Nuss H B, Marbán E, Johns D C
Section of Molecular and Cellular Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
J Clin Invest. 1999 Mar;103(6):889-96. doi: 10.1172/JCI5073.
The high incidence of sudden death in heart failure may reflect abnormalities of repolarization and heightened susceptibility to arrhythmogenic early afterdepolarizations (EADs). We hypothesized that overexpression of the human K+ channel HERG (human ether-a-go-go-related gene) could enhance repolarization and suppress EADs. Adult rabbit ventricular myocytes were maintained in primary culture, which suffices to prolong action potentials and predisposes to EADs. To achieve efficient gene transfer, we created AdHERG, a recombinant adenovirus containing the HERG gene driven by a Rous sarcoma virus (RSV) promoter. The virally expressed HERG current exhibited pharmacologic and kinetic properties like those of native IKr. Transient outward currents in AdHERG-infected myocytes were similar in magnitude to those in control cells, while stimulated action potentials (0.2 Hz, 37 degrees C) were abbreviated compared with controls. The occurrence of EADs during a train of action potentials was reduced by more than fourfold, and the relative refractory period was increased in AdHERG-infected myocytes compared with control cells. Gene transfer of delayed rectifier potassium channels represents a novel and effective strategy to suppress arrhythmias caused by unstable repolarization.
心力衰竭患者猝死的高发生率可能反映了复极化异常以及对致心律失常早期后除极(EADs)的易感性增加。我们推测,人类钾通道HERG(人类ether-a-go-go相关基因)的过表达可增强复极化并抑制EADs。成年兔心室肌细胞进行原代培养,这种培养足以延长动作电位并易引发EADs。为实现高效基因转移,我们构建了AdHERG,一种重组腺病毒,其包含由劳氏肉瘤病毒(RSV)启动子驱动的HERG基因。病毒表达的HERG电流表现出与天然IKr相似的药理学和动力学特性。AdHERG感染的心肌细胞中的瞬时外向电流幅度与对照细胞相似,而与对照相比,刺激的动作电位(0.2 Hz,37℃)缩短。与对照细胞相比,AdHERG感染的心肌细胞在一系列动作电位期间EADs的发生率降低了四倍以上,相对不应期延长。延迟整流钾通道的基因转移是一种抑制由不稳定复极化引起的心律失常的新颖且有效的策略。