The Scientific World Journal / 2013 / Article / Fig 1

Review Article

Exercise-Induced Rhabdomyolysis and Stress-Induced Malignant Hyperthermia Events, Association with Malignant Hyperthermia Susceptibility, and RYR1 Gene Sequence Variations

Figure 1

Schematic representation of a skeletal muscle cell and of Ca2+ and Na+ ion fluxes across the sarcolemma and sarcoplasmic reticulum (SR). Activation of Cav1.1 by membrane depolarization causes the RyR1 channel to open and to release Ca2+ from SR, thus triggering muscle contraction. Ca2+ concentration is regulated by the Ca2+-ATPase membrane pump (SERCA) that sequesters Ca2+ in the SR and by the Na+-K+-ATPase membrane pump and the Ca2+-Na+ antiport that exchange Ca2+ for Na+ across the sarcolemma. Regulation of calcium flux may be disrupted at any of these sites. ATP depletion, by consumption during muscle contraction, or reduced ATP production, results in intracellular Ca2+ increasing, muscle contraction, and continued energy consumption, leading to rhabdomyolysis.

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