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Associate Professor of Medicine and Neurosciences
Pulmonary Division 111J(W) Cleveland VA Medical Center
10701 East Boulevard
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The overall interest of our laboratory is the regulation of skeletal muscle contraction, with an emphasis on the respiratory neuromuscular system. Current areas of focus are the regulation of diaphragm muscle contraction by K+ channels, and the control of acetylcholine release and replenishment at the phrenic-diaphragm neuromuscular junction, as described further below. Other areas of investigation include the contractile and structural properties of thoracic and upper airway respiratory muscles, and the manner in which their activity is controlled by the brain during breathing.
Skeletal muscles contain a high density of membranous K+ channels, including voltage-senstive delayed and inward rectifier K+ channels, Ca++-activated K+ channels, and ATP-sensitive K+ channels. Studies are examining the extent to which alteration of K+ conductance through one or more of these channels alters muscle contractile performance. In particular, the role of delayed rectifier channels are being defined, as these are the channels responsible for action potential repolarization. Studies are finding that K+ channel blockade augments muscle force at low to intermediate stimulation frequencies, and that the force increases can be maintained over time during repetitive stimulation. Moreover, the magnitude of the force increases exceeds that typically seen with other skeletal muscle inotropic agents. The extent to which the salutatory effects of K+ channel blockers on muscle contractile performance extend to diseased muscle is being tested, which may lead to the development of a new therapeutic approach to a variety of muscle disorders.
Transmission at the neuromuscular junction requires sufficient acetylcholine release so that the consequentially elicited postsynaptic endplate potential exceeds the threshold for action potential generation. During repetitive activation, transmitter release diminishes, which when severe leads to transmission failure. This issue is particularly important for respiratory neuromuscular junctions, which unlike limb neuromuscular junctions remain active throughout the lifetime of the organism. Restoration of acetylcholine available for release depends on two separate but interrelated processes: recycling of transmitter from the synaptic cleft, and repletion of the immediately releaseable vesicle pool from one or more reserve pools. Respiratory muscles are active continuously, so that transmitter replenishment needs to be sufficiently robust to ensure that a constant supply of acetylcholine is available for release. Studies are defining intrinsic and extrinsic factors which regulate neurotransmitter replenishment, in particular stimulation frequency, intracellular Ca++ levels, temperature and hypoxia.