N Kraus-Friedmann

University of Texas Medical School, Houston, TX, USA

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Publications (30)89.49 Total impact

  • Article: Disruption of filamentous actin diminishes hormonally evoked Ca2+ responses in rat liver.
    N S Yamamoto, C J Merkle, N Kraus-Friedmann
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    ABSTRACT: Previous studies have suggested a role for the actin cytoskeleton in hormonally evoked Ca2+ signaling in the liver. Here, we present evidence supporting a connection between filamentous actin (F-actin) organization and the ability of vasopressin and glucagon to increase cytosolic free-Ca2+ ([Ca2+]i) levels. F-actin was disrupted in hepatic cells by perfusion of rat liver with cytochalasin D. Epifluorescence microscopy of subsequently isolated cells showed reduced cortical fluorescent phalloidin staining in cytochalasin D-treated liver cells. Cytochalasin D pretreatment of liver cells reduced the vasopressin-stimulated elevation of [Ca2+]i by 60% and of glucagon by 50%. Experiments performed on cytochalasin D-treated cells using Mn2+ as an indicator of Ca2+ influx quenched fura-2 fluorescence signals following vasopressin administration. This indicates that a structurally intact cortical F-actin web is not a prerequisite for the influx of calcium. Therefore, the attenuation of the increase in cytosolic calcium observed in cytochalasin D-treated liver cells was likely caused either by the depletion of the calcium store by treatment with cytochalasin D or by the need for an intact cytoskeletal structure for its release. Because the resting level of calcium did not change in cells exposed to cytochalasin D, the latter is likely. The reduced [Ca2+]i response may be the mechanism by which cytochalasin D pretreatment inhibits vasopressin-induced metabolic effects. Cytochalasin D pretreatment also decreased the ability of glucagon to stimulate gluconeogenesis and reduced the stimulation of O2 uptake usually observed following glucagon administration. In conclusion, these results suggest that the hormonal elevation of [Ca2+]i and resultant activation of specific metabolic pathways require normal F-actin organization.
    Metabolism 11/1999; 48(10):1241-7. · 2.66 Impact Factor
  • Article: Expression of photoreceptor cyclic nucleotide-gated cation channel alpha subunit (CNGCalpha) in the liver and skeletal muscle.
    L Feng, I Subbaraya, N Yamamoto, W Baehr, N Kraus-Friedmann
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    ABSTRACT: Glucagon and beta-adrenergic agents increase cAMP levels and stimulate Ca2+ influx in liver cells. There is no consensus as to the mechanism by which these hormones stimulate the influx of Ca2+. Using mouse retinal rod CNGCalpha cDNA probes, we cloned rat liver and skeletal muscle, and human hepatic CNGCalpha subunit sequences showing 97-100% identity with the human rod channel. In order to assess channel activity, the effect of cyclic nucleotides on free intracellular Ca2+ levels of isolated hepatocytes was measured. Dibutyryl-cAMP was more effective in increasing free Ca2+ levels than dibutyryl-cGMP. These data indicate that the CNGCalpha subunit is expressed in both the liver and skeletal muscle possibly mediating hormonal effects on ion fluxes.
    FEBS Letters 11/1996; 395(1):77-81. · 3.54 Impact Factor
  • Article: The role of intracellular Ca2+ in the regulation of gluconeogenesis.
    N Kraus-Friedmann, L Feng
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    ABSTRACT: A hypothesis for the hormonal regulation of gluconeogenesis, in which increases in cytosolic free-Ca2+ levels ([Ca2+]i) play a major role, is presented. This hypothesis is based on the observation that gluconeogenic hormones evoke a common pattern of Ca2+ redistribution, resulting in increases in [Ca2+]i. Current concepts of hormonally evoked Ca2+ fluxes are presented and discussed. It is suggested that the increase in [Ca2+]i is functionally linked to stimulation of gluconeogenesis. The stimulation of gluconeogenesis is accomplished in two ways: (1) by increasing the activities of the Krebs cycle and the electron-transfer chain, thereby supplying adenosine triphosphates (ATP) and reducing equivalents to the process; and (2) by stimulating the activities of key gluconeogenic enzymes, such as pyruvate carboxylase. The hypothesis presents a conceptual framework that ties together two interrelated manifestations of hormone action: signal transduction and metabolism.
