CaMKII delta interaction with neuronal sodium channel Nav1.8 contributes to arrhythmogenic triggers in failing human and mouse cardiomyocytes

 

In heart failure, enhanced persistent current through neuronal sodium channel NaV1.8 (INaL) may induce influx of Na+ into cardiomyocytes. This may cause Ca2+ influx via the Na+/Ca2+ exchanger leading to increased proarrhythmogenic diastolic sarcoplasmic reticulum (SR) Ca2+ leak. This Ca2+ may activate Ca2+/calmodulin-dependent protein kinase IIδ (CaMKIIδ) which can induce INaL augmentation by phosphorylating NaV1.5 channels leading to a vicious cycle between INaL and CaMKIIδ.

Here, we examined whether CaMKIIδ associates with NaV1.8 in human and mouse cardiomyocytes thereby regulating its function. Interaction and co-localisation of CaMKIIδ and NaV1.8 were confirmed by co-immunoprecipitation and immunocytochemistry. Whole-cell patch clamp showed a potent reduction of INaL after addition of novel specific Nav1.8 blockers, either A-803467 (30 nmol/L) or PF-01247324 (1 μmol/L) in failing mouse cardiomyocytes overexpressing CaMKIIδc (CaMKIIδc+/T: −109.4±10.6 vs A-803467: −56.9±11.7 and PF-01247324:−-69.9±8.6 A*ms*F-1). In failing human cardiomyocytes inhibition of either NaV1.8 or CaMKIIδ using AIP (1 μmol/L) or AIP and PF-01247324 together led to a significant and comparable decrease of INaL (control: −93.7±7.1 vs PF-01247324: −56.8±6.6; AIP: −44.2±6.6; AIP+PF-01247324: −39.8±5.4 A*ms*F-1). Furthermore, to confirm whether observed alterations in INaL after inhibition of NaV1.8 are not due to an overall reduction in peak sodium current (INa) we measured INa properties in mouse cardiomyocytes. Importantly, we observed no difference neither in the peak nor in inactivation between wild type (WT), WT with PF-01247324 and in mice lacking NaV1.8. Using confocal microscopy we investigated whether inhibition of the NaV1.8-mediated INaL could attenuate the increase of proarrhythmogenic SR Ca2+ spark frequency (CaSpF) caused by overexpression of CaMKIIδ in mice. We observed a significant reduction of CaSpF in both NaV1.8 inhibitor groups (PF-01247324: 0.51±0.08 and A-803467: 0.57±0.08 μm–1 s–1) compared to control (1.00±0.13 μm–1 s–1). Incubation of human failing cardiomyocytes with either AIP (0.35±0.06 μm–1 s–1) or PF-01247324 (0.44±0.11 μm–1 s–1), or blocking CaMKIIδ and NaV1.8 together (0.30±0.08 μm–1 s–1) resulted in significant decrease of CaSpF compared to control (0.89±0.13 μm–1 s–1).

In conclusion, we show for the first time subcellular localisation of the neuronal sodium channel NaV1.8 and its interaction with CaMKIIδ in both human and mouse ventricular cardiomyocytes. Moreover, pharmacological inhibition of NaV1.8 caused a reduction of the augmented INaL and spontaneous diastolic SR-Ca2+ release in both failing human and mouse cardiomyocytes. NaV1.8 and CaMKIIδ interaction seem to play a relevant role for the generation of arrhythmogenic triggers (INaL & spontaneous diastolic SR-Ca2+ release) in both human and mouse cardiomyocytes from failing hearts.

Funding Acknowledgement

Type of funding source: None

SCN10A-knock-out improves survival and proarrhythmia in a transgenic heart failure mouse model

Background

In heart failure (HF) both Ca2+/Calmodulin-dependent protein-kinase II (CaMKII) and late sodium current (INaL) are known to contribute to arrhythmogenesis as they contribute to action-potential (AP) prolongation and the occurrence of early- (EADs) and delayed afterdepolarizations (DADs). Further, augmented CaMKII and INaL maintain a vicious cycle as they both can activate each other. We recently found that the sodium channel isoform NaV1.8 is upregulated in HF and hypertrophy and that it is involved in INaL-generation. In the current study we investigated the effects of NaV1.8-knock-out (KO) on HF-progression and arrhythmogenesis in a CaMKII-overexpressing HF mouse model.

