TY - JOUR
T1 - Comparison of the IKr blockers moxifloxacin, dofetilide and E-4031 in five screening models of pro-arrhythmia reveals lack of specificity of isolated cardiomyocytes
AU - Nalos, L
AU - Varkevisser, R
AU - Jonsson, Mkb
AU - Houtman, Mjc
AU - Beekman, Jd
AU - van der Nagel, R
AU - Thomsen, Morten Bækgaard
AU - Duker, G
AU - Sartipy, P
AU - de Boer, Tp
AU - Peschar, M
AU - Rook, Mb
AU - van Veen, Tab
AU - van der Heyden, Mag
AU - Vos, Ma
N1 - © 2011 The Authors. British Journal of Pharmacology © 2011 The British Pharmacological Society.
PY - 2012/1
Y1 - 2012/1
N2 - Background and Purpose Drug development requires the testing of new chemical entities for adverse effects. For cardiac safety screening, improved assays are urgently needed. Isolated adult cardiomyocytes (CM) and human embryonic stem cell-derived cardiomyocytes (hESC-CM) could be used to identify pro-arrhythmic compounds. In the present study, five assays were employed to investigate their sensitivity and specificity for evaluating the pro-arrhythmic properties of I Kr blockers, using moxifloxacin (safe compound) and dofetilide or E-4031 (unsafe compounds). Experimental Approach Assays included the anaesthetized remodelled chronic complete AV block (CAVB) dog, the anaesthetized methoxamine-sensitized unremodelled rabbit, multi-cellular hESC-CM clusters, isolated CM obtained from CAVB dogs and isolated CM obtained from the normal rabbit. Arrhythmic outcome was defined as Torsade de Pointes (TdP) in the animal models and early afterdepolarizations (EADs) in the cell models. Key Results At clinically relevant concentrations (5-12 μM), moxifloxacin was free of pro-arrhythmic properties in all assays with the exception of the isolated CM, in which 10 μM induced EADs in 35% of the CAVB CM and in 23% of the rabbit CM. At supra-therapeutic concentrations (≥100 μM), moxifloxacin was pro-arrhythmic in the isolated rabbit CM (33%), in the hESC-CM clusters (18%), and in the methoxamine rabbit (17%). Dofetilide and E-4031 induced EADs or TdP in all assays (50-83%), and the induction correlated with a significant increase in beat-to-beat variability of repolarization. Conclusion and Implications Isolated cardiomyocytes lack specificity to discriminate between TdP liability of the I Kr blocking drugs moxifloxacin and dofetilide or E4031.
AB - Background and Purpose Drug development requires the testing of new chemical entities for adverse effects. For cardiac safety screening, improved assays are urgently needed. Isolated adult cardiomyocytes (CM) and human embryonic stem cell-derived cardiomyocytes (hESC-CM) could be used to identify pro-arrhythmic compounds. In the present study, five assays were employed to investigate their sensitivity and specificity for evaluating the pro-arrhythmic properties of I Kr blockers, using moxifloxacin (safe compound) and dofetilide or E-4031 (unsafe compounds). Experimental Approach Assays included the anaesthetized remodelled chronic complete AV block (CAVB) dog, the anaesthetized methoxamine-sensitized unremodelled rabbit, multi-cellular hESC-CM clusters, isolated CM obtained from CAVB dogs and isolated CM obtained from the normal rabbit. Arrhythmic outcome was defined as Torsade de Pointes (TdP) in the animal models and early afterdepolarizations (EADs) in the cell models. Key Results At clinically relevant concentrations (5-12 μM), moxifloxacin was free of pro-arrhythmic properties in all assays with the exception of the isolated CM, in which 10 μM induced EADs in 35% of the CAVB CM and in 23% of the rabbit CM. At supra-therapeutic concentrations (≥100 μM), moxifloxacin was pro-arrhythmic in the isolated rabbit CM (33%), in the hESC-CM clusters (18%), and in the methoxamine rabbit (17%). Dofetilide and E-4031 induced EADs or TdP in all assays (50-83%), and the induction correlated with a significant increase in beat-to-beat variability of repolarization. Conclusion and Implications Isolated cardiomyocytes lack specificity to discriminate between TdP liability of the I Kr blocking drugs moxifloxacin and dofetilide or E4031.
U2 - 10.1111/j.1476-5381.2011.01558.x
DO - 10.1111/j.1476-5381.2011.01558.x
M3 - Journal article
C2 - 21718297
SN - 1359-5075
SN - 1476-5381
VL - 165
SP - 467
EP - 478
JO - British Journal of Pharmacology
JF - British Journal of Pharmacology
IS - 2
ER -