    Metabolism 04/1996; 45(3):389-403. · 2.66 Impact Factor
  • Article: Hormonal regulation of cytosolic calcium levels in the liver.
    N Kraus-Friedmann
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    ABSTRACT: Regulation of free cytosolic Ca2+ level in the liver is important because of the many Ca2(+)-dependent processes in the liver, such as respiration, gluconeogenesis, glycogenolysis, cell division, etc. Free cytosolic Ca2+ levels are maintained in the unstimulated state below 1 microM. This level is maintained by an outwardly directed Ca2(+)-ATPase in the plasma membrane, sequestration into the endoplasmic reticulum by a Ca2(+)-ATPase, binding of Ca2+ to specific Ca2(+)-binding proteins, such as calmodulin, and membrane potential-driven uptake into the mitochondria. Upon stimulation by hormones which act by increasing cytosolic free Ca2+ levels, both Ca2+ influx and the release of stored Ca2+ from the endoplasmic reticulum contribute to the increases in cytosolic free Ca2+ levels. The exact mechanism(s) by which these events occur is being intensively studied and debated. Here, it is suggested that hormones activate through a second messenger 1) a ligand-gated Ca2+ channel present in the plasma membrane, and 2) a different Ca2+ channel present in the endoplasmic reticulum. As a result, cytosolic-free Ca2+ levels increase and Ca2(+)-dependent processes are activated. A role for the cytoskeleton in the activation of the ryanodine-binding channel is proposed. Future studies are needed to identify the molecular identity of the hepatic ryanodine receptor and to define the role of the cytoskeleton in signal transduction.
    Brazilian Journal of Medical and Biological Research 04/1995; 28(3):275-84. · 1.13 Impact Factor
  • Article: Reduction of ryanodine binding and cytosolic Ca2+ levels in liver by the immunosuppressant FK506.
    N Kraus-Friedmann, L Feng
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    ABSTRACT: The mechanism of action of the immunosuppressant FK506 in the liver was studied. The hypothesis was tested that FK506 exerts its effect in the liver by interacting with the ryanodine-binding Ca2+ release channel. Two types of experiments were carried out: (1) [3H]-ryanodine binding studies with isolated microsomal fractions, and (2) cytosolic-free Ca2+ ([Ca2+]i) measurements with the intracellular Ca(2+)-indicator fura-2. The inclusion of FK506 in the incubation medium significantly decreased the binding of [3H]-ryanodine to liver microsomes. The Bmax of binding in control experiments was 405 fmol/mg protein; the presence of FK506 decreased the Bmax to 157 fmol/mg protein. Measurements of [Ca2+]i in the presence and absence of FK506 showed a decrease in [Ca2+]i in the presence of FK506. The data support the notion that FK506 interacts with the ryanodine binding Ca2+ channel in the liver and suggest a critical role for the ryanodine-binding Ca2+ channel in the hepatic responses to FK506. The interaction between FKBP-12 (FK506 binding protein) and the ryanodine-binding Ca2+ channel may be an essential link in the chain of events by which FK506 alters Ca(2+)-dependent cellular processes.
    Biochemical Pharmacology 01/1995; 48(12):2157-62. · 4.70 Impact Factor
  • Article: Changes in 1,4,5-inositol trisphosphate binding following partial hepatectomy.
    L Feng, N Kraus-Friedmann
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    ABSTRACT: Hepatic parenchymal cells possess two receptors for 1,4,5-trisphosphate, one isolated with the plasma membrane fraction and another isolated with the nuclear fraction. Their interaction with antibodies generated against the receptor in the cerebellum indicates that these two receptor proteins are different. The potential involvement of the nuclear receptor in rapid cell proliferation was tested by measuring [3H]-IP3 binding, following partial hepatectomy. In nuclear fractions isolated 18 hours after the operation, a 33% decline in binding sites was detected. In nuclear fractions isolated 30 hours after the operation, a 60% decline in the binding sites was detected, but the Kd remained unchanged. A 70% decrease in binding sites was also detected in the plasma membrane fraction. These results show that partial hepatectomy is associated with a parallel loss of receptor sites in the nuclear and plasma membrane fractions.
    Biochemical and Biophysical Research Communications 12/1994; 205(1):291-7. · 2.48 Impact Factor
  • Article: Signal transduction and calcium: a suggested role for the cytoskeleton in inositol 1,4,5-trisphosphate action.
