New insights from cardiac muscle applied to skeletal muscle

I have recently described the origin of the second Ca2+ binding in the triggering of contractile activity in cardiac myo ibrils that is the origin of the Ca2+ Hill coef icient of 2 for the ATPase. This site is not a simple protein binding site and cannot be measured by 45Ca2+ binding. The myo ibril protein unit requirements are described by me and so are the consequences of disruption of the function of these units and the related medical outcomes. The purpose of this paper is to review the topic and extend the reasoning to the function of skeletal muscle and cite the literature that supports this.


Introduction
I have recently described the origin of the second Ca 2+ binding in the triggering of contractile activity in cardiac myo ibrils that is the origin of the Ca 2+ Hill coef icient of 2 for the ATPase. This site is not a simple protein binding site and cannot be measured by 45 Ca 2+ binding. The myo ibril protein unit requirements are described by me and so are the consequences of disruption of the function of these units and the related medical outcomes. The purpose of this paper is to review the topic and extend the reasoning to the function of skeletal muscle and cite the literature that supports this.

Summary
In muscle activation Ca 2+ binds to the activating subunit troponin-C (TnC) which changes its interaction with another subunit troponin-I (TnI) which changes the interaction of this with yet another subunit tropomyosin (Tm). The consequence of this complex activity is the unblocking of interaction of the myosin light chain (LC), ATP bound, with the actin chain allowing the formation of a cross-bridge between the thick and thin ilaments and the resulting ATPase activity giving muscle contraction and/or force. The cycle is completed by replacement of the ATPase products (ADP and phosphate Pi) by the binding of MgATP to the myosin light chain. This is the story accepted to date in all striated muscle systems. However in the cardiac system I irst suggested in 2001 [1] that this was not all embracing and mooted that a further Ca 2+ binding was required to satisfy the observed cooperativity (raised Hill coef icient for Ca 2+ activation > 1). This I have recently revisited [2] to show the implication of yet another myo ibril subunit in the Ca 2+ activation of myocyte contraction, i.e. the myosin binding protein-C (MyBP-C) [2][3][4] and applied this to the cardiac system [5], and thus demonstrating the origin of many cardiomyopathies, particularly hypertropy [5]. The key to these results is that the MgATP bound myosin is the fully relaxed state, it is not used in the functioning of the cross-bridge and in the unperturbed system the presence of intact cMyBP-C ensures this. There are many references to the cMyBP-C acting to modulate the Ca 2+ sensitivity of the cardiac muscle but absolutely none give clear mechanistic explanation of how this occurs. My recent papers show that along with the cTnI the cMyBP-C ensure the Myosin bound MgATP has to become myosin bound CaATP before the cross-bridge can form. In the heart this binding of Ca 2+ requires a concentration [Ca 2+ ] well above that required by the TnC binding and is also inhibited competitively by Mg 2+ . Any failure of this concerted action of the subunits, cTnI and cMyBP-C, results in the binding of Ca 2+ by cTnC becoming the sole requirement for activation of contraction, this produces some contraction at much lower [Ca 2+ ] and hence incomplete relaxation in diastole. The result of incomplete relaxation in diastole is chronic tension that is transmitted to another myo ibril component, the giant protein titin, this tension acts at the spring region of the titin releasing a myocyte growth factor the result of which is unwanted growth, i.e. hypertrophy.
For considering extending the above indings to skeletal myo ibrils the key lead in citations involve those that deplete the sarcomere of subunits by the use of EDTA to remove all bound divalent cations from their structural binding sites. This also includes the substitution with differently resourced units or retention of speci ic proteins [6,7]. I initially lay the ground by giving a comprehensive review of the three subunits intimately involved.

Background
In this study I concentrate on three proteins that are essential components of the Ca 2+ stimulated control of muscle contraction. The proteins are the Ca 2+ binding activating unit Troponin-C (TnC), the inbibitory unit Troponin-I (TnI) and myosin binding protein-C (MyBP-C), table 1. These all show isoforms speci ic to adult muscle type, fast and slow skeletal and cardiac. The gene name and number for TnI and MyBP-C are in agreement, three genetic versions slow skeletal, fast skeletal and cardiac but only two, fast skeletal and slow/ cardiac for TnC.

