1
|
Gao B, Abi-Gerges N, Truong K, Stafford A, Nguyen W, Sutherland W, Vargas HM, Qu Y. Assessment of sarcomere shortening and calcium transient in primary human and dog ventricular myocytes. J Pharmacol Toxicol Methods 2023; 123:107278. [PMID: 37268094 DOI: 10.1016/j.vascn.2023.107278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023]
Abstract
Understanding translation from preclinical observations to clinical findings is important for evaluating the efficacy and safety of novel compounds. Of relevance to cardiac safety is profiling drug effects on cardiomyocyte (CM) sarcomere shortening and intracellular Ca2+ dynamics. Although CM from different animal species have been used to assess such effects, primary human CM isolated from human organ donor heart represent an ideal non-animal alternative approach. We performed a study to evaluate primary human CM and have them compared to freshly isolated dog cardiomyocytes for their basic function and responses to positive inotropes with well-known mechanisms. Our data showed that simultaneous assessment of sarcomere shortening and Ca2+-transient can be performed with both myocytes using the IonOptix system. Amplitude of sarcomere shortening and Ca2+-transient (CaT) were significantly higher in dog compared to human CM in the basic condition (absence of treatment), while longer duration of sarcomere shortening and CaT were observed in human cells. We observed that human and dog CMs have similar pharmacological responses to five inotropes with different mechanisms, including dobutamine and isoproterenol (β-adrenergic stimulation), milrinone (PDE3 inhibition), pimobendan and levosimendan (increase of Ca2+sensitization as well as PDE3 inhibition). In conclusion, our study suggests that myocytes obtained from both human donor hearts and dog hearts can be used to simultaneously assess drug-induced effects on sarcomere shortening and CaT using the IonOptix platform.
Collapse
Affiliation(s)
- BaoXi Gao
- Amgen Research, Translational Safety & Bioanalytical Sciences, Amgen Inc, 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA.
| | - Najah Abi-Gerges
- AnaBios Corporation, 3030 Bunker Hill St, San Diego, CA 92109, USA
| | - Ky Truong
- AnaBios Corporation, 3030 Bunker Hill St, San Diego, CA 92109, USA
| | - Alexa Stafford
- AnaBios Corporation, 3030 Bunker Hill St, San Diego, CA 92109, USA
| | - William Nguyen
- AnaBios Corporation, 3030 Bunker Hill St, San Diego, CA 92109, USA
| | - Weston Sutherland
- Amgen Research, Translational Safety & Bioanalytical Sciences, Amgen Inc, 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA
| | - Hugo M Vargas
- Amgen Research, Translational Safety & Bioanalytical Sciences, Amgen Inc, 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA
| | - Yusheng Qu
- Amgen Research, Translational Safety & Bioanalytical Sciences, Amgen Inc, 1 Amgen Center Drive, Thousand Oaks, CA 91320, USA
| |
Collapse
|
2
|
Dark N, Cosson MV, Tsansizi LI, Owen TJ, Ferraro E, Francis AJ, Tsai S, Bouissou C, Weston A, Collinson L, Abi-Gerges N, Miller PE, MacLeod KT, Ehler E, Mitter R, Harding SE, Smith JC, Bernardo AS. Generation of left ventricle-like cardiomyocytes with improved structural, functional, and metabolic maturity from human pluripotent stem cells. Cell Rep Methods 2023; 3:100456. [PMID: 37159667 PMCID: PMC10163040 DOI: 10.1016/j.crmeth.2023.100456] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/23/2023] [Accepted: 03/25/2023] [Indexed: 05/11/2023]
Abstract
Decreased left ventricle (LV) function caused by genetic mutations or injury often leads to debilitating and fatal cardiovascular disease. LV cardiomyocytes are, therefore, a potentially valuable therapeutical target. Human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) are neither homogeneous nor functionally mature, which reduces their utility. Here, we exploit cardiac development knowledge to instruct differentiation of hPSCs specifically toward LV cardiomyocytes. Correct mesoderm patterning and retinoic acid pathway blocking are essential to generate near-homogenous LV-specific hPSC-CMs (hPSC-LV-CMs). These cells transit via first heart field progenitors and display typical ventricular action potentials. Importantly, hPSC-LV-CMs exhibit increased metabolism, reduced proliferation, and improved cytoarchitecture and functional maturity compared with age-matched cardiomyocytes generated using the standard WNT-ON/WNT-OFF protocol. Similarly, engineered heart tissues made from hPSC-LV-CMs are better organized, produce higher force, and beat more slowly but can be paced to physiological levels. Together, we show that functionally matured hPSC-LV-CMs can be obtained rapidly without exposure to current maturation regimes.
Collapse
Affiliation(s)
| | | | - Lorenza I. Tsansizi
- The Francis Crick Institute, London, UK
- NHLI, Imperial College London, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Andreia S. Bernardo
- The Francis Crick Institute, London, UK
- NHLI, Imperial College London, London, UK
| |
Collapse
|
3
|
Miller JM, Meki MH, Elnakib A, Ou Q, Abouleisa RRE, Tang XL, Salama ABM, Gebreil A, Lin C, Abdeltawab H, Khalifa F, Hill BG, Abi-Gerges N, Bolli R, El-Baz AS, Giridharan GA, Mohamed TMA. Biomimetic cardiac tissue culture model (CTCM) to emulate cardiac physiology and pathophysiology ex vivo. Commun Biol 2022; 5:934. [PMID: 36085302 PMCID: PMC9463130 DOI: 10.1038/s42003-022-03919-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
There is need for a reliable in vitro system that can accurately replicate the cardiac physiological environment for drug testing. The limited availability of human heart tissue culture systems has led to inaccurate interpretations of cardiac-related drug effects. Here, we developed a cardiac tissue culture model (CTCM) that can electro-mechanically stimulate heart slices with physiological stretches in systole and diastole during the cardiac cycle. After 12 days in culture, this approach partially improved the viability of heart slices but did not completely maintain their structural integrity. Therefore, following small molecule screening, we found that the incorporation of 100 nM tri-iodothyronine (T3) and 1 μM dexamethasone (Dex) into our culture media preserved the microscopic structure of the slices for 12 days. When combined with T3/Dex treatment, the CTCM system maintained the transcriptional profile, viability, metabolic activity, and structural integrity for 12 days at the same levels as the fresh heart tissue. Furthermore, overstretching the cardiac tissue induced cardiac hypertrophic signaling in culture, which provides a proof of concept for the ability of the CTCM to emulate cardiac stretch-induced hypertrophic conditions. In conclusion, CTCM can emulate cardiac physiology and pathophysiology in culture for an extended time, thereby enabling reliable drug screening.
Collapse
Affiliation(s)
- Jessica M Miller
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
- Department of Bioengineering, University of Louisville, Louisville, USA
| | - Moustafa H Meki
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
- Department of Bioengineering, University of Louisville, Louisville, USA
| | - Ahmed Elnakib
- Department of Bioengineering, University of Louisville, Louisville, USA
| | - Qinghui Ou
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
| | - Riham R E Abouleisa
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
| | - Xian-Liang Tang
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
| | - Abou Bakr M Salama
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmad Gebreil
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
| | - Cindy Lin
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
| | - Hisham Abdeltawab
- Department of Bioengineering, University of Louisville, Louisville, USA
| | - Fahmi Khalifa
- Department of Bioengineering, University of Louisville, Louisville, USA
| | - Bradford G Hill
- Envirome Institute, Diabetes and Obesity Center, Department of Medicine, University of Louisville, Louisville, USA
| | | | - Roberto Bolli
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA
| | - Ayman S El-Baz
- Department of Bioengineering, University of Louisville, Louisville, USA
| | | | - Tamer M A Mohamed
- From the Institute of Molecular Cardiology, Department of Medicine, University of Louisville, Louisville, USA.
- Department of Bioengineering, University of Louisville, Louisville, USA.
- Envirome Institute, Diabetes and Obesity Center, Department of Medicine, University of Louisville, Louisville, USA.
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, USA.
- Institute of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom.
| |
Collapse
|
4
|
Schmid C, Abi-Gerges N, Leitner MG, Zellner D, Rast G. Ion Channel Expression and Electrophysiology of Singular Human (Primary and Induced Pluripotent Stem Cell-Derived) Cardiomyocytes. Cells 2021; 10:3370. [PMID: 34943878 PMCID: PMC8699770 DOI: 10.3390/cells10123370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 01/19/2023] Open
Abstract
Subtype-specific human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are promising tools, e.g., to assess the potential of drugs to cause chronotropic effects (nodal hiPSC-CMs), atrial fibrillation (atrial hiPSC-CMs), or ventricular arrhythmias (ventricular hiPSC-CMs). We used single-cell patch-clamp reverse transcriptase-quantitative polymerase chain reaction to clarify the composition of the iCell cardiomyocyte population (Fujifilm Cellular Dynamics, Madison, WI, USA) and to compare it with atrial and ventricular Pluricytes (Ncardia, Charleroi, Belgium) and primary human atrial and ventricular cardiomyocytes. The comparison of beating and non-beating iCell cardiomyocytes did not support the presence of true nodal, atrial, and ventricular cells in this hiPSC-CM population. The comparison of atrial and ventricular Pluricytes with primary human cardiomyocytes showed trends, indicating the potential to derive more subtype-specific hiPSC-CM models using appropriate differentiation protocols. Nevertheless, the single-cell phenotypes of the majority of the hiPSC-CMs showed a combination of attributes which may be interpreted as a mixture of traits of adult cardiomyocyte subtypes: (i) nodal: spontaneous action potentials and high HCN4 expression and (ii) non-nodal: prominent INa-driven fast inward current and high expression of SCN5A. This may hamper the interpretation of the drug effects on parameters depending on a combination of ionic currents, such as beat rate. However, the proven expression of specific ion channels supports the evaluation of the drug effects on ionic currents in a more realistic cardiomyocyte environment than in recombinant non-cardiomyocyte systems.
Collapse
Affiliation(s)
- Christina Schmid
- Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany; (M.G.L.); (G.R.)
