Tang Wen, Cai Dihui, Fu Yin, Zheng Zequn, Huang Xiaoyan, Khouzam Rami N, Song Yongfei, Lian Jiangfang
Department of Cardiology, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, China.
Ningbo Institute of Innovation for Combined Medicine and Engineering, Ningbo, China.
J Thorac Dis. 2023 Aug 31;15(8):4472-4485. doi: 10.21037/jtd-23-1252. Epub 2023 Aug 28.
Long QT syndrome type 2 (LQT2) is caused by mutations in the /human ether-à-go-go-related gene (hERG). Some hERG genetic mutation-associated diseases are alleviated by hERG-specific drug chaperones (glycerol, dimethyl sulfoxide, trimethylamine N-oxide, thapsigargin), delayed rectifier K current (IKr) blockers methanesulfonanilide E4031, the antihistamine astemizole, or the prokinetic drug cisapride, and the anti-arrhythmic drug quinidine. Meanwhile, many and studies have reported the efficacy of 4-phenylbutyric acid (4-PBA) in diseases with inherited genetic mutations. This study aims to explore potential therapeutic agents for hERG/G572R mutated ion channel.
pcDNA3/hERG [wild type (WT)]-FLAG and pcDNA3/hERG (G572R)-FLAG plasmids were transfected into HEK293 cells. A western blot (WB) experiment was conducted to analyze protein expression. Quantitative real-time polymerase chain reaction (qPCR) was used to analyze the messenger RNA (mRNA) expression levels in the WT/G572R heterozygous HEK293 cell model treated with or without 4-PBA. The interaction between WT/G572R and BIP (GRP78), GRP94, and 3-hydroxy-3-methylglutaryl coenzyme A reductase degradation protein 1 (HRD1) was tested by co-immunoprecipitation (co-IP). To investigate the effect of 4-PBA on the WT/G572R channel current, we used electrophysiological assays (patch-clamp electrophysiological recordings).
The results showed that WT/G572R activated the ATF6 pathway in the endoplasmic reticulum stress (ERS), the ERS response markers GRP78, GRP94, and calreticulin (CRT)/calnexin (CNX), and HRD1, which decreased after application of the ERS inhibitor 4-PBA. The results of co-IP confirmed that the ability of hERG interacted with GRP78, GRP94, and HRD1. Moreover, 4-PBA increased the current of WT/G572R and reversed the gating kinetics of the WT/G572R channel.
4-PBA corrects hERG channel transport defects by inhibiting excessive ERS and the endoplasmic reticulum-associated degradation (ERAD)-related gene E3 ubiquitin ligase HRD1. Additionally, 4-PBA improved WT/G572R channel current. 4-PBA is expected to be developed as a new treatment method for LQT2.
2型长QT综合征(LQT2)由人ether-à-go-go相关基因(hERG)突变引起。一些与hERG基因突变相关的疾病可通过hERG特异性药物伴侣(甘油、二甲基亚砜、三甲胺N-氧化物、毒胡萝卜素)、延迟整流钾电流(IKr)阻滞剂甲磺酰苯胺E4031、抗组胺药阿司咪唑或促动力药西沙必利以及抗心律失常药奎尼丁得到缓解。同时,许多研究报告了4-苯基丁酸(4-PBA)在遗传性基因突变疾病中的疗效。本研究旨在探索hERG/G572R突变离子通道的潜在治疗药物。
将pcDNA3/hERG[野生型(WT)]-FLAG和pcDNA3/hERG(G572R)-FLAG质粒转染至HEK293细胞。进行蛋白质免疫印迹(WB)实验分析蛋白质表达。采用定量实时聚合酶链反应(qPCR)分析在有或无4-PBA处理的WT/G572R杂合HEK293细胞模型中的信使核糖核酸(mRNA)表达水平。通过免疫共沉淀(co-IP)检测WT/G572R与结合免疫球蛋白蛋白(BIP,GRP78)、葡萄糖调节蛋白94(GRP94)和3-羟基-3-甲基戊二酰辅酶A还原酶降解蛋白1(HRD1)之间的相互作用。为研究4-PBA对WT/G572R通道电流的影响,我们采用了电生理检测(膜片钳电生理记录)。
结果显示,WT/G572R在内质网应激(ERS)中激活了活化转录因子6(ATF6)通路,ERS反应标志物GRP78、GRP94和钙网蛋白(CRT)/钙连蛋白(CNX)以及HRD1在应用ERS抑制剂4-PBA后降低。免疫共沉淀结果证实hERG与GRP78、GRP94和HRD1相互作用的能力。此外,4-PBA增加了WT/G572R的电流,并逆转了WT/G572R通道的门控动力学。
4-PBA通过抑制过度的内质网应激和内质网相关降解(ERAD)相关基因E3泛素连接酶HRD1来纠正hERG通道转运缺陷。此外,4-PBA改善了WT/G572R通道电流。4-PBA有望开发成为LQT2的一种新治疗方法。