Methods/Results

CaMKII overexpressing mice (CaMKII+/T) were crossbred with NaV1.8-KO mice (SCN10A−/−). To our surprise knock-out of NaV1.8 in CaMKII+/T mice (SCN10A−/−/CaMKII+/T) significantly improved survival (median survival 103 days vs 74.5 CaMKII+/T, p<0.01). CaMKII+/T mice exhibited a strong HF phenotype compared to WT with increased heart-weight to tibia length ratio as well as reduced ejection fraction and left-ventricular end-diastolic diameter obtained by echocardiography. However, these structural parameters did not differ between SCN10A−/−/CaMKII+/T and CaMKII+/T. Therefore, cellular electrophysiology experiments were performed in isolated cardiomyocytes for a better understanding of the observed improvement in survival. INaL, measured by patch-clamp technique, was significantly augmented in CaMKII+/T vs WT and SCN10A−/−, while SCN10A−/−/CaMKII+/T showed significantly less INaL than CaMKII+/T alone. Further, AP-duration (APD) was significantly reduced in SCN10A−/−/CaMKII+/T vs CaMKII+/T while AP-amplitude, resting membrane-potential and upstroke velocity (dv/dtmax) remained unchanged. In addition, the occurrence of afterdepolarizations was significantly lower in SCN10A−/−/ CaMKII+/T vs CaMKII+/T. Confocal microscopy using the dye Fluo-4AM was performed and significantly less diastolic Ca2+-waves occurred in SCN10A−/−/CaMKII+/T compared to CaMKII+/T. In order to analyze an organ-specific SCN10A-KO, we generated homozygous SCN10A-KO lines of induced pluripotent stem cells by using CRISPR/Cas9 technology. 2-month old iPSC-cardiomyocytes lacking NaV1.8 were treated with low dose isoprenaline and showed significantly less INaL, thereby serving as a final proof of the relevant role of this Na+-channel on INaL-generation in the cardiomyocyte.

Conclusion

We found a survival benefit by selective knock-out of the neuronal sodium channel isoform NaV1.8 in a proarrhythmic HF mouse model with augmented CaMKII expression. However, in our model NaV1.8-knock-out showed no effects on HF progression, while cellular proarrhythmic triggers were attenuated. Taken together with our findings in IPS-cardiomyocytes treated with the CRSIPR/Cas9 technology NaV1.8 plays a significant role for the generation of INaL and cellular arrhythmogenic triggers in the cardiomyocyte.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): Deutsche Stiftung für Herzforschung

P1596Interaction of CaMKII and NaV1.8 modulates cardiac electrophysiology in human heart failure

Introduction

In human heart failure, electrical remodeling contributes to the risk of arrhythmia generation. Increased expression of Ca/Calmodulin-dependent protein kinase IIδ (CaMKIIδ) and an enhanced persistent Na current (INaL) have been linked to arrhythmogenesis. CaMKIIδ increases INaL via regulation of sodium channels thereby contributing to arrhythmias through early- and delayed-afterdepolarizations (EADs and DADs). Genome-wide association studies (GWAS) have described the implication of the neuronal sodium channel isoform NaV1.8 (SCN10A) in cardiac electrophysiology showing modulation in cardiac conduction. We showed that the expression of the isoform Nav1.8 is significantly increased in human failing cardiomyocytes and contributes substantially to the enhanced INaL.

Purpose

We investigated a potential interaction of CaMKIIδ and NaV1.8 and thereby its role in arrhythmia generation and electrophysiology in human and murine failing hearts.

Methods

Cardiomyocytes were isolated from explanted failing hearts and CaMKIIδ transgenic (TG) mice. We performed immunostainings and co-immunoprecipitation (Co-IP) to show interactions of CaMKIIδ and Nav1.8 in isolated cardiomyocytes and homogenates. Whole-cell patch clamp experiments were conducted in isolated human and murine ventricular cardiomyocytes. Additionally, Ca2+ transients were measured using epifluorescence microscopy with the Ca2+ dye fura-2 (10μmol/L) whereas Ca2+ sparks measurements were performed by using confocal microscopy with the Ca2+ dye fluo-4 (10μmol/L). PF-01247324 is a novel specific NaV1.8 inhibitor (orally bioavailable; 1 μmol/L) and autocamtide inhibitory peptide (AIP, 1 μmol/L) was used to inhibit CaMKIIδ.

