Key result
ICA-105574 shortens the QTc interval by ~20% in preclinical models.
Why the study?
Inherited gain-of-function mutations in hERG channels cause short QT syndrome and fatal arrhythmias, raising concerns that hERG activator drugs may pose arrhythmia risk.
The hERG activator ICA-105574 significantly shortens QT and QTc intervals in experimental models, highlighting the potential proarrhythmic risk of drugs that activate hERG channels.
Answers are grounded in this paper and cite their sources.
May flag hERG activators for arrhythmia risk in drug screening; leaves open clinical translation in short QT syndrome.
In short QT syndrome, inherited gain-of-function mutations in the human ether a-gogo-related gene (hERG) K(+) channel have been associated with development of fatal arrhythmias. This implies that drugs that activate hERG as a side effect may likewise pose significant arrhythmia risk. hERG activators have been found to have diverse mechanisms of activation, which may reflect their distinct binding sites. Recently, the new hERG activator ICA-105574 was introduced, which disables inactivation of the hERG channel with very high potency. We explored characteristics of this new drug in several experimental models. Patch clamp experiments were used to verify activation of hERG channels by ICA-105574 in human embryonic kidney cells stably-expressing hERG channels. ICA-105574 significantly shortened QT and QTc intervals and monophasic action potential duration (MAP(90)) in Langendorff-perfused guinea-pig hearts. We also administered ICA-105574 to anesthetized dogs while recording ECG and drug plasma concentrations. ICA-105574 (10 mg/kg) significantly shortened QT and QTc intervals, with a free plasma concentration of approximately 1.7 µM at the point of maximal effect. Our data showed that unbound ICA-105574 caused QT shortening in dogs at concentrations comparable to the half maximal effective concentration (EC(50), 0.42 µM) of hERG activation in the patch clamp studies.
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Asayama et al. (2012) studied Normal electrophysiology (animal model) (n=4). ICA-105574 vs. Vehicle (pre-treatment control) was evaluated on QTc (V) interval (shortened by 20%, p=<0.001). Intravenous administration of the hERG activator ICA-105574 at 10 mg/kg significantly shortened the QTc interval from 305 ms to 245 ms in anesthetized dogs.
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