    N Kraus-Friedmann
    Cell Motility and the Cytoskeleton 02/1994; 28(4):279-84. · 4.19 Impact Factor
  • Article: Association of the hepatic IP3 receptor with the plasma membrane: relevance to mode of action.
    L Feng, N Kraus-Friedmann
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    ABSTRACT: Studies were carried out to characterize the interaction between inositol 1,4,5-trisphosphate (IP3) receptors and the plasma membrane fraction. Extraction of the membranes with the nonionic detergents Nonidet P-40 and Triton X-100, followed by centrifugation at 100,000 g, resulted in the doubling of the IP3 receptor in the pellets, whereas no detectable binding was found in the supernatants. These data indicate that the detergents did not solubilize the receptor, that it remained associated with membrane particles, and that it is likely to be associated with the cytoskeleton. The cytoskeleton proteins actin, ankyrin, and spectrin were identified in the plasma membrane fraction. However, comparison of the amount of these proteins in different fractions of the detergent, or otherwise treated plasma membrane fractions, showed no direct correlation between the presence of any of these proteins in the plasma membrane fraction and their ability to bind [3H]IP3. This is in contrast to the brain and T-lymphoma cells in which the IP3 receptor is attached to ankyrin (L. Y. W. Bourguigon, H. Jin, N. Iida, N. R. Brandt, and S. H. Zhang. J. Biol. Chem. 268: 6477-6486, 1993; and S. K. Joseph and S. Samanta. J. Biol. Chem 268: 6477-6486, 1993). Thus the hepatic IP3 receptor, which is different from the brain receptor, might attach to the cytoskeleton by anchoring to a different protein. Because cytochalasin D treatment of livers diminishes the ability of IP3 to raise cytosolic free Ca2+ levels, the attachment of the IP3 receptor to the cytoskeleton seems to involve an association with microfilaments.
    The American journal of physiology 01/1994; 265(6 Pt 1):C1588-96.
  • Article: Demonstration of ryanodine-induced metabolic effects in rat liver.
    B Pereira, L Feng, R Bazotte, L Hernandez, S Uribe, N Kraus-Friedmann
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    ABSTRACT: The effects of ryanodine, a plant alkaloid which alters Ca2+ sequestration in the liver, on O2 uptake and gluconeogenesis were measured. Ryanodine administration to perfused rat liver resulted in the stimulation of O2 uptake and of gluconeogenesis. Because ryanodine does not affect directly mitochondrial respiration, its stimulatory effect on O2 uptake in the whole cell is likely to be secondary to the increased cytosolic free Ca2+ levels.
    Biochemical Pharmacology 09/1992; 44(3):413-6. · 4.70 Impact Factor
  • Article: Different localization of inositol 1,4,5-trisphosphate and ryanodine binding sites in rat liver.
    L Feng, B Pereira, N Kraus-Friedmann
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    ABSTRACT: The distribution of inositol 1,4,5-trisphosphate and ryanodine binding sites between plasma membrane, microsomal, and mitochondrial fractions of rat liver were compared. IP3 bound mostly to the plasma membrane fraction (Kd = 6 nM; Bmax = 802 fmol/mg protein). Some IP3 binding sites were also present in the microsomal and mitochondrial fractions (Kd = 2.5 and 2.9 nM; Bmax = 35 and 23 fmol/mg protein respectively). The possibility that these binding sites are due to contamination of the fractions with plasma membrane cannot be excluded. Binding of IP3 to the plasma membrane was inhibited by heparin but not by either caffeine or tetracaine. High-affinity ryanodine binding sites were present mostly in the microsomal fraction (Kd = 13 nM; Bmax = 301 fmol/mg protein). Lower affinity binding sites were also found to be present in the mitochondrial and plasma membrane fractions. Binding of ryanodine to the microsomal fraction was inhibited by both caffeine and tetracaine but not by heparin. These data demonstrate that IP3 and ryanodine binding sites are present in different cellular compartments in the liver. These differences in the localization of the binding sites might be indicative of their functional differences.
    Cell Calcium 03/1992; 13(2):79-87. · 3.77 Impact Factor
  • Article: Effects of ryanodine on calcium sequestration in the rat liver.
