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Dexmedetomidine, an alpha2-adrenergic agonist inhibits neuronal delayed-rectifier potassium current

Dexmedetomidine, an alpha2-adrenergic agonist inhibits neuronal delayed-rectifier potassium current
Dexmedetomidine, an alpha2-adrenergic agonist inhibits neuronal delayed-rectifier potassium current

NEUROSCIENCES AND NEUROANAESTHESIA

Dexmedetomidine,an a 2-adrenergic agonist,inhibits neuronal

delayed-recti?er potassium current and sodium current

B.-S.Chen 13,H.Peng 2and S.-N.Wu 12*

1Institute of Basic Medical Sciences and 2Department of Physiology,National Cheng Kung University Medical College,No.1,University Road,Tainan 70101,Taiwan,Republic of China.3Department of

Anesthesiology,Buddhist Dalin Tzu Chi General Hospital,Chiayi County,Taiwan,Republic of China

*Corresponding author.E-mail:snwu@https://www.doczj.com/doc/272038226.html,.tw

Background.Dexmedetomidine (DEX),a selective agonist of a 2-adrenergic receptors,is

recognized to facilitate analgesia and anaesthesia in humans.Despite the potential for wide

use,its effects on ion currents and membrane potential in neurones remain largely unclear.

Methods.W e investigated the effects of DEX on ion channels in NG108-15neuronal cells dif-

ferentiated with dibutyryl cyclic AMP and in cultured cerebellar neurones.

Results.DEX suppressed the amplitude of delayed recti?er K +current [I K(DR)]in a concen-

tration-dependent manner with an IC 50value of 4.6m M in NG108-15cells.No change in the

steady-state inactivation of I K(DR)was evident in the presence of DEX.A minimal binding

scheme was also used to evaluate DEX-induced block of I K(DR).Inhibition of I K(DR)by DEX

was still observed in cells preincubated with yohimbine (10m M)or efaroxan (10m M).DEX

depressed the peak amplitude of Na +current (I

Na ),whereas it had minimal effect on L-type

Ca 2+current.Under current-clamp con?guration,DEX increased the duration of action poten-

tials (APs).I K(DR)and I Na in response to AP waveforms were more sensitive to block by DEX

than those elicited during rectangular pulses.In isolated cerebellar granule cells,DEX also

effectively suppressed I K(DR).

Conclusions.The effects of DEX are not limited to its interactions with a 2-adrenergic recep-

tors.Inhibitory effects on I K(DR)and I Na constitute one of the underlying mechanisms through

which DEX and its structurally related compounds might affect neuronal activity in vivo .

Br J Anaesth 2009;103:244–54

Keywords :ions,ion channels,pharmacology;ions,ion channels,voltage-gated;model,

neuroblastoma cells;pharmacology,dexmedetomidine

Accepted for publication:April 7,2009

Dexmedetomidine (DEX)is a potent and highly selective agonist of the a 2-adrenergic receptors that is approved by the US Food and Drug Administration for the provision of short-term sedation of adult patients in the intensive care unit.It exerts a variety of actions on the human brain,including sedation,anaesthetic-sparing effects,and analge-sia.12Because this agent has minimal effects on venti-lation,it is relatively safe in the setting of functional neurosurgery.3Its sedative action is thought to involve inhibition of the locus coeruleus and subsequent disinhibi-tion of the ventrolateral preoptic nucleus.4DEX has been reported to decrease the convulsive potency of bupivacaine and levobupivacaine in awake rats.5A recent study showed that as an anaesthetic adjunct,DEX at a high concentration can affect transcranial motor evoked responses.6However,there are limited reports regarding its ionic mechanism of action on neurones.

Recent evidence has emerged that the effects on ion channels may be an important mechanism underlying DEX-induced actions in neurones.For example,previous studies demonstrated the ability of DEX to modify L-type Ca 2+current (I Ca,L )in pheochromocytoma cells 7and to inhibit M 3muscarinic receptors in dorsal root ganglion cells.8In paraventricular nucleus neurones or substantia gelatinosa neurones,DEX increases G-protein-coupled inwardly recti-fying K +current

and inhibits hyperpolarization-elicited inward current.910Voltage-gated K +(K V )channels play an essential role in determining the excitability of neurones.#The Author [2009].Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia.All rights reserved.

British Journal of Anaesthesia 103(2):244–54(2009)

doi:10.1093/bja/aep107Advance Access publication June 20,

2009

Among them,delayed recti?er K +(K DR )channels are ubi-quitous in neurones.In fast-spiking neurones,a causal relationship between K V 3,especially K V 3.1,and the delayed recti?er K +current [I K(DR)]has been well estab-lished.The K V 3recombinant channel has properties suit-able for the generation of high-frequency ?ring.High activation threshold (about 220mV)and fast deactivation

kinetics of the channels make them ideal for narrowing

spike width and inter-spike interval.11The I K(DR)containing

K V 3subunits contributes to changes in membrane potential in differentiated NG108-15cells.12–14Previous studies in our laboratory have shown that tra-madol suppresses the amplitude of I K(DR)in NG108-15

