Ben Jehuda Ronen, Barad Lili
Department of Physiology, Biophysics and Systems Biology; The Rappaport Institute; Ruth and Bruce Rappaport Faculty of Medicine; Department of Biotechnology, Technion, Haifa, Israel.
Department of Physiology, Biophysics and Systems Biology; The Rappaport Institute; Ruth and Bruce Rappaport Faculty of Medicine.
J Atr Fibrillation. 2016 Aug 31;9(2):1423. doi: 10.4022/jafib.1423. eCollection 2016 Aug-Sep.
Catecholaminergic polymorphic ventricular tachycardia (CPVT), an inherited arrhythmia often leading to sudden cardiac death in children and young adults, is characterized by polymorphic/bidirectional ventricular tachycardia induced by adrenergic stimulation associated with emotionally stress or physical exercise. There are two forms of CPVT: 1. CPVT1 is caused by mutations in the RYR2 gene, encoding for ryanodine receptor type 2. CPVT1 is the most common form of CPVT in the population, and is inherited by a dominant mechanism. 2. CPVT2 is caused by mutations in the CASQ2 gene, encoding for cardiac calsequestrin 2 and is inherited by recessive mechanism. Patient-specific induced Pluripotent Stem Cells (iPSC) have the ability to differentiate into cardiomyocytes carrying the patient's genome including CPVT-linked mutations and expressing the disease phenotype in vitro at the cellular level. The potency for in vitro modeling using iPSC-derived cardiomyocytes (iPSC-CMs) has been exploited to investigate a variety of inherited diseases including cardiac arrhythmias such as CPVT. In this review we attempted to cover the majority of CPVT patient specific iPSC research studies previously published. CPVT patient-specific iPSC model enables the in vitro investigation of the molecular and cellular disease-mechanisms by the means of electrophysiologycal and Ca imaging methodologies. Furthermore, this in vitro model allows the screening of various antiarrhythmic drugs, specifically for each patient, also known as "personalized medicine".
儿茶酚胺能多形性室性心动过速(CPVT)是一种遗传性心律失常,常导致儿童和年轻人心脏性猝死,其特征是由情绪应激或体育锻炼引起的肾上腺素能刺激诱发的多形性/双向性室性心动过速。CPVT有两种形式:1. CPVT1由编码兰尼碱受体2型的RYR2基因突变引起。CPVT1是人群中最常见的CPVT形式,通过显性机制遗传。2. CPVT2由编码心肌肌钙蛋白2的CASQ2基因突变引起,通过隐性机制遗传。患者特异性诱导多能干细胞(iPSC)有能力分化为携带患者基因组(包括与CPVT相关的突变)的心肌细胞,并在细胞水平上在体外表达疾病表型。利用iPSC衍生的心肌细胞(iPSC-CM)进行体外建模的能力已被用于研究包括CPVT等心律失常在内的多种遗传性疾病。在这篇综述中,我们试图涵盖此前发表的大多数CPVT患者特异性iPSC研究。CPVT患者特异性iPSC模型能够通过电生理学和钙成像方法在体外研究分子和细胞层面的疾病机制。此外,这种体外模型允许筛选各种抗心律失常药物,特别是针对每个患者的药物,也就是所谓的“个性化医疗”。