Ion Channels and Their Regulation in Vascular Smooth Muscle

*Arsalan U. Syed, Thanhmai Le, Manuel F. Navedo and Madeline Nieves-Cintrón*

### **Abstract**

Vascular smooth muscle excitability is exquisitely regulated by different ion channels that control membrane potential (Em) and the magnitude of intracellular calcium inside the cell to induce muscle relaxation or contraction, which significantly influences the microcirculation. Among them, various members of the K<sup>+</sup> channel family, voltage-gated Ca2+ channels, and transient receptor potential (TRP) channels are fundamental for control of vascular smooth muscle excitability. These ion channels exist in complex with numerous signaling molecules and binding partners that modulate their function and, in doing so, impact vascular smooth muscle excitability. In this book chapter, we will review our current understanding of some of these ion channels and binding partners in vascular smooth muscle and discuss how their regulation is critical for proper control of (micro)vascular function.

**Keywords:** ion channels, signal transduction, vascular tone, vascular smooth muscle, microcirculation

### **1. Introduction**

Vascular smooth muscle cells wrapping around small resistance arteries and arterioles are crucial for vascular reactivity [1]. These cells enable dynamic, moment-to-moment control of vessel diameter and pressure-induced contraction (e.g., vascular tone). This control is central to autoregulation of resistance vessels, maintenance of vessel caliber independently of changes in blood pressure, and proper perfusion to meet the metabolic demands of a given tissue.

To regulate arterial diameter, vascular smooth muscle receives and integrates many inputs, including changes in intraluminal pressure, vasoconstrictor and vasodilatory signals from endothelial cells lining the inner arterial wall, and nerve terminals innervating the vessels [2]. These inputs regulate vascular smooth muscle excitability, at least in part, by modulating the activity of a number of ion channels to control membrane potential (Em) and the magnitude of intracellular Ca2+ concentration ([Ca2+]i) [1]. Among the many ion channels, transient receptor potential (TRP) channels, voltage-gated (KV), Ca2+-activated (BKCa) and inward rectifier (Kir) K+ channels, and voltage-gated Ca2+ channels (VGCC) are fundamental in transducing mechanical force, establishing Em, and regulating [Ca2+]i [1]. Mechanisms for the regulation of vascular smooth muscle ion channels, including those mentioned above, involve agonist-independent and agonist-dependent activation of Gq and/or Gs protein-coupled receptors (GxPCR) [3]. The optimal

activation and regulation of these mechanisms are often dependent on the formation of macromolecular complexes driven by scaffold proteins to target and compartmentalize proteins/signaling events to specific regions and substrates [4].

In this chapter, we provide a brief overview of our current understanding of the role of different subunits of TRP channels, several K+ channel subtypes, as well as key VGCCs in control of vascular smooth muscle excitability and (micro)vascular function. We will also discuss their regulation by signaling pathways and macromolecular complexes. Note that many more studies than those cited here can be found in the scientific literature. Comprehensive studies exploring additional aspects of vascular ion channel regulation, vascular smooth muscle excitability, and (micro) vascular function in health and disease can be found in recent reviews [1, 5–9].

## **2. TRP channels**

The TRP channel superfamily is composed of 28 members divided into 6 subfamilies based on their molecular and biophysical properties [10]. Functional TRP channels are composed of four subunits, each with six membrane-spanning helices that can exist in a homomeric or heteromeric form. Vascular smooth muscle cells express a number of these channels, including members of the TRPC, TRPV, TRPM, and TRPP subfamilies [7, 9]. The function of TRP channels in vascular smooth muscle ranges from regulating contractility to modulating the proliferative state of the cells. In this section, we focused our discussion on the functional role and regulation of specific TRP channels in vascular smooth muscle excitability.

#### **2.1 Functional role of vascular smooth muscle TRP channels**

The function of different TRP channels in vascular smooth muscle has been unmasked using conventional and innovative molecular, pharmacological, and genetic approaches. These approaches revealed distinctive roles of specific TRP channel subfamilies in modulating vascular smooth muscle excitability and vascular reactivity. For instance, studies have found that TRPC3 channels are not essential for pressure-induced constriction. Yet, TRPC3 channels play a key role in receptormediated vasoconstriction of resistance arteries upon activation of various GqPCRs, including purinergic receptors, endothelin (ETA) receptors, and angiotensin II (AT1) receptors [7, 11, 12]. The mechanisms for TRPC3 channel activation involve direct coupling of the channel with IP3 receptors located in the sarcoplasmic reticulum (SR) in a process that does not require SR Ca2+ release [13]. TRPC5 channels, in association with TRPC1 channels, have been shown to contribute to store-operated Ca2+ entry in vascular smooth muscle from arterioles [14], which may modulate cell excitability. Expression of TRPP channels in vascular smooth muscle contributes to stretch-activated cation currents, which causes vascular smooth muscle membrane depolarization. The activity of these channels has been associated with stretchdependent regulation of vascular tone in cerebral arteries and control of systemic blood pressure [15, 16]. The nonselective cation channel TRPC6 is involved in Ca2+ mobilization leading to vascular smooth muscle contraction [17]. More recently, these channels have been shown to be part of a mechanosensation complex [18]. In this model (see **Figure 1**), stretch is "sensed" by AT1 receptors. These receptors then induce the activation of TRPC6 channels to bolster Ca2+ release from the SR, which triggers TRPM4 channel activity and vascular smooth muscle contraction. This model reveals an exquisite and finely orchestrated macromolecular complex for control of stretch-induced contraction.

