which 20% of the type-2 diabetic population carries the KATP channel variant. In summary, the findings presented in this thesis have implications on treatment strategies in the clinical setting, as a NCX inhibitor can be beneficial in IHD and possibly type-2 diabetes. Moreover, a pharmacogenomic approach in treating type-2 diabetes may also provide a positive outcome when considering co-morbid cardiac complications such as atrial fibrillation and heart failure.
Language
English
DOI
doi:10.7939/R3NP45
Rights
License granted by Daniel Soliman (dsoliman@ualberta.ca) on 2010-11-24T22:28:03Z (GMT): Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of the above terms. The author reserves all other publication and other rights in association with the copyright in the thesis, and except as herein provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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File title: Microsoft Word - thesis final draft post defense
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