- Food Chemistry and Toxicology, Department of Chemistry, University of Kaiserslautern, 67663 Kaiserslautern, Germany
| | | | - Michael Georg Leitner
- Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany; (M.G.L.); (G.R.)
| | - Dietmar Zellner
- Non-Clinical Statistics, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany
| | - Georg Rast
- Drug Discovery Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach, Germany; (M.G.L.); (G.R.)
| |
Collapse
|
5
|
Ton AT, Nguyen W, Miron Y, Hernandez E, Geft V, Rasoul L, Wong T, Indersmitten T, Truong K, Page G, Miller PE, Ghetti A, Abi-Gerges N. Late sustained sodium current in the adult human heart. J Pharmacol Toxicol Methods 2021. [DOI: 10.1016/j.vascn.2021.106962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
6
|
Ton AT, Nguyen W, Sweat K, Miron Y, Hernandez E, Wong T, Geft V, Macias A, Espinoza A, Truong K, Rasoul L, Stafford A, Cotta T, Mai C, Indersmitten T, Page G, Miller PE, Ghetti A, Abi-Gerges N. Arrhythmogenic and antiarrhythmic actions of late sustained sodium current in the adult human heart. Sci Rep 2021; 11:12014. [PMID: 34103608 PMCID: PMC8187365 DOI: 10.1038/s41598-021-91528-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022] Open
Abstract
Late sodium current (late INa) inhibition has been proposed to suppress the incidence of arrhythmias generated by pathological states or induced by drugs. However, the role of late INa in the human heart is still poorly understood. We therefore investigated the role of this conductance in arrhythmias using adult primary cardiomyocytes and tissues from donor hearts. Potentiation of late INa with ATX-II (anemonia sulcata toxin II) and E-4031 (selective blocker of the hERG channel) slowed the kinetics of action potential repolarization, impaired Ca2+ homeostasis, increased contractility, and increased the manifestation of arrhythmia markers. These effects could be reversed by late INa inhibitors, ranolazine and GS-967. We also report that atrial tissues from donor hearts affected by atrial fibrillation exhibit arrhythmia markers in the absence of drug treatment and inhibition of late INa with GS-967 leads to a significant reduction in arrhythmic behaviour. These findings reveal a critical role for the late INa in cardiac arrhythmias and suggest that inhibition of this conductance could provide an effective therapeutic strategy. Finally, this study highlights the utility of human ex-vivo heart models for advancing cardiac translational sciences.
Collapse
Affiliation(s)
- Anh Tuan Ton
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - William Nguyen
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Katrina Sweat
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Yannick Miron
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Eduardo Hernandez
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Tiara Wong
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Valentyna Geft
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Andrew Macias
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Ana Espinoza
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Ky Truong
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Lana Rasoul
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Alexa Stafford
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Tamara Cotta
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Christina Mai
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Tim Indersmitten
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Guy Page
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Paul E Miller
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Andre Ghetti
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA
| | - Najah Abi-Gerges
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA, 92109, USA.
| |
Collapse
|
7
|
Jordaan P, Dumotier B, Traebert M, Miller PE, Ghetti A, Urban L, Abi-Gerges N. Cardiotoxic Potential of Hydroxychloroquine, Chloroquine and Azithromycin in Adult Human Primary Cardiomyocytes. Toxicol Sci 2021; 180:356-368. [PMID: 33483756 PMCID: PMC7928616 DOI: 10.1093/toxsci/kfaa194] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Substantial efforts have been recently committed to develop coronavirus disease-2019 (COVID-19) medications, and Hydroxychloroquine alone or in combination with Azithromycin has been promoted as a repurposed treatment. Although these drugs may increase cardiac toxicity risk, cardiomyocyte mechanisms underlying this risk remain poorly understood in humans. Therefore, we evaluated the proarrhythmia risk and inotropic effects of these drugs in the cardiomyocyte contractility-based model of the human heart. We found Hydroxychloroquine to have a low proarrhythmia risk, whereas Chloroquine and Azithromycin were associated with high risk. Hydroxychloroquine proarrhythmia risk changed to high with low level of K+, whereas high level of Mg2+ protected against proarrhythmic effect of high Hydroxychloroquine concentrations. Moreover, therapeutic concentration of Hydroxychloroquine caused no enhancement of elevated temperature-induced proarrhythmia. Polytherapy of Hydroxychloroquine plus Azithromycin and sequential application of these drugs were also found to influence proarrhythmia risk categorization. Hydroxychloroquine proarrhythmia risk changed to high when combined with Azithromycin at therapeutic concentration. However, Hydroxychloroquine at therapeutic concentration impacted the cardiac safety profile of Azithromycin and its proarrhythmia risk only at concentrations above therapeutic level. We also report that Hydroxychloroquine and Chloroquine, but not Azithromycin, decreased contractility while exhibiting multi-ion channel block features, and Hydroxychloroquine's contractility effect was abolished by Azithromycin. Thus, this study has the potential to inform clinical studies evaluating repurposed therapies, including those in the COVID-19 context. Additionally, it demonstrates the translational value of the human cardiomyocyte contractility-based model as a key early discovery path to inform decisions on novel therapies for COVID-19, malaria, and inflammatory diseases.
Collapse
Affiliation(s)
- Pierre Jordaan
- Chief Medical Officer and Patient Safety, Novartis AG, Basel, Switzerland
| | - Bérengère Dumotier
- Novartis Institutes for Biomedical Research, Preclinical Safety, Basel, Switzerland
| | - Martin Traebert
- Novartis Institutes for Biomedical Research, Preclinical Safety, Basel, Switzerland
| | - Paul E Miller
- AnaBios Corporation, San Diego, California 92109, USA
| | - Andre Ghetti
- AnaBios Corporation, San Diego, California 92109, USA
| | - Laszlo Urban
- Novartis Institutes for Biomedical Research, Preclinical Secondary Pharmacology, Cambridge, Massachusetts, USA
| | | |
Collapse
|
8
|
Nguyen N, Page G, Abi-Gerges N, Miller P, Adams J. Selective beta-3 adrenergic receptor blockade increases contractility of human ventricular trabeculae from HFrEF donors. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Alterations of the beta-adrenergic system have been extensively described in the setting of heart failure (HF). Upregulation of beta-3 adrenergic receptor (β3-AdrR) expression in human failing hearts depresses myocardial contractility and, during an acute decompensation event, can be considered a maladaptive compensatory mechanism that exacerbates cardiac dysfunction. APD418 is a selective β3-AdrR antagonist currently in development for patients who have acute heart failure with reduced ejection fraction (HFrEF). APD418 is designed to improve myocardial contractility by selectively antagonizing the β3-AdrR and thereby avoiding the cAMP/Ca2+ signaling pathway stimulated by current inotropes.
Purpose
This study evaluated the effect of a selective β3-AdrR antagonist (APD418) on contractile responses in explanted human ventricular trabeculae obtained from normal and HFrEF hearts.
Methods
Left ventricular trabeculae from normal and HFrEF donors were electrically stimulated (1 Hz) ex-vivo to analyze force generated during contractions. First, BRL37344, a selective β3-AdrR agonist, was applied at increasing concentrations (0.01–10 μM) to confirm β3-AdrR mediated negative inotropy in human myocardial tissue. To test the effect of a selective β3-AdrR antagonist on contractile force, myocardial tissue was pre-treated with APD418 or vehicle for 5 minutes, followed by treatment with non-selective β-AdrR agonists isoproterenol (10 nM) or norepinephrine (5 μM).
Results
In heart tissue from normal donors, the β3-AdrR agonist BRL37344 did not affect contractile function at 0.01 and 0.1 μM. However, in heart tissue from HFrEF donors, BRL37344 induced a significant decrease in contractility at 0.01, 0.1 and 1 μM (85.9±1.8% with 0.1 μM BRL37344 vs 104.1±2.9% with vehicle). Selective blockade of β3-AdrR with APD418 had no effect on force of contraction induced by norepinephrine in cardiac tissue from normal donors. In contrast, APD418 potentiated the force of contraction induced by either isoproterenol (49.1±20.6% increase with 0.1 μM APD418 compared to baseline) or norepinephrine (26.5±4.9% increase with 0.01 μM APD418 compared to baseline) in cardiac tissue from HFrEF patients.
Conclusion
This is, to our knowledge, the first evidence showing that selective blockade of β3-AdrR increases contractility of human ventricular trabeculae from HFrEF donors and suggests that further studies evaluating the therapeutic benefit of APD418 in patients with HFrEF are warranted.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Arena Pharmaceuticals
Collapse
Affiliation(s)
- N Nguyen
- Arena Pharmaceuticals, San Diego, United States of America
| | - G Page
- Anabios Corporation, San Diego, United States of America
| | - N Abi-Gerges
- Anabios Corporation, San Diego, United States of America
| | - P.E Miller
- Anabios Corporation, San Diego, United States of America
| | - J.W Adams
- Arena Pharmaceuticals, San Diego, United States of America
| |
Collapse
|
9
|
Otsomaa L, Levijoki J, Wohlfahrt G, Chapman H, Koivisto AP, Syrjänen K, Koskelainen T, Peltokorpi SE, Finckenberg P, Heikkilä A, Abi-Gerges N, Ghetti A, Miller PE, Page G, Mervaala E, Nagy N, Kohajda Z, Jost N, Virág L, Varró A, Papp JG. Discovery and characterization of ORM-11372, a novel inhibitor of the sodium-calcium exchanger with positive inotropic activity. Br J Pharmacol 2020; 177:5534-5554. [PMID: 32959887 PMCID: PMC7707092 DOI: 10.1111/bph.15257] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/14/2020] [Accepted: 09/03/2020] [Indexed: 11/29/2022] Open
Abstract
Background and Purpose The lack of selective sodium–calcium exchanger (NCX) inhibitors has hampered the exploration of physiological and pathophysiological roles of cardiac NCX 1.1. We aimed to discover more potent and selective drug like NCX 1.1 inhibitor. Experimental Approach A flavan series‐based pharmacophore model was constructed. Virtual screening helped us identify a novel scaffold for NCX inhibition. A distinctively different NCX 1.1 inhibitor, ORM‐11372, was discovered after lead optimization. Its potency against human and rat NCX 1.1 and selectivity against other ion channels was assessed. The cardiovascular effects of ORM‐11372 were studied in normal and infarcted rats and rabbits. Human cardiac safety was studied ex vivo using human ventricular trabeculae. Key Results ORM‐11372 inhibited human NCX 1.1 reverse and forward currents; IC50 values were 5 and 6 nM respectively. ORM‐11372 inhibited human cardiac sodium 1.5 (INa) and hERG KV11.1 currents (IhERG) in a concentration‐dependent manner; IC50 values were 23.2 and 10.0 μM. ORM‐11372 caused no changes in action potential duration; short‐term variability and triangulation were observed for concentrations of up to 10 μM. ORM‐11372 induced positive inotropic effects of 18 ± 6% and 35 ± 8% in anaesthetized rats with myocardial infarctions and in healthy rabbits respectively; no other haemodynamic effects were observed, except improved relaxation at the lowest dose. Conclusion and Implications ORM‐11372, a unique, novel, and potent inhibitor of human and rat NCX 1.1, is a positive inotropic compound. NCX inhibition can induce clinically relevant improvements in left ventricular contractions without affecting relaxation, heart rate, or BP, without pro‐arrhythmic risk.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Piet Finckenberg
- Department of Pharmacology, Faculty of Medicine, Helsinki, Finland
| | | | | | | | | | - Guy Page
- R&D, AnaBios Corporation, San Diego, CA, USA
| | - Eero Mervaala
- Department of Pharmacology, Faculty of Medicine, Helsinki, Finland
| | - Norbert Nagy
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zsófia Kohajda
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary
| | - Norbert Jost
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - László Virág
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - András Varró
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Julius Gy Papp
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, Faculty of Medicine, University of Szeged, Szeged, Hungary
| |
Collapse
|
10
|
Abi-Gerges N, Truong K, Nguyen W, Ratchada P, Indersmitten T, Ton AT, Page G, Miller PE, Ghetti A. Predicting cardiotoxicity of cancer tyrosine kinase inhibitors with adult human primary cardiomyocytes. J Pharmacol Toxicol Methods 2020. [DOI: 10.1016/j.vascn.2020.106717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
11
|
Komori HK, Gaidarov I, Bruinsma K, Karimi-Naser L, Ton AT, Indersmitten T, Abi-Gerges N, Miller PE, Unett D, Dang H, Chen X, Adams JW. Etrasimod, a Selective S1P
1,4,5
Receptor Modulator, Exhibits Differential G Protein Signaling Compared to Other S1P Receptor Modulators. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.04933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
12
|
Abi-Gerges N, Miller PE, Ghetti A. Human Heart Cardiomyocytes in Drug Discovery and Research: New Opportunities in Translational Sciences. Curr Pharm Biotechnol 2019; 21:787-806. [PMID: 31820682 DOI: 10.2174/1389201021666191210142023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/14/2019] [Accepted: 10/28/2019] [Indexed: 12/28/2022]
Abstract
In preclinical drug development, accurate prediction of drug effects on the human heart is critically important, whether in the context of cardiovascular safety or for the purpose of modulating cardiac function to treat heart disease. Current strategies have significant limitations, whereby, cardiotoxic drugs can escape detection or potential life-saving therapies are abandoned due to false positive toxicity signals. Thus, new and more reliable translational approaches are urgently needed to help accelerate the rate of new therapy development. Renewed efforts in the recovery of human donor hearts for research and in cardiomyocyte isolation methods, are providing new opportunities for preclinical studies in adult primary cardiomyocytes. These cells exhibit the native physiological and pharmacological properties, overcoming the limitations presented by artificial cellular models, animal models and have great potential for providing an excellent tool for preclinical drug testing. Adult human primary cardiomyocytes have already shown utility in assessing drug-induced cardiotoxicity risk and helping in the identification of new treatments for cardiac diseases, such as heart failure and atrial fibrillation. Finally, strategies with actionable decision-making trees that rely on data derived from adult human primary cardiomyocytes will provide the holistic insights necessary to accurately predict human heart effects of drugs.
