Computational prediction of drug response in short QT syndrome type 1 based on measurements of compound effect in stem cell-derived cardiomyocytes

PLoS Comput Biol. 2021 Feb 16;17(2):e1008089. doi: 10.1371/journal.pcbi.1008089. eCollection 2021 Feb.

Abstract

Short QT (SQT) syndrome is a genetic cardiac disorder characterized by an abbreviated QT interval of the patient's electrocardiogram. The syndrome is associated with increased risk of arrhythmia and sudden cardiac death and can arise from a number of ion channel mutations. Cardiomyocytes derived from induced pluripotent stem cells generated from SQT patients (SQT hiPSC-CMs) provide promising platforms for testing pharmacological treatments directly in human cardiac cells exhibiting mutations specific for the syndrome. However, a difficulty is posed by the relative immaturity of hiPSC-CMs, with the possibility that drug effects observed in SQT hiPSC-CMs could be very different from the corresponding drug effect in vivo. In this paper, we apply a multistep computational procedure for translating measured drug effects from these cells to human QT response. This process first detects drug effects on individual ion channels based on measurements of SQT hiPSC-CMs and then uses these results to estimate the drug effects on ventricular action potentials and QT intervals of adult SQT patients. We find that the procedure is able to identify IC50 values in line with measured values for the four drugs quinidine, ivabradine, ajmaline and mexiletine. In addition, the predicted effect of quinidine on the adult QT interval is in good agreement with measured effects of quinidine for adult patients. Consequently, the computational procedure appears to be a useful tool for helping predicting adult drug responses from pure in vitro measurements of patient derived cell lines.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Action Potentials / drug effects
  • Adult
  • Ajmaline / pharmacology
  • Algorithms
  • Anti-Arrhythmia Agents / pharmacology*
  • Arrhythmias, Cardiac / drug therapy*
  • Arrhythmias, Cardiac / genetics
  • Arrhythmias, Cardiac / physiopathology*
  • Cell Line
  • Computational Biology
  • Drug Evaluation, Preclinical / methods*
  • Drug Evaluation, Preclinical / statistics & numerical data
  • ERG1 Potassium Channel / genetics
  • Electrocardiography
  • Heart Conduction System / abnormalities*
  • Heart Conduction System / physiopathology
  • Heart Defects, Congenital / drug therapy*
  • Heart Defects, Congenital / genetics
  • Heart Defects, Congenital / physiopathology*
  • Humans
  • In Vitro Techniques
  • Induced Pluripotent Stem Cells / drug effects
  • Induced Pluripotent Stem Cells / physiology
  • Ivabradine / pharmacology
  • Mexiletine / pharmacology
  • Models, Cardiovascular*
  • Mutation
  • Myocytes, Cardiac / drug effects*
  • Myocytes, Cardiac / physiology*
  • Quinidine / pharmacology
  • Translational Research, Biomedical

Substances

  • Anti-Arrhythmia Agents
  • ERG1 Potassium Channel
  • KCNH2 protein, human
  • Ajmaline
  • Mexiletine
  • Ivabradine
  • Quinidine

Supplementary concepts

  • Short QT Syndrome 1

Grants and funding

KJ, SW and AT was supported by the Research Council of Norway funded IDENTIPHY project #309871/E50. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.