Journal of Forensic Medicine ›› 2025, Vol. 41 ›› Issue (2): 144-151.DOI: 10.12116/j.issn.1004-5619.2024.440503

• Topic on Forensic Identification of Poisoning • Previous Articles     Next Articles

The Mechanism of Calcium Handling Proteins and NF-κB in Calcium Dyshomeostasis of Cardiomyocytes Caused by Acute MDMA Exposure

Rong-shuai WANG1,2(), Si-zhe HUANG1,3, Yun-yun WANG1, Yan-fei DENG1,4, Zi-jiao DING1,5, Jie ZHANG1, Yong LIU1, Liang REN1(), Liang LIU1()   

  1. 1.Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    2.School of Forensic Medicine, Wannan Medical College, Wuhu 241000, Anhui Province, China
    3.The Seventh Affiliated Hospital of Southern Medical University, Foshan 528244, Guangdong Province, China
    4.Jiangxi Provincial Public Security Department, Nanchang 330038, China
    5.Department of Forensic Medicine, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, China
  • Online:2025-08-11 Published:2025-04-25
  • Contact: Liang REN, Liang LIU

Abstract:

Objective To explore the mechanism of myocardial toxicity caused by N-methyl-3,4-methyle-nedioxyamphetamine (MDMA), the changes of intracellular calcium oscillation mode and calcium handling proteins during acute exposure to different concentrations of MDMA were detected, and the involvement of nuclear factor κB (NF-κB) and its effect on calcium handling proteins were investigated. Methods Primary rat cardiomyocytes were cultured to establish MDMA acute exposure model, and a control group was set up. The MDMA poisoning model was divided into three concentration groups of 10, 100 and 1 000 μmol/L. After 1 h of exposure, the morphological changes of cardiomyocytes were observed, the cytotoxicity and changes in calcium signals were measured, and the changes in calcium handling proteins RyR2, SERCA2a, PLN, NCX1 and Cav1.2 were detected. The changes of NF-κB activity and the expression of nucleoprotein p-p65 (Ser311) and PKCζ after MDMA exposure, and the intervention of NF-κB inhibitors pyrrolidine dithiocarbamate ammonium (PDTC) and protein kinase C (PKC) inhibitor chelerythrine (CHE) were detected by electrophoretic mobility shift assay (EMSA) and Western blotting. The effects of PDTC intervention on calcium signals, and the expressions of RyR2, SERCA2a, PLN, NCX1 and Cav1.2 after acute MDMA exposure were also observed. Results No obvious changes were observed in the morphology of cardiomyocytes after acute exposure to MDMA, whereas the oscillation waveform of intracytoplasmic calcium ion showed irregular changes with increased oscillation amplitude, intense fluctuations, irregular frequency, and increased fluctuation range of relative optical density values. The expression of RyR2, SERCA2a and NCX1 increased, while the expression of Cav1.2 and PLN decreased. Acute MDMA exposure could increase NF-κB activity, while PDTC and CHE intervention could inhibit NF-κB activity. In MDMA exposed group, the expression of PKCζ and nucleoprotein p-p65 (Ser311) both increased and could be inhibited by CHE. After the intervention of PDTC to block NF-κB, the amplitude of calcium oscillation was lower than that of the MDMA exposed group, and the expression of RyR2, SERCA2a and NCX1 decreased. There was no significant change in PLN, while the expression of Cav1.2 increased. Conclusion MDMA can lead to an increase of calcium ion concentration in cardiomyocytes. Calcium ions are involved in myocardial toxicity of MDMA. The mechanism is related to changes in calcium handling proteins, mainly associated with the increased expression of RyR2. MDMA can up-regulate the intracellular activity of NF-κB through the PKCζ-NF-κB pathway and affect calcium handling proteins, which aggravate intracellular calcium overload during acute MDMA exposure.

Key words: forensic pathology, forensic toxicology, N-methyl-3,4-methylenedioxyamphetamine (MDMA), cytotoxicity, calcium homeostasis, calcium handling protein, nuclear factor κB (NF-κB), protein kinase C (PKC)

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