cells.14If K V 3-encoded K +currents are located at nerve terminals,modulation of current amplitude might be expected indirectly to alter Ca 2+in?ux and to affect neuro-transmitter release in the absence of overt changes in ?ring patterns.1115However,whether DEX can interact with I K(DR)or other types of ion currents to modify mem-brane potential in neurones remains largely unclear,despite its clinical use in a variety of neurosurgical pro-cedures.2–4In this study,we investigated the effects of DEX on ion currents (e.g.delayed recti?er K +current [I K(DR)],Na +current [I Na ],and L-type Ca 2+current [I Ca,L ])and mem-brane potential in NG108-15neuronal cells differentiated with dibutyryl cyclic AMP and in cultured cerebellar neur-ones.DEX was able to suppress both I K(DR)and I Na .The major action of DEX on I K(DR)is thought to be through an

open-channel mechanism.These inhibitory effects are not mediated by a 2-adrenergic receptors and might contribute

to its pharmacological actions in vivo .Methods Drugs and solutions DEX (dexmedetomidine HCl;(S )-4-[1-(2,3-dimethylphenyl)ethyl]-1H-imidazole hydrochloride;Precedex w )was obtained from Abbott Laboratories (Abbott Park,IL,USA).Collagenase,dibutyryl cyclic AMP,DNase I,efaroxan,tetraethylammonium chloride,and tetrodotoxin were purchased from Sigma Chemicals (St Louis,MO,USA),and yohimbine was from Tocris (Bristol,UK).Tissue culture media,L -glutamine penicillin–streptomycin,fungi-

zone,and trypsin were obtained from Life Technologies (Carlsbad,CA,USA).All other chemicals,including CsCl 2and CdCl 2,were commercially available and of reagent grade.The composition of normal Tyrode’s solution was 136.5mM NaCl,5.4mM KCl,1.8mM CaCl 2,0.53mM MgCl 2,5.5mM glucose,and 5.5mM HEPES–NaOH buffer,pH 7.4.To record I K(DR)or membrane potential,the patch pipette was ?lled with a solution consisting of 140mM KCl,1mM MgCl 2,3mM Na 2ATP,0.1mM Na 2GTP,0.1mM EGTA,and 5mM HEPES–KOH buffer,pH 7.2.To measure I Na or I Ca,L ,K +ions inside the pipette solution were replaced with equimolar Cs +ions,and the pH was adjusted to 7.2with CsOH.In some experiments,the pipette was ?lled with the solution which contained 10m M DEX.

Cell preparation and differentiation

The clonal strain NG108-15cell line,formed by Sendai

virus-induced fusion of the mouse neuroblastoma clone

N18TG-2and the rat glioma clone C6BV-1,was obtained from the European Collection of Cell Cultures

(ECACC-88112302;Wiltshire,UK).Cells

were kept in monolayer cultures at a density of 106ml 21in plastic disks containing Dulbecco’s modi?ed Eagle’s medium supplemented with 100m M hypoxanthine,1m M amino-

pterin,16m M thymidine,and 5%fetal bovine serum as

the culture medium,in a humidi?ed incubator equilibrated with 90%air/10%CO 2at 378C.14Media were replenished every 2–3days with fresh media.To induce neuronal differentiation,culture medium was replaced with medium containing 1mM dibutyryl cyclic AMP and cells were cultured in the incubator for 1–7days.16In a separate set of experiments,differentiated NG108-15cells were prein-cubated with yohimbine (10m M)or efaroxan (10m M)for 5h before electrophysiological experiments were performed.

Isolation of cerebellar granule cells

Cerebellar granule cells were isolated from Wistar rat pups

of post-natal days 9–10.Cerebella of 5–7animals were

excised after decapitation,and minced and digested with

collagenase (50mg ml 21)for 10min.Mechanical tritura-

tion with a Pasteur pipette was made in a DNase I/soybean

trypsin inhibitor solution.Dissociated cells were centri-

fuged and suspended in normal Tyrode’s solution.Cells were used for experiments within 2–3h after isolation.Animal experiments were conducted according to the pro-tocols that follow the NIH standards and the guidelines for the Care and Use of Experimental Animals.The procedure was approved by the Animal Care and Use Committee of the National Cheng Kung University,Tainan,Taiwan,Republic of China.

Electrophysiological measurements

Immediately before each experiment,cells were disso-ciated and an aliquot of cell suspension was transferred to a recording chamber mounted on the stage of an inverted DM-IL microscope (Leica,Wetzlar,Germany).Cells were bathed at room temperature (20–258C)in normal Tyrode’s

solution containing 1.8mM CaCl 2.Patch pipettes were

pulled from Kimax-51glass capillaries (Kimble Glass,Vineland,NJ,USA)on a PP-830microelectrode puller (Narishige,Tokyo,Japan),and their tips were ?re-polished

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with an MF-83microforge (Narishige).The resistances of the patch pipettes when ?lled with the internal solutions were between 3and 5M V .Ion currents were measured with glass pipettes in a whole-cell con?guration of the patch-clamp technique,using an RK-400patch-clamp ampli?er (Biologic,Claix,France).1317Data recordings and analyses Signals were displayed on an HM-507oscilloscope (Hameg Inc.,East Meadow,NY,USA).Data were stored online in a Slimnote VX 3computer (Lemel,Taipei,

Taiwan)at 10kHz equipped with a Digidata-1322A inter-face (Molecular Devices,Sunnyvale,CA,USA).Series resistance,in the range of 5–15M V ,was electronically compensated.Data were analysed by the use of pCLAMP

