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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 6

Optogenetics-based APD modulation at the tissue level.

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Optogenetics-based APD modulation at the tissue level.
(A) Scheme descri...
(A) Scheme describing the derivation of the in vitro coculture model. The hiPSC-derived cardiomyocyte cell sheets (hiPSC-CCSs) were seeded on top of a monolayer of CoChR-expressing HEK293 cells. (B) Confocal microscopy based 2D (bottom panels) and 3D reconstructed z-series (top panel) immunostainings of the cocultures. The hiPSC-CMs are identified as α-actinin+ cells (red) and engineered HEK293 cells by their eGFP expression (green). Gap junctions are indicated by the positive connexin 43 punctuate immunosignal (white) and indicated by arrows. Nuclei are counterstained with DAPI (blue). Scale bars: 50 mm (upper panel), 20 mm (lower panels). (C) Optogenetic-based APD modulation protocol. Both pacing (short flash [10 ms], black line) and APD (prolonged pulsed stimulus [100 ms], light-blue) modulation stimuli were achieved through diffuse light exposure of the culture. (D) Representative optical APs recordings (from 6 experiments) at baseline (black tracing) and during applications of the optogenetic APD modulating stimuli at variable durations (blue tracings). Note the correlation between the optical stimulus duration and the resulting APD prolongation. Scale bar: 200 ms. (E) Optical mapping–derived color-coded APD80 maps acquired at baseline (darkness, left) and during applications of the APD modulating signals (105, 225, and 345 ms). (F) Summary of changes in APD80 values at baseline (darkness) and following applications of the optogenetic stimuli in healthy control hiPSC–CCSs (n = 6; *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001 using 1-way ANOVA for repeated measurements, followed by Tukey post hoc test). (G and H) Optogenetic-based modulations of APD80 (n = 4, G) and ERP (n = 5, H) values in the CoChR-SQTS–hiPSC-CCSs cocultures. Shown are baseline values and the effects of optogenetic stimuli of different durations (*P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001 using 1-way ANOVA for repeated measurements, followed by Tukey post hoc test). P < 0.01 using unpaired Student’s t test when comparing ERP values in SQTS versus healthy control hiPSC-CCS.

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