Collapse
Affiliation(s)
- Najah Abi-Gerges
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA 92109, United States
| | - Paul E Miller
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA 92109, United States
| | - Andre Ghetti
- AnaBios Corporation, 3030 Bunker Hill St., Suite 312, San Diego, CA 92109, United States
| |
Collapse
|
13
|
Pang L, Sager P, Yang X, Shi H, Sannajust F, Brock M, Wu JC, Abi-Gerges N, Lyn-Cook B, Berridge BR, Stockbridge N. Workshop Report: FDA Workshop on Improving Cardiotoxicity Assessment With Human-Relevant Platforms. Circ Res 2019; 125:855-867. [PMID: 31600125 DOI: 10.1161/circresaha.119.315378] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Given that cardiovascular safety concerns remain the leading cause of drug attrition at the preclinical drug development stage, the National Center for Toxicological Research of the US Food and Drug Administration hosted a workshop to discuss current gaps and challenges in translating preclinical cardiovascular safety data to humans. This white paper summarizes the topics presented by speakers from academia, industry, and government intended to address the theme of improving cardiotoxicity assessment in drug development. The main conclusion is that to reduce cardiovascular safety liabilities of new therapeutic agents, there is an urgent need to integrate human-relevant platforms/approaches into drug development. Potential regulatory applications of human-derived cardiomyocytes and future directions in employing human-relevant platforms to fill the gaps and overcome barriers and challenges in preclinical cardiovascular safety assessment were discussed. This paper is intended to serve as an initial step in a public-private collaborative development program for human-relevant cardiotoxicity tools, particularly for cardiotoxicities characterized by contractile dysfunction or structural injury.
Collapse
Affiliation(s)
- Li Pang
- From the Division of Systems Biology, National Center for Toxicological Research, U.S. Food and Drug Administration (L.P.)
| | | | - Xi Yang
- Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (X.Y.)
| | - Hong Shi
- Discovery Toxicology, Bristol-Myers Squibb (BMS) Company (H.S.)
| | - Frederick Sannajust
- Safety & Exploratory Pharmacology Department, SALAR Division, Merck & Co (F.S.)
| | | | - Joseph C Wu
- Stanford University School of Medicine, Stanford Cardiovascular Institute (J.C.W.)
| | | | - Beverly Lyn-Cook
- Division of Biochemical Toxicology, National Center for Toxicological Research, U.S. Food and Drug Administration (B.L.-C.)
| | - Brian R Berridge
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health (B.R.B.)
| | - Norman Stockbridge
- Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (N.S.)
| |
Collapse
|
14
|
Abi-Gerges N, Indersmitten T, Truong K, Nguyen W, Tapia I, Nguyen N, MIller PE, Ghetti A. A human cardiomyocyte-based platform for the profiling of drug-induced effects on cardiac contractility: Predicting inotropic mechanisms of action. J Pharmacol Toxicol Methods 2019. [DOI: 10.1016/j.vascn.2019.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
15
|
Abi-Gerges N, McMahon C, Vargas H, Sager P, Chui R, Stevens D, Davila J, Schaub JR, Wu JC, Del Rio C, Mathes C, Miller PE, Burns-Naas LA, Ghetti A. The West coast regional safety pharmacology society meeting update: Filling translational gaps in safety assessment. J Pharmacol Toxicol Methods 2019; 98:106582. [PMID: 31077805 DOI: 10.1016/j.vascn.2019.106582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/20/2022]
Abstract
The Safety Pharmacology Society (SPS) held a West Coast Regional Meeting in Foster City, CA on November 14, 2018 at the Gilead Sciences Inc. site. The meeting was attended by scientists from the pharmaceutical and biotechnology industry, contract research organizations (CROs) and academia. A variety of scientific topics were presented by speakers, covering a broad variety of topics in the fields of safety risk assessment; from pro-arrhythmia and contractility risk evaluation, to models of heart failure and seizure in-a-dish; and discovery sciences; from stem cells and precision medicine, to models of inherited cardiomyopathy and precision cut tissue slices. The present review summarizes the highlights of the presentations and provides an overview of the high level of innovation currently underlying many frontiers in safety pharmacology.
Collapse
Affiliation(s)
| | | | | | - Philip Sager
- Stanford University, School of Medicine, Stanford, CA 94305, USA
| | - Ray Chui
- Amgen Inc., Thousand Oaks, CA 92320, USA
| | - Dale Stevens
- Genentech Inc., South San Francisco, CA 94080, USA
| | | | | | - Joseph C Wu
- Stanford University School of Medicine, Stanford Cardiovascular Institute, Stanford, CA 94305, USA
| | | | | | | | | | | |
Collapse
|
16
|
Nguyen N, Nguyen W, Miron Y, Ratchada P, Page G, Miller P, Ghetti A, Abi-Gerges N. Adult human primary cardiomyocyte model for the simultaneous prediction of drug-induced inotropic and pro-arrhythmia risk. J Pharmacol Toxicol Methods 2018. [DOI: 10.1016/j.vascn.2018.01.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
17
|
Qu Y, Page G, Abi-Gerges N, Miller P, Ghetti A, Vargas HM. Action potential recordings and analysis in human ventricular trabeculae for assessment of pro-arrhythmic risk. J Pharmacol Toxicol Methods 2018. [DOI: 10.1016/j.vascn.2018.01.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
18
|
Qu Y, Page G, Abi-Gerges N, Miller PE, Ghetti A, Vargas HM. Action Potential Recording and Pro-arrhythmia Risk Analysis in Human Ventricular Trabeculae. Front Physiol 2018; 8:1109. [PMID: 29354071 PMCID: PMC5760531 DOI: 10.3389/fphys.2017.01109] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/14/2017] [Indexed: 01/20/2023] Open
Abstract
To assess drug-induced pro-arrhythmic risk, especially Torsades de Pointe (TdP), new models have been proposed, such as in-silico modeling of ventricular action potential (AP) and stem cell-derived cardiomyocytes (SC-CMs). Previously we evaluated the electrophysiological profile of 15 reference drugs in hESC-CMs and hiPSC-CMs for their effects on intracellular AP and extracellular field potential, respectively. Our findings indicated that SC-CMs exhibited immature phenotype and had the propensity to generate false positives in predicting TdP risk. To expand our knowledge with mature human cardiac tissues for drug-induced pro-arrhythmic risk assessment, human ventricular trabeculae (hVT) from ethically consented organ donors were used to evaluate the effects of the same 15 drugs (8 torsadogenic, 5 non-torsadogenic, and 2 discovery molecules) on AP parameters at 1 and 2 Hz. Each drug was tested blindly with 4 concentrations in duplicate trabeculae from 2 hearts. To identify the pro-arrhythmic risk of each drug, a pro-arrhythmic score was calculated as the weighted sum of percent drug-induced changes compared to baseline in various AP parameters, including AP duration and recognized pro-arrhythmia predictors such as triangulation, beat-to-beat variability and incidence of early-afterdepolarizations, at each concentration. In addition, to understand the translation of this preclinical hVT AP-based model to clinical studies, a ratio that relates each testing concentration to the human therapeutic unbound Cmax (Cmax) was calculated. At a ratio of 10, for the 8 torsadogenic drugs, 7 were correctly identified by the pro-arrhythmic score; 1 was mislabeled. For the 5 non-torsadogenic drugs, 4 were correctly identified as safe; 1 was mislabeled. Calculation of sensitivity, specificity, positive predictive value, and negative predictive value indicated excellent performance. For example, at a ratio of 10, scores for sensitivity, specificity, positive predictive value and negative predictive values were 0.88, 0.8, 0.88 and 0.8, respectively. Thus, the hVT AP-based model combined with the integrated analysis of pro-arrhythmic score can differentiate between torsadogenic and non-torsadogenic drugs, and has a greater predictive performance when compared to human SC-CM models.