The notable diff erences between these protein isoforms
TnI comparisons: The most obvious difference are between the cardiac and the other (skeletal) versions. The cardiac has an extended N terminal sequence that folds and binds to the inhibitory region (residues 137-148) Figure 1.
Layland, et al. [9] report "binding of Ca 2+ to cTnC during systole induces conformational changes that relieve the inhibitory in luence of cardiac cTnI". More correctly put this should read "binding of Ca 2+ to troponin C and myosin ATP…." Phosphorylation of cTnI alters its function, in particular the threonine of the cardiac version (residue 142 or 3 or 4 depending on the reference used) which undergoes phosphorylation by PKC-βII under diastolic stretch, the Frank-Starling law [3,4,10], all the TnIs also get serine phosphorylated in various places altering function.

Mutations of TnI
To date, no human disease has been reported with mutations in ssTnI [11]. However mutations in the fsTnI gene have been found to cause myopathy and distal arthrogryposis (DA). A missense mutation R174Q, a nonsense mutation (premature stop codon R156X), and three in-frame deletion mutations ΔE167, ΔK175 and ΔK176 have been reported in DA patients [12]. The mutations associated with DA are all in the C-terminal actin-tropomyosin binding domain. Many mutations of cTnI have been found to cause hyper, restrictive, and dilated myopathies [5,13,14].

MyBP-C comparisons
The name, now changed from protein-C to myosin binding protein-C arises from the irst indings that it binds to the S2 region of myosin, Figure 2. The last realised unit of the sarcomere can only now be recognised as important as TnC in triggering of contraction, if not more so. It is unfortunate that the binding to actin has been so overlooked in many studies. The FHL-1 gene binding couple with the titin binding is probably re lected in myo ibril growth, hypertrophy, as is the FHOD-3 binding.

TnC comparisons
A comprehensive review by Katrukha [8] has many leading references within ( Figure 3). All TnC forms have four Ca 2+ -binding EF-hands that are combined pairwise into the N-terminal (sites I and II) and C-terminal (sites III and IV) globular domains. In the fast skeletal isoform of TnC, all four EF-hands are able to bind Ca 2+ or Mg 2+ . Only the N-terminal domain EF-hands I and II have a lower af inity but high selectivity for Ca 2+ and both play a crucial role in the regulation   A few amino acid substitutions in the irst EF-hand of the c/ssTnC isoform (site I) impede the ion binding so that c/ssTnC has only three Ca 2+ -binding sites, only one active in contraction stimulation.
The activation binding of Ca 2+ to the two types of TnC is well de ined by Lee [17] and has been resolved for some time [18][19][20]. In the heart the single activating Ca 2+ binding site in cTnC gives rise to a Ca 2+ Hill coef icient of 2 when measured carefully on the completely intact system. This cooperativity of a second site with the single TnC site II is explained as arising from an exchange of Mg 2+ for Ca 2+ on the myosin light chain controlled by cMyBP-C [1][2][3][4]. For the fast skeletal muscle the situation is more muddled as the Hill coef icient, especially when measuring tension can be much higher than the value of 3 that is anticipated if the two fsTnC sites work with the fsMyBP-C in the same way as cardiac [21].

The sarcolema complex
Scheme 1, the cross-bridge cycle The ATPase protein complex consists of MyBP-C which through its N-terminus (S1S2) binds both thick ilament (Myosin) and thin ilament (Actin). Creatine Kinase is bound to the MyBP-C. The MyBP-C S1S2 fragment when added binds to the actin and myosin, scheme 1, in the same way as the whole in the spaces between the MyBP-C units. The fragment does not have the MgATP inhibitory function of the whole and bypasses the Ca 2+ swap for Mg 2+ as does the MyBP-C removal, this cation swap obeys normal competitive binding. The ilaments are associated along length with the giant protein Titin which is structural and reacts to chronic stress with the release of sarcolemal growth factors.

