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Vol. 292, Issue 1, 131-135, January 2000


MCC-134, a Novel Vascular Relaxing Agent, Is an Inverse Agonist for the Pancreatic-Type ATP-Sensitive K+ Channel1

Takashi Shindo, Yusuke Katayama, Yoshiyuki Horio and Yoshihisa Kurachi

Department of Pharmacology II, Graduate School of Medicine, Osaka University, Osaka, Japan

    Abstract
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Abstract
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Materials and Methods
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The effects of a novel vasorelaxant agent, MCC-134 (1-[4-(1H-imidazol-1-yl)benzoyl]-N-methyl-cyclobutanecarbothioamide), were examined on reconstituted ATP-sensitive K+ (KATP) channels, which are composed of an inwardly rectifying K+ channel, Kir6.2, and three types of sulfonylurea receptors (SUR): SUR1, SUR2A, and SUR2B. Each type of KATP channel was heterologously expressed in human embryonic kidney 293T cells. The expressed KATP channel currents were measured with the whole-cell configuration of the patch-clamp method. MCC-134 activated the SUR2B/Kir6.2 channel, was a weak activator of the SUR2A/Kir6.2 channel, but did not activate the SUR1/Kir6.2 channel. MCC-134 suppressed SUR1/Kir6.2 channel currents that had been fully activated by either diazoxide or NaCN, whereas it did not affect the fully activated SUR2A/Kir6.2 or SUR2B/Kir6.2 channel currents. Thus, MCC-134, which is a relatively effective opener of the vascular smooth muscle type (SUR2B) of KATP channel, is an antagonist of the pancreatic type (SUR1) of KATP channel. Therefore, depending on the subtype of SUR, a pharmacological agent can cause either activation or inhibition of KATP channel activity.

    Introduction
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ATP-sensitive K+ (KATP) channels are inhibited by intracellular ATP and activated by NDPs and thus provide a link between the metabolic state and cellular excitability in various tissues (Ashcroft, 1988; Terzic et al., 1995). These channels are associated with various cellular functions, such as vasodilatation, insulin secretion, cardiac preconditioning during ischemia, neurotransmitter release, and oocyte maturation. It is established that KATP channels are heteromultimers composed of an ATP-binding cassette protein, known as the sulfonylurea receptor (SUR), and an inwardly rectifying K+ channel (Kir) subunit, Kir6.2 (Aguilar-Bryan et al., 1995; Inagaki et al., 1995; Sakura et al., 1995). When expressed with Kir6.2, all three types of SUR identified so far (i.e., SUR1, SUR2A, and SUR2B) form KATP channels. The reconstituted KATP channels all exhibit the same single-channel characteristics; weak inward rectification and a unitary conductance of ~80 pS in the inward direction in the presence of 150 mM extracellular K+. However, they show distinct sensitivities to various vasorelaxant K+ channel openers (KCOs; Inagaki et al., 1995, 1996; Isomoto et al., 1996). For instance, the SUR1/Kir6.2 channel is activated by diazoxide but not by pinacidil; the SUR2A/Kir6.2 channel is activated by pinacidil but not by diazoxide; and the SUR2B/Kir6.2 channel is activated by both pinacidil and diazoxide. Therefore, it is now widely accepted that SURs are responsible for the differential effects of KCOs on each type of KATP channel in various tissues.

Pharmacological and electrophysiological studies have reported that SUR1/Kir6.2 represents the pancreatic beta -cell KATP channel, whereas SUR2A/Kir6.2 is thought to represent the cardiac KATP channel (Aguilar-Bryan et al., 1995; Inagaki et al., 1995, 1996; Sakura et al., 1995). However, the molecular composition of native vascular smooth muscle cell K+ channels is controversial. Current data strongly suggest that SUR2B/Kir6.1 may represent the vascular NDP-sensitive K+ (KNDP) channel, which is the main target of KCOs in vascular smooth muscle (Beech et al., 1993; Quayle et al., 1997; Yamada et al., 1997; Satoh et al., 1998). Because KNDP and KATP channels differ in their single-channel characteristics and intracellular nucleotide-mediated gating, it has been difficult to electrophysiologically compare the affinities of various KCOs for smooth muscle KNDP channels with those for pancreatic and cardiac KATP channels in a quantitative manner. Therefore, for this purpose, we adopted a strategy using the reconstituted KATP channels with the same pore subunit, Kir6.2 and different SURs to examine the effects of KCOs on these channels (Shindo et al., 1998).