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    ABSTRACT: Ryanodine, a highly toxic alkaloid known to react specifically with the Ca2+ release channels in sarcoplasmic reticulum (SR), was employed to study Ca2+ sequestration in the liver. Ryanodine at a 200 microM concentration increased cytosolic free Ca2+ levels and phosphorylase a activity in isolated hepatocytes. These effects may involve microsomal Ca2+ sequestration, because ryanodine, in the presence of inhibitors of mitochondrial Ca2+ uptake, at concentrations of 1 nM, 1 microM, 50 microM and 100 microM decreased 45Ca2+ retention in permeabilized hepatocytes. This inhibition of Ca2+ retention by ryanodine was not due to inhibition of the microsomal Ca(2+)-ATPase. Dantrolene, a compound shown previously to inhibit ryanodine binding in the liver, also decreased 45Ca2+ retention in permeabilized hepatocytes, and activated phosphorylase a. These results show that ryanodine administration alters calcium sequestration in liver. The possibility of the existence of a ryanodine-sensitive Ca(2+)-release channel in liver is discussed.
    Biochemical Pharmacology 11/1991; 42(9):1799-803. · 4.70 Impact Factor
  • Article: Characterization of high-affinity ryanodine-binding sites of rat liver endoplasmic reticulum. Differences between liver and skeletal muscle.
    V Shoshan-Barmatz, T A Pressley, S Higham, N Kraus-Friedmann
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    ABSTRACT: In this study, the binding of [3H]ryanodine to liver microsomal subfractions was investigated. The specific binding of [3H]ryanodine, as determined both by vacuum filtration and by ultracentrifugation, is to a single class of high-affinity binding sites with a Kd of 10 +/- 2.5 nM and density of 500 +/- 100 and 1200 +/- 200 fmol/mg of protein by the filtration and centrifugation methods respectively. [3H]Ryanodine binding reached equilibrium in about 1 min and 2 min at 36 degrees C and 24 degrees C respectively, and the half-time of dissociation at 37 degrees C was approx. 15 s. The binding of [3H]ryanodine is Ca(2+)-independent: it is slightly stimulated by NaCl, Mg2+, ATP and InsP3 but strongly inhibited by caffeine, diltiazem and sodium dantrolene. Thus the binding of ryanodine to endoplasmic reticulum membranes shares some of the characteristics of its binding to the sarcoplasmic reticulum but also differs from it in several important properties, such as its Ca(2+)-independence, its rapid association and dissociation, and its inhibition by caffeine. The structural similarities between the skeletal muscle and liver binding sites were further explored by employing in vitro DNA amplification techniques, using the known sequence of the skeletal muscle receptor as reference point. The data obtained with this method indicate that the liver does not process mRNA for the skeletal muscle ryanodine receptor.
    Biochemical Journal 06/1991; 276 ( Pt 1):41-6. · 4.90 Impact Factor
  • Article: Purification of the microsomal Ca2(+)-ATPase from rat liver.
    Y J Jong, A Sheldon, G H Zhang, N Kraus-Friedmann
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    ABSTRACT: The Ca2(+)-ATPase from rat liver microsomes has been solubilized in Triton X-100 and purified to homogeneity by ficoll-sucrose treatment, column chromatography with agarose-hexane adenosine 5'-triphosphate Type 2, and high pressure liquid chromatography (HPLC). The purified enzyme obtained by this sequential procedure exhibited a 183-fold increase in specific activity. After ficoll-sucrose treatment, the activity of the Ca2(+)-ATPase was stable for at least two weeks when stored at -70 degrees C. In SDS-polyacrylamide gels, several fractions from HPLC chromatography showed a single band at a position corresponding to a molecular weight of about 107 kDa. This value is consistent with the molecular weight of the phosphoenzyme intermediate of endoplasmic reticulum (ER) Ca2(+)-ATPase. Further characterization of the ER Ca2(+)-ATPase was performed by western immunoblots. Antiserum raised against the 100-kDa sarcoplasmic reticulum (SR) Ca2(+)-ATPase cross-reacted with the purified Ca2(+)-ATPase from rat liver ER membranes.
    Journal of Membrane Biology 11/1990; 118(1):49-53. · 1.81 Impact Factor
  • Article: Distinct ryanodine- and inositol 1,4,5-trisphosphate-binding sites in hepatic microsomes.
