Institute of Medical Sciences, Buddhist Tzu Chi University, Taiwan.
Reprod Toxicol. 2012 Apr;33(2):233-44. doi: 10.1016/j.reprotox.2011.12.008. Epub 2011 Dec 29.
Amiodarone is a class D drug given to treat arrhythmia, including pregnant women, but its effects on the developing heart have not been studied. Although some studies have suggested that this drug is safe for fetuses, they have been conducted on mothers with fetuses at or beyond six months of gestational age.
The occurrence of valve defect was positively proportional to Amiodarone concentrations over 9 μM, but not lower than 6 μM. Ectopic overexpression of versican was observed at the atrioventricular canal of the Amiodarone-treated embryos at 15 μM (EC(50)). VE-cadherin (cdh5), normally downregulated at the endocardial cushion, was also ectopically overexpressed in the Amiodarone-treated embryos. Knockdown of either versican or cdh5 in the Amiodarone-treated embryos could rescue the valve defect caused by Amiodarone.
By inducing versican ectopical overexpression, leading, in turn, to cdh5 ectopical overexpression, Amiodarone treatment causes failure of cardiac valve formation in zebrafish embryos.
胺碘酮是一种 D 类药物,用于治疗心律失常,包括孕妇,但它对发育中心脏的影响尚未得到研究。尽管一些研究表明这种药物对胎儿是安全的,但这些研究是在妊娠 6 个月或以上的胎儿母亲身上进行的。
瓣膜缺陷的发生与胺碘酮浓度呈正相关,超过 9 μM,但低于 6 μM 则没有相关性。在 15 μM(EC(50))的胺碘酮处理胚胎的心耳房室管中观察到 versican 的异位过表达。VE-cadherin(cdh5)通常在内皮垫中下调,在胺碘酮处理的胚胎中也异位过表达。在胺碘酮处理的胚胎中敲低 versican 或 cdh5 均可挽救胺碘酮引起的瓣膜缺陷。
胺碘酮通过诱导 versican 的异位过表达,进而导致 cdh5 的异位过表达,导致斑马鱼胚胎中心脏瓣膜形成失败。