**5**

**Figure 1.**

*described above. Na+*

*at the surface membrane to promote K<sup>+</sup>*

*C; DAG = diacylglycerol; IP3 = inositol trisphosphate.*

*Ion Channels and Their Regulation in Vascular Smooth Muscle*

Contrary to the contractile influences of the TRP channels described above, activation of TRPV4 channels is associated with vascular smooth muscle relaxation (**Figure 1**) [19]. The underlying mechanism involves the formation of a macromolecular complex between TRPV4 and BKCa channels in the plasma membrane and ryanodine receptors (RyR) in the SR. This complex does not depend on direct protein-protein interactions between TRPV4 and BKCa channels and RyR but requires their close physical proximity. The close association between these proteins facilitates Ca2+ influx via TRPV4 channels that stimulates RyR activity resulting in the generation of Ca2+ sparks. The ensuing Ca2+ sparks activate BKCa channels leading to vascular smooth muscle membrane potential hyperpolarization and relaxation [20]. Because of the high Ca2+ permeability of TRPV4 channels in vascular smooth muscle [21], they could potentially activate adjacent BKCa channels directly to regulate cell excitability and vascular reactivity. Examination of this exciting possibility is an excellent opportunity for further research. Moreover, additional work is needed to comprehensively define the role of TRP channels in vascular smooth muscle in the microcirculation during physiological and pathological conditions.

*Regulation of vascular smooth muscle excitability by TRP channels. Diverse TRP channels contribute to vascular smooth muscle relaxation or contraction. Ca2+ influx via TRPV4 channels is associated with an increase in the frequency of Ca2+ release through ryanodine receptors (RyR) located in the sarcoplasmic reticulum (e.g., Ca2+ sparks). The production of Ca2+ sparks triggers the activity of adjacent BKCa channels* 

*muscle relaxation [18]. TRPV4 channel activity can be stimulated by activation of AT1 receptors (AT1R) by angiotensin II (angII) via an AKAP5-mediated PKC signaling pathway [20, 25]. This AT1R/AKAP5/PKC/ TRPV4 axis may serve as a negative feedback mechanism to offset stimulation of L-type Ca2+ channel CaV1.2 (LTCCs) leading to contraction in response to angII. AT1R, independent of angII, has also been implicated in a mechanosensitive pathway that activates TRPC6 channels to boost cytosolic Ca2+ via stimulation of IP3 receptors (IP3R). This increase in cytosolic Ca2+ promotes the activity of TRPM4 channels leading to vascular smooth muscle membrane depolarization and subsequent contraction in response to stretch [17]. The orange wavelike lines highlight stretch-sensing proteins. The model was generated by taking in consideration studies cited and* 

 *efflux, membrane potential hyperpolarization, and vascular smooth* 

 *= sodium; Ca2+ = calcium; AKAP5 = A kinase anchoring protein 5; PKC = protein kinase* 

It has been well documented that agonist-dependent activation of GqPCRs/ protein kinase C (PKC) and GsPCRs/protein kinase A (PKA) signaling regulates TRP channels [10]. Protein kinase G (PKG) modulation of TRP channels has also been reported. However, how these signaling pathways control TRP channel activity in vascular smooth muscle, as well as the underlying consequences in vascular

**2.2 Regulation of TRP channels in vascular smooth muscle**

*DOI: http://dx.doi.org/10.5772/intechopen.88962*

*Ion Channels and Their Regulation in Vascular Smooth Muscle DOI: http://dx.doi.org/10.5772/intechopen.88962*

#### **Figure 1.**

*Basic and Clinical Understanding of Microcirculation*

**2. TRP channels**

role of different subunits of TRP channels, several K+

activation and regulation of these mechanisms are often dependent on the formation of macromolecular complexes driven by scaffold proteins to target and compartmentalize proteins/signaling events to specific regions and substrates [4].

key VGCCs in control of vascular smooth muscle excitability and (micro)vascular function. We will also discuss their regulation by signaling pathways and macromolecular complexes. Note that many more studies than those cited here can be found in the scientific literature. Comprehensive studies exploring additional aspects of vascular ion channel regulation, vascular smooth muscle excitability, and (micro) vascular function in health and disease can be found in recent reviews [1, 5–9].

The TRP channel superfamily is composed of 28 members divided into 6 subfamilies based on their molecular and biophysical properties [10]. Functional TRP channels are composed of four subunits, each with six membrane-spanning helices that can exist in a homomeric or heteromeric form. Vascular smooth muscle cells express a number of these channels, including members of the TRPC, TRPV, TRPM, and TRPP subfamilies [7, 9]. The function of TRP channels in vascular smooth muscle ranges from regulating contractility to modulating the proliferative state of the cells. In this section, we focused our discussion on the functional role and regulation of specific TRP channels in vascular smooth muscle excitability.