9.0software (Molecular Devices),Origin 7.5software

(Microcal Software,Northampton,MA,USA),or custom-made macros built in Excel 2007spreadsheet running on

Windows Vista (Microsoft,Redmond,WA,USA).The

pCLAMP-generated voltage-step protocols were used to measure the current–voltage (I–V )relations for ion cur-rents.Action potential duration (APD)was measured at 90%of repolarization (APD 90).To evaluate the percentage inhibition of DEX on I K(DR),NG108-15cells were bathed in normal Ca 2t-free Tyrode’s solution and each cell was depolarized from 250to +50mV.The amplitude of I K(DR)at the end of depolarizing pulse during exposure to different concentrations (0.1–30m M)of DEX was measured.Concentration–response data for inhibition of I K(DR)were ?tted with a modi?ed form of the Hill equation:y ?e1àa T??DEX àn H

?DEX àn H tIC àn H 50ta ;where y is the normalized amplitude of I K(DR);[DEX]rep-resents the DEX concentration;and IC 50and n H are the concentration required for 50%inhibition and Hill coef?-cient,respectively.Maximal inhibition (i.e.12a )was also estimated.By the use of a least squares method,the smooth curve shown in Figure 1B was allowed to converge on the experimental data when the maximal block was left unde?ned.Time constants of current activation (t act )in the absence or presence of DEX were determined by ?tting

the trajectory of each current trace with single exponential

curves.To determine the effect of DEX on the steady-state inactivation of I K(DR),the relationship between the con-ditioning potentials and the normalized amplitude of I K(DR)obtained with or without addition of DEX (3m M)was ?tted by the Boltzmann function:I ?I max 1texp eV àa =b Twhere I max represents the maximal activated I K(DR),V is the membrane potential in mV,a the membrane potential for a half-maximal inactivation,and b the slope factor of the inactivation curve of I K(DR).

Values are provided as means (SEM )with sample sizes (n )indicating the number of cells from which the data were taken.The paired or unpaired Student’s t -test and

one-way analysis of variance (ANOV A )with the least signi?-

cant difference method for multiple comparisons were used for the statistical evaluation of differences among means.Non-parametric Kruskal–Wallis test was then used,if the assumption of normality underlying ANOVA was

violated.Statistical analyses were performed using SPSS 14.0(SPSS Inc.,Chicago,IL,USA).Statistical signi?-cance was determined at a P -value of ,0.05.

Results

Effect of DEX on delayed recti?er K +current [I K(DR)]in differentiated NG108-15cells

In an initial set of experiments,a whole-cell con?guration of the patch-clamp technique was used to evaluate the effects of DEX on ion currents in NG108-15cells differ-entiated with dibutyryl cyclic AMP (1mM).To record I K(DR),cells were bathed in Ca 2+-free Tyrode’s solution which contained tetrodotoxin (1m M)and CdCl 2(0.5mM),and the recording pipette was ?lled with a K +-containing solution.Figure 1shows that DEX can depress the amplitude of I K(DR)in a concentration-dependent manner.In these experiments,each cell was

depolarized from 250to +50mV with a duration of 300

ms,and current amplitudes of I K(DR)were measured at the

end of depolarizing pulses.DEX (0.1–30m M)suppressed

the amplitude of I K(DR)in a concentration-dependent

manner.The relationship between the DEX concentration and the percentage inhibition of I K(DR)was constructed and plotted in Figure 1B .The IC 50value for DEX-induced inhibition of I K(DR)was 4.6m M.Figure 1C illustrates aver-aged I–V relationships of I K(DR)obtained in the control and during cell exposure to 3m M DEX.The results demonstrate that DEX has a signi?cant depressant action on I K(DR)functionally expressed in differentiated NG108-15cells.

Kinetic studies of DEX-induced block of I K(DR)Because the activation time course of I K(DR)during exposure to DEX tends to be progressively reduced,it is important to determine the kinetics of DEX-induced block in these cells.As shown in Figure 1D ,when cells were

depolarized from 250to +50mV,exposure to DEX was

noted to produce a reduction of t act in a concentration-

dependent fashion.Therefore,the results suggest that the

inhibitory effects of DEX on I K(DR)can be primarily

explained by state-dependent blocker where it can bind to

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the open state of the channel according to the minimal kinetic scheme:18C O O · D

where a and b are kinetic constants for the opening and

closing of the channel,k 1and k 21are those for forward and reverse rate constants of DEX binding,and D is the

DEX concentration.C,O,and O .D represent the closed,open,and open-bound states,respectively.Forward and reverse rate constants,k 1and k 21,were estimated from the values of t

act for DEX-induced change in the trajectory of

I K(DR)(Fig.1E ).The values were calculated using the

relation:

t à1?k 1??D tk à1

In particular,k 1and k 21,respectively,result from the slope and from the y -axis intercept at [D ]=0of the linear p A 1000020003000–50050m V [DEX] (μM)