Collapse
Affiliation(s)
- Yusheng Qu
- Integrated Discovery and Safety Pharmacology, Amgen Inc., Thousand Oaks, CA, United States
| | - Guy Page
- AnaBios Corporation, San Diego, CA, United States
| | | | | | - Andre Ghetti
- AnaBios Corporation, San Diego, CA, United States
| | - Hugo M Vargas
- Integrated Discovery and Safety Pharmacology, Amgen Inc., Thousand Oaks, CA, United States
| |
Collapse
|
19
|
Nguyen N, Nguyen W, Nguyenton B, Ratchada P, Page G, Miller PE, Ghetti A, Abi-Gerges N. Adult Human Primary Cardiomyocyte-Based Model for the Simultaneous Prediction of Drug-Induced Inotropic and Pro-arrhythmia Risk. Front Physiol 2017; 8:1073. [PMID: 29311989 PMCID: PMC5742250 DOI: 10.3389/fphys.2017.01073] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/06/2017] [Indexed: 12/19/2022] Open
Abstract
Cardiac safety remains the leading cause of drug development discontinuation. We developed a human cardiomyocyte-based model that has the potential to provide a predictive preclinical approach for simultaneously predicting drug-induced inotropic and pro-arrhythmia risk. Methods: Adult human primary cardiomyocytes from ethically consented organ donors were used to measure contractility transients. We used measures of changes in contractility parameters as markers to infer both drug-induced inotropic effect (sarcomere shortening) and pro-arrhythmia (aftercontraction, AC); contractility escape (CE); time to 90% relaxation (TR90). We addressed the clinical relevance of this approach by evaluating the effects of 23 torsadogenic and 10 non-torsadogenic drugs. Each drug was tested separately at four multiples of the free effective therapeutic plasma concentration (fETPC). Results: Human cardiomyocyte-based model differentiated between torsadogenic and non-torsadogenic drugs. For example, dofetilide, a torsadogenic drug, caused ACs and increased TR90 starting at 10-fold the fETPC, while CE events were observed at the highest multiple of fETPC (100-fold). Verapamil, a non-torsadogenic drug, did not change TR90 and induced no AC or CE up to the highest multiple of fETPCs tested in this study (222-fold). When drug pro-arrhythmic activity was evaluated at 10-fold of the fETPC, AC parameter had excellent assay sensitivity and specificity values of 96 and 100%, respectively. This high predictivity supports the translational safety potential of this preparation and of the selected marker. The data demonstrate that human cardiomyocytes could also identify drugs associated with inotropic effects. hERG channel blockers, like dofetilide, had no effects on sarcomere shortening, while multi-ion channel blockers, like verapamil, inhibited sarcomere shortening. Conclusions: Isolated adult human primary cardiomyocytes can simultaneously predict risks associated with inotropic activity and pro-arrhythmia and may enable the generation of reliable and predictive data for assessing human cardiotoxicity at an early stage in drug discovery.
Collapse
Affiliation(s)
| | | | | | | | - Guy Page
- AnaBios Corporation, San Diego, CA, United States
| | | | - Andre Ghetti
- AnaBios Corporation, San Diego, CA, United States
| | | |
Collapse
|
20
|
Nguyen N, Miron Y, Ratchada P, Page G, Miller PE, GHetti A, Abi-Gerges N. Adult Human Primary Cardiomyocytes: An Integrative Translational Model for Preclinical Drug Testing. J Pharmacol Toxicol Methods 2017. [DOI: 10.1016/j.vascn.2017.09.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
21
|
Britton O, Page G, Ratchada P, Miron Y, Miller P, Ghetti A, Abi-Gerges N, Rodriguez B. Investigation of Inter-individual Variability in Electrophysiological Response to Drug Block Using Human Ex Vivo Ventricular Preparations and Heart-specific Populations of Cardiomyocyte Models. J Pharmacol Toxicol Methods 2017. [DOI: 10.1016/j.vascn.2017.09.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
22
|
Britton OJ, Abi-Gerges N, Page G, Ghetti A, Miller PE, Rodriguez B. Quantitative Comparison of Effects of Dofetilide, Sotalol, Quinidine, and Verapamil between Human Ex vivo Trabeculae and In silico Ventricular Models Incorporating Inter-Individual Action Potential Variability. Front Physiol 2017; 8:597. [PMID: 28868038 PMCID: PMC5563361 DOI: 10.3389/fphys.2017.00597] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/02/2017] [Indexed: 01/20/2023] Open
Abstract
Background:In silico modeling could soon become a mainstream method of pro-arrhythmic risk assessment in drug development. However, a lack of human-specific data and appropriate modeling techniques has previously prevented quantitative comparison of drug effects between in silico models and recordings from human cardiac preparations. Here, we directly compare changes in repolarization biomarkers caused by dofetilide, dl-sotalol, quinidine, and verapamil, between in silico populations of human ventricular cell models and ex vivo human ventricular trabeculae. Methods and Results:Ex vivo recordings from human ventricular trabeculae in control conditions were used to develop populations of in silico human ventricular cell models that integrated intra- and inter-individual variability in action potential (AP) biomarker values. Models were based on the O'Hara-Rudy ventricular cardiomyocyte model, but integrated experimental AP variability through variation in underlying ionic conductances. Changes to AP duration, triangulation and early after-depolarization occurrence from application of the four drugs at multiple concentrations and pacing frequencies were compared between simulations and experiments. To assess the impact of variability in IC50 measurements, and the effects of including state-dependent drug binding dynamics, each drug simulation was repeated with two different IC50 datasets, and with both the original O'Hara-Rudy hERG model and a recently published state-dependent model of hERG and hERG block. For the selective hERG blockers dofetilide and sotalol, simulation predictions of AP prolongation and repolarization abnormality occurrence showed overall good agreement with experiments. However, for multichannel blockers quinidine and verapamil, simulations were not in agreement with experiments across all IC50 datasets and IKr block models tested. Quinidine simulations resulted in overprolonged APs and high incidence of repolarization abnormalities, which were not observed in experiments. Verapamil simulations showed substantial AP prolongation while experiments showed mild AP shortening. Conclusions: Results for dofetilide and sotalol show good agreement between experiments and simulations for selective compounds, however lack of agreement from simulations of quinidine and verapamil suggest further work is needed to understand the more complex electrophysiological effects of these multichannel blocking drugs.
Collapse
Affiliation(s)
- Oliver J. Britton
- Department of Computer Science, University of OxfordOxford, United Kingdom
| | | | - Guy Page
- AnaBios CorporationSan Diego, CA, United States
| | | | | | - Blanca Rodriguez
- Department of Computer Science, University of OxfordOxford, United Kingdom
| |
Collapse
|
23
|
Windley MJ, Abi-Gerges N, Fermini B, Hancox JC, Vandenberg JI, Hill AP. Measuring kinetics and potency of hERG block for CiPA. J Pharmacol Toxicol Methods 2017; 87:99-107. [PMID: 28192183 DOI: 10.1016/j.vascn.2017.02.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/25/2017] [Accepted: 02/07/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The Comprehensive in vitro Proarrhythmic Assay (CiPA) aims to update current cardiac safety testing to better evaluate arrhythmic risk. A central theme of CiPA is the use of in silico approaches to risk prediction incorporating models of drug binding to hERG. To parameterize these models, accurate in vitro measurement of potency and kinetics of block is required. The Ion Channel Working Group was tasked with: i) selecting a protocol that could measure kinetics of block and was easily implementable on automated platforms for future rollout in industry and ii) acquiring a reference dataset using the standardized protocol. METHODS Data were acquired using a 'step depolarisation' protocol using manual patch-clamp at ambient temperature. RESULTS Potency, kinetics and trapping characteristics of hERG block for the CiPA training panel of twelve drugs were measured. Timecourse of block and trapping characteristics could be reliably measured if the time constant for onset of block was between ~500ms and ~15s. Seven drugs, however had time courses of block faster than this cut-off. DISCUSSION Here we describe the implementation of the standardized protocol for measurement of kinetics and potency of hERG block for CiPA. The results highlight the challenges in identifying a single protocol to measure hERG block over a range of kinetics. The dataset from this study is being used by the In Silico Working Group to develop models of drug binding for risk prediction and is freely available as a 'gold standard' ambient temperature dataset to evaluate variability across high throughput platforms.
Collapse
Affiliation(s)
- Monique J Windley
- Molecular Cardiology and Biophysics Division, Victor Chang Cardiac Research Institute, 405 Liverpool Street, Sydney, NSW 2010, Australia; St. Vincent's Clinical School, University of New South Wales, Sydney, NSW 2052, Australia
| | | | - Bernard Fermini
- Coyne Scientific, LLC, 58 Edgewood Ave NE Atlanta, GA 30303, USA
| | - Jules C Hancox
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, UK
| | - Jamie I Vandenberg
- Molecular Cardiology and Biophysics Division, Victor Chang Cardiac Research Institute, 405 Liverpool Street, Sydney, NSW 2010, Australia; St. Vincent's Clinical School, University of New South Wales, Sydney, NSW 2052, Australia
| | - Adam P Hill
- Molecular Cardiology and Biophysics Division, Victor Chang Cardiac Research Institute, 405 Liverpool Street, Sydney, NSW 2010, Australia; St. Vincent's Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.
| |
Collapse
|
24
|
Abi-Gerges N, Pointon A, Oldman KL, Brown MR, Pilling MA, Sefton CE, Garside H, Pollard CE. Assessment of extracellular field potential and Ca2+ transient signals for early QT/pro-arrhythmia detection using human induced pluripotent stem cell-derived cardiomyocytes. J Pharmacol Toxicol Methods 2017; 83:1-15. [DOI: 10.1016/j.vascn.2016.09.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/02/2016] [Accepted: 09/08/2016] [Indexed: 12/29/2022]
|
25
|
Page G, Ratchada P, Miron Y, Steiner G, Ghetti A, Miller PE, Reynolds JA, Wang K, Greiter-Wilke A, Polonchuk L, Traebert M, Gintant GA, Abi-Gerges N. Human ex-vivo action potential model for pro-arrhythmia risk assessment. J Pharmacol Toxicol Methods 2016; 81:183-95. [PMID: 27235787 PMCID: PMC5042841 DOI: 10.1016/j.vascn.2016.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/03/2016] [Accepted: 05/24/2016] [Indexed: 12/20/2022]
Abstract
While current S7B/E14 guidelines have succeeded in protecting patients from QT-prolonging drugs, the absence of a predictive paradigm identifying pro-arrhythmic risks has limited the development of valuable drug programs. We investigated if a human ex-vivo action potential (AP)-based model could provide a more predictive approach for assessing pro-arrhythmic risk in man. Human ventricular trabeculae from ethically consented organ donors were used to evaluate the effects of dofetilide, d,l-sotalol, quinidine, paracetamol and verapamil on AP duration (APD) and recognized pro-arrhythmia predictors (short-term variability of APD at 90% repolarization (STV(APD90)), triangulation (ADP90-APD30) and incidence of early afterdepolarizations at 1 and 2Hz to quantitatively identify the pro-arrhythmic risk. Each drug was blinded and tested separately with 3 concentrations in triplicate trabeculae from 5 hearts, with one vehicle time control per heart. Electrophysiological stability of the model was not affected by sequential applications of vehicle (0.1% dimethyl sulfoxide). Paracetamol and verapamil did not significantly alter anyone of the AP parameters and were classified as devoid of pro-arrhythmic risk. Dofetilide, d,l-sotalol and quinidine exhibited an increase in the manifestation of pro-arrhythmia markers. The model provided quantitative and actionable activity flags and the relatively low total variability in tissue response allowed for the identification of pro-arrhythmic signals. Power analysis indicated that a total of 6 trabeculae derived from 2 hearts are sufficient to identify drug-induced pro-arrhythmia. Thus, the human ex-vivo AP-based model provides an integrative translational assay assisting in shaping clinical development plans that could be used in conjunction with the new CiPA-proposed approach.
