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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 1

Experimental scheme and functional characterization of ChR2 photocurrents in hiPSC-CMs.

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Experimental scheme and functional characterization of ChR2 photocurrent...
(A) Experimental outline: patient-specific or control hiPSCs are differentiated into cardiomyocytes, transduced to express the different opsins, and subjected to patch-clamp or optical imaging analysis. Total original magnification, ×28. (B) Representative traces showing 1 example of 7 similar voltage-clamp experiments in the ChR2-expressing hiPSC-CMs. Peak and steady-state photocurrents are shown. Scale bars: 100 pA and 100 ms on y and x axes, respectively. The stimulation protocol (insert) included voltage steps of 1 second (first 500 ms conducted in darkness followed by 500 ms of continuous blue light illumination) from –80 mV to 60 mV, with 10 mV increments. (C) Current-voltage relationship of the ChR2 photocurrents. Mean ± SEM of peak and steady state currents are plotted (n = 7). (D and E) Representative traces (from 5 experiments) describing the photocurrents evoked in the hiPSC-CMs by light-stimuli applied during phase 2 (D) or 3 (E) in the AP clamp experiments. The upper panel shows the voltage AP clamp protocol, while the lower panel depicts the measured photocurrents [after baseline (darkness) subtraction]. (F) The conceptual differences in the type of photocurrents generated by light-induced ChR2 activation during different AP phases. An optical stimulus will produce a hyperpolarizing current if the Vm is more positive than ChR2-ERev (early phase 2); whereas a depolarizing current will be generated if Vm is more negative than ChR2-ERev (repolarization phase). Scale bar: 200 ms.

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