D A C u r

r e n t a m p l

i t u

d

e (

p

A

)

ms 002000e d c b a pA 2040Time (ms)Fig 1Inhibitory effect of DEX on I K(DR)in NG108-15cells differentiated with dibutyryl cyclic AMP.Cells were bathed in Ca 2+-free Tyrode’s solution that contained tetrodotoxin (1m M)and CdCl 2(0.5mM).(A )Superimposed current traces obtained in the absence and presence of DEX.The upper part indicates the voltage protocol used.Inset shown in the right side of (A )indicates expanded time scale of current traces (dashed box).a,control;b,0.1m M DEX;c,0.3m M DEX;d,1m M DEX;and e,3m M DEX.(B )Concentration–response relationship for DEX-induced inhibition of I K(DR).Each cell was depolarized from 250to 50mV.Each point represents the mean (SEM )value (n =6–9).The smooth line represents the best ?t to the Hill equation as described in Methods.The IC 50value was derived from the non-linear curve ?t.The IC 50value,maximally inhibited percentage of I K(DR),and Hill coef?cient (n H )were 4.6m M,90%(i.e.a =0.1),and 1.1,respectively.(C )Averaged I–V relationships of I K(DR)obtained in the absence and presence of 3m M DEX.Mean (SEM )(n =7–12).In (D ),the time courses of current activation in the absence and presence of DEX were well ?tted by a single exponential.a,control;b,0.1m M DEX;c,0.3m M DEX;d,1m M DEX;and e,3m M DEX.The inset indicates the voltage protocol used.In (E ),the reciprocal of the activation time constant (t act ),obtained by a single-exponential ?t of the increasing phase of I K(DR),was plotted against the DEX concentration.Data points were ?tted by a linear regression,suggesting that the interaction occurs with a stoichiometry of 1.Forward (k 1)and reverse (k 21)rate constants,given by the slope and the y -axis intercept of the interpolated line,were 0.056ms 21m M 21and 0.34ms 21,respectively.Each point represents the mean (SEM )value (n =8–11).

Dexmedetomidine inhibits neuronal ion currents

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regression interpolating the reciprocal of time constants (i.e.t 21)vs different DEX concentrations (i.e.[D ]).In agreement with this kinetic scheme,the relationship between k 1and [D ]was found to be linear with a corre-

lation coef?cient of 0.95(Fig.1E ).The forward and reverse rate constants obtained from 6to 8different cells were calculated to be 0.056ms 21m M 21and 0.34ms 21,respectively.On the basis of these rate constants,a value of 6.1m M for the dissociation constant (K D =k 21?k 121)of

this drug was derived.Notably,this value was found to agree with its IC 50value determined from the concen-

tration–response curve (Fig.1B ).However,the backward rate constant (i.e.k 21)showed little dependence on the

DEX concentration:k 21was 0.34ms 21(n =6)at 1m M

and 0.34ms 21(n =6)at 3m https://www.doczj.com/doc/272038226.html,ck of effect of DEX on steady-state inactivation curve of I K(DR)To characterize the inhibitory effect of DEX on I K(DR),we

next investigated whether this drug affects the steady-state inactivation curve of I K(DR)in differentiated NG108-15

cells.Figure 2illustrates the steady-state inactivation curve of I K(DR)obtained in the absence and presence of DEX

(3m M).In these experiments,a 10s conditioning pulse to different membrane potentials preceded the test pulse to +50mV from a holding potential of 250mV.The

relationships between the conditioning potentials and the

normalized amplitudes of I K(DR)with or without appli-cation of DEX (3m M)were plotted and ?tted by the Boltzmann equation as described in Methods.In control,a =212.3(2.2)mV,b =6.6(0.8)mV (n =6),whereas in the presence of DEX (3m M),a =212.1(2.1)mV,b =6.3(0.7)mV (n =6).The values for a and b were not signi?cantly modi?ed in the presence of DEX (3m M),although it reduced the maximal conductance of I K(DR)by about 50%.Effect of DEX on averaged I–V relations of I K(DR)in NG108-15cells treated with yohimbine

DEX was reported to be a selective agonist of

a 2-adrenergic receptors.1Previous studies showed the ability of yohimbine to reverse both increased K +outward

currents and anticonvulsant effect caused by DEX.5910

We next evaluated whether inhibition of a -adrenergic receptors can in?uence DEX-induced block of I K(DR)in

NG108-15cells.In these experiments,differentiated NG108-15cells preincubated with yohimbine (10m M)for

5h.Yohimbine is an a 2-adrenoceptor antagonist,whereas efaroxan is an antagonist of imidazoline-I 1and a 2-

adrenergic receptors.In yohimbine-treated cells,the

inhibitory effect of DEX on the I–V relationship of I K(DR)

remained unaltered (Fig.3).No signi?cant difference in

the magnitude of DEX-induced inhibition of I K(DR)

between control cells and cells treated with DEX can be seen.Moreover,subsequent application of yohimbine (10m M)or efaroxan (10m M)did not reverse the inhibition of

I K(DR)caused by DEX (3m M)(data not shown).Similarly,in cells treated with efaroxan (10m M)for 5h,the magnitude of DEX-induced inhibition of I K(DR)remained unchanged.These results are thus interpreted to mean that the inhibitory effect of DEX on I K(DR)in these cells is unrelated to its binding to a 2-adrenergic receptors.Effect of DEX on voltage-gated Na +current (I Na )in differentiated NG108-15cells

We next investigated whether DEX has any effects on I Na present in these cells.Cells were bathed in Ca 2+-free Tyrode’s solution containing 0.5mM CdCl 2and the pipette was ?lled with a Cs +-containing solution.The effect of DEX on I Na was examined at different potentials and an I–V relationship of I Na was constructed.As shown