Collapse
Affiliation(s)
- Guy Page
- AnaBios Corporation, San Diego, CA 92109, USA
| | | | | | - Guido Steiner
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | | | | | | | - Ken Wang
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | - Andrea Greiter-Wilke
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | - Liudmila Polonchuk
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | - Martin Traebert
- Novartis Institutes of Biomedical Research, Safety Pharmacology, CH-4057 Basel, Switzerland
| | - Gary A Gintant
- Department of Integrative Pharmacology Integrated Sciences & Technology, AbbVie, North Chicago, IL, USA
| | | |
Collapse
|
26
|
Hill AP, Perry MD, Abi-Gerges N, Couderc JP, Fermini B, Hancox JC, Knollmann BC, Mirams GR, Skinner J, Zareba W, Vandenberg JI. Computational cardiology and risk stratification for sudden cardiac death: one of the grand challenges for cardiology in the 21st century. J Physiol 2016; 594:6893-6908. [PMID: 27060987 PMCID: PMC5134408 DOI: 10.1113/jp272015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/16/2016] [Indexed: 12/25/2022] Open
Abstract
Risk stratification in the context of sudden cardiac death has been acknowledged as one of the major challenges facing cardiology for the past four decades. In recent years, the advent of high performance computing has facilitated organ-level simulation of the heart, meaning we can now examine the causes, mechanisms and impact of cardiac dysfunction in silico. As a result, computational cardiology, largely driven by the Physiome project, now stands at the threshold of clinical utility in regards to risk stratification and treatment of patients at risk of sudden cardiac death. In this white paper, we outline a roadmap of what needs to be done to make this translational step, using the relatively well-developed case of acquired or drug-induced long QT syndrome as an exemplar case.
Collapse
Affiliation(s)
- Adam P Hill
- Victor Chang Cardiac Research Institute, 405 Liverpool Street, Darlinghurst, NSW, 2010, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Matthew D Perry
- Victor Chang Cardiac Research Institute, 405 Liverpool Street, Darlinghurst, NSW, 2010, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Najah Abi-Gerges
- AnaBios Corporation, 3030 Bunker Hill St., San Diego, CA, 92109, USA
| | | | - Bernard Fermini
- Global Safety Pharmacology, Pfizer Inc, MS8274-1347 Eastern Point Road, Groton, CT, 06340, USA
| | - Jules C Hancox
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Bjorn C Knollmann
- Vanderbilt University School of Medicine, 1285 Medical Research Building IV, Nashville, Tennessee, 37232, USA
| | - Gary R Mirams
- Computational Biology, Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Jon Skinner
- Cardiac Inherited Disease Group, Starship Hospital, Auckland, New Zealand
| | - Wojciech Zareba
- University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Jamie I Vandenberg
- Victor Chang Cardiac Research Institute, 405 Liverpool Street, Darlinghurst, NSW, 2010, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia
| |
Collapse
|
27
|
Rodriguez B, Carusi A, Abi-Gerges N, Ariga R, Britton O, Bub G, Bueno-Orovio A, Burton RAB, Carapella V, Cardone-Noott L, Daniels MJ, Davies MR, Dutta S, Ghetti A, Grau V, Harmer S, Kopljar I, Lambiase P, Lu HR, Lyon A, Minchole A, Muszkiewicz A, Oster J, Paci M, Passini E, Severi S, Taggart P, Tinker A, Valentin JP, Varro A, Wallman M, Zhou X. Human-based approaches to pharmacology and cardiology: an interdisciplinary and intersectorial workshop. Europace 2015; 18:1287-98. [PMID: 26622055 PMCID: PMC5006958 DOI: 10.1093/europace/euv320] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 08/20/2015] [Indexed: 12/12/2022] Open
Abstract
Both biomedical research and clinical practice rely on complex datasets for the physiological and genetic characterization of human hearts in health and disease. Given the complexity and variety of approaches and recordings, there is now growing recognition of the need to embed computational methods in cardiovascular medicine and science for analysis, integration and prediction. This paper describes a Workshop on Computational Cardiovascular Science that created an international, interdisciplinary and inter-sectorial forum to define the next steps for a human-based approach to disease supported by computational methodologies. The main ideas highlighted were (i) a shift towards human-based methodologies, spurred by advances in new in silico, in vivo, in vitro, and ex vivo techniques and the increasing acknowledgement of the limitations of animal models. (ii) Computational approaches complement, expand, bridge, and integrate in vitro, in vivo, and ex vivo experimental and clinical data and methods, and as such they are an integral part of human-based methodologies in pharmacology and medicine. (iii) The effective implementation of multi- and interdisciplinary approaches, teams, and training combining and integrating computational methods with experimental and clinical approaches across academia, industry, and healthcare settings is a priority. (iv) The human-based cross-disciplinary approach requires experts in specific methodologies and domains, who also have the capacity to communicate and collaborate across disciplines and cross-sector environments. (v) This new translational domain for human-based cardiology and pharmacology requires new partnerships supported financially and institutionally across sectors. Institutional, organizational, and social barriers must be identified, understood and overcome in each specific setting.
Collapse
Affiliation(s)
- Blanca Rodriguez
- Department of Computer Science, University of Oxford, Oxford, UK
| | | | - Najah Abi-Gerges
- AnaBios Corporation, San Diego Science Center, San Diego, CA 92109, USA
| | - Rina Ariga
- Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Oliver Britton
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Gil Bub
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | | | - Rebecca A B Burton
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | | | | | - Matthew J Daniels
- Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | | | - Sara Dutta
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Andre Ghetti
- AnaBios Corporation, San Diego Science Center, San Diego, CA 92109, USA
| | - Vicente Grau
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - Stephen Harmer
- William Harvey Heart Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | - Ivan Kopljar
- Discovery Sciences, Dis&Dev Research, Janssen Pharmaceutical NV, Beerse, Belgium
| | - Pier Lambiase
- Institute of Cardiovascular Science, University College London, Bars Heart Centre, London, UK
| | - Hua Rong Lu
- Discovery Sciences, Dis&Dev Research, Janssen Pharmaceutical NV, Beerse, Belgium
| | - Aurore Lyon
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Ana Minchole
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Anna Muszkiewicz
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Julien Oster
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - Michelangelo Paci
- Department of Electronics and Communications Engineering, Tampere University of Technology, BioMediTech, Tampere, Finland
| | - Elisa Passini
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Stefano Severi
- Department of Electrical, Electronic and Information Engineering, University of Bologna, Cesena 47521, Italy
| | - Peter Taggart
- Institute of Cardiovascular Science, University College London, Bars Heart Centre, London, UK
| | - Andy Tinker
- William Harvey Heart Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | | | | | | | - Xin Zhou
- Department of Computer Science, University of Oxford, Oxford, UK
| |
Collapse
|
28
|
Abi-Gerges N, Oldman KL, Garside H, Pointon A, Pollard CE. Would field potential duration, recorded from human induced pluripotent stem cell-derived cardiomyocytes, have utility as an early QT screen? J Pharmacol Toxicol Methods 2015. [DOI: 10.1016/j.vascn.2015.08.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
29
|
Butler L, Cros C, Harmer A, Pointon A, Pollard C, Abi-Gerges N. Enhanced characterization of inotropy in cardiomyocytes paced at different frequencies. J Pharmacol Toxicol Methods 2015. [DOI: 10.1016/j.vascn.2015.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
30
|
Fermini B, Hancox JC, Abi-Gerges N, Bridgland-Taylor M, Chaudhary KW, Colatsky T, Correll K, Crumb W, Damiano B, Erdemli G, Gintant G, Imredy J, Koerner J, Kramer J, Levesque P, Li Z, Lindqvist A, Obejero-Paz CA, Rampe D, Sawada K, Strauss DG, Vandenberg JI. A New Perspective in the Field of Cardiac Safety Testing through the Comprehensive In Vitro Proarrhythmia Assay Paradigm. ACTA ACUST UNITED AC 2015; 21:1-11. [PMID: 26170255 DOI: 10.1177/1087057115594589] [Citation(s) in RCA: 198] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/11/2015] [Indexed: 12/31/2022]
Abstract
For the past decade, cardiac safety screening to evaluate the propensity of drugs to produce QT interval prolongation and Torsades de Pointes (TdP) arrhythmia has been conducted according to ICH S7B and ICH E14 guidelines. Central to the existing approach are hERG channel assays and in vivo QT measurements. Although effective, the present paradigm carries a risk of unnecessary compound attrition and high cost, especially when considering costly thorough QT (TQT) studies conducted later in drug development. The C: omprehensive I: n Vitro P: roarrhythmia A: ssay (CiPA) initiative is a public-private collaboration with the aim of updating the existing cardiac safety testing paradigm to better evaluate arrhythmia risk and remove the need for TQT studies. It is hoped that CiPA will produce a standardized ion channel assay approach, incorporating defined tests against major cardiac ion channels, the results of which then inform evaluation of proarrhythmic actions in silico, using human ventricular action potential reconstructions. Results are then to be confirmed using human (stem cell-derived) cardiomyocytes. This perspective article reviews the rationale, progress of, and challenges for the CiPA initiative, if this new paradigm is to replace existing practice and, in time, lead to improved and widely accepted cardiac safety testing guidelines.
