scholarly journals A human pluripotent stem cell model of catecholaminergic polymorphic ventricular tachycardia recapitulates patient-specific drug responses

2016 ◽  
Vol 9 (9) ◽  
pp. 927-939 ◽  
Author(s):  
Marcela K. Preininger ◽  
Rajneesh Jha ◽  
Joshua T. Maxwell ◽  
Qingling Wu ◽  
Monalisa Singh ◽  
...  
Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Marcela K Preininger ◽  
Rajneesh Jha ◽  
Qingling Wu ◽  
Monalisa Singh ◽  
Joshua T Maxwell ◽  
...  

Introduction: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited arrhythmia syndrome characterized by diastolic store overload-induced Ca2+ waves during β-adrenergic receptor (β-AR) stimulation. Mysteriously, β-blockers are ineffective at abolishing stress-induced ventricular arrhythmias in ~25% of patients. Induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) generated from these CPVT patients offer an attractive system for investigating the phenomenon, but it remains unknown whether iPSC-CMs can recapitulate clinically observed patient-specific drug responses. Hypothesis: This study assessed the hypothesis that patient-specific refractoriness to β-blocker therapy can be observed in vitro using CPVT iPSC-CMs. Methods: We generated iPSC-CMs from a control individual and a CPVT patient insensitive to the widely prescribed β-blocker nadolol, but responsive to flecainide, and compared the efficacy of the two drugs in vitro in diminishing diastolic Ca2+ waves and restoring Ca2+ spark parameters during β-AR stimulation. Results: In CPVT hiPSC-CMs (n = 34), β-AR agonism elicited intense diastolic Ca2+ waves and potentiated unduly frequent, large, and prolonged Ca2+ sparks compared to control iPSC-CMs (n = 12). Pursuant to the patient’s in vivo responses, nadolol-treated CPVT iPSC-CMs (n = 27) demonstrated inadequate improvement of Ca2+ handling defects during β-AR stimulation relative to flecainide-treated CPVT iPSC-CMs (n = 25). Nadolol showed no significant effect on the frequency of diastolic Ca2+ waves, but reduced mean amplitude by 50% (p < 0.0001). In contrast, flecainide reduced both frequency and amplitude by 83% (p < 0.001) and 72% (p < 0.0001), respectively. During nadolol treatment, Ca2+ spark frequency, width, and duration remained significantly altered, while flecainide restored all Ca2+ spark parameters to baseline levels. Conclusions: Clinically observed recalcitrance to β-blocker therapy in individuals with CPVT can be modeled in vitro using patient-derived iPSC-CMs. Furthermore, the efficacy of other drugs such as flecainide can be comparatively evaluated, supporting the use of patient-specific iPSC-CMs as a clinically-relevant implement of precision medicine.


iScience ◽  
2021 ◽  
Vol 24 (1) ◽  
pp. 101931
Author(s):  
Matthew C. Sinton ◽  
Jose Meseguer-Ripolles ◽  
Baltasar Lucendo-Villarin ◽  
Sara Wernig-Zorc ◽  
John P. Thomson ◽  
...  

2018 ◽  
Vol 32 (10) ◽  
pp. 5350-5364 ◽  
Author(s):  
Morgan G. Stykel ◽  
Kayla Humphries ◽  
Mathew P. Kirby ◽  
Chris Czaniecki ◽  
Tinya Wang ◽  
...  

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