I

/

I

m a

x

Conditioning potential (mV)

B

C u r r

e n t

a m p

l

i t

u

d e

(p

A )010 000Time (ms)500020 00015 0000100020003000A ms 0

–50050mV 10000Fig 2Steady-state inactivation curve of I K(DR)in the absence or presence of DEX in differentiated NG108-15cells.Conditioning voltage pulses with a duration of 10s to potentials between 260and +60mV were applied from a holding potential of 250mV.After each conditioning pulse,a test pulse to +50mV was applied to evoke I K(DR).An example of current traces obtained by two-pulse protocol in the control is illustrated in (A ).The inset shown in (A )indicates the voltage protocol used.(B )Steady-state inactivation curve of I K(DR)obtained with or without application of DEX (3m M).The normalized amplitude of I K(DR)(I /I max )was constructed against the conditioning potentials,and the smooth curves were ?tted by the Boltzmann equation (see text for details).Mean (SEM )(n =5–9).Note that the steady-state inactivation curves of I K(DR)in the absence and presence of DEX are virtually superimposable.

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in Figure 4,DEX at a concentration of 10m M could signi?cantly decrease the peak amplitude of I Na ,when

cells were depolarizing from 280mV to different poten-tials ranging from 280to +40mV.For example,when the cell was depolarized from 280to 240mV,application of DEX (10m M)signi?cantly decreased I Na from 0.79(0.07)

to 0.62(0.07)nA (n =7).After washout of the drug,I Na

was returned to 0.76(0.06)nA (n =6).However,the overall I–V con?guration of I Na did not differ between the

absence and the presence of DEX.A subsequent appli-cation of yohimbine (10m M)did not reverse the inhibition of I Na caused by DEX (data not shown).Lack of effect of DEX on L-type Ca 2+current (I Ca,L )

in differentiated NG108-15cells

Previous reports showed that DEX is able to modify Ca 2+current in phaeochromocytoma cells.7We also determined the ability of this agent to alter the amplitude of I Ca,L in

these cells.The experimental results are illustrated in

Figure 5.When the cell was depolarized from 240to different potentials ranging from 240to +40mV,the

peak amplitude of I Ca,L was not found to differ between the absence and the presence of 10m M DEX.Moreover,when cells were exposed to this agent,no modi?cation of

the I–V relationship of I Ca,L can be demonstrated.

Therefore,unlike I Na ,I Ca,L is relatively insensitive to inhi-

bition by DEX in these cells.

Effect of DEX on action potentials in differentiated NG108-15cells

In another set of experiments,we determined the ability of

DEX to alter membrane potential.In these experiments,cells were bathed in normal Tyrode’s solution containing 1.8mM CaCl 2,and current-clamp recordings were made

in a K +-containing pipette solution.The resting membrane

potential and APD measured at 90%repolarization

(APD 90)in differentiated NG108-15cells were 270(8)

mV and 119(20)ms,respectively (n =21).A representative

example of DEX-induced effects on action potentials

(APs)in differentiated NG108-15cells is illustrated in

Figure 6.DEX at a concentration of 10m M signi?cantly decreased the amplitude of APs from 86(3)to 75(3)mV and prolonged the duration of APs from 76(9)to 143(21)ms (n =7).However,no discernible change in resting mem-brane potential can be demonstrated in the presence of C u r

r

e n t

a m

p l i

t

u

d e

(n A

)m V Control DEX

Time (ms)

050100150Fig 4Inhibitory effect of DEX on I Na in differentiated NG108-15neuronal cells.Cells were bathed in Ca 2+-free Tyrode’s solution containing 10mM tetraethylammonium chloride and 0.5mM CdCl 2.The recording pipette was ?lled with a Cs +-containing solution.(A )Superimposed current traces when the cell was depolarized from 280mV to different potentials.Upper panel is the control,and lower panel was obtained 2min after application of 10m M DEX.The uppermost part indicates the voltage protocol used.(B )Averaged I–V relationships of peak

I Na obtained in the absence or presence of 10m M DEX.Mean (SEM )(n =6–11).DEX reduced the peak amplitude of I Na with no change in the overall I–V con?guration.

C u

r r

e n t

a

m p

l

i t

u d e

(

p A )

Membrane potential (mV)Fig 3Effect of DEX on averaged I–V relationships of I K(DR)in

NG108-15cells treated with yohimbine.Before each experiment,cells were preincubated with yohimbine (10m M)for 5h.In each cell examined,I K(DR)was elicited from 250mV to different potentials ranging from 250to +50mV with 10mV increments.The I–V relationships of I K(DR)obtained in the absence or presence of 3m M DEX are illustrated.Mean (SEM )(n =5–10).Dexmedetomidine inhibits neuronal ion currents

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DEX.The widening of APs caused by DEX could be pri-marily explained by its block of I K(DR)and I Na ,but not by the activation of I Ca,L .Inhibitory effects of DEX on ion currents in response to AP waveforms in differentiated NG108-15cells The size and time course of ion currents [e.g.I Na and