The function of different TRP channels in vascular smooth muscle has been unmasked using conventional and innovative molecular, pharmacological, and genetic approaches. These approaches revealed distinctive roles of specific TRP channel subfamilies in modulating vascular smooth muscle excitability and vascular reactivity. For instance, studies have found that TRPC3 channels are not essential for pressure-induced constriction. Yet, TRPC3 channels play a key role in receptormediated vasoconstriction of resistance arteries upon activation of various GqPCRs, including purinergic receptors, endothelin (ETA) receptors, and angiotensin II (AT1) receptors [7, 11, 12]. The mechanisms for TRPC3 channel activation involve direct coupling of the channel with IP3 receptors located in the sarcoplasmic reticulum (SR) in a process that does not require SR Ca2+ release [13]. TRPC5 channels, in association with TRPC1 channels, have been shown to contribute to store-operated Ca2+ entry in vascular smooth muscle from arterioles [14], which may modulate cell excitability. Expression of TRPP channels in vascular smooth muscle contributes to stretch-activated cation currents, which causes vascular smooth muscle membrane depolarization. The activity of these channels has been associated with stretchdependent regulation of vascular tone in cerebral arteries and control of systemic blood pressure [15, 16]. The nonselective cation channel TRPC6 is involved in Ca2+ mobilization leading to vascular smooth muscle contraction [17]. More recently, these channels have been shown to be part of a mechanosensation complex [18]. In this model (see **Figure 1**), stretch is "sensed" by AT1 receptors. These receptors then induce the activation of TRPC6 channels to bolster Ca2+ release from the SR, which triggers TRPM4 channel activity and vascular smooth muscle contraction. This model reveals an exquisite and finely orchestrated macromolecular complex for

**2.1 Functional role of vascular smooth muscle TRP channels**

In this chapter, we provide a brief overview of our current understanding of the

channel subtypes, as well as

**4**

control of stretch-induced contraction.

*Regulation of vascular smooth muscle excitability by TRP channels. Diverse TRP channels contribute to vascular smooth muscle relaxation or contraction. Ca2+ influx via TRPV4 channels is associated with an increase in the frequency of Ca2+ release through ryanodine receptors (RyR) located in the sarcoplasmic reticulum (e.g., Ca2+ sparks). The production of Ca2+ sparks triggers the activity of adjacent BKCa channels at the surface membrane to promote K<sup>+</sup> efflux, membrane potential hyperpolarization, and vascular smooth muscle relaxation [18]. TRPV4 channel activity can be stimulated by activation of AT1 receptors (AT1R) by angiotensin II (angII) via an AKAP5-mediated PKC signaling pathway [20, 25]. This AT1R/AKAP5/PKC/ TRPV4 axis may serve as a negative feedback mechanism to offset stimulation of L-type Ca2+ channel CaV1.2 (LTCCs) leading to contraction in response to angII. AT1R, independent of angII, has also been implicated in a mechanosensitive pathway that activates TRPC6 channels to boost cytosolic Ca2+ via stimulation of IP3 receptors (IP3R). This increase in cytosolic Ca2+ promotes the activity of TRPM4 channels leading to vascular smooth muscle membrane depolarization and subsequent contraction in response to stretch [17]. The orange wavelike lines highlight stretch-sensing proteins. The model was generated by taking in consideration studies cited and described above. Na+ = sodium; Ca2+ = calcium; AKAP5 = A kinase anchoring protein 5; PKC = protein kinase C; DAG = diacylglycerol; IP3 = inositol trisphosphate.*

Contrary to the contractile influences of the TRP channels described above, activation of TRPV4 channels is associated with vascular smooth muscle relaxation (**Figure 1**) [19]. The underlying mechanism involves the formation of a macromolecular complex between TRPV4 and BKCa channels in the plasma membrane and ryanodine receptors (RyR) in the SR. This complex does not depend on direct protein-protein interactions between TRPV4 and BKCa channels and RyR but requires their close physical proximity. The close association between these proteins facilitates Ca2+ influx via TRPV4 channels that stimulates RyR activity resulting in the generation of Ca2+ sparks. The ensuing Ca2+ sparks activate BKCa channels leading to vascular smooth muscle membrane potential hyperpolarization and relaxation [20]. Because of the high Ca2+ permeability of TRPV4 channels in vascular smooth muscle [21], they could potentially activate adjacent BKCa channels directly to regulate cell excitability and vascular reactivity. Examination of this exciting possibility is an excellent opportunity for further research. Moreover, additional work is needed to comprehensively define the role of TRP channels in vascular smooth muscle in the microcirculation during physiological and pathological conditions.

#### **2.2 Regulation of TRP channels in vascular smooth muscle**

It has been well documented that agonist-dependent activation of GqPCRs/ protein kinase C (PKC) and GsPCRs/protein kinase A (PKA) signaling regulates TRP channels [10]. Protein kinase G (PKG) modulation of TRP channels has also been reported. However, how these signaling pathways control TRP channel activity in vascular smooth muscle, as well as the underlying consequences in vascular

reactivity are not well understood. A limited number of studies have shown that PKG inhibits TRPC3 channels and that this may contribute to nitric oxide (NO) mediated relaxation, but the mechanisms require further examination [22]. PKA signaling stimulates the activity of several members of the TRPV channel subfamily while inhibiting TRPC5 and TRPC6 channels in vascular smooth muscle [7]. PKA-mediated inhibition of TRPC6 channels in response to agonist stimulation was shown to be dependent on phosphorylation of the TRPC6 subunit at threonine 69, which resulted in a reduction in angiotensin II (angII)-induced vasoconstriction [23], thus revealing a comprehensive mechanism for the regulation of TRP channels and the underlying effects in vascular reactivity.

