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Published on: March 24, 2023
Inactivation block of the HERG human cardiac K+ channels by RP58866
1Research Center, Montreal Heart Institute, 5000 Belanger East, Montreal, Quebec H1T 1C8, Canada. wangz2icm.umontreal.ca
Insights
RP58866 effectively treats arrhythmias by blocking HERG channels, particularly during ischemia. Its unique action on inactivated channels explains efficacy even with depolarized membranes.
Area of Science:
- Cardiovascular pharmacology
- Electrophysiology
- Ion channel research
Background:
- Arrhythmias, especially during ischemia, pose significant clinical challenges.
- The HERG (human ether-à-go-go-related gene) channel is crucial for cardiac repolarization.
- RP58866 demonstrates anti-arrhythmic properties, particularly in conditions with membrane depolarization.
Purpose of the Study:
- To elucidate the ionic mechanisms underlying RP58866's anti-arrhythmic effects.
- To investigate the interaction of RP58866 with HERG channels.
Main Methods:
- Heterologous expression of HERG channels in Xenopus oocytes.
- Electrophysiological recordings to assess RP58866's effects on HERG channel function.
- Utilizing mutated HERG channels (S631A) to probe inactivation mechanisms.
Main Results:
- RP58866 inhibited HERG channels concentration-dependently (IC50 ~1 microM).
- Inhibition was enhanced by protocols favoring inactivation and shifted inactivation curves negatively.
- Reduced extracellular potassium and mutated channels (weakened inactivation) significantly diminished RP58866's potency.
Conclusions:
- RP58866 primarily blocks HERG channels by binding to their inactivated state.
- This unique mechanism explains RP58866's sustained efficacy in prolonging action potential duration and treating arrhythmias under depolarized conditions, such as during ischemia.
Abstract:
1. RP58866 possesses a unique electrophysiological property: highly effective against various types of arrhythmias including ventricular fibrillation in animal models, noticeably those occurring during ischaemia with depolarized membrane due to elevated extracellular K+ concentrations. To understand the potential ionic mechanisms, we performed detailed studies on the effects of RP58866 on the HERG channels expressed in Xenopus oocytes, which are believed to be important compositions of the rapid component of delayed rectifier K+ current in the hearts. 2. RP58866 significantly inhibited the HERG channels in a concentration-dependent manner, with approximately 50% decrease in the current amplitude at a concentration of 1 microM. RP58866 produced more pronounced inhibition with voltage protocols which favoured inactivation of the HERG channels. It caused substantial negative shift of the inactivation curves but did not alter the activation properties. The inhibition was considerably relieved by elevating [K+]o from 5 - 20 mM, which weakened the channel inactivation. More importantly, the potency was reduced by approximately 100 fold on the mutated HERG channels (S631A) in which the C-type inactivation was substantially weakened. 4. We conclude that blockade of the HERG channels by RP58866 is mainly associated with the binding of the drugs to the inactivated channels. This unique property of HERG blockade might explain some previously reported but unexplained observations: RP58866 maintains its efficacy in APD prolongation with depolarized membrane potential and in arrhythmias during ischaemia with manifested membrane depolarization.
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