In this study, we examined the effects of a newly synthesized vasorelaxant agent, 1-[4-(1H-imidazol-1-yl)benzoyl]-N-methyl-cyclobutanecarbothioamide (MCC-134), on the heterologously expressed SUR1/Kir6.2, SUR2A/Kir6.2, and SUR2B/Kir6.2 channels in human embryonic kidney (HEK) 293T cells. We found that this compound is most effective as an agonist for the SUR2B/Kir6.2 channel but is an antagonist for the SUR1/Kir6.2 channel. This study suggests that depending on the subtype of SUR, a single pharmacological agent can cause not only activation but also inhibition of KATP channel activity.

    Materials and Methods
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Abstract
Introduction
Materials and Methods
Results
Discussion
References

Functional Expression of SUR1/Kir6.2, SUR2A/Kir6.2, and SUR2B/Kir6.2 Channels. The cDNA clones of rat Kir6.2 and mouse SURs (SUR1, SUR2A, and SUR2B) were used (Isomoto et al., 1996; Ohta et al., 1998; Shindo et al., 1998). The coding region of each cDNA was individually subcloned into an expression vector pcDNA3 (InVitrogen, San Diego, CA). The plasmid containing Kir6.2 was cotransfected with either SUR1, SUR2A, or SUR2B cDNA into HEK 293T cells with the use of LipofectAMINE (Life Technologies, Grand Island, NY) according to the manufacturer's instruction. Electrophysiological measurements were usually conducted 2 to 4 days after transfection.

Electrophysiological Recordings. The channels expressed in the HEK 293T cells were studied using the whole-cell configuration of the patch-clamp method at room temperature as described previously (Shindo et al., 1998). The agents used in these experiments were diluted in the bathing solution and applied to the bath. The tip of the electrodes had a resistance of 2 to 5 MOmega after being coated with silicon and fire polished. The channel currents were measured with a patch-clamp amplifier (Axopatch 200A; Axon Instruments, Foster City, CA) and monitored throughout the experiments with an analog-storage oscilloscope (Dual Beam Storage Oscilloscope; Tektronix, Inc., Beaverton, OR). For subsequent analyses, currents were recorded on videocassette tapes by using a PCM recorder (VR-10B; Instrutech Corp., Great Neck, NY). For analysis, the data were reproduced, low-pass filtered at 1.0 kHz (-3 dB) with an 8-pole Bessel filter (Frequency Devices, Haverhill, MA) and digitized at 3 or 5 kHz with an AD converter (ITC-16; Instrutech Corp.). The data were analyzed off-line using a computer (Macintosh Quadra 700; Apple Computer Inc., Cupertino, CA) with commercially available programs: Pulse Program (HEKA Electronik, Lambrecht, Germany) and Patch Analyst Pro (MT Corporation, Hyogo, Japan).

In the whole-cell configuration, activation of KATP channels by various KCOs, including pinacidil for the SUR2A/Kir6.2 and the SUR2B/Kir6.2 channels and diazoxide for the SUR1/Kir6.2 channel, resulted in an increase of time-independent K+ current. The K+ currents exhibited almost linear current-voltage relationship and reversed at ~-85 mV with extracellular K+ concentration ([K+]o) of 5.4 mM, as reported previously (Okuyama et al., 1998). The K+ currents activated by MCC-134 in the cells expressing the SUR2A/Kir6.2 or SUR2B/Kir6.2 channels showed the same properties (data not shown). For comparison of the potency of various KCOs, the cells were held at either -60 or -30 mV. The whole-cell current response to pinacidil or MCC-134 in the cells expressing SUR2A/Kir6.2 or SUR2B/Kir6.2 channels was measured by subtracting the basal current from that in the presence of these agents. The subtracted current at each concentration of MCC-134 was normalized to that induced by 100 µM pinacidil in each cell, which was 58 ± 13 and 55 ± 9 pA/pF (mean ± S.E., n = 7 for each) at -60 mV in the coexpressed SUR2A/Kir6.2 or SUR2B/Kir6.2 channels, respectively (5.4 mM extracellular K+). No significant difference was detected between these two values (P = .837). The inhibitory response of the whole-cell current in SUR1/Kir6.2 channels to MCC-134 was measured by subtracting the basal current from that in the presence of this agent. The subtracted current at each concentration of the agent was normalized to that recorded in the presence of 300 µM diazoxide or 2 mM NaCN in each cell (5.4 mM extracellular K+, and the cells were held at -30 mV).

