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Application of human stem cell-derived cardiomyocytes in safety pharmacology requires caution beyond hERG
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摘要
Human embryonic stem cell-derived cardiomyocytes (hESC-CM) have been proposed as a new model for safety pharmacology. So far, a thorough description of their basic electrophysiology and extensive testing, and mechanistic explanations, of their overall pro-arrhythmic ability is lacking. Under standardized conditions, we have evaluated the sensitivity of hESC-CM to proarrhythmic provocations by blockade of hERG and other channels. Using voltage patch clamp, some ion current densities (pA/pF) in hESC-CM were comparable to adult CM: IKr (鈭?#xA0;12.5 卤 6.9), IKs (0.65 卤 0.12), INa,peak (鈭?#xA0;72 卤 21), INa,late (鈭?#xA0;1.10 卤 0.36), and ICa,L (鈭?#xA0;4.3 卤 0.6). If density was larger (鈭?#xA0;10 卤 1.1) and IK1 not existent or very small (鈭?#xA0;2.67 卤 0.3). The low IK1 density was corroborated by low KCNJ2 mRNA levels. Effects of pro-arrhythmic compounds on action potential (AP) parameters and provocation of early afterdepolarizations (EADs) revealed that Chromanol293B (100 渭mol/l) and Bay K8644 (1 渭mol/l) both significantly prolonged APD90. ATX-II (< 1 渭mol/l ) and BaCl2 (10 渭mol/l ) had no effect on APD. The only compound that triggered EADs was hERG blocker Cisapride. Computer simulations and AP clamp showed that the immature AP of hESC-CM prevents proper functioning of INa-channels, and result in lower peak/maximal currents of several other channels, compared to the adult situation. Lack of functional IK1 channels and shifted INa channel activation cause a rather immature electrophysiological phenotype in hESC-CM, and thereby limits the potential of this model to respond accurately to pro-arrhythmic triggers other than hERG block. Maturation of the electrical phenotype is a prerequiste for future implementation of the model in arrhythmogenic safety testing.

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