Pharmacology of cardiovascular gap junctions

Gap junction (GJ) channels play an important role in forming a functional network or syncytium of cells by allowing the transfer of small molecules or the conduction of electrical activation. These channels can be regulated at the level of acute opening or closure as well as at the level of expression including synthesis, protein trafficking and degradation. Many of the underlying mechanisms depend on phosphorylation or dephosphorylation of connexins. A number of drugs is available to study GJ function and connexin expression. Some of these drugs have shown therapeutic effects, e.g. the anti-arrhythmic peptides AAP10 and ZP123 in the prevention of certain types of arrhythmia. Moreover, mediators involved in cardiovascular pathophysiology, e.g. angiotensin, endothelin, tumor necrosis factor-alpha, fibroblast growth factor and others, affect connexin expression and can alter the Cx43/Cx40 ratio, which may contribute to the formation of an arrhythmogenic substrate. On the other hand, drugs affecting these mediators may influence GJ networking and may thus open new therapeutic horizons.