PKC activity inhibits TRPC3 channels and activates TRPM4 and TRPV4 channels in smooth muscle [7, 9, 21, 24]. TRPM4 activation by PKC proceeds, at least in part, by stimulating channel trafficking and membrane translocation via a mechanism requiring PKCδ [25]. This PKCδ-dependent anterograde TRPM4 trafficking is functionally relevant as it promotes vascular smooth muscle contraction. PKC-dependent regulation of TRPV4 channels has been suggested to be critical for counteracting the vasoconstriction stimulated by angII [21]. Intriguingly, TRPV4 channels are found in complex with the scaffold A kinase anchoring protein 5 (AKAP5 = human AKAP79 and murine AKAP150) in vascular smooth muscle (**Figure 1**) [21, 26]. This scaffold protein provides a platform for targeting and compartmentalization of signaling molecules (e.g., PKA, PKC, protein phosphatase 2B = PP2B) to specific substrates (e.g., ion channels) [4]. With a suggested distance between them of ~200 nm [26], optimal AKAP5-anchored PKC modulation of TRPV4 activity is highly dependent on the distance between the targeted kinase and the ion channel. This tight regulation of TRPV4 activity by AKAP5 may be essential for vascular smooth muscle excitability given the high Ca2+ permeability of these channels, as mentioned previously. Mechanisms regulating TRPP channels by PKA and/or PKC in vascular smooth muscle are currently unclear. The studies discussed above reveal the complex functional role of TRP channels in vascular smooth muscle and how their regulation alters vascular function and highlights unique opportunities for further research. For instance, it will be important to define the role of the AKAP5/PKC/PKA complex and its association with other TRP channels in regulating vascular smooth muscle excitability and vascular reactivity. It also remains to be determined whether dynamic trafficking of other TRP channels and the involvement of the AKAP5/PKC/ PKA complex in this process also play a role in fine-tuning vascular reactivity.

#### **3. K+ channels**

The activity of K+ channels determines vascular smooth muscle membrane potential and is therefore key regulators of vascular tone [1]. By setting and controlling the membrane potential, these channels influence the levels of [Ca2+]i and therefore, vascular smooth muscle contraction. Intriguingly, a subset of K+ channels has also been linked to regulation of vascular smooth muscle proliferation (see recent review on this topic in [27, 28]). Vascular smooth muscle cells express a wide variety of isoforms from several classes of K+ channels, including KV, BKCa, and Kir channels (see **Figure 2**). In the following sections, we will describe the expression, function, and regulation of these K+ channels and their control of vascular function.

### **3.1 KV channels**

A number of KV channels isoforms are expressed in vascular smooth muscle, including members of the KV1 (KV1.1, KV1.2, KV1.3, KV1.5, KV1.6), KV2 (KV2.1), and

**7**

**Figure 2.**

*number of K<sup>+</sup>*

*vascular tone. K+*

*Ion Channels and Their Regulation in Vascular Smooth Muscle*

KV 7 (KV7.1–5), as well as several silent KV subunits (e.g., KV9.3) [1]. KV channels are formed by a homo- or heterotetrameric assembly of pore-forming α subunits and regulatory β subunits. Key examples with functional relevance in vascular smooth muscle excitability from multiple vascular beds are KV channels assembled by KV1.2/KV1.5 subunits, KV2.1 subunits with KV9.3, and KV1/KV7 subunits. These subunit compositions confer functional and pharmacological diversity essential for fine-tuning vascular smooth muscle excitability and vascular reactivity [29–31]. The mechanisms for this involve activation of KV channels by a depolarizing stimulus (e.g., stretch-induced depolarization) and their regulation by

*Regulation of vascular smooth muscle excitability by K***+** *channels. Vascular smooth muscle cells express a* 

*(ΔEm; denoted by dotted black lines) leading to a reduction in the open probability of LTCC CaV1.2 and TTCC CaV3.1 that results in a decrease in global [Ca2+]i leading to vascular smooth muscle relaxation [32, 95]. As* 

*vasoactive agents acting through the Gs/AC/PKA, NO/sGC/PKG, and Gq/PLC/PKC axes to either increase or decrease their activity. An example is the regulation of KV1.X channels by β adrenergic signaling (e.g., through β1 adrenergic receptors) [44–46]. Here, KV1.X channel regulation by β1 adrenergic signaling requires PKA targeting to the channel by postsynaptic density protein 95 (PSD95). Whether PSD95 as well as further* 

*KV7.X, Kir2.X) as well as RyR is unclear (denoted by dotted red lines in the cartoon). The model was generated* 

*kinase anchoring protein 5; BKCa = large-conductance Ca2+ activated potassium channels; AC = adenylyl cyclase; PKA = protein kinase A; NO = nitric oxide; sGC = soluble guanylyl cyclase; PKG = protein kinase G;* 

 *channel activation results in efflux of K+*

*scaffolding of proteins by AKAP5 is required for PKA regulation of KV1.X and other K<sup>+</sup>*

*mentioned in Figure 1, activation of ryanodine receptors (RyR) K<sup>+</sup>*

*by taking in consideration studies cited and described above. K+*

*PLC = phospholipase C; PKC = protein kinase C.*

 *channels that, upon activation, provide negative feedback regulation of membrane potential and* 

potential of vascular smooth muscle leading to a decrease in the open probability of voltage-gated L-type Ca2+ channels CaV1.2 (LTCCs), which contributes to decrease [Ca2+]i and relaxation (**Figure 2**). Conversely, their inhibition depolarizes the membrane potential, which will increase the open probability of LTCCs and lead to an increase in global [Ca2+]i and vascular smooth muscle contraction. This

control of vascular smooth muscle excitability and vascular reactivity. However, in the context of the microcirculation, not much is known regarding the expression, functional composition, physiological role, and regulation of KV channels in arteriolar vascular smooth muscle. Consideration of these issues is important as recent studies have implicated that impairment in KV channel expression and/or function in the development of channelopathies are associated with small vessel

efflux hyperpolarizes the membrane

 *ions that hyperpolarize the membrane potential* 

 *= potassium; Ca2+ = calcium; AKAP5 = A* 

 *channels can be distinctively regulated by* 

 *channels (e.g., KV2.X,* 

channels, is essential for fine

vasoactive agents [1, 32, 33]. The resultant K<sup>+</sup>

negative feedback regulation, together with other K<sup>+</sup>

*DOI: http://dx.doi.org/10.5772/intechopen.88962*

*Ion Channels and Their Regulation in Vascular Smooth Muscle DOI: http://dx.doi.org/10.5772/intechopen.88962*