Collapse
Affiliation(s)
| | - Jules C Hancox
- School of Physiology and Pharmacology, University of Bristol, Bristol, UK
| | - Najah Abi-Gerges
- Translational Safety, Drug Safety and Metabolism, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield, UK AnaBios Corporation, San Diego, CA, USA
| | - Matthew Bridgland-Taylor
- Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield, UK
| | | | - Thomas Colatsky
- Division of Applied Regulatory Science, CDER, US Food and Drug Administration, Silver Spring, MD, USA
| | | | | | - Bruce Damiano
- Global Safety Pharmacology, Discovery Sciences, Janssen Research & Development LLC, Spring House, PA, USA
| | - Gul Erdemli
- Center for Proteomic Chemistry, Novartis Institutes for BioMedical Research, Inc, Cambridge, MA, USA
| | - Gary Gintant
- Department of Integrative Pharmacology, Integrated Sciences & Technology, AbbVie, North Chicago, IL, USA
| | - John Imredy
- Department of Safety Assessment, Merck & Co, Kenilworth, NJ, USA
| | - John Koerner
- Division of Cardiovascular and Renal Products, CDER, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - James Kramer
- ChanTest, A Charles River Company, Cleveland, OH, USA
| | - Paul Levesque
- Bristol Myers Squibb Research & Development, Princeton, NJ, USA
| | - Zhihua Li
- Division of Applied Regulatory Science, CDER, US Food and Drug Administration, Silver Spring, MD, USA
| | | | | | - David Rampe
- Preclinical Safety, Sanofi, Bridgewater, NJ, USA
| | - Kohei Sawada
- Global Cardiovascular Assessment, Eisai Co., Ltd., Ibaraki, Japan
| | - David G Strauss
- Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Jamie I Vandenberg
- Victor Chang Cardiac Research Institute, St Vincent's Clinical School, University of NSW, Darlinghurst, NSW, Australia
| |
Collapse
|
31
|
Mannikko R, Bridgland-Taylor MH, Pye H, Swallow S, Abi-Gerges N, Morton MJ, Pollard CE. Pharmacological and electrophysiological characterization of AZSMO-23, an activator of the hERG K(+) channel. Br J Pharmacol 2015; 172:3112-25. [PMID: 25684549 DOI: 10.1111/bph.13115] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 01/31/2015] [Accepted: 02/09/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND PURPOSE We aimed to characterize the pharmacology and electrophysiology of N-[3-(1H-benzimidazol-2-yl)-4-chloro-phenyl]pyridine-3-carboxamide (AZSMO-23), an activator of the human ether-a-go-go-related gene (hERG)-encoded K(+) channel (Kv 11.1). EXPERIMENTAL APPROACH Automated electrophysiology was used to study the pharmacology of AZSMO-23 on wild-type (WT), Y652A, F656T or G628C/S631C hERG, and on other cardiac ion channels. Its mechanism of action was characterized with conventional electrophysiology. KEY RESULTS AZSMO-23 activated WT hERG pre-pulse and tail current with EC50 values of 28.6 and 11.2 μM respectively. At 100 μM, pre-pulse current at +40 mV was increased by 952 ± 41% and tail current at -30 mV by 238 ± 13% compared with vehicle values. The primary mechanism for this effect was a 74.5 mV depolarizing shift in the voltage dependence of inactivation, without any shift in the voltage dependence of activation. Structure-activity relationships for this effect were remarkably subtle, with close analogues of AZSMO-23 acting as hERG inhibitors. AZSMO-23 blocked the mutant channel, hERG Y652A, but against another mutant channel, hERG F656T, its activator activity was enhanced. It inhibited activity of the G628C/S631C non-inactivating hERG mutant channel. AZSMO-23 was not hERG selective, as it blocked hKv 4.3-hKChIP2.2, hCav 3.2 and hKv 1.5 and activated hCav 1.2/β2/α2δ channels. CONCLUSION AND IMPLICATIONS The activity of AZSMO-23 and those of its close analogues suggest these compounds may be of value to elucidate the mechanism of type 2 hERG activators to better understand the pharmacology of this area from both a safety perspective and in relation to treatment of congenital long QT syndrome.
Collapse
Affiliation(s)
- R Mannikko
- Institute of Neurology, Faculty of Brain Sciences, University College London, London, Middlesex, UK
| | | | - H Pye
- AstraZeneca, Macclesfield, Cheshire, UK
| | - S Swallow
- AstraZeneca, Macclesfield, Cheshire, UK
| | | | | | | |
Collapse
|
32
|
Butler L, Cros C, Oldman KL, Harmer AR, Pointon A, Pollard CE, Abi-Gerges N. Enhanced Characterization of Contractility in Cardiomyocytes During Early Drug Safety Assessment. Toxicol Sci 2015; 145:396-406. [DOI: 10.1093/toxsci/kfv062] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
|
33
|
Pointon A, Harmer AR, Dale IL, Abi-Gerges N, Bowes J, Pollard C, Garside H. Assessment of cardiomyocyte contraction in human-induced pluripotent stem cell-derived cardiomyocytes. Toxicol Sci 2014; 144:227-37. [PMID: 25538221 DOI: 10.1093/toxsci/kfu312] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Functional changes to cardiomyocytes are a common cause of attrition in preclinical and clinical drug development. Current approaches to assess cardiomyocyte contractility in vitro are limited to low-throughput methods not amenable to early drug discovery. Human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs) were used to assess their suitability to detect drug-induced changes in cardiomyocyte contraction. Application of field stimulation and measurement of cardiac contraction (IonOptix edge detection) and Ca(2+) transients confirmed hiPS-CMs to be a suitable model to investigate drug-induced changes in cardiomyocyte contractility. Using a live cell, fast kinetic fluorescent assay with a Ca(2+) sensitive dye to test 31 inotropic and 20 non-inotropic compounds in vivo, we report that hiPS-CMs provide a high-throughput experimental model to detect changes in cardiomyocyte contraction that is applicable to early drug discovery with a sensitivity and specificity of 87% and 70%, respectively. Moreover, our data provide evidence of the detection of this liability at therapeutically relevant concentrations with throughput amenable to influencing chemical design in drug discovery. Measurement of multiple parameters of the Ca(2+) transient in addition to the number of Ca(2+) transients offered no insight into the mechanism of cardiomyocyte contraction.
Collapse
Affiliation(s)
- Amy Pointon
- *Translational Safety, Discovery Safety, Drug Safety and Metabolism and Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield SK10 4TG, UK
| | - Alexander R Harmer
- *Translational Safety, Discovery Safety, Drug Safety and Metabolism and Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield SK10 4TG, UK
| | - Ian L Dale
- *Translational Safety, Discovery Safety, Drug Safety and Metabolism and Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield SK10 4TG, UK
| | - Najah Abi-Gerges
- *Translational Safety, Discovery Safety, Drug Safety and Metabolism and Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield SK10 4TG, UK
| | - Joanne Bowes
- *Translational Safety, Discovery Safety, Drug Safety and Metabolism and Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield SK10 4TG, UK
| | - Christopher Pollard
- *Translational Safety, Discovery Safety, Drug Safety and Metabolism and Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield SK10 4TG, UK
| | - Helen Garside
- *Translational Safety, Discovery Safety, Drug Safety and Metabolism and Discovery Sciences, Innovative Medicines and Early Development, AstraZeneca R&D, Macclesfield SK10 4TG, UK
| |
Collapse
|
34
|
Scott CW, Zhang X, Peters MF, Abassi YA, Abi-Gerges N. Developing a medium throughput cellular assay to quantify modulators of contractility using human induced pluripotent stem cell-derived cardiomyocytes. J Pharmacol Toxicol Methods 2014. [DOI: 10.1016/j.vascn.2014.03.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
35
|
Mirams GR, Davies MR, Brough SJ, Bridgland-Taylor MH, Cui Y, Gavaghan DJ, Abi-Gerges N. Prediction of Thorough QT study results using action potential simulations based on ion channel screens. J Pharmacol Toxicol Methods 2014; 70:246-54. [PMID: 25087753 PMCID: PMC4266452 DOI: 10.1016/j.vascn.2014.07.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 06/18/2014] [Accepted: 07/10/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Detection of drug-induced pro-arrhythmic risk is a primary concern for pharmaceutical companies and regulators. Increased risk is linked to prolongation of the QT interval on the body surface ECG. Recent studies have shown that multiple ion channel interactions can be required to predict changes in ventricular repolarisation and therefore QT intervals. In this study we attempt to predict the result of the human clinical Thorough QT (TQT) study, using multiple ion channel screening which is available early in drug development. METHODS Ion current reduction was measured, in the presence of marketed drugs which have had a TQT study, for channels encoded by hERG, CaV1.2, NaV1.5, KCNQ1/MinK, and Kv4.3/KChIP2.2. The screen was performed on two platforms - IonWorks Quattro (all 5 channels, 34 compounds), and IonWorks Barracuda (hERG & CaV1.2, 26 compounds). Concentration-effect curves were fitted to the resulting data, and used to calculate a percentage reduction in each current at a given concentration. Action potential simulations were then performed using the ten Tusscher and Panfilov (2006), Grandi et al. (2010) and O'Hara et al. (2011) human ventricular action potential models, pacing at 1Hz and running to steady state, for a range of concentrations. RESULTS We compared simulated action potential duration predictions with the QT prolongation observed in the TQT studies. At the estimated concentrations, simulations tended to underestimate any observed QT prolongation. When considering a wider range of concentrations, and conventional patch clamp rather than screening data for hERG, prolongation of ≥5ms was predicted with up to 79% sensitivity and 100% specificity. DISCUSSION This study provides a proof-of-principle for the prediction of human TQT study results using data available early in drug development. We highlight a number of areas that need refinement to improve the method's predictive power, but the results suggest that such approaches will provide a useful tool in cardiac safety assessment.
Collapse
Affiliation(s)
- Gary R Mirams
- Computational Biology, Dept. of Computer Science, University of Oxford, Oxford OX1 3QD, UK.
| | - Mark R Davies
- Clinical Informatics, R&D Information, AstraZeneca, Alderley Park, SK10 4TG, UK
| | - Stephen J Brough
- Screening & Compound Profiling, GlaxoSmithKline, Stevenage SG1 2NY, UK
| | | | - Yi Cui
- Safety Evaluation and Risk Management, Global Clinical Safety, GlaxoSmithKline, Middlesex UB11 1BT, UK
| | - David J Gavaghan
- Computational Biology, Dept. of Computer Science, University of Oxford, Oxford OX1 3QD, UK
| | - Najah Abi-Gerges
- Translational Safety Department, Drug Safety & Metabolism, AstraZeneca, Alderley Park, SK10 4TG, UK
| |
Collapse
|
36
|
Mirams G, Davies M, Stott J, Rodriguez B, Cui Y, Noble D, Gavaghan D, Abi-Gerges N. In silico pro-arrhythmia assessment: Can the results of the thorough QT study be predicted? J Pharmacol Toxicol Methods 2014. [DOI: 10.1016/j.vascn.2014.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
37
|
Scott CW, Zhang X, Abi-Gerges N, Lamore SD, Abassi YA, Peters MF. An impedance-based cellular assay using human iPSC-derived cardiomyocytes to quantify modulators of cardiac contractility. Toxicol Sci 2014; 142:331-8. [PMID: 25237062 DOI: 10.1093/toxsci/kfu186] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cardiovascular toxicity, a prominent reason for late-stage failures in drug development, has resulted in a demand for in vitro assays that can predict this liability in early drug discovery. Current in vitro cardiovascular safety testing primarily focuses on ion channel modulation and low throughput cardiomyocyte (CM) contractility measurements. We evaluated both human induced pluripotent stem cell-derived CMs (hiPSC-CMs) and rat neonatal CMs (rat CMs) on the xCELLigence Cardio system which uses impedance technology to quantify CM beating properties in a 96-well format. Forty-nine compounds were tested in concentration-response mode to determine potency for modulation of CM beating, a surrogate biomarker for contractility. These compounds had previously been tested in vivo and in a low throughput in vitro optical-based contractility assay that measures sarcomere shortening in electrically paced dog CMs. In comparison with in vivo contractility effects, hiPSC-CM impedance had assay sensitivity, specificity, and accuracy values of 90%, 74%, and 82%, respectively. These values compared favorably to values reported for the dog CM optical assay (83%, 84%, and 82%) and were slightly better than impedance using rat CMs (77%, 74%, and 74%). The potency values from the hiPSC-CM and rat CM assays spanned four orders of magnitude and correlated with values from the dog CM optical assay (r(2 )= 0.76 and 0.70, respectively). The Cardio system assay has >5× higher throughput than the optical assay. Thus, hiPSC-CM impedance testing can help detect the human cardiotoxic potential of novel therapeutics early in drug discovery, and if a hazard is identified, has sufficient throughput to support the design-make-test-analyze cycle to mitigate this liability.
