Skeletal Muscle Sarcoplasmic Reticulum in the Malignant Hyperthermia Syndrome

  • T. E. Nelson


A general working hypothesis for the aetiology of malignant hyperthermia is that triggering anaesthetic agents produce an increased myoplasmic Ca2+ level that stimulates metabolic and contracture events. As long as the Ca2+ remains at a concentration capable of activating skeletal muscle heat, metabolic products and abnormal electrolyte balance will result, ultimately fulminating to the life-threatening malignant hyperthermia syndrome. Under a normal resting state, the Ca2+ concentration in myoplasm is 10-7 M or lower and at Ca2+ concentrations of 10-6 to 10-5 M or greater, the metabolic and contractile systems are activated. The primary regulatory system for Ca2+ in skeletal muscle is the sarcoplasmic reticulum which serves three main functions: Ca2+ storage, Ca2+ release and Ca2+ uptake. In this chapter, we discuss current understanding of the sarcoplasmic reticulum in performing these functions and review data from studies on sarcoplasmic reticulum function in malignant hyperthermia skeletal muscle. Studies on Ca2+ transport in sarcoplasmic reticulum from malignant hyperthermia human and pig muscle do not support a defect in the transport function of sarcoplasmic reticulum in malignant hyperthermia skeletal muscle. In addition to the Ca2+ pump protein, the sarcoplasmic reticulum membrane also contains Ca2+ channels through which the stored Ca2+ is released to initiate muscle contraction. Several studies have shown a defect in the Ca2+ channel that is receptor mediated with Ca2+ as an agonist. These mechanisms related to electromechanical coupling in skeletal muscle are likely defective sites in malignant hyperthermia susceptible muscle.


Malignant Hyperthermia Malignant Hyperthermia Malignant Hyperthermia Syndrome Normal Human Skeletal Muscle Malignant Hyperthermia Patient 
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Copyright information

© Martinus Nijhoff Publishing, Boston 1987

Authors and Affiliations

  • T. E. Nelson
    • 1
  1. 1.Department of AnesthesiologyThe University of Texas Medical BranchGalvestonUSA

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