    V Shoshan-Barmatz, G H Zhang, L Garretson, N Kraus-Friedmann
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    ABSTRACT: A light hepatic microsomal preparation was fractionated by sucrose-density centrifugation into one rough, one intermediate and two smooth fractions. The four fractions were characterized with respect to parameters relevant to Ca2+ sequestration. Ca2(+)-ATPase activity was similar in the rough, intermediate and smooth I fractions, but lower in the smooth II fraction. Ca2+ accumulation was the highest in the smooth I and intermediate fractions. On the other hand, Ca2+ efflux from the rough fraction was several-fold faster than from the smooth I fraction. All four subfractions exhibited specific binding sites for inositol 1,4,5-trisphosphate (IP3) and ryanodine; however, the receptors were especially enriched in the smooth I fraction. The total binding sites for ryanodine in that fraction exceeded the number of binding sites for IP3 by about 10-fold. The two receptors responded differently to pharmacological agents; caffeine and dantrolene strongly inhibited ryanodine binding but not IP3 binding, whereas heparin inhibited IP3 binding only. Thus the two receptors are distinct entities. The four fractions also showed distinct gel electrophoretic patterns. The use of two different SDS/polyacrylamide-gel gradients and two protein-staining methods revealed major differences in the distribution of the bands corresponding to Mr values of (x 10(-3) 380, 320, 260, 170, 90, 29 and 21. These proteins were enriched in the smooth fraction. The results indicate that the smooth I fraction might have special importance in stimulus-evoked Ca2(+)-release processes.
    Biochemical Journal 07/1990; 268(3):699-705. · 4.90 Impact Factor
  • Article: Mechanism of action of GTP in the induction of Ca2+ release from hepatic microsomes.
    S Kimura, S Higham, B C Robison, N Kraus-Friedmann
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    ABSTRACT: The mechanism by which GTP induces Ca2+ release from Ca2(+)-preloaded rat hepatic microsomes was studied. In the same concentration range as that for Ca2+ release, GTP inhibited the initial rate of ATP-driven Ca2+ uptake. It also inhibited the formation by ATP of the phosphorylated intermediate of Ca2(+)-ATPase, which had previously been identified by us as a 97-116 kDa protein (Fleschner, C.R., et al. (1985) Biochem. J. 226, 839). Vanadate, an inhibitor of Ca2(+)-ATPase, also caused Ca2+ release in a similar fashion, but its effect was not additive to that of GTP. Although the non-metabolizable GTP analogues, GMPPNP and GTP gamma S, did not cause Ca2+ release by themselves, GTP gamma S completely and GMPPNP partially blocked the effect of GTP. Pretreatment of vesicles with either cholera or pertussis toxin did not alter the responsiveness to GTP. These results indicate that GTP inhibits microsomal Ca2(+)-ATPase, independently of the Gs and Gi proteins. Because a decrease in Ca2+ uptake results in a net increase in Ca+ release, this effect of GTP seems to account, at least partially, for the GTP-induced Ca2+ release from microsomes.
    Journal of Biochemistry 05/1990; 107(4):550-3. · 2.37 Impact Factor
  • Source
    Article: Effects of heavy metal on rat liver microsomal Ca2(+)-ATPase and Ca2+ sequestering. Relation to SH groups.
    G H Zhang, M Yamaguchi, S Kimura, S Higham, N Kraus-Friedmann
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    ABSTRACT: In isolated hepatic microsomal vesicles the heavy metals Cd2+, Cu2+, and Zn2+ inhibit Ca2+ uptake and evoke a prompt efflux of Ca2+ from preloaded vesicles in a dose-dependent manner. N-Ethylmaleimide also inhibits Ca2+ uptake and causes Ca2+ release, but it is less effective in these respects than the heavy metals. Measurement of mannose-6-phosphatase activity indicate that the heavy metal-induced Ca2+ efflux is not caused by a general increase in membrane permeability. Heavy metals also inhibit the Ca2(+)-ATPase activity and the formation of the phosphorylated intermediate of the enzyme. In contrast, the sulfhydryl modifying reagent, N-ethylmaleimide inhibits the Ca2(+)-ATPase activity while it has a relatively small effect on Ca2+ release. Thus, the effects of these agents on Ca2+ sequestering and Ca2(+)-ATPase activity are not strictly proportional. The sulfhydryl group reducing agent dithiothreitol protects the microsomes from the effects of heavy metals, while glutathione is less protective. Addition of vanadate to vesicles, at a concentration which completely blocked the activity of the Ca2(+)-ATPase, resulted in a small and slow release of the accumulated Ca2+. Subsequent additions of heavy metals evoked a massive Ca2+ release. Thus, the effects of heavy metals on Ca2+ efflux cannot be due entirely to their inhibition of the Ca2+ pump. The heavy metal-induced Ca2+ efflux is not inhibited either by ruthenium red or tetracaine.
