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

Marcela K. Preininger, Rajneesh Jha, Joshua T. Maxwell, Qingling Wu, Monalisa Singh, Bo Wang, Aarti Dalal, Zachary T. McEachin, Wilfried Rossoll, Chadwick M. Hales, Peter S. Fischbach, Mary B. Wagner, Chunhui Xu

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Although β-blockers can be used to eliminate stress-induced ventricular arrhythmias in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT), this treatment is unsuccessful in ∼25% of cases. Induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) generated from these patients have potential for use in investigating the phenomenon, but it remains unknown whether they can recapitulate patient-specific drug responses to β-blockers. This study assessed whether the inadequacy of β-blocker therapy in an individual can be observed in vitro using patient-derived CPVT iPSC-CMs. An individual with CPVT harboring a novel mutation in the type 2 cardiac ryanodine receptor (RyR2) was identified whose persistent ventricular arrhythmias during β-blockade with nadolol were abolished during flecainide treatment. iPSC-CMs generated from this patient and two control individuals expressed comparable levels of excitation-contraction genes, but assessment of the sarcoplasmic reticulum Ca2+ leak and load relationship revealed intracellular Ca2+ homeostasis was altered in the CPVT iPSC-CMs. β-adrenergic stimulation potentiated spontaneous Ca2+ waves and unduly frequent, large and prolonged Ca2+ sparks in CPVT compared with control iPSC-CMs, validating the disease phenotype. Pursuant to the patient's in vivo responses, nadolol treatment during β-adrenergic stimulation achieved negligible reduction of Ca2+ wave frequency and failed to rescue Ca2+ spark defects in CPVT iPSC-CMs. In contrast, flecainide reduced both frequency and amplitude of Ca2+ waves and restored the frequency, width and duration of Ca2+ sparks to baseline levels. By recapitulating the improved response of an individual with CPVT to flecainide compared with β-blocker therapy in vitro, these data provide new evidence that iPSC-CMs can capture basic components of patient-specific drug responses.

Original languageEnglish (US)
Pages (from-to)927-939
Number of pages13
JournalDMM Disease Models and Mechanisms
Volume9
Issue number9
DOIs
StatePublished - Sep 1 2016

Keywords

  • Arrhythmia models
  • CPVT
  • Ca2+ handling
  • Cardiomyocytes
  • Ipscs

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Medicine (miscellaneous)
  • Immunology and Microbiology (miscellaneous)
  • Biochemistry, Genetics and Molecular Biology(all)

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    Preininger, M. K., Jha, R., Maxwell, J. T., Wu, Q., Singh, M., Wang, B., Dalal, A., McEachin, Z. T., Rossoll, W., Hales, C. M., Fischbach, P. S., Wagner, M. B., & Xu, C. (2016). A human pluripotent stem cell model of catecholaminergic polymorphic ventricular tachycardia recapitulates patient-specific drug responses. DMM Disease Models and Mechanisms, 9(9), 927-939. https://doi.org/10.1242/dmm.026823