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Dow R, DeLong C, Jiang G, Attili D, Creech J, Kraan R, Campbell K, Saraithong P, O’Shea S, Monteiro da Rocha A, McInnis MG, Herron TJ. Bipolar Patient-Specific In Vitro Diagnostic Test Reveals Underlying Cardiac Arrhythmia Phenotype Caused by Calcium Channel Genetic Risk Factor. Biol Psychiatry Glob Open Sci 2024; 4:100296. [PMID: 38560725 PMCID: PMC10978474 DOI: 10.1016/j.bpsgos.2024.100296] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/12/2024] [Accepted: 02/02/2024] [Indexed: 04/04/2024] Open
Abstract
A common genetic risk factor for bipolar disorder is CACNA1C, a gene that is also critical for cardiac rhythm. The impact of CACNA1C mutations on bipolar patient cardiac rhythm is unknown. Here, we report the cardiac electrophysiological implications of a bipolar disorder-associated genetic risk factor in CACNA1C using patient induced pluripotent stem cell-derived cardiomyocytes. Results indicate that the CACNA1C bipolar disorder-related mutation causes cardiac electrical impulse conduction slowing mediated by impaired intercellular coupling via connexin 43 gap junctions. In vitro gene therapy to restore connexin 43 expression increased cardiac electrical impulse conduction velocity and protected against thioridazine-induced QT prolongation. Patients positive for bipolar disorder CACNA1C genetic risk factors may have elevated proarrhythmic risk for adverse events in response to psychiatric medications that slow conduction or prolong the QT interval. This in vitro diagnostic tool enables cardiac testing specific to patients with psychiatric disorders to determine their sensitivity to off-target effects of psychiatric medications.
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Affiliation(s)
- Rachel Dow
- Frankel Cardiovascular Regeneration Core Laboratory, University of Michigan, Ann Arbor, Michigan
| | - Cindy DeLong
- Michigan Medicine, Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan
| | - Guihua Jiang
- Michigan Medicine, Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan
| | - Durga Attili
- Michigan Medicine, Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan
| | - Jeffery Creech
- Frankel Cardiovascular Regeneration Core Laboratory, University of Michigan, Ann Arbor, Michigan
| | - Rachel Kraan
- Frankel Cardiovascular Regeneration Core Laboratory, University of Michigan, Ann Arbor, Michigan
| | - Katherine Campbell
- Michigan Medicine, Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan
| | - Prakaimuk Saraithong
- Frankel Cardiovascular Regeneration Core Laboratory, University of Michigan, Ann Arbor, Michigan
- Michigan Medicine, Internal Medicine-Cardiology, University of Michigan, Ann Arbor, Michigan
| | - Sue O’Shea
- Michigan Medicine, Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan
- Michigan Medicine, Psychiatry Department, University of Michigan, Ann Arbor, Michigan
| | - Andre Monteiro da Rocha
- Frankel Cardiovascular Regeneration Core Laboratory, University of Michigan, Ann Arbor, Michigan
- Michigan Medicine, Internal Medicine-Cardiology, University of Michigan, Ann Arbor, Michigan
| | - Melvin G. McInnis
- Michigan Medicine, Psychiatry Department, University of Michigan, Ann Arbor, Michigan
| | - Todd J. Herron
- Frankel Cardiovascular Regeneration Core Laboratory, University of Michigan, Ann Arbor, Michigan
- Michigan Medicine, Internal Medicine-Cardiology, University of Michigan, Ann Arbor, Michigan
- Michigan Medicine, Molecular & Integrative Physiology, University of Michigan, Ann Arbor, Michigan
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