AbbreviationsI Kr -rapid delayed rectifying potassium current; I Ks -slow delayed rectifying potassium current; I K1 -inward rectifying potassium current; iPSC -induced pluripotent stem cell; hERG -human ether-a-go-go-related gene;FPD -field potential duration; NRVM -neonatal rat ventricular myocyte; CV -conduction velocity; MCRmaximum capture rate; TdP -Torsade de Pointes
AbstractErythromycin is an antibiotic that prolongs the QT-interval and causes Torsade de Pointes (TdP) by blocking the rapid delayed rectifying potassium current (I Kr ) without affecting either the slow delayed rectifying potassium current (I Ks ) or inward rectifying potassium current (I K1 ). Erythromycin exerts this effect in the range of 1.5 µM-100 μ M. However, the mechanism of action underlying its cardiotoxic effect and its role in the induction of arrhythmias, especially in multicellular cardiac experimental models, remain unclear. In this study the re-entry formation, conduction velocity, and maximum capture rate were investigated in a monolayer of human induced pluripotent stem cell (iPSC)-derived cardiomyocytes from a healthy donor and in a neonatal rat ventricular myocyte (NRVM) monolayer using the optical mapping method under erythromycin concentrations of 15, 30, and 45 μ M. In the monolayer of human iPSC-derived cardiomyocytes, the conduction velocity (CV) varied up to 12±9% at concentrations of 15-45 μ M as compared with that of the control, whereas the maximum capture rate (MCR) declined substantially up to 28±12% (p < 0.05). In contrast, the tests on the NRVM monolayer showed no significant effect on the MCR. The results of the arrhythmogenicity test provided evidence for a "window" of concentrations of the drug (15 to 30 μ M) at which the probability of re-entry increased.
AcknowledgmentsThis study was funded by the Russian Ministry of Education and Science of the Russian Federation grant (state task) 6.9906.2017/BCh.