Results and discussion
In the light of my previous studies on the cardiac system [1][2][3][4][5], in particular the effect of removal of cTnC, Figure 4 [7], my start point was the same treatment given earlier to skeletal muscle by Brandt, et al. [6]. The data quoted are nearly all presented as fractional tension v pCa charts the shifts and slope changes of which are informative of what is happening.

The extraction of cTnC
First I quote from Hofmann the results obtained with the cardiac system, Figure 4 (and later Figures 8 and 9 for comparison with their other data), I follow with the addition of an N-terminal fragment of MyBP-C to cardiac myo ibrils, Figure 5, to introduce the MyBP-C extraction problem with other data and The Brandt data giving igure 6.

The addition of the N-terminal fragment of MyBP-C, C1mC2, to cardiac myofi laments
The addition of the N-terminal fragments of MyBP-C, Figure 5 [22] to the cardiac myo ibrils changes the response of the system activation to the level of [Ca 2+ ] de ining the importance of MyBP-C in the control mechanism. The Actin ilament carries the troponin complex, TnC troponin-C (the Ca 2+ binding activation), TnI (the inhibitory unit)whose inhibitory function is relieved on Ca 2+ activation and Tm (the tropomyosin) which is moved away to allow the MyLC-Actin cross-bridge to form and last, the TnT troponin T.  I now realise how the addition of N-terminal fragments give this result. It was initially believed that the MyBP-C binding to the myosin S2 region [23] was being displaced by the fragment, this is not true as the K m for the Ca 2+ independent activation is much higher than the concentration used. In fact the MyBP-C binds to actin as well as myosin [24] and is located along the ilaments spaced out with many more binding sites on both ilaments unoccupied. The N-terminal fragment, especially with cardiac ilaments, binds both the actin and the myosin [25], with the many unoccupied binding sites the fragment binds to these and as it lacks the MgATP blocking of the whole subunit it allows the ATPase to function without the Mg 2+ -Ca 2+ exchange. The curve is shifted to lower [Ca 2+ ], towards the Km for TnC, and the cooperativity is lost, the Hill coef icient goes to 1.

The extraction of fsTnC from skeletal myofi brils
In this early study the ion binding to the structural sites of TnC is removed by the indiscriminate binding of Mg 2+ and Ca 2+ by the low selectivity chelator EDTA [6]. This allows the dissociation of the unit from the sarcomere and its washing away. Doing stopped assays over a time course gave the data     This data from Brandt, et al. [6] is somewhat confusing until one realises that the EDTA wash is also removing fsMyBP-C, almost certainly faster than the fsTnC. The result is the cooperativity, Hill coef icient, reaches that expected for solely the two Ca 2+ binding sites on fsTnC being required for activation. This was 1984 as opposed to reference 7 which was later 1991 when this was realised by Moss [7].

Partial extraction of skeletal TnC in the presence of free Mg 2+
By the addition of 1mM Mg 2+ to the EDTA extraction procedure the loss of MyBP-C is minimised and this is ensured by only partial extraction of the fsTnC, Moss, et al. [26]. Note, Figure 7, only a small loss of cooperativity but considerable shift to lower pCa, higher [Ca 2+ ] i.e. towards the Km of the Mg 2+ dependent Ca 2+ activation.

Total extraction of TnC from both skeletal and cardiac myofi brils with reversal
Morimoto and Ohtsuki changed the extraction in a similar way to Moss but with a different chelator. Endogenous troponin C in skinned psoas ibers and trabeculae was extracted by CDTA treatment until the preparations developed no Ca 2+ activated tension or ATPase, i.e. complete extraction of TnC. The CDTAtreated preparations were either reconstituted or substituted with isolated fast-twitch skeletal or cardiac troponin C. When added back the Hill coef icients are as expected with partial MyBP-C extraction occurring as well. Can this be repeated with complete removal of the MyBP-C to give the skeletal and cardiac hill coef icients of 2 and 1 corresponding to fsTnC and cTnC binding alone? (Table 3).
Similar extraction results were obtained by Zot and Potter [28].