Data are expressed as mean ± S.E. The Student's unpaired t test was used for statistical analysis. A value of P < .05 was taken to be statistically significant.

Solutions and Chemicals. In the whole-cell current recording configuration, the bath was perfused with a control bathing solution containing 136.5 mM NaCl, 5.4 mM KCl, 1.8 mM CaCl2, 0.53 mM MgCl2, 5.5 mM glucose, and 5.5 mM HEPES-NaOH (pH 7.4). In the experiments simulating "in vitro ischemia" with the use of cyanide, glucose was omitted (Duchen, 1990). The pipette was filled with an internal solution containing 140 mM KCl, 2 mM MgCl2, 5 mM EGTA-KOH, and 5 mM HEPES-KOH (pH 7.3). ATP (3 mM) and GTP (100 µM) were added to the internal solution with the concentration of free Mg2+ adjusted to 1.4 mM with reference to the stability constants of the Mg/nucleotide complexes (Dawson et al., 1986; Sigel, 1987), except in the experiments with cyanide. Stock solutions of compounds were prepared as follows: 200 mM MCC-134 in glacial acetic acid, 100 mM pinacidil in 0.1 M HCl, 90 mM diazoxide in 0.1 M NaOH, 100 mM tolbutamide in 0.1 M NaOH, and 10 mM glibenclamide in dimethyl sulfoxide. These vehicles by themselves did not have any significant effect on the whole-cell current of the nontransfected or transfected HEK 293T cells at the maximum vehicle concentrations used in this study (n = 5 for each). Drugs were diluted to the desired concentrations in the control bathing solution. The maximum final concentration of MCC-134 that could be dissolved under these conditions was 100 µM. MCC-134 was a gift from Mitsubishi Chemical Corporation, Research and Development Division (Yokohama, Japan; Fig. 1A). Pinacidil was purchased from Research Biochemicals, Inc. (Natick, MA). ATP and glibenclamide were obtained from Sigma Chemical Co. (St. Louis, MO). GTP, diazoxide, tolbutamide, and NaCN were obtained from Wako Pure Chemical Industries, Ltd. (Osaka, Japan). Other chemicals and materials were obtained from commercial sources.


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Fig. 1.   Chemical structure of MCC-134 (A) and the effects of MCC-134 on whole-cell currents in HEK 293T cells expressing the SUR1/Kir6.2, SUR2A/Kir6.2 and SUR2B/Kir6.2 channels. Concentration-dependent effect of MCC-134 on the SUR1/Kir6.2 (B), SUR2A/Kir6.2 (C), and SUR2B/Kir6.2 (D) channels were measured at -60 mV with 5.4 mM external K+ in the whole-cell configuration. The perfusion protocol is indicated above each trace. Arrowheads indicate the zero current level. E, relationship between the concentration of MCC-134 and the whole-cell current of the SUR1/Kir6.2 (triangle ), SUR2A/Kir6.2 (open circle ), and SUR2B/Kir6.2 () channels. In cells containing SUR2/Kir6.2 channels, the current amplitude induced by each concentration of MCC-134 was normalized to the pinacidil (100 µM)-induced current in the same cells. Symbols and bars indicate the mean and S.E. values, respectively. The number of the observations at each point was four or five. The lines are the fit of the data with the equation (see text) at concentrations between 0.1 and 100 µM.

    Results
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Materials and Methods
Results
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References

Effects of MCC-134 on SUR1/Kir6.2, SUR2A/Kir6.2, and SUR2B/Kir6.2 Channel Whole-Cell Currents. Figure 1 (B-D) shows the effect of different concentrations of MCC-134 on the whole-cell current in HEK 293T cells expressing SUR1/Kir6.2, SUR2A/Kir6.2, or SUR2B/Kir6.2 channels, respectively. In these experiments, the cells were held at -60 mV. In the cells expressing SUR1/Kir6.2 channels, the sequential application of 1, 10, and 100 µM MCC-134 was without an obvious effect, except for slight depression of the basal cell current.

