INHIBITION OF CA2-DEPENDENT K+ TRANSPORT AND CELL DEHYDRATION IN SICKLE ERYTHROCYTES BY CLOTRIMAZOLE AND OTHER IMIDAZOLE DERIVATIVES()

We have investigated the interaction of clotrimazole (CLT) and related compounds with the erythroid Ca2+ -activated K+ channel, a mediator o f sickle cell dehydration. We measured K+ transport, membrane potentia l, and cell volume upon activation of this pathway in sickle erythrocy tes. CLT blocked almost completely Ca2+-activated K+ transport in homo zygous hemoglobin S cells, with IC50 values of 29 +/- 15 nM in isotoni c 20 mM salt solution and 51 +/- 15 nM in normal saline (n = 3). The i nhibition of K+ transport by CLT was caused by a specific interaction with the Ca2+-activated K+ channel of human red cells, since it displa ced bound I-125-Charybdotoxin, a specific ligand of the Gardos channel , with an IC50 (12 +/- 4 nM in isotonic 20 mM) similar to the IC50 val ues for flux inhibition. When homozygous hemoglobin S cells were dehyd rated by incubation in the presence of 100 muM CaCl2 and the ionophore A23187, or by exposure to cycles of oxygenation and deoxygenation, CL T effectively inhibited cell dehydration and K+ loss. The IC50, of CLT for inhibition of Ca2+-activated K+ transport in sickle cells is sign ificantly lower than plasma concentrations of CLT achievable after non toxic oral doses. We therefore propose that oral administration of CLT may prevent red cell dehydration in patients with sickle cell anemia.