9种不同心血管风险的临床药物对hERG钾通道的作用
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国家“重大新药创制”科技重大专项(2015ZX09501004?002?006);上海市科委“科技创新行动计划”项目(17140900700)


Effects of nine clinical drugs with different careiovascular risk on hERG potassium channels
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    摘要:

    目的:在GLP实验室评估膜片钳检测临床用药物对hERG(human ether-à-go-go related gene)钾通道作用的差异性和重复性,研究9种致尖端扭转型室速(TdP)风险的临床用药物(高风险临床用药物:苄普地尔、奎尼丁、索他洛尔;中风险临床用药物:昂丹司琼、西沙比利、特非那定;低风险临床用药物:雷诺嗪、维拉帕米和美西律)对hERG钾通道的阻断作用。方法:采用全细胞膜片钳技术记录不同浓度的苄普地尔、奎尼丁、索他洛尔、昂丹司琼、西沙比利、特非那定、雷诺嗪、维拉帕米和美西律作用于外源稳定转染表达hERG钾通道的HEK293细胞(hERG-HEK293稳态细胞)后hERG电流(IKr)的变化,研究上述临床用药物对IKr作用的浓度依赖性及半数抑制浓度(IC50)。结果:9种临床用药物对hERG-HEK293细胞上IKr作用具有浓度依赖性,且高风险临床用药物苄普地尔和奎尼丁的IC50值分别为98.32 nmol/L和1.95 μmol/L,索他洛尔的IC50值大于300 μmol/L;中风险临床用药物昂丹司琼、西沙比利和特非那定的IC50值分别为0.94 μmol/L、39.10 nmol/L和128.58 nmol/L;低风险临床用药物雷诺嗪、维拉帕米和美西律的IC50值分别为9.94 μmol/L、235.49 nmol/L和65.56 μmol/L。本实验所得临床用药物IC50值基本与文献相符。结论:临床用药物致TdP风险与hERG通道的阻滞作用密切相关,但hERG通道阻断不等同于TdP风险,还与心脏上表达的多种离子通道有关,某些临床用药物可以通过阻断钠通道和钙通道而降低风险。本研究结果提示本方法所得数据可靠,为国内GLP实验室进行hERG钾通道评价研究提供了参考依据,可用于药物心脏毒性评价。

    Abstract:

    Objective:To assess the variability and reproducibility of patch clamp platforms/sites for defining clinical drug effects on human ether-à-go-go related gene(hERG) currents across and between platforms and sites and to investigate the blocking effect of nine clinical drugs that have high(bepridil,quinidine,sotalol),intermediate(ondansetron,cisapride,terfenadine)and low(ranolazine,verapamil and mexiletine)torsade de pointes risk(TdP)on hERG potassium channel. Methods:The whole-cell patch clamp technique was used to record the change in hERG potassium current(IKr)on HEK293 cells that stably expressed hERG potassium channel(hERG-HEK293 steady-state cells),which was treated with four test concentrations of bepridil,quinidine,sotalol,ondansetron,cisapride,terfenadine,ranolazine,verapamil and mexiletine,to study the concentration-dependence of the effects on IKr and the half maximal inhibitory concentration(IC50). Resuts:All of the nine clinical drugs tested produced a concentration-dependent reduction of hERG current. The IC50 values of bepridil and quinidine(high TdP risk clinical drugs) were about 98.32 nmol/L and 1.95 μmol/L,respectively,and the IC50 values of sotalol was >300 μmol/L. The IC50 values of ondansetron,cisapride,terfenadine(intermediate TdP risk clinical drugs)were 0.94 μmol/L,39.10 nmol/L,128.58 nmol/L,respectively. The IC50 values of ranolazine,verapamil and mexiletine(low TdP risk clinical drugs)were 9.94 μmol/L,235.49 nmol/L and 65.56 μmol/L,respectively. The IC50 values for the nine clinical drugs corresponded well to those published within the literature. Conclusion:The risk of drug-induced TdP is closely related to the block of the hERG channel,but the hERG channel block is lack of specificity as a predictor of TdP,which is also associated with multiple ion channel effects. Some clinical drugs also block Nav1.5-late and/or Cav1.2 currents,which can reduce the risk of TdP caused by hERG block. The data obtained by this method is reliable,which provides a reference for the hERG block test performed by domestic GLP laboratories and can be used for the safety evaluation of drug cardiac toxicity.

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孙红云,邢红艳,赵 琪,王淑颜,宋 征,李 华,汪溪洁.9种不同心血管风险的临床药物对hERG钾通道的作用[J].南京医科大学学报(自然科学版),2019,(1):1-9

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  • 收稿日期:2018-03-14
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  • 在线发布日期: 2019-02-21
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