In the same cells, diazoxide clearly stimulated SUR1/Kir6.2 currents (Fig. 1B). In the cells expressing SUR2A/Kir6.2 channels, >10 µM MCC-134 induced an outward current in a concentration-dependent fashion. The current slightly decreased during the continuous application of 100 µM MCC-134. The current induced by 100 µM MCC-134 was ~20% of that induced in the same cell by 100 µM pinacidil (Fig. 1C). On the other hand, the SUR2B/Kir6.2 channel could be significantly activated by >1 µM MCC-134. MCC-134 (30 µM) activated the channel to approximately the same or a greater extent than 100 µM pinacidil (Fig. 1D). The diazoxide-, pinacidil-, and MCC-134-induced currents exhibited a linear current-voltage relationship with a reversal potential of ~-85 mV with 5.4 mM extracellular K+ and were inhibited completely by 3 µM glibenclamide (data not shown; Okuyama et al., 1998).

Figure 1E depicts the relationship between the concentration of MCC-134 and the whole-cell SUR1/Kir6.2, SUR2A/Kir6.2, or SUR2B/Kir6.2 channel currents. The currents induced by each concentration of MCC-134 were normalized to that evoked by 100 µM pinacidil (SUR2A/Kir6.2 and SUR2B/Kir6.2) or 300 µM diazoxide (SUR1/Kir6.2) in each cell. The SUR1/Kir6.2 channel was not activated by MCC-134. In both SUR2A/Kir6.2 and SUR2B/Kir6.2 channels, glibenclamide-sensitive outward K+ currents were activated by MCC-134 in a concentration-dependent manner. The threshold concentration of MCC-134 to activate the SUR2A/Kir6.2 channel was ~3 µM. In SUR2A/Kir6.2 channels, the maximum current evoked by 30 µM MCC-134 was only 22 ± 4% (n = 5) of that induced by 100 µM pinacidil. On the other hand, the maximum current produced by SUR2B/Kir6.2 channels in response to 100 µM MCC-134 was 108 ± 17% (n = 5) of that evoked by 100 µM pinacidil. The concentration-response relationship for MCC-134-activation of SUR2A/Kir6.2 or SUR2B/Kir6.2 channels obtained from five different cells was fitted with the following modified Hill equation: Relative current = A/{1 + (K/[MCC-134])n}

where the relative current is that normalized with reference to the current induced by 100 µM pinacidil in the same cells, A is the maximum relative current induced by MCC-134, K is the apparent dissociation constant of MCC-134, [MCC-134] is the concentration of MCC-134, and n is the Hill coefficient. The values of A, K, and n were 0.21, 8.5 µM, and 2.23 for the SUR2A/Kir6.2 channel and 1.09, 5.2 µM, and 1.09 for the SUR2B/Kir6.2 channel, respectively. We recently reported that these values for pinacidil were 1.05, 9.8 µM, and 1.24 for the SUR2A/Kir6.2 channel and 1.03, 1.4 µM, and 1.42 for the SUR2B/Kir6.2 channel, respectively (Shindo et al., 1998). Therefore, MCC-134 showed almost the same potency and efficacy as pinacidil in activating SUR2B/Kir6.2 channels but was much less efficient than pinacidil in activating SUR2A/Kir6.2 channels.

Effects of MCC-134 on KCO- or NaCN-Induced Currents of SUR1/Kir6.2 Channel in Whole-Cell Configuration. In Fig. 2, we examined the effects of MCC-134 on the diazoxide- or NaCN-activated SUR1/Kir6.2 channel recorded at -30 mV. SUR1/Kir6.2 channels were fully activated by 300 µM diazoxide. MCC-134 added to the bath inhibited the diazoxide-induced SUR1/Kir6.2 channel currents in a concentration-dependent and reversible manner (Fig. 2A). In Fig. 2B, the SUR1/Kir6.2 channel current was induced by the addition of NaCN (2 mM) to the glucose-free bathing solution. MCC-134 also reversibly inhibited the NaCN-induced channel activity. We further examined the effects of nicorandil and pinacidil on the NaCN-induced SUR1/Kir6.2 channel currents. Neither 1 mM nicorandil nor 100 µM pinacidil inhibited the K+ current induced by NaCN in these cells (n = 3 for each drug; data not shown). Therefore, inhibition of the SUR1/Kir6.2 channel current seems to be specific to MCC-134. Figure 2C depicts the relationship between the concentration of MCC-134 and the relative SUR1/Kir6.2 channel activity. MCC-134 inhibited the channel currents induced by either 300 µM diazoxide or 2 mM NaCN in a similar concentration-dependent fashion at the concentrations of 3 to 100 µM (n = 5, for each).