I K(DR)]in response to change in AP waveforms tend to be

different from those elicited by rectangular voltage-clamp pulses.The effects of DEX on ion currents during APs generated from NG108-15cells were also investigated.In these experiments,cells were bathed in normal Tyrode’s solution,and the waveforms of APs were digitally gener-ated as voltage templates and replayed to evoke ion cur-rents.19As shown in Figure 7,the amplitudes of I Na and

I K(DR)in response to AP waveforms were reduced in the

presence of DEX.For example,after application of 1m M

DEX,the peak amplitude of I Na elicited by the waveforms of APs was decreased by about 10%.Moreover,I K(DR)in response to AP waveforms was suppressed by about 30%.The results led us to suggest that I Na and I K(DR)evoked by AP waveforms are more sensitive to block by this agent than those during rectangular pulses.Effect of DEX on I K(DR)in isolated rat cerebellar

granule cells Previous studies have demonstrated the presence of I K(DR)(i.e.K V 3.3-encoded current)in cerebellar granule cells.20DEX was shown to in?uence the cyclic GMP effector system in the mouse cerebellum.21Therefore,to verify whether the DEX-induced inhibition of I K(DR)could also be observed in another type of cells,we also investigated

the effect of DEX on I K(DR)in isolated cerebellar granular

cells.In isolated cerebellar granule cells,the I K(DR),which was clearly identi?ed as a slowly inactivating I K(DR),could be elicited.As shown in Figure 8,DEX was effec-

tive in suppressing I K(DR)found in these cells.When depolarizing pulses from –50to +50mV were applied,DEX (30m M)signi?cantly decreased current amplitude at the end of the voltage pulses from 2018(152)to 1196(81)pA (n =7).Consistent with the observations made in differentiated NG108-14cells,these data indicate that DEX is capable of inducing the block of I K(DR)and

increasing current activation in cerebellar granule cells.

Discussion

The present results demonstrate that in differentiated NG108-15neuronal cells,DEX produces a depressant action on I K(DR)in a concentration-and state-dependent fashion.DEX also blocks the peak amplitude of I Na ,whereas it had little or no effect on I Ca,L .This study

suggests that the exposure to this agent can produce inhibi-

tory effects on I K(DR)and I Na .In addition to activation of

a 2-adrenergic receptors,DEX-induced block of these cur-

rents could thus be potential mechanisms through which it

may depress neuronal excitability.

A notable feature of the block of I K(DR)by DEX in NG108-15cells is that the activating phase of the current C u r

r e

n t

a

m p l i

t u d e (p A

)m V

Control DEX Time (ms)

Fig 5Lack of effect of DEX on I Ca,L in differentiated NG108-15cells.Cells,bathed in normal Tyrode’s solution containing 1.8mM CaCl 2and 1m M tetrodotoxin,were held at 240mV and voltage pulses ranging from 240to +50mV in 10mV increments with a duration of 300ms were applied.In (A ),superimposed current traces shown in the upper part are control,and those in the lower part were recorded 2min after application of 10m M DEX.Voltage protocol is shown in the uppermost part.(B )Averaged I–V relationships of peak I Ca,L obtained under control or during exposure to 10m M DEX.Mean (SEM )(n =6–8).The I–V relationships of I Ca,L in the absence and presence of DEX are virtually superimposable.

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(i.e.activation time course)was elevated in the presence

of this agent.At the beginning of the depolarizing stimuli,

d I /d t is proportional to th

e number o

f channels available

for activation.Our experimental results showed that the

values of d I /d t and t

act were signi?cantly altered during

exposure to DEX,suggesting that DEX reaches the block-

ing site only when the channel is in the open state.No

modi?cation of the steady-state inactivation of I K(DR)can

be seen in the presence of DEX.Thus,block by DEX of

I K(DR)presented here tends to be located at the open states

of the channel.It is also possible that DEX has a greater

af?nity for the open conformation of K DR channels than

the closed conformation even without producing a block at

the open states.However,it will remain to be determined

whether other types of K DR channels can be differentially subject to block by this drug or other structurally related

compounds.

We provide the direct evidence that DEX has a depress-

ant action on I K(DR)in differentiated NG108-15cells.The

half-blocking concentration of DEX required for inhibition

of I K(DR)with an IC 50value of 4.6m M appears to be of

the same order of magnitude as the concentration used

elicit outward K +currents in other types of neurones.910The concentration used in this study tends to be greater

than mean plasma concentration during sedation (0.9–2.3ng ml 21;4–10nM).22–24However,the concentration

immediately after a bolus of

injection with DEX can range

between 0.1and 1m M.22–24Individual patients can differ

physiologically owing to differences in regional blood ?ow or volume of distribution.2425Moreover,the I K(DR)and I Na in response to AP waveforms were more sensitive to block by DEX than those evoked by rectangular pulses.Control B A A P

D 90 (m

s

) 3 μM 10 μM m V a b c Fig 6Effect of DEX on APs in differentiated NG108-15cells.Cells were bathed in normal Tyrode’s solution containing 1.8mM CaCl 2.Patch

pipettes were ?lled with a K +-containing solution.Changes in membrane potential were measured under current-clamp con?guration.(A )Potential traces obtained in the absence (a)or presence of 3m M (b)or 10m M (c)DEX.(B )Summary of the data showing the effect of DEX on APD at 90%repolarization (APD 90).Each bar represents the mean (SEM )value (n =7).Statistical comparisons were performed by paired Student’s t -test (*P ,0.05vs control).a b Control 1 μM 3 μM

m V A Time (ms)ms 2015–1000–500

0a b p A p A Fig 7Inhibitory effects of DEX on AP waveform-induced currents in differentiated NG108-15cells.(A )Current traces obtained in the absence (a)or presence (b)of 1m M DEX.The upper part shows the AP waveform generated from an NG108-15cell.The inset indicates expanded time scale of current traces (dashed box).(B )Summary of the data showing inhibitory effect of 1and 3m M DEX on I Na (?lled box)and I K(DR)(open box)in response to AP waveforms.Each bar represents the mean (SEM )(n =6–9).Statistical comparisons were performed by paired Student’s t -test (*P ,0.05vs controls).