The extraction of cMyBP-C from cardiac myofi brils
I now return to the data of Hofmann and their studies with partial extraction of subunits of the sarcomere [7]. In this irst of their studies the extraction was limited to removal of solely MyBP-C by the addition of TnC to the extraction ensuring it remains in the myo ibril. Other damage to the system was minimised by limiting the degree of extraction igure 8. As the extractions were only partial, unlike the unintentional loss of MyBP-C by Brandt, et al. [6] the precise values of the Hill coef icients are not relevant, so they are omitted, although follow the expected. The pCa dependency slopes and shifts are good enough indicators. In this exercise one can easily see the loss of Ca 2+ cooperativity with a large shift toward the Km for TnC.
The process is reversible, Figure 9. Therefore the effect is due to cMyBP-C.

The extraction of fsMyBP-C from skeletal myofi brils (psoas fi bres)
The same exercise as above was performed on skeletal muscle myo ibrils igure 10. The authors explain dif iculties in obtaining all the data on reversability. However, although the results are less spectacular than those from cardiac myo ibrils the same effects are observed i.e. a pCa 50 shift to lower [Ca 2+ ] and decrease in the slope.
The extraction process was again reversible igure 11.
The partial extraction of cTnC, and the subsequent extraction of cMyBP-C I return to the cardiac data reported by Hofmann [7] to emphasise the strength of my earlier argument that there are two bindings of Ca 2+ required for activation of muscle contraction, only one of which, on TnC, is measurable by binding of 45 Ca 2+ . Figure 12 clearly shows the results of each extraction, both reduce the cooperativity and spectacularly give pCa shifts in opposite directions towards the Km of that Figure 10: The eff ects of fsMyBP-C partial extraction on tension developed by rabbit psoas fi bers, cumulative data.

Conclusion
I have indicated that the basic functions of TnC and MyBP-C apply in both skeletal and cardiac systems, although modi ied, one can assume that the interactions described above also apply to TnI whether type 1,2 or 3. There are many con licting reports in the literature on the function of MyBP-C including one where the title absolutely contradicts all current knowledge [16]. Of the other reports including one in 2018, e.g. [29][30][31][32][33] the key to the confusion is the unrelenting lack of acceptance of my 2001 paper with the unfounded dogma that protein activating ion binding sites must be measurable by radio-isotope binding. Disruption of either cTnI or cMyBP-C, e.g. by mutation, can result in the shift of pCa 50 to lower [Ca 2+ ] and in the heart poor relaxation in diastole resulting in hypertrophic myopathy, but not in skeletal muscle. The main difference between the types of muscle are the rapid cycling of contraction in the heart, with guaranteed relaxation in diastole as opposed to the requirement for prolongation of contraction in the skeletal system and maintenance of developed tension for a period of time. These differences originate especially in the subunits of the sarcomere described here. In cardiac the Km for the Mg 2+ dependant Ca 2+ activation is at considerably higher [Ca 2+ ] than that of the cTnC. This is not so for skeletal muscle. The above reported binding of the N-terminal MyBP-C to actin has resulted in the observation of isoforms of skeletal MyBP-C binding differently [34,35] and tune the molecular contractility of divergent skeletal muscle systems. I quote, "MyBP-C modulates muscle contractility, presumably through its N terminus extending from the thick ilament and interacting with either the myosin head region and/or the actin thin ilament. There is a further function of MyBP-C in that it binds creatine kinase ensuring that it is in the location of the cross-bridge ATPase as is MyBP-C and ensures the rapid replacement of the ADP and Pi produced with relaxing MgATP, [36]. One can only hope that the biochemical function of MyBP-C that I have described gets recognised soon and the research lourish.
All reproduced igures are in the public domain and the originals cited. Figure 11: The eff ects of fsMyBP-C partial extraction on tension developed by rabbit psoas fi bers, and to which fsMyBP-C was subsequently readded. After extraction, tension at pCa 4.5 was 0.99 of control Po; while after C-protein readdition, maximum tension was 0.90 of control Po. Figure 12: Data from a myocyte from which both cTnC and cMyBP-C were extracted: control (•), after extraction of cTnC (○), and after the subsequent extraction of cMyBP-C (▲). After extraction of cTnC, tension at pCa 4.5 was 0.40 of control Po; after extraction of cMyBP-C, tension was 0.37 control Po.