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Fig. 2.   Inhibitory effects of MCC-134 on SUR1/Kir6.2 channel currents induced by 300 µM diazoxide (A) and 2 mM NaCN (B) measured in the whole-cell configuration. The extracellular K+ concentration was 5.4 mM, and the cells were held at -30 mV. The perfusion protocol is indicated above each trace. Arrowheads indicate the zero current level. C, inhibitory relationship between the concentration of MCC-134 and the relative channel activity of the SUR1/Kir6.2. The current amplitude induced by each concentration of MCC-134 was normalized to the 300 µM diazoxide (open circle )- or 2 mM NaCN ()-induced current in the same cells. Symbols and bars indicate the mean and S.E. values, respectively. The number of the observations at each point was five.

Effects of MCC-134 on KCO- or NaCN-Induced Currents of SUR2A/Kir6.2 and SUR2B/Kir6.2 Channels in Whole-Cell Configuration. We further examined the effects of MCC-134 on SUR2/Kir6.2 channels that had been activated by KCOs or NaCN recorded at -30 mV (Fig. 3). Because the SUR2A/Kir6.2 channel could not be activated by diazoxide, we used pinacidil for its activation (Fig. 3A, a). Pinacidil (30 µM, Fig. 3A, a) and NaCN (2 mM, Fig. 3A, b) added to the bath effectively activated the SUR2A/Kir6.2 channel. MCC-134 (100 µM) did not inhibit the pinacidil or NaCN-induced currents, whereas 3 µM glibenclamide completely inhibited the K+ currents. Similarly, MCC-134 did not inhibit the diazoxide- or NaCN-induced SUR2B/Kir6.2 channels current as shown in Fig. 3B, a and b.


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Fig. 3.   Effects of MCC-134 on the activated SUR2A/Kir6.2 (A) and SUR2B/Kir6.2 (B) channel currents measured in the whole-cell configuration. The extracellular K+ concentration was 5.4 mM, and the cells were held at -30 mV. The perfusion protocol is indicated above each trace. Arrowheads indicate the zero current level. Before the application of MCC-134, SUR2/Kir6.2 channels were activated by KCOs: 30 µM pinacidil (A, a) and 300 µM diazoxide (B, a). In A (b) and B (b), SUR2/Kir6.2 channels were preactivated by 2 mM NaCN. The number of the observations was three for A (a) and B (a) and five for A (b) and B (b), respectively.

    Discussion
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Abstract
Introduction
Materials and Methods
Results
Discussion
References

MCC-134 is a newly synthesized vasorelaxant agent (Seino et al., 1996). We found that this agent effectively activates the KATP channel with smooth muscle type of SUR (SUR2B/Kir6.2 channel) but inhibits the pancreatic type of KATP channel (SUR1/Kir6.2 channel). Therefore, this study clearly shows that a single compound can cause not only activation but also inhibition of SUR/Kir6.2 channel activity in a SUR subtype-dependent manner.

Because MCC-134 inhibited specifically the SUR1/Kir6.2 channel currents induced by either diazoxide or NaCN but did not inhibit the fully activated SUR2A or SUR2B/Kir6.2 channel currents, the inhibitory effect of this agent may be mediated through its action on SUR1 and not on the Kir6.2 pore. MCC-134 did not affect the NaCN-induced K+ currents of HEK 293T cells expressing the Kir6.2Delta C26 mutant alone, which show significant currents (Tucker et al., 1997; data not shown). This is consistent with current theories for the mechanism of KCO action, which suggest that the drugs interact primarily with the SURs and not the Kir subunit of the KATP channel (Hambrock et al., 1998; Schwanstecher et al., 1998). Because the inhibitory effect of MCC-134 on the SUR1/Kir6.2 channel was the same when tested against diazoxide-induced K+ currents and NaCN-induced K+ currents, the inhibitory effect may not be due to specific inhibition of the action of diazoxide. Therefore, MCC-134 seems to be directly affecting the function of SUR receptors and acts as an inverse agonist for the SUR1/Kir6.2 channel (Milligan et al., 1995), whereas it is a full agonist for the SUR2B/Kir6.2 channel and a partial agonist for the SUR2A/Kir6.2 channel. Previously, it was shown that diazoxide, which activates native pancreatic KATP channels, inhibits cardiac KATP channels (Faivre and Findlay, 1989), which indicates that diazoxide is an agonist for SUR1 but an inverse agonist for SUR2A.