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The K DR channels may thus be an important target for the action of this agent.Both the alterations in the channel gating and the reduction of the currents caused by this agent are also likely to be clinically relevant,if similar results are found in intact neurones in vivo .To what extent block of I K(DR)presented here contribute to the unusual

subcortical form of DEX-induced sedation 3also remains to be further elucidated.Intracellular dialysis with 10m M DEX had little or no effects on I K(DR)or I Na in differentiated NG108-15cells.Although its detailed mechanisms are unclear,the site of DEX action could be localized mainly on the extracellular side of the channel molecule near the outer channel mouth.Moreover,previous studies showed that in hypo-thalamic paraventricular nucleus neurones,DEX (0.1–20m M)suppressed hyperpolarization-elicited inward current and activated G-proteins-coupled inwardly rectifying K +currents,and yohimbine antagonized DEX-induced effects.9However,in the present study,in cells treated with yohimbine or efaroxan,DEX-induced inhibition of I K(DR)was unaltered.Therefore,block by this agent of I K(DR)or I Na in differentiated NG108-15neuronal cells appears to be direct and is unlikely to be mediated through binding to a 2-adrenergic receptors.Previous reports at our laboratory demonstrated the ability of propofol to reduce the amplitude of I Ca,L in H9c2myoblasts.26However,in this study,little or no effects of DEX on I Ca,L was observed in differentiated NG108-15cells.The observations seem to be different from earlier studies showing the ability of this agent to modify the amplitude of I Ca,L in phaeochromocytoma cells treated with nerve growth factor.7This discrepancy is currently unclear;however,it could be due to the fact that there are different types of Ca 2+channel-forming subunits in different cell types.The Ca V 1.3(a 1D )Ca 2+channel-forming

subunit is predominantly expressed in NG108-15cells.

27It has been reported that K V 3.1,one of the Shaw -type

K +channels,is the major molecular component of I K(DR)

in differentiated NG108-15cells.12–14A partial block of the classical Hodgkin–Huxley-type K +current leads to the increased number of evoked APs,whereas a partial block of the slowly inactivating I K(DR)(e.g.K V 3.1-encoded current)can decrease the number of evoked APs.28Through an inhibition of I K(DR)presented here,DEX can depolarize the cell and exacerbate the inhibition of I Na to a greater extent,thereby diminishing its depressant action on I Na .Therefore,the block by DEX of I K(DR)at depolarizing potentials can delay repolarization,which could cause a reduction in neuronal excitability.Besides its action at a 2-adrenergic receptors,DEX exhibits some af?nity for imidazoline binding sites.29Previous studies in isolated portal vein cells have demon-strated that several agents containing an imidazoline moiety can induce the inhibition of I K(DR).30DEX was recently reported to increase the expression of phos-phorylated extracellular signal-regulated kinases via a mechanism linked to its binding to imidazoline I 1recep-tors.31It is thus possible that DEX exerts its inhibitory effects on I K(DR)by an interaction with an imidazoline binding site.It also remains to be clari?ed whether levo-medetomidine,an inactive isomer of DEX,22has any effect on I K(DR),although this agent showed little pharmacological action.C u r r e n t a m p l i t u d e (p A )A

Control DEX

Time (ms)

ms 0200–400mV 400Fig 8Effect of DEX on I K(DR)in isolated cerebellar granule cells.Cells were bathed in Ca 2+-free Tyrode’s solution that contained tetrodotoxin (1m M)and CdCl 2(0.5mM).(A )Superimposed current traces obtained in the absence (upper)and presence (lower)of 3m M DEX.The inset indicates the voltage protocol used.(B )Averaged I–V relationships of I K(DR)obtained in control or during the exposure to 3m M DEX.Mean (SEM )(n =7).Chen et al.

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In summary,the inhibitory effect of DEX on I K(DR)in NG108-15cells and in isolated cerebellar granule cells is not associated with binding to a 2-adrenergic receptors.Because of the importance of I K(DR)(i.e.K V 3.1-encoded current)in contributing to excitability and automaticity of neuronal cells,these effects shown in this study could provide novel insights into electrophysiological properties of DEX and other structurally related compounds.Funding This study was partly supported by a grant from Buddhist Dalin Tzu Chi General Hospital (DTCRD98-08),Chiayi County,Taiwan.The work in this laboratory was also sup-ported by grants from the National Science Council (NSC-95-2745B-002-MY2),and the Programme for Promoting Academic Excellence and Developing World Class Research Centers,Ministry of Education,Taiwan.References 1Scheinin H,Virtanen R,MacDonald E,Lammintausta R,Scheinin M.Medetomidine—a novel a 2-adrenoceptor agonist:a review of