Results

Co-immunoprecipitation experiments revealed an association of CaMKIIδ and Nav1.8 in human homogenates compared to healthy controls. Furthermore, immunohistochemistry stainings in isolated human cardiomyocytes showed a co-localization of CaMKIIδ and NaV1.8 at the intercalated disc and t-tubules. We observed a significant reduction of INaL integral and proarrhythmic SR-Ca2+ spark frequency (CaSpF) after addition of either PF-01247324 or the CaMKIIδ inhibitor AIP in failing human and murine ventricular cardiomyocytes. When PF-01247324 and AIP were added together, the decrease in INaL integral and CaSpF was comparable to PF-01247324 alone in human failing cardiomyocytes. Inhibition of NaV1.8 did not show an effect on Ca2+ transient amplitude or Ca2+ transient decay at different stimulation frequencies in CaMKIIδ TG cardiomyocytes.

Conclusion

Our results demonstrate the significance of both CaMKIIδ and NaV1.8 in INaL generation and their detrimental interaction. This data suggest that increased CaMKIIδ activity plays a substantial role for the activation of NaV1.8-mediated late sodium current and SR-Ca2+ leak.

4966Targeting INaL by a neuronal sodium channel isoform improves survival in a CaMKII-transgenic heart failure mouse model

Background

Cardiac pathologies like hypertrophy and heart failure are known to be associated with proarrhythmogenic triggers like early- (EADs) and delayed afterdepolarizations (DADs) that can be partly attributed to an augmentation of late sodium current (INaL). Enhanced INaL is closely connected with increased activity of Ca2+/calmodulin dependent-kinase II (CaMKII) in pathology as it is enhanced by CaMKII on the one hand but can also indirectly increase CaMKII-activity on the other. We recently found neuronal sodium channel NaV1.8 to be involved in INaL-augmentation in heart failure and cardiac hypertrophy. Here, we studied possible antiarrhythmic effects of NaV1.8-inhibition in a transgenic mouse model with enhanced CaMKII-expression by selectively knocking out NaV1.8.

Methods/Results

To investigate antiarrhythmic effects of NaV1.8-depletion in-vivo and in-vitro we crossbred CaMKII-transgenic mice (CaMKII+/T) with NaV1.8-knock-out mice (SCN10A−/−). Surprisingly, CaMKII+/T-mice lacking NaV1.8 (CaMKII+/T & SCN10A−/−) showed a significantly improved survival compared to CaMKII+/T alone (97.5 vs 72.0 days, p<0.05). Heart weight to tibia length ratio was significantly increased in CaMKII+/T-mice compared to wild-type, without any differences between CaMKII+/T and CaMKII+/T & SCN10A−/−. To investigate the underlying mechanisms out of this observation we isolated single cardiomyocytes and performed patch-clamp experiments as well as confocal microscopy to measure Ca2+-transients and diastolic Ca2+-waves. INaL-integral was significantly smaller in cardiomyocytes from CaMKII+/T & SCN10A−/−-mice compared to CaMKII+/T alone. During action potential recordings, significantly less afterdepolarizations occurred in CaMKII+/T & SCN10A−/− compared to cardiomyocytes from CaMKII+/T -mice (16.7/min vs 34.9/min, p<0.05). There was a trend of less cells exhibiting diastolic Ca2+-waves in Ca2+-measurements from CaMKII+/T & SCN10A−/− compared to CaMKII+/T (15% vs 25%, p=0.09). As some cells showed more than one event, we calculated the frequency of Ca2+-waves and found a significant reduction of Ca2+-waves in CaMKII+/T & SCN10A−/− vs. CaMKII+/T (22.8/min vs 43.0/min, p<0.05). Moreover, the time to the first event was significantly longer in CaMKII+/T & SCN10A−/−. Ca2+-transient amplitude (F/F0) was significantly lower in CaMKII+/T compared to CaMKII+/T & SCN10A−/− (4.6 vs. 5.3, p=0.05). Further, Ca2+-extrusion from the cytosol was significantly faster in CaMKII+/T & SCN10A−/−.

Conclusion

Our data demonstrates, that inhibition of INaL by targeting NaV1.8 has a potent antiarrhythmic potential as we found a reduction of EADs, DADs and diastolic Ca2+-waves in CaMKII+/T & SCN10A−/−-cardiomyocytes. This antiarrhythmic potential appears to be potent enough to improve survival and to rescue the proarrhythmogenic phenotype of CaMKII-overexpression. However, further in-vivo experiments are necessary to investigate NaV1.8-inhibition for a possible therapeutic approach.