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Optogenetic modulation of cardiac action potential properties may prevent arrhythmogenesis in short and long QT syndromes
Amit Gruber, Oded Edri, Irit Huber, Gil Arbel, Amira Gepstein, Assad Shiti, Naim Shaheen, Snizhana Chorna, Michal Landesberg, Lior Gepstein
Amit Gruber, Oded Edri, Irit Huber, Gil Arbel, Amira Gepstein, Assad Shiti, Naim Shaheen, Snizhana Chorna, Michal Landesberg, Lior Gepstein
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Research Article Cardiology Stem cells

Optogenetic modulation of cardiac action potential properties may prevent arrhythmogenesis in short and long QT syndromes

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Abstract

Abnormal action potential (AP) properties, as occurs in long or short QT syndromes (LQTS and SQTS, respectively), can cause life-threatening arrhythmias. Optogenetics strategies, utilizing light-sensitive proteins, have emerged as experimental platforms for cardiac pacing, resynchronization, and defibrillation. We tested the hypothesis that similar optogenetic tools can modulate the cardiomyocyte’s AP properties, as a potentially novel antiarrhythmic strategy. Healthy control and LQTS/SQTS patient–specific human induced pluripotent stem cell–derived cardiomyocytes (hiPSC-CMs) were transduced to express the light-sensitive cationic channel channelrhodopsin-2 (ChR2) or the anionic-selective opsin, ACR2. Detailed patch-clamp, confocal-microscopy, and optical mapping studies evaluated the ability of spatiotemporally defined optogenetic protocols to modulate AP properties and prevent arrhythmogenesis in the hiPSC-CMs cell/tissue models. Depending on illumination timing, light-induced ChR2 activation induced robust prolongation or mild shortening of AP duration (APD), while ACR2 activation allowed effective APD shortening. Fine-tuning these approaches allowed for the normalization of pathological AP properties and suppression of arrhythmogenicity in the LQTS/SQTS hiPSC-CM cellular models. We next established a SQTS–hiPSC-CMs–based tissue model of reentrant-arrhythmias using optogenetic cross-field stimulation. An APD-modulating optogenetic protocol was then designed to dynamically prolong APD of the propagating wavefront, completely preventing arrhythmogenesis in this model. This work highlights the potential of optogenetics in studying repolarization abnormalities and in developing novel antiarrhythmic therapies.

Authors

Amit Gruber, Oded Edri, Irit Huber, Gil Arbel, Amira Gepstein, Assad Shiti, Naim Shaheen, Snizhana Chorna, Michal Landesberg, Lior Gepstein

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Figure 4

Optogenetic APD modulation in ACR2-expressing hiPSC-CMs.

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Optogenetic APD modulation in ACR2-expressing hiPSC-CMs.
(A and B) Intra...
(A and B) Intracellular recordings (A) and a summary plot (B) characterizing the changes in AP morphology and APD80 values of the ACR2–hiPSC-CMs as a function of the optical stimulus’ intensity (signal duration, 50ms; onset, 100ms). Scale bars: 20 mV and 200 ms for the y and x axes, respectively; n = 5. (C and D) Intracellular recordings (C) and a summary plot (D) characterizing changes in AP morphology and APD80 values of the ACR2–hiPSC-CMs as a function of the timing of the delivered stimulus (intensity, 1.3 mW/mm2; duration, 50 ms) onset. Note the clear correlation (Pearson’s correlation coefficient = 0.98, n = 5) between stimulus onset and APD80 shortening, with earlier onsets leading to shorter APD80 values. (E) Patch-clamp recordings showing robust shortening of the abnormally long APD values in LQTS–hiPSC-CMs following light-induced ACR2 activation. APD shortening inversely correlated with the onset of the optical stimulus (intensity, 1.3 mW/mm2; duration, 50 ms), which was initiated at 50, 100, 150, 200, or 250 ms after AP onset. (F) Summary of the effects of application of a 50 ms–long stimulus (intensity, 1.3 mW/mm2; onset, 100 ms) to the ACR2-expressing LQTS–hiPSC-CMs. Notice the significant shortening of APD80 values (n = 9, *P < 0.01 using paired t test).

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