#### **Figure 2.**

*Basic and Clinical Understanding of Microcirculation*

and the underlying effects in vascular reactivity.

reactivity are not well understood. A limited number of studies have shown that PKG inhibits TRPC3 channels and that this may contribute to nitric oxide (NO) mediated relaxation, but the mechanisms require further examination [22]. PKA signaling stimulates the activity of several members of the TRPV channel subfamily while inhibiting TRPC5 and TRPC6 channels in vascular smooth muscle [7]. PKA-mediated inhibition of TRPC6 channels in response to agonist stimulation was shown to be dependent on phosphorylation of the TRPC6 subunit at threonine 69, which resulted in a reduction in angiotensin II (angII)-induced vasoconstriction [23], thus revealing a comprehensive mechanism for the regulation of TRP channels

PKC activity inhibits TRPC3 channels and activates TRPM4 and TRPV4 channels in smooth muscle [7, 9, 21, 24]. TRPM4 activation by PKC proceeds, at least in part, by stimulating channel trafficking and membrane translocation via a mechanism requiring PKCδ [25]. This PKCδ-dependent anterograde TRPM4 trafficking is functionally relevant as it promotes vascular smooth muscle contraction. PKC-dependent regulation of TRPV4 channels has been suggested to be critical for counteracting the vasoconstriction stimulated by angII [21]. Intriguingly, TRPV4 channels are found in complex with the scaffold A kinase anchoring protein 5 (AKAP5 = human AKAP79 and murine AKAP150) in vascular smooth muscle (**Figure 1**) [21, 26]. This scaffold protein provides a platform for targeting and compartmentalization of signaling molecules (e.g., PKA, PKC, protein phosphatase 2B = PP2B) to specific substrates (e.g., ion channels) [4]. With a suggested distance between them of ~200 nm [26], optimal AKAP5-anchored PKC modulation of TRPV4 activity is highly dependent on the distance between the targeted kinase and the ion channel. This tight regulation of TRPV4 activity by AKAP5 may be essential for vascular smooth muscle excitability given the high Ca2+ permeability of these channels, as mentioned previously. Mechanisms regulating TRPP channels by PKA and/or PKC in vascular smooth muscle are currently unclear. The studies discussed above reveal the complex functional role of TRP channels in vascular smooth muscle and how their regulation alters vascular function and highlights unique opportunities for further research. For instance, it will be important to define the role of the AKAP5/PKC/PKA complex and its association with other TRP channels in regulating vascular smooth muscle excitability and vascular reactivity. It also remains to be determined whether dynamic trafficking of other TRP channels and the involvement of the AKAP5/PKC/ PKA complex in this process also play a role in fine-tuning vascular reactivity.

channels determines vascular smooth muscle membrane

channels and their control of vascular function.

channels, including KV, BKCa, and Kir channels

channels

potential and is therefore key regulators of vascular tone [1]. By setting and controlling the membrane potential, these channels influence the levels of [Ca2+]i and

has also been linked to regulation of vascular smooth muscle proliferation (see recent review on this topic in [27, 28]). Vascular smooth muscle cells express a wide variety

(see **Figure 2**). In the following sections, we will describe the expression, function,

A number of KV channels isoforms are expressed in vascular smooth muscle, including members of the KV1 (KV1.1, KV1.2, KV1.3, KV1.5, KV1.6), KV2 (KV2.1), and

therefore, vascular smooth muscle contraction. Intriguingly, a subset of K+

**6**

**3. K+**

 **channels**

The activity of K+

and regulation of these K+

**3.1 KV channels**

of isoforms from several classes of K+

*Regulation of vascular smooth muscle excitability by K***+** *channels. Vascular smooth muscle cells express a number of K<sup>+</sup> channels that, upon activation, provide negative feedback regulation of membrane potential and vascular tone. K+ channel activation results in efflux of K+ ions that hyperpolarize the membrane potential (ΔEm; denoted by dotted black lines) leading to a reduction in the open probability of LTCC CaV1.2 and TTCC CaV3.1 that results in a decrease in global [Ca2+]i leading to vascular smooth muscle relaxation [32, 95]. As mentioned in Figure 1, activation of ryanodine receptors (RyR) K<sup>+</sup> channels can be distinctively regulated by vasoactive agents acting through the Gs/AC/PKA, NO/sGC/PKG, and Gq/PLC/PKC axes to either increase or decrease their activity. An example is the regulation of KV1.X channels by β adrenergic signaling (e.g., through β1 adrenergic receptors) [44–46]. Here, KV1.X channel regulation by β1 adrenergic signaling requires PKA targeting to the channel by postsynaptic density protein 95 (PSD95). Whether PSD95 as well as further scaffolding of proteins by AKAP5 is required for PKA regulation of KV1.X and other K+ channels (e.g., KV2.X, KV7.X, Kir2.X) as well as RyR is unclear (denoted by dotted red lines in the cartoon). The model was generated by taking in consideration studies cited and described above. K+ = potassium; Ca2+ = calcium; AKAP5 = A kinase anchoring protein 5; BKCa = large-conductance Ca2+ activated potassium channels; AC = adenylyl cyclase; PKA = protein kinase A; NO = nitric oxide; sGC = soluble guanylyl cyclase; PKG = protein kinase G; PLC = phospholipase C; PKC = protein kinase C.*

