Nitric Oxide modulates spontaneous Ca2+ release and ventricular arrhythmias during β adrenergic signalling through S-nitrosylation of Calcium/Calmodulin dependent kinase II

RationaleNitric oxide (NO) has been identified as a signalling molecule generated during {beta}-adrenergic receptor (AR) stimulation in the heart. Furthermore, a role for NO in triggering spontaneous Ca2+ release via S-nitrosylation of Ca2+/calmodulin kinase II delta (CaMKII{delta}) is emerging. NO donors are routinely used clinically for their cardioprotective effects in the heart, but it is unknown how NO donors modulate the pro-arrhythmic CaMKII to alter cardiac arrhythmia incidence. ObjectiveWe test the role of S-nitrosylation of CaMKII{delta} at the Cys-273 inhibitory site and Cys-290 activating site in cardiac Ca2+ handling and arrhythmogenesis before and during {beta}-AR stimulation. Methods and ResultsWe measured Ca2+-handling in isolated cardiomyocytes from C57BL/6J wild-type (WT) mice and mice lacking CaMKII{delta} expression (CaMKII{delta}-KO) or with deletion of the S-nitrosylation site on CaMKII{delta} at Cys-273 or Cys-290 (CaMKII{delta}-C273S and -C290A knock-in mice). Cardiomyocytes were exposed to NO donors, S-nitrosoglutathione (GSNO; 150 M), sodium nitroprusside (SNP; 200 M) and/or {beta}-adrenergic agonist isoproterenol (ISO; 100 nM). WT and CaMKII{delta}-KO cardiomyocytes treated with GSNO showed no change in Ca2+ transient or spark properties under baseline conditions (0.5 Hz stimulation frequency). Both WT and CaMKII{delta}-KO cardiomyocytes responded to ISO with a full inotropic and lusitropic Ca2+ transient response as well as increased Ca2+ spark frequency. However, the increase in Ca2+ spark frequency was significantly attenuated in CaMKII{delta}-KO cardiomyocytes. The protection from ISO-induced Ca2+ sparks and waves was mimicked by GSNO pre-treatment in WT cardiomyocytes, but lost in CaMKII{delta}-C273S cardiomyocytes that displayed a robust increase in Ca2+ waves. This observation is consistent with CaMKII{delta}-C273 S-nitrosylation being critical in limiting ISO-induced arrhythmogenic sarcoplasmic reticulum Ca2+ leak. When GSNO was applied after ISO this protection was not observed in WT or CaMKII{delta}-C273S but was apparent in CaMKII{delta}-C290A. In Langendorff-perfused isolated hearts, GSNO pre-treatment limited ISO-induced arrhythmias in WT but not CaMKII{delta}-C273S hearts, while GSNO exposure after ISO sustained or exacerbated arrhythmic events. ConclusionsWe conclude that prior S-nitrosylation of CaMKII{delta} at Cys-273 can limit subsequent {beta}-AR induced arrhythmias, but that S-nitrosylation at Cys-290 might worsen or sustain {beta}-AR-induced arrhythmias. This has important implications for the administration of NO donors in the clinical setting.