Collapse
Affiliation(s)
- Clay W Scott
- *Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Waltham, Massachusetts 02451, ACEA Biosciences Inc., San Diego, California 92121 and Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Alderley Park, SK10 4TG, UK
| | - Xiaoyu Zhang
- *Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Waltham, Massachusetts 02451, ACEA Biosciences Inc., San Diego, California 92121 and Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Alderley Park, SK10 4TG, UK
| | - Najah Abi-Gerges
- *Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Waltham, Massachusetts 02451, ACEA Biosciences Inc., San Diego, California 92121 and Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Alderley Park, SK10 4TG, UK
| | - Sarah D Lamore
- *Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Waltham, Massachusetts 02451, ACEA Biosciences Inc., San Diego, California 92121 and Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Alderley Park, SK10 4TG, UK
| | - Yama A Abassi
- *Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Waltham, Massachusetts 02451, ACEA Biosciences Inc., San Diego, California 92121 and Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Alderley Park, SK10 4TG, UK
| | - Matthew F Peters
- *Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Waltham, Massachusetts 02451, ACEA Biosciences Inc., San Diego, California 92121 and Drug Safety and Metabolism, AstraZeneca Pharmaceuticals, Alderley Park, SK10 4TG, UK
| |
Collapse
|
38
|
Molina CE, Johnson DM, Mehel H, Spätjens RLHMG, Mika D, Algalarrondo V, Slimane ZH, Lechêne P, Abi-Gerges N, van der Linde HJ, Leroy J, Volders PGA, Fischmeister R, Vandecasteele G. Interventricular differences in β-adrenergic responses in the canine heart: role of phosphodiesterases. J Am Heart Assoc 2014; 3:e000858. [PMID: 24904016 PMCID: PMC4309082 DOI: 10.1161/jaha.114.000858] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background RV and LV have different embryologic, structural, metabolic, and electrophysiologic characteristics, but whether interventricular differences exist in β‐adrenergic (β‐AR) responsiveness is unknown. In this study, we examine whether β‐AR response and signaling differ in right (RV) versus left (LV) ventricles. Methods and Results Sarcomere shortening, Ca2+ transients, ICa,L and IKs currents were recorded in isolated dog LV and RV midmyocytes. Intracellular [cAMP] and PKA activity were measured by live cell imaging using FRET‐based sensors. Isoproterenol increased sarcomere shortening ≈10‐fold and Ca2+‐transient amplitude ≈2‐fold in LV midmyocytes (LVMs) versus ≈25‐fold and ≈3‐fold in RVMs. FRET imaging using targeted Epac2camps sensors revealed no change in subsarcolemmal [cAMP], but a 2‐fold higher β‐AR stimulation of cytoplasmic [cAMP] in RVMs versus LVMs. Accordingly, β‐AR regulation of ICa,L and IKs were similar between LVMs and RVMs, whereas cytoplasmic PKA activity was increased in RVMs. Both PDE3 and PDE4 contributed to the β‐AR regulation of cytoplasmic [cAMP], and the difference between LVMs and RVMs was abolished by PDE3 inhibition and attenuated by PDE4 inhibition. Finally LV and RV intracavitary pressures were recorded in anesthetized beagle dogs. A bolus injection of isoproterenol increased RV dP/dtmax≈5‐fold versus 3‐fold in LV. Conclusion Canine RV and LV differ in their β‐AR response due to intrinsic differences in myocyte β‐AR downstream signaling. Enhanced β‐AR responsiveness of the RV results from higher cAMP elevation in the cytoplasm, due to a decreased degradation by PDE3 and PDE4 in the RV compared to the LV.
Collapse
Affiliation(s)
- Cristina E Molina
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| | - Daniel M Johnson
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, 6202 AZ, Maastricht, The Netherlands (D.M.J., R.G.S., P.A.V.)
| | - Hind Mehel
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| | - Roel L H M G Spätjens
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, 6202 AZ, Maastricht, The Netherlands (D.M.J., R.G.S., P.A.V.)
| | - Delphine Mika
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| | - Vincent Algalarrondo
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| | - Zeineb Haj Slimane
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| | - Patrick Lechêne
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| | - Najah Abi-Gerges
- Department of Translational Safety, DrugSafety and Metabolism, AstraZeneca R&D Innovative Medicines and Early Development, Alderley Park, Macclesfield, SK10 4TG, Cheshire, UK (N.A.G.)
| | - Henk J van der Linde
- Global Safety Research, Preclinical Development & Safety, Discovery Sciences, Janssen Research & Development, Beerse, Belgium (H.J.L.)
| | - Jérôme Leroy
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| | - Paul G A Volders
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, 6202 AZ, Maastricht, The Netherlands (D.M.J., R.G.S., P.A.V.)
| | - Rodolphe Fischmeister
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| | - Grégoire Vandecasteele
- INSERM UMR-S 769, LabEx LERMIT, DHU TORINO, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.) Université Paris-Sud, Châtenay-Malabry, France (C.E.M., H.M., D.M., V.A., Z.H.S., P.L., L., R.F., G.V.)
| |
Collapse
|
39
|
DI Veroli GY, Davies MR, Zhang H, Abi-Gerges N, Boyett MR. hERG inhibitors with similar potency but different binding kinetics do not pose the same proarrhythmic risk: implications for drug safety assessment. J Cardiovasc Electrophysiol 2013; 25:197-207. [PMID: 24118558 DOI: 10.1111/jce.12289] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/22/2013] [Accepted: 08/29/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Since the discovery of the link that exists between drug-induced hERG inhibition and Torsade de Pointes (TdP), extreme attention has been given to avoid new drugs inhibiting this channel. hERG inhibition is routinely screened for in new drugs and, typically, IC50 values are compared to projected plasma concentrations to define a safety margin. METHODS AND RESULTS We aimed to show that drugs with similar hERG potency are not uniformly pro-arrhythmic-this depends on the drug binding kinetics and mode of action (trapped or not) rather than the IC50 value only. We used a mathematical model of hERG and its related encoded current IKr to simulate drug binding in different configurations. Expression systems mimicking the screening process were first investigated. hERG model was then incorporated into a canine action potential (AP) and tissue model to study the impact of drug binding configurations on AP and pseudo-ECG (QT interval prolongation). Our data show that: (1) trapped and not trapped configurations and different binding kinetics could be identified during hERG screening; (2) slow binding, not trapped drugs, induced less AP prolongation and minimal QT interval prolongation (4.7%) at a concentration equal to the IC50 whereas maximal pro-arrhythmic risk was observed for trapped drugs at the same concentration (QT interval prolongation, 23.1%). CONCLUSION Our study demonstrates the need for screening for hERG binding configurations rather than potency alone. It also demonstrates the potential link between hERG, drug mode of action and TdP, and the need to question the current regulatory guidance.
Collapse
Affiliation(s)
- Giovanni Y DI Veroli
- Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK; Translational Safety, Drug Safety & Metabolism, AstraZeneca, Manchester, UK
| | | | | | | | | |
Collapse
|
40
|
Elkins RC, Davies MR, Brough SJ, Gavaghan DJ, Cui Y, Abi-Gerges N, Mirams GR. Variability in high-throughput ion-channel screening data and consequences for cardiac safety assessment. J Pharmacol Toxicol Methods 2013; 68:112-22. [PMID: 23651875 PMCID: PMC4135079 DOI: 10.1016/j.vascn.2013.04.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/05/2013] [Accepted: 04/25/2013] [Indexed: 11/29/2022]
Abstract
Introduction Unwanted drug interactions with ionic currents in the heart can lead to an increased proarrhythmic risk to patients in the clinic. It is therefore a priority for safety pharmacology teams to detect block of cardiac ion channels, and new technologies have enabled the development of automated and high-throughput screening assays using cell lines. As a result of screening multiple ion-channels there is a need to integrate information, particularly for compounds affecting more than one current, and mathematical electrophysiology in-silico action potential models are beginning to be used for this. Methods We quantified the variability associated with concentration-effect curves fitted to recordings from high-throughput Molecular Devices IonWorks® Quattro™ screens when detecting block of IKr (hERG), INa (NaV1.5), ICaL (CaV1.2), IKs (KCNQ1/minK) and Ito (Kv4.3/KChIP2.2), and the Molecular Devices FLIPR® Tetra fluorescence screen for ICaL (CaV1.2), for control compounds used at AstraZeneca and GlaxoSmithKline. We examined how screening variability propagates through in-silico action potential models for whole cell electrical behaviour, and how confidence intervals on model predictions can be estimated with repeated simulations. Results There are significant levels of variability associated with high-throughput ion channel electrophysiology screens. This variability is of a similar magnitude for different cardiac ion currents and different compounds. Uncertainty in the Hill coefficients of reported concentration-effect curves is particularly high. Depending on a compound’s ion channel blocking profile, the uncertainty introduced into whole-cell predictions can become significant. Discussion Our technique allows confidence intervals to be placed on computational model predictions that are based on high-throughput ion channel screens. This allows us to suggest when repeated screens should be performed to reduce uncertainty in a compound’s action to acceptable levels, to allow a meaningful interpretation of the data.