KV 7 (KV7.1–5), as well as several silent KV subunits (e.g., KV9.3) [1]. KV channels are formed by a homo- or heterotetrameric assembly of pore-forming α subunits and regulatory β subunits. Key examples with functional relevance in vascular smooth muscle excitability from multiple vascular beds are KV channels assembled by KV1.2/KV1.5 subunits, KV2.1 subunits with KV9.3, and KV1/KV7 subunits. These subunit compositions confer functional and pharmacological diversity essential for fine-tuning vascular smooth muscle excitability and vascular reactivity [29–31]. The mechanisms for this involve activation of KV channels by a depolarizing stimulus (e.g., stretch-induced depolarization) and their regulation by vasoactive agents [1, 32, 33]. The resultant K<sup>+</sup> efflux hyperpolarizes the membrane potential of vascular smooth muscle leading to a decrease in the open probability of voltage-gated L-type Ca2+ channels CaV1.2 (LTCCs), which contributes to decrease [Ca2+]i and relaxation (**Figure 2**). Conversely, their inhibition depolarizes the membrane potential, which will increase the open probability of LTCCs and lead to an increase in global [Ca2+]i and vascular smooth muscle contraction. This negative feedback regulation, together with other K<sup>+</sup> channels, is essential for fine control of vascular smooth muscle excitability and vascular reactivity. However, in the context of the microcirculation, not much is known regarding the expression, functional composition, physiological role, and regulation of KV channels in arteriolar vascular smooth muscle. Consideration of these issues is important as recent studies have implicated that impairment in KV channel expression and/or function in the development of channelopathies are associated with small vessel

diseases [34]. Moreover, additional pathologies such as hypertension, metabolic disorders, and diabetic hyperglycemia impair (micro)vascular function, at least in part, by altering the expression/function of KV channels, but mechanisms remain not fully understood (see review in [5]).

Many vasoactive agents modulate vascular function by acting on KV channels expressed in vascular smooth muscle. For instance, agents that trigger activation of GqPCRs, such as angII, phenylephrine, and endothelin 1, are known to stimulate vasoconstriction, at least in part, by decreasing the expression and/or function of KV channels, particularly those of the KV1, KV2, and KV7 subfamilies (**Figure 2**) [1, 35–37]. The effects of these vasoconstrictors are related to PKC-mediated phosphorylation and/or changes in surface expression of KV subunits [36, 38–40], perhaps via engagement of different PKC isoforms [41]. This may contribute to selective control of KV channel activity in response to different stimuli. In addition, increases in [Ca2+]i have also been associated with inhibition of KV channels [42, 43]. Considering that activation of GqPCRs also increases [Ca2+]i, these data suggest that both PKC activity and elevated [Ca2+]i could synergize to exacerbate KV channel inhibition, which will result in membrane potential depolarization, activation of LTCCs, and vascular smooth muscle contraction.

In stark contrast to Gq signaling, activation of NO/PKG and Gs/PKA signaling is typically associated with stimulation of vascular KV channels, including the members of the KV1 and KV7 subfamilies [1]. The functional consequence of this regulation is vascular smooth muscle relaxation. Phosphorylation of KV channels by PKA is opposed by protein phosphatases such as PP2B, which will dephosphorylate the different subunits [44]. Whether GsPCR/PKA/PP2B regulation of KV channels requires scaffolding proteins that could target all components of the signaling complex within close proximity to the channels is not well understood. A recent series of studies have demonstrated that the scaffold protein postsynaptic density 95 (PSD95), which was thought to be a neuronal-specific protein, is expressed in vascular smooth muscle (**Figure 2**) [45, 46]. Intriguingly, PSD95 was found to be necessary for basal- and isoproterenol-induced PKA-mediated activation of KV1.X channels that resulted in vascular smooth muscle relaxation [45–47]. This was due to the formation of a distinctive PSD95-mediated signaling complex involving the β1-adrenergic receptor (β1 AR)-, PKA-, and KV1.2-containing channels [45, 47]. Since PSD95 is associated with AKAP5 in neurons [48], the argument was made that the PSD95-AKAP5 complex may be essential for PKA targeting and regulation of KV1.2 function and that this will have an impact on vascular smooth muscle excitability and vascular reactivity [47]. However, additional studies have found that K<sup>+</sup> currents produced by KV1.X and KV2.X subunits and BKCa channels are of similar magnitude in wild-type and AKAP5-depleted (AKAP5<sup>−</sup>/<sup>−</sup>) vascular smooth muscle cells [5, 49, 50]. These results suggest that, at least basally, AKAP5 is not necessary, and PSD95 may be sufficient for PKA-dependent regulation of K+ channels in these cells. β-Adrenergic stimulation has also been found to regulate KV7 channels leading to vasorelaxation [51], but whether a scaffold protein is mediating these effects is unknown and thus requires further examination. In addition, it is also unclear how KV2-containing channels, which contribute about 70% of the KV current in mouse cerebral and mesenteric vascular smooth muscle [49], are regulated by PKA signaling, presenting another area of further research.

