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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Coll+Cardiol
2016 ; 68
(19
): 2086-2096
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Patient-Specific and Genome-Edited Induced Pluripotent Stem Cell-Derived
Cardiomyocytes Elucidate Single-Cell Phenotype of Brugada Syndrome
#MMPMID27810048
Liang P
; Sallam K
; Wu H
; Li Y
; Itzhaki I
; Garg P
; Zhang Y
; Vermglinchan V
; Lan F
; Gu M
; Gong T
; Zhuge Y
; He C
; Ebert AD
; Sanchez-Freire V
; Churko J
; Hu S
; Sharma A
; Lam CK
; Scheinman MM
; Bers DM
; Wu JC
J Am Coll Cardiol
2016[Nov]; 68
(19
): 2086-2096
PMID27810048
show ga
BACKGROUND: Brugada syndrome (BrS), a disorder associated with characteristic
electrocardiogram precordial ST-segment elevation, predisposes afflicted patients
to ventricular fibrillation and sudden cardiac death. Despite marked achievements
in outlining the organ level pathophysiology of the disorder, the understanding
of human cellular phenotype has lagged due to a lack of adequate human cellular
models of the disorder. OBJECTIVES: The objective of this study was to examine
single cell mechanism of Brugada syndrome using induced pluripotent stem
cell-derived cardiomyocytes (iPSC-CMs). METHODS: This study recruited 2 patients
with type 1 BrS carrying 2 different sodium voltage-gated channel alpha subunit 5
variants as well as 2 healthy control subjects. We generated iPSCs from their
skin fibroblasts by using integration-free Sendai virus. We used directed
differentiation to create purified populations of iPSC-CMs. RESULTS: BrS iPSC-CMs
showed reductions in inward sodium current density and reduced maximal upstroke
velocity of action potential compared with healthy control iPSC-CMs. Furthermore,
BrS iPSC-CMs demonstrated increased burden of triggered activity, abnormal
calcium (Ca(2+)) transients, and beating interval variation. Correction of the
causative variant by genome editing was performed, and resultant iPSC-CMs showed
resolution of triggered activity and abnormal Ca(2+) transients. Gene expression
profiling of iPSC-CMs showed clustering of BrS compared with control subjects.
Furthermore, BrS iPSC-CM gene expression correlated with gene expression from BrS
human cardiac tissue gene expression. CONCLUSIONS: Patient-specific iPSC-CMs were
able to recapitulate single-cell phenotype features of BrS, including blunted
inward sodium current, increased triggered activity, and abnormal Ca(2+)
handling. This novel human cellular model creates future opportunities to further
elucidate the cellular disease mechanism and identify novel therapeutic targets.