    Journal of Biological Chemistry 03/1990; 265(4):2184-9. · 4.77 Impact Factor
  • Article: Hormonal stimulation of Ca2+ release from the perfused liver: effects of uncoupler.
    N Kraus-Friedmann, S Higham, C R Fleschner
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    ABSTRACT: Administration of vasopressin and glucagon evokes a transient release of Ca2+ from perfused livers. The Ca2+ is released from a pool that is depletable by the mitochondrial uncoupler carbonyl cyanide p-trifluoromethoxyphenylhydrazone (FCCP). Therefore, the mechanism of the FCCP-stimulated Ca2+ release was examined. The FCCP-stimulated Ca2+ release was associated with a decrease in ATP levels. In the presence of oligomycin, which blocked the FCCP-induced rapid ATP breakdown, FCCP did not release Ca2+ though it still stimulated respiration. The possibility that FCCP might indirectly cause a release of Ca2+ by lowering hepatic ATP was examined at two levels of organization: 1) in the whole organ, by perfusing livers with fructose, a compound that was shown previously to drastically lower ATP in the liver, and 2) in isolated microsomal vesicles by depleting ATP with glucose and hexokinase. Fructose evoked Ca2+ release from the perfused liver. Similarly, depletion of ATP by the addition of glucose and hexokinase evoked a rapid release of the accumulated Ca2+ from microsomal vesicles probably by the inhibition of the Ca2(+)-ATPase. These results demonstrate that the major mechanism by which FCCP releases Ca2+ in intact cells is by lowering ATP levels.
    The American journal of physiology 02/1990; 258(1 Pt 1):G73-7.
  • Article: Demonstration of adenylate-kinase activity in hepatic microsomes. Relevance to Ca2+ uptake.
    G H Zhang, N Kraus-Friedmann
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    ABSTRACT: It is demonstrated that the hepatic microsomal fraction contains significant adenylate-kinase activity. This explains a paradoxical ADP-stimulated Ca2+ uptake into microsomal vesicles which is inhibited when adenylate kinase is inhibited. The presence of adenylate kinase in the microsomal fraction helps to prevent sudden drops in ATP level, and thus has a stabilizing effect on the many ATP-dependent reactions carried out in this subcellular compartment.
    Biochemistry international 09/1989; 19(2):333-43.
  • Article: Inhibitor of anion transport, DIDS, releases Ca2+ from hepatic microsomes.
    S Kimura, B C Robison, N Kraus-Friedmann
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    ABSTRACT: Addition of 4,4'-diisothiocyanostilbene-2, 2'-disulfonic acid (DIDS) to Ca2+ loaded hepatic microsomal vesicles evoked a dose-dependent release of the accumulated Ca2+. Ca2+ uptake was also inhibited. The effects of DIDS do not seem to be due to the inhibitions of either Cl- or proton fluxes. The results indicate that DIDS inhibits Ca2+ uptake and releases Ca2+ by inhibiting the Ca2+-ATPase and the formation of the phosphorylated intermediate of the enzyme, and that it might interact with a specific site on the vesicle which is involved in the translocation of Ca2+ across the microsomal and mitochondrial membranes.
    Biochemical and Biophysical Research Communications 03/1988; 151(1):396-401. · 2.48 Impact Factor
  • Article: The hepatic microsomal Ca2+ sequestering system.
    N Kraus-Friedmann, C R Fleschner, P Zimniak, P Moore
    Advances in experimental medicine and biology 02/1988; 232:59-68. · 1.09 Impact Factor

Institutions

  • 1988–1992
    • University of Texas Medical School
      Houston, TX, USA
  • 1990–1991
    • Ben-Gurion University of the Negev
      Beersheba, Southern District, Israel
    • The University of Tokyo
      • Institute of Medical Science
      Tokyo, Tokyo-to, Japan
  • 1988–1989
    • University of Texas Health Science Center at Houston
      • Medical School
      Houston, TX, USA
  • 1981–1988
    • Baylor College of Medicine
      Houston, TX, USA