### **3.2 BKCa channels**

BKCa channels are abundantly expressed in vascular smooth muscle cells [52]. The pore-forming α subunit (BKCa α1.1) assembles into tetramers to form a functional channel, but unlike TRP and KV subunits, it contains seven transmembrane

**9**

**3.3 Kir channels**

observed at a potential negative to the K+

*Ion Channels and Their Regulation in Vascular Smooth Muscle*

Regardless, the activation of these channels should result in K<sup>+</sup>

domains and a heavily regulated long carboxyl terminal. Further regulation of BKCa channel function is conferred by the association of the α subunit with accessory β1 and LRRC26 γ subunits, which increases the Ca2+ sensitivity of the channel [52]. BKCa channels are sensitive to voltage and Ca2+. The Ca2+ source to activate BKCa channels comes from the release of Ca2+ from the SR via RyRs (**Figure 2**) [20]. This complex does not depend on direct protein-protein interactions between BKCa channels and RyR but requires that both of these ion channels are in close physical proximity to each other. As mentioned above, data also have suggested that TRPV4 is responsible for triggering RyR activity [19], and thus, these channels have been proposed to form part of the same signaling complex with BKCa and RyRs in vascular smooth muscle. Intriguingly, LTCCs have been found to have an indirect or "loose" coupling with RyRs that could enable their activation [53], perhaps by modulating the SR Ca2+ concentration [54]. Additional components of the same or similar signaling complexes (see T-type Ca2+ channels section) with divergent roles have been identified [1, 7, 13, 55], but an integrated model remains to be defined.

larizes the plasma membrane of vascular smooth muscle cells leading to relaxation. The physiological influence of BKCa channels in control of membrane potential and vascular tone, however, seems to be species-, stimulus-, and vessel-dependent, even when compared between different orders of the same vascular tree. Indeed, studies have reported a clear involvement of BKCa channels in tonic negative feedback regulation of membrane potential and pressure-induced constriction, even in human resistance arteries, whereas others have failed to establish a relationship (exemplary studies in [56–62]). The differences may be associated with disparities in the BKCa channel's Ca2+ sensitivity and/or subunit expression levels and composition in the different vascular beds. A recent and broader discussion on this topic can be found in [1]. Thus, given the distinctive role of BKCa channels in the vasculature, further research on how these channels are regulated to control vascular tone in different vascular beds during physiological and pathological conditions is warranted. Generally, vasoactive agents that act via activation of the Gs/adenylyl cyclase (AC)/PKA and NO/soluble guanylyl cyclase (sGC)/PKG axes potentiate BKCa channel activity, whereas those acting through the Gq/phospholipase C (PLC)/PKC axis inhibit the channel [1, 52]. Vasoactive agents may also regulate BKCa channel activity indirectly by modulating the function of RyR in the SR or other ion channels (e.g., L-type CaV1.2 and T-type CaV3.2 channels) in the plasma membrane that are involved with direct activation of RyR or SR Ca2+ refilling [54, 63, 64]. Although there is some evidence that scaffold proteins such as AKAP5 may help target signaling molecules to BKCa channels [65], whether this indeed occurs in native vascular smooth muscle cells, as well as its functional relevance, is unclear. Considering the role of BKCa channels in negative feedback regulation of vascular tone, the physiological implications of vasoactive agents acting through distinct GxPCRs on BKCa

channels will be either vascular smooth muscle relaxation or contraction.

As their name implies, Kir channels produce an inward current. This current is

the resting Em [1, 66]. They also produce a small outward current at depolarizing potentials that serves as an electrical amplifier to magnify hyperpolarization. Inward rectification occurs due to voltage-dependent blockade of the channel by polyamines and Mg2+. Kir channels are regulated by lipids (e.g., phosphatidylinositol 4,5 bisphosphate (PIP2) and cholesterol) [1, 66]. Intriguingly, a recent study found that cholesterol, but not PIP2, regulates Kir channel activity in the cerebral

equilibrium potential that helps stabilize

efflux that hyperpo-

*DOI: http://dx.doi.org/10.5772/intechopen.88962*

*Basic and Clinical Understanding of Microcirculation*

not fully understood (see review in [5]).

of LTCCs, and vascular smooth muscle contraction.

and PSD95 may be sufficient for PKA-dependent regulation of K<sup>+</sup>

ing, presenting another area of further research.

cells. β-Adrenergic stimulation has also been found to regulate KV7 channels leading to vasorelaxation [51], but whether a scaffold protein is mediating these effects is unknown and thus requires further examination. In addition, it is also unclear how KV2-containing channels, which contribute about 70% of the KV current in mouse cerebral and mesenteric vascular smooth muscle [49], are regulated by PKA signal-

BKCa channels are abundantly expressed in vascular smooth muscle cells [52]. The pore-forming α subunit (BKCa α1.1) assembles into tetramers to form a functional channel, but unlike TRP and KV subunits, it contains seven transmembrane

channels in these

diseases [34]. Moreover, additional pathologies such as hypertension, metabolic disorders, and diabetic hyperglycemia impair (micro)vascular function, at least in part, by altering the expression/function of KV channels, but mechanisms remain

