Assessment of Proarrhythmic Potential of Drugs in Optogenetically Paced Induced Pluripotent Stem Cell-Derived Cardiomyocytes. (26th March 2019)

• Record Type: Journal Article
• Authors: Patel, Dakshesh; Stohlman, Jayna; Dang, Qianyu; Strauss, David G; Blinova, Ksenia
• Is Part Of: Toxicological sciences. Volume 170:Number 1(2019)
• Page Start: 167
• Page End: 179
• Publication Date: 2019-03-26
• Subjects: CiPA -- iPSC-CMs -- MEA -- optogenetics -- pacing -- proarrhythmia; Toxicology -- Periodicals; Toxicology -- Periodicals; Toxicology; Periodicals; 615.9
• DOI: 10.1093/toxsci/kfz076
• Languages: English
• ISSNs: 1096-6080

Abstract

Abstract: Cardiac side-effects are one of the major reasons for failure of drugs during preclinical development. Induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) have been proposed as a model for predicting drug-induced arrhythmias under the Comprehensive in vitro Proarrhythmia Assay (CiPA) paradigm. Field potential duration (FPD) in spontaneously beating iPSC-CMs is commonly corrected for beating rate using formulas originally derived from the clinical QT–RR relationship that have not been thoroughly validated for use with iPSC-CMs. In this study, channelrhodopsin-2 was expressed in iPSC-CMs allowing for recordings in both spontaneously beating and optically paced (0.8, 1, and 1.5 Hz pacing rate) iPSC-CMs using a microelectrode array system (Maestro, Axion Biosystems). After optimizing the intensity (>1 mW/mm 2 ), duration (15 ms) and frequency of the stimulating light pulses, we recorded iPSC-CMs' responses to 28 blinded CiPA compounds with clinically characterized risk of causing ventricular arrhythmia (Torsade de Pointes or TdP). Drug-induced FPD prolongation data along with drug-induced arrhythmia-like events were used to build a logistic regression model, separating high or intermediate TdP risk drugs from low-or-no TdP risk drugs. The area under the receiver operator characteristic curve for drug TdP risk prediction was identical for spontaneously beating and 0.8 Hz-paced iPSC-CMs (AUC = 0.96; 95% CI [0.9, 1]), while it was slightly lower for 1 and 1.5 Hz pacing (AUC = 0.88; 95% CI [0.76, 1] and 0.93; 95% CI [0.84, 1], respectively). In this study, optical pacing did not offer substantial improvement in proarrhythmic risk prediction when compared with nonpaced iPSC-CMs in the sample of 28 drugs.