This study also indicates the possibility of developing drugs whose profiles are optimal to treat patients with certain diseases. For example, because MCC-134 may possess hypoglycemic and vasodilatating actions, it may be useful to treat patients with noninsulin-dependent diabetes mellitus and hypertension. Because MCC-134 does not inhibit the cardiac type of KATP channel, it might also be beneficial for the treatment of patients with noninsulin-dependent diabetes mellitus by avoiding the cardiovascular complications associated with sulfonylurea derivatives (Cleveland et al., 1997; Garratt et al., 1999). Thus, MCC-134 may be a prototype of new drugs acting selectively on different types of KATP channels.

SUR2A and SUR2B are splice variants generated from the same gene, and they are both composed of 1546 amino acids differing only in the last 42 amino acid residues at their carboxyl-terminal ends (amino acids 1505-1546; Isomoto et al., 1996). It was recently shown that these 42 amino acid residues are important for determining the affinities of KCOs in binding to SUR2 subtypes (Schwanstecher et al., 1998). In the present study, half-activation of the whole-cell current by MCC-134 occurred at an ~10 µM concentration of the drug in both SUR2A/Kir6.2 and SUR2B/Kir6.2 channels, whereas the evoked maximum current of the SUR2A/Kir6.2 channel was ~20% of that of the SUR2B/Kir6.2 channel. Therefore, like the case of nicorandil (Shindo et al., 1998), it may be reasonable to suggest that the carboxyl-terminal regions of SUR2A and SUR2B may play a critical role in regulating the efficacy of MCC-134 to activate SUR2A/Kir6.2 and SUR2B/Kir6.2 channels.

We do not know whether the 42 amino acid residues of the carboxyl-terminal end of SUR1 are important for MCC-134 inhibition of the SUR1/Kir6.2 channel current. This region of SUR1 showed 74% identity with that of SUR2B but only 33% identity with that of SUR2A. Because MCC-134 activated both SUR2A/Kir6.2 and SUR2B/Kir6.2 channels, the carboxyl-terminal region may not be responsible for the inhibitory action of this agent. Further studies that include the construction and expression of various chimeras of SUR1 and SUR2s are needed to clarify the sites of interaction between MCC-134 and subtypes of SUR and the mechanisms by which these interactions regulate channel activity in positive as well as in negative ways.

In conclusion, MCC-134 may be useful to describe the molecular mechanism underlying the tissue specificity of various KCOs and regulatory mechanisms of KATP channels through distinct SURs. The specific properties of this agent also suggest that it may lead to the development of novel nonsulfonylurea-derivative hypoglycemic agents.

    Acknowledgments

We thank Dr. Ian Findlay (Tours, France) for critical reading of the manuscript. We also thank Mari Imanishi for technical assistance and Keiko Tsuji for secretarial support.

    Footnotes

Accepted for publication September 14, 1999.

Received for publication May 13, 1999.

1 This work was supported by the Research Grant for Cardiovascular Disease (IIC-I) from the Ministry of Health and Welfare; grants from the Ministry of Education, Science, Sports and Culture of Japan; the "Research for the Future" Program from The Japan Society for the Promotion of Science (JSPS-RFTF96L00302); and the Human Frontier Science Program (RG0158/1997-B).

Send reprint requests to: Dr. Yoshihisa Kurachi, Department of Pharmacology II, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. E-mail: ykurachi{at}pharma2.med.osaka-u.ac.jp

    Abbreviations

KATP channel, ATP-sensitive K+ channel; KNDP, NDP-sensitive K+ channel; KCO, K+ channel opener; HEK, human embryonic kidney; SUR, sulfonylurea receptor; Kir, inwardly rectifying K+ channel.

    References
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THE JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS
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