Many vasoactive agents modulate vascular function by acting on KV channels expressed in vascular smooth muscle. For instance, agents that trigger activation of GqPCRs, such as angII, phenylephrine, and endothelin 1, are known to stimulate vasoconstriction, at least in part, by decreasing the expression and/or function of KV channels, particularly those of the KV1, KV2, and KV7 subfamilies (**Figure 2**) [1, 35–37]. The effects of these vasoconstrictors are related to PKC-mediated phosphorylation and/or changes in surface expression of KV subunits [36, 38–40], perhaps via engagement of different PKC isoforms [41]. This may contribute to selective control of KV channel activity in response to different stimuli. In addition, increases in [Ca2+]i have also been associated with inhibition of KV channels [42, 43]. Considering that activation of GqPCRs also increases [Ca2+]i, these data suggest that both PKC activity and elevated [Ca2+]i could synergize to exacerbate KV channel inhibition, which will result in membrane potential depolarization, activation

In stark contrast to Gq signaling, activation of NO/PKG and Gs/PKA signaling is typically associated with stimulation of vascular KV channels, including the members of the KV1 and KV7 subfamilies [1]. The functional consequence of this regulation is vascular smooth muscle relaxation. Phosphorylation of KV channels by PKA is opposed by protein phosphatases such as PP2B, which will dephosphorylate the different subunits [44]. Whether GsPCR/PKA/PP2B regulation of KV channels requires scaffolding proteins that could target all components of the signaling complex within close proximity to the channels is not well understood. A recent series of studies have demonstrated that the scaffold protein postsynaptic density 95 (PSD95), which was thought to be a neuronal-specific protein, is expressed in vascular smooth muscle (**Figure 2**) [45, 46]. Intriguingly, PSD95 was found to be necessary for basal- and isoproterenol-induced PKA-mediated activation of KV1.X channels that resulted in vascular smooth muscle relaxation [45–47]. This was due to the formation of a distinctive PSD95-mediated signaling complex involving the β1-adrenergic receptor (β1 AR)-, PKA-, and KV1.2-containing channels [45, 47]. Since PSD95 is associated with AKAP5 in neurons [48], the argument was made that the PSD95-AKAP5 complex may be essential for PKA targeting and regulation of KV1.2 function and that this will have an impact on vascular smooth muscle excitability and vascular reactivity [47]. However, additional studies have found that K<sup>+</sup> currents produced by KV1.X and KV2.X subunits and BKCa channels are of similar magnitude in wild-type and AKAP5-depleted (AKAP5<sup>−</sup>/<sup>−</sup>) vascular smooth muscle cells [5, 49, 50]. These results suggest that, at least basally, AKAP5 is not necessary,

**8**

**3.2 BKCa channels**

domains and a heavily regulated long carboxyl terminal. Further regulation of BKCa channel function is conferred by the association of the α subunit with accessory β1 and LRRC26 γ subunits, which increases the Ca2+ sensitivity of the channel [52]. BKCa channels are sensitive to voltage and Ca2+. The Ca2+ source to activate BKCa channels comes from the release of Ca2+ from the SR via RyRs (**Figure 2**) [20]. This complex does not depend on direct protein-protein interactions between BKCa channels and RyR but requires that both of these ion channels are in close physical proximity to each other. As mentioned above, data also have suggested that TRPV4 is responsible for triggering RyR activity [19], and thus, these channels have been proposed to form part of the same signaling complex with BKCa and RyRs in vascular smooth muscle. Intriguingly, LTCCs have been found to have an indirect or "loose" coupling with RyRs that could enable their activation [53], perhaps by modulating the SR Ca2+ concentration [54]. Additional components of the same or similar signaling complexes (see T-type Ca2+ channels section) with divergent roles have been identified [1, 7, 13, 55], but an integrated model remains to be defined. Regardless, the activation of these channels should result in K<sup>+</sup> efflux that hyperpolarizes the plasma membrane of vascular smooth muscle cells leading to relaxation. The physiological influence of BKCa channels in control of membrane potential and vascular tone, however, seems to be species-, stimulus-, and vessel-dependent, even when compared between different orders of the same vascular tree. Indeed, studies have reported a clear involvement of BKCa channels in tonic negative feedback regulation of membrane potential and pressure-induced constriction, even in human resistance arteries, whereas others have failed to establish a relationship (exemplary studies in [56–62]). The differences may be associated with disparities in the BKCa channel's Ca2+ sensitivity and/or subunit expression levels and composition in the different vascular beds. A recent and broader discussion on this topic can be found in [1]. Thus, given the distinctive role of BKCa channels in the vasculature, further research on how these channels are regulated to control vascular tone in different vascular beds during physiological and pathological conditions is warranted.

Generally, vasoactive agents that act via activation of the Gs/adenylyl cyclase (AC)/PKA and NO/soluble guanylyl cyclase (sGC)/PKG axes potentiate BKCa channel activity, whereas those acting through the Gq/phospholipase C (PLC)/PKC axis inhibit the channel [1, 52]. Vasoactive agents may also regulate BKCa channel activity indirectly by modulating the function of RyR in the SR or other ion channels (e.g., L-type CaV1.2 and T-type CaV3.2 channels) in the plasma membrane that are involved with direct activation of RyR or SR Ca2+ refilling [54, 63, 64]. Although there is some evidence that scaffold proteins such as AKAP5 may help target signaling molecules to BKCa channels [65], whether this indeed occurs in native vascular smooth muscle cells, as well as its functional relevance, is unclear. Considering the role of BKCa channels in negative feedback regulation of vascular tone, the physiological implications of vasoactive agents acting through distinct GxPCRs on BKCa channels will be either vascular smooth muscle relaxation or contraction.