Collapse
Affiliation(s)
- Ryan C Elkins
- Global Safety Pharmacology, Global Safety Assessment, AstraZeneca, Alderley Park SK10 4TG, UK
| | | | | | | | | | | | | |
Collapse
|
41
|
Pointon A, Abi-Gerges N, Cross MJ, Sidaway JE. Phenotypic Profiling of Structural Cardiotoxins In Vitro Reveals Dependency on Multiple Mechanisms of Toxicity. Toxicol Sci 2013; 132:317-26. [DOI: 10.1093/toxsci/kft005] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
|
42
|
Di Veroli GY, Davies MR, Zhang H, Abi-Gerges N, Boyett MR. High-throughput screening of drug-binding dynamics to HERG improves early drug safety assessment. Am J Physiol Heart Circ Physiol 2013; 304:H104-17. [DOI: 10.1152/ajpheart.00511.2012] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The use of computational models to predict drug-induced changes in the action potential (AP) is a promising approach to reduce drug safety attrition but requires a better representation of more complex drug-target interactions to improve the quantitative prediction. The blockade of the human ether-a-go-go-related gene (HERG) channel is a major concern for QT prolongation and Torsade de Pointes risk. We aim to develop quantitative in-silico AP predictions based on a new electrophysiological protocol (suitable for high-throughput HERG screening) and mathematical modeling of ionic currents. Electrophysiological recordings using the IonWorks device were made from HERG channels stably expressed in Chinese hamster ovary cells. A new protocol that delineates inhibition over time was applied to assess dofetilide, cisapride, and almokalant effects. Dynamic effects displayed distinct profiles for these drugs compared with concentration-effects curves. Binding kinetics to specific states were identified using a new HERG Markov model. The model was then modified to represent the canine rapid delayed rectifier K+ current at 37°C and carry out AP predictions. Predictions were compared with a simpler model based on conductance reduction and were found to be much closer to experimental data. Improved sensitivity to concentration and pacing frequency variables was obtained when including binding kinetics. Our new electrophysiological protocol is suitable for high-throughput screening and is able to distinguish drug-binding kinetics. The association of this protocol with our modeling approach indicates that quantitative predictions of AP modulation can be obtained, which is a significant improvement compared with traditional conductance reduction methods.
Collapse
Affiliation(s)
- Giovanni Y. Di Veroli
- Institute of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
- Global Safety Assessment, AstraZeneca, United Kingdom
| | - Mark R. Davies
- Clinical Informatics, Research and Development Information, AstraZeneca, United Kingdom
| | - Henggui Zhang
- Biological Physics, University of Manchester, Manchester, United Kingdom
| | | | - Mark R. Boyett
- Institute of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
43
|
Johnson DM, Heijman J, Bode EF, Greensmith DJ, van der Linde H, Abi-Gerges N, Eisner DA, Trafford AW, Volders PGA. Diastolic spontaneous calcium release from the sarcoplasmic reticulum increases beat-to-beat variability of repolarization in canine ventricular myocytes after β-adrenergic stimulation. Circ Res 2012; 112:246-56. [PMID: 23149594 DOI: 10.1161/circresaha.112.275735] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
RATIONALE Spontaneous Ca(2+) release (SCR) from the sarcoplasmic reticulum can cause delayed afterdepolarizations and triggered activity, contributing to arrhythmogenesis during β-adrenergic stimulation. Excessive beat-to-beat variability of repolarization duration (BVR) is a proarrhythmic marker. Previous research has shown that BVR is increased during intense β-adrenergic stimulation, leading to SCR. OBJECTIVE We aimed to determine ionic mechanisms controlling BVR under these conditions. METHODS AND RESULTS Membrane potentials and cell shortening or Ca(2+) transients were recorded from isolated canine left ventricular myocytes in the presence of isoproterenol. Action-potential (AP) durations after delayed afterdepolarizations were significantly prolonged. Addition of slowly activating delayed rectifier K(+) current (I(Ks)) blockade led to further AP prolongation after SCR, and this strongly correlated with exaggerated BVR. Suppressing SCR via inhibition of ryanodine receptors, Ca(2+)/calmodulin-dependent protein kinase II inhibition, or by using Mg(2+) or flecainide eliminated delayed afterdepolarizations and decreased BVR independent of effects on AP duration. Computational analyses and voltage-clamp experiments measuring L-type Ca(2+) current (I(CaL)) with and without previous SCR indicated that I(CaL) was increased during Ca(2+)-induced Ca(2+) release after SCR, and this contributes to AP prolongation. Prolongation of QT, T(peak)-T(end) intervals, and left ventricular monophasic AP duration of beats after aftercontractions occurred before torsades de pointes in an in vivo dog model of drug-induced long-QT1 syndrome. CONCLUSIONS SCR contributes to increased BVR by interspersed prolongation of AP duration, which is exacerbated during I(Ks) blockade. Attenuation of Ca(2+)-induced Ca(2+) release by SCR underlies AP prolongation via increased I(CaL.) These data provide novel insights into arrhythmogenic mechanisms during β-adrenergic stimulation besides triggered activity and illustrate the importance of I(Ks) function in preventing excessive BVR.
Collapse
Affiliation(s)
- Daniel M Johnson
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Davies MR, Mistry HB, Hussein L, Pollard CE, Valentin JP, Swinton J, Abi-Gerges N. An in silico canine cardiac midmyocardial action potential duration model as a tool for early drug safety assessment. Am J Physiol Heart Circ Physiol 2012; 302:H1466-80. [DOI: 10.1152/ajpheart.00808.2011] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cell lines expressing ion channels (IC) and the advent of plate-based electrophysiology device have enabled a molecular understanding of the action potential (AP) as a means of early QT assessment. We sought to develop an in silico AP (isAP) model that provides an assessment of the effect of a compound on the myocyte AP duration (APD) using concentration-effect curve data from a panel of five ICs (hNav1.5, hCav1.2, hKv4.3/hKChIP2.2, hKv7.1/hminK, hKv11.1). A test set of 53 compounds was selected to cover a range of selective and mixed IC modulators that were tested for their effects on optically measured APD. A threshold of >10% change in APD at 90% repolarization (APD90) was used to signify an effect at the top test concentration. To capture the variations observed in left ventricular midmyocardial myocyte APD data from 19 different dogs, the isAP model was calibrated to produce an ensemble of 19 model variants that could capture the shape and form of the APs and also quantitatively replicate dofetilide- and diltiazem-induced APD90 changes. Provided with IC panel data only, the isAP model was then used, blinded, to predict APD90 changes greater than 10%. At a simulated concentration of 30 μM and based on a criterion that six of the variants had to agree, isAP prediction was scored as showing greater than 80% predictivity of compound activity. Thus, early in drug discovery, the isAP model allows integrating separate IC data and is amenable to the throughput required for use as a virtual screen.
Collapse
Affiliation(s)
| | | | - L. Hussein
- Safety Pharmacology, Safety Assessment United Kingdom, AstraZeneca R&D, Macclesfield, United Kingdom
| | - C. E. Pollard
- Safety Pharmacology, Safety Assessment United Kingdom, AstraZeneca R&D, Macclesfield, United Kingdom
| | - J.-P. Valentin
- Safety Pharmacology, Safety Assessment United Kingdom, AstraZeneca R&D, Macclesfield, United Kingdom
| | - J. Swinton
- Computational Biology, Discovery Sciences and
| | - N. Abi-Gerges
- Safety Pharmacology, Safety Assessment United Kingdom, AstraZeneca R&D, Macclesfield, United Kingdom
| |
Collapse
|
45
|
Harmer A, Abi-Gerges N, Morton M, Pullen G, Valentin J, Pollard C. Validation of an in vitro contractility assay using canine ventricular myocytes. Toxicol Appl Pharmacol 2012; 260:162-72. [DOI: 10.1016/j.taap.2012.02.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 02/06/2012] [Accepted: 02/13/2012] [Indexed: 12/21/2022]
|
46
|
Johnson D, Heijman J, Bode E, Greensmith D, Abi-Gerges N, Eisner D, Trafford A, Volders P. Increased ICaL Underlies Ventricular Action-Potential Prolongation After Spontaneous Ca2+ Release From The Sarcoplasmic Reticulum. Heart Rhythm 2011. [DOI: 10.1016/j.hrthm.2011.09.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
47
|
Abi-Gerges N, Holkham H, Jones EMC, Pollard CE, Valentin JP, Robertson GA. hERG subunit composition determines differential drug sensitivity. Br J Pharmacol 2011; 164:419-32. [PMID: 21449979 PMCID: PMC3188906 DOI: 10.1111/j.1476-5381.2011.01378.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 03/04/2011] [Accepted: 03/07/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE The majority of human ether-a-go-go-related gene (hERG) screens aiming to minimize the risk of drug-induced long QT syndrome have been conducted using heterologous systems expressing the hERG 1a subunit, although both hERG 1a and 1b subunits contribute to the K+ channels producing the repolarizing current I(Kr) . We tested a range of compounds selected for their diversity to determine whether hERG 1a and 1a/1b channels exhibit different sensitivities that may influence safety margins or contribute to a stratified risk analysis. EXPERIMENTAL APPROACH We used the IonWorks™ plate-based electrophysiology device to compare sensitivity of hERG 1a and 1a/1b channels stably expressed in HEK293 cells to 50 compounds previously shown to target hERG channels. Potency was determined as IC₅₀ values (µM) obtained from non-cumulative, eight-point concentration-effect curves of normalized data, fitted to the Hill equation. To minimize possible sources of variability, compound potency was assessed using test plates arranged in alternating columns of cells expressing hERG 1a and 1a/1b. KEY RESULTS Although the potency of most compounds was similar for the two targets, some surprising differences were observed. Fluoxetine (Prozac) was more potent at blocking hERG 1a/1b than 1a channels, yielding a corresponding reduction in the safety margin. In contrast, E-4031 was a more potent blocker of hERG 1a compared with 1a/1b channels, as previously reported, as was dofetilide, another high-affinity blocker. CONCLUSIONS AND IMPLICATIONS The current assays may underestimate the risk of some drugs to cause torsades de pointes arrhythmia, and overestimate the risk of others.
Collapse
Affiliation(s)
- N Abi-Gerges
- Safety Pharmacology, Safety Assessment UK, AstraZeneca R&D Alderley Park, Macclesfield, UK.
| | | | | | | | | | | |
Collapse
|
48
|
Holkham HO, Robertson GA, Pollard CE, Valentin JP, Abi-Gerges N. hERG1a/1B heteromeric and hERG1a homomeric channels exhibit different pharmacological sensitivities. J Pharmacol Toxicol Methods 2010. [DOI: 10.1016/j.vascn.2010.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
49
|
Andersson B, Abi-Gerges N, Carlsson L. The combined ion channel blocker AZD1305 attenuates late Na current and IKr-induced action potential prolongation and repolarization instability. Europace 2010; 12:1003-10. [DOI: 10.1093/europace/euq070] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
50
|
Abi-Gerges N, Holkham H, Pollard C, Valentin J, Robertson GA. hERG Heteromeric 1A/1B and Homomeric 1A Channels Exhibit Differential Pharmacological Sensitivities. Biophys J 2010. [DOI: 10.1016/j.bpj.2009.12.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|