its pharmacodynamic effects.Prog Neuropsychopharmacol Biol Psychiatry 1989;13:635–512Martin E,Ramsay G,Mantz J,Sum-Ping ST .The role of the a 2-adrenoceptor agonist dexmedetomidine in postsurgical sedation in the intensive care unit.J Intensive Care Med 2003;18:29–413Rozet I.Anaesthesia for functional neurosurgery:the role of dex-medetomidine.Curr Opin Anaesthesiol 2008;21:537–434Nelson BA,Lu J,Guo T ,Saper CB,Franks NP ,Maze M.The a 2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects.Anesthesiology 2003;98:428–365T anaka K,Oda Y ,Funao T ,T akahashi R,Hamaoka N,Asada A.Dexmedetomidine decreases the convulsive potency of bupiva-caine and levobupivacaine in rats:involvement of a 2-adrenoceptor for controlling convulsions.Anesth Analg 2005;100:687–966Bala E,Sessler DI,Nair DR,McLain R,Dalton JE,Farag E.Motor and somatosensory evoked potentials are well maintained in patients given dexmedetomidine during spine surgery.Anesthesiology 2008;109:417–257Soini SL,Duzic E,Lanier SM,Akerman KE.Dual modulation of calcium channel current via recombinant a 2-adrenoceptors in phaeochromocytoma (PC-12)cells.P?u ¨gers Arch 1998;435:280–58T akizuka A,Minami K,Uezono Y ,et al .Dexmedetomidine inhibits muscarinic type 3receptors expressed in Xenopus oocytes and muscarine-induced intracellular Ca 2+elevation in cultured rat dorsal root ganglia cells.Naunyn-Schmiedeberg’s Arch Pharmacol 2007;375:293–3019Shirasaka T ,Kannan H,T akasaki M.Activation of a G protein-coupled inwardly rectifying K +current and suppression of I h contribute to dexmedetomidine-induced inhibition of rat hypothalamic paraventricular nucleus neurones.Anesthesiology 2007;107:605–1510Ishii H,Kohno T ,Y amakura T ,Ikoma M,Baba H.Action of dex-medetomidine on the substantia gelatinosa neurones of the rat spinal cord.Eur J Neurosci 2008;27:3182–9011Rudy B,McBain CJ.Kv3channels:voltage-gated K +channels designed for high-frequency repetitive ?ring.Trends Neurosci 2001;24:517–2612Y okoyama S,Kawamura T ,Ito Y ,Hoshi N,Enomoto K,Higashida

H.Potassium channels cloned from NG108-15neuroblastoma-glioma hybrid cells.Functional expression in Xenopus oocytes

and mammalian ?broblast cells.Ann N Y Acad Sci 1993;707:

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terminals.J Neurosci 2000;20:114–2216Lin MW ,Wang YJ,Liu SI,Lin AA,Lo YC,Wu SN.

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vating potassium current to delayed ?ring of action potentials in NG108-15neuronal cells:experimental and theoretical studies.J Theor Biol 2008;252:711–2118Lo YC,Y ang SR,Huang MH,Liu YC,Wu SN.Characterization of chromanol 293B-induced block of the delayed-recti?er K +current in heart-derived H9c2cells.Life Sci 2005;76:2275–86

19Wu SN,Chen H,Liu YC,Chiang HT .Block of L-type Ca 2+current by beauvericin,a toxic cyclopeptide,in the NG108-15neuronal cell line.Chem Res Toxicol 2002;15:854–6020Chang SY ,Zagha E,Kwon ES,et al .Distribution of Kv3.3potass-ium subunits in distinct neuronal populations of mouse brain.J Comp Neurol 2007;502:953–7221Vulliemoz Y ,Virag L,Whittington RA.Interaction of the a -2adrenergic-and opioid receptor with the cGMP system in the mouse cerebellum.Brain Res 1998;813:26–3122Kuusela E,Raekallio M,Anttila M,Falck I,Mo ¨lsa ¨S,Vainio O.Clinical effects and pharmacokinetics of medetomidine and its enantiomers in dogs.J Vet Pharmacol Ther 2000;23:15–2023Ebert TJ,Hall JE,Barney JA,Uhrich TD,Colinco MD.The effects of increasing plasma concentrations of dexmedetomidine in humans.Anesthesiology 2000;93:382–9424Venn RM,Karol MD,Grounds RM.Pharmacokinetics of dexme-detomidine infusions for sedation of postoperative patients requiring intensive care.Br J Anaesth 2002;88:669–7525Snapir A,T alke P ,Posti J,Huiku M,Kentala E,Scheinin M.Effects of nitric oxide synthase inhibition on dexmedetomidine-induced vasoconstriction in healthy human volunteers.Br J Anaesth 2009;102:38–4626Liu YC,Wang YJ,Wu SN.The mechanisms of propofol-induced block on ion currents in differentiated H9c2cardiac cells.Eur J Pharmacol 2008;590:93–827Kim HL,Chang YL,Lee SM,Hong YS.Genomic structure of the regulatory region of the voltage-gated calcium channel a 1D.Exp Mol Med 1998;30:246–5128Baranauskas G.Ionic channel function in action potential generation:current perspective.Mol Neurobiol 2007;35:129–50

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