arrhythmias Archives - Sanford Burnham Prebys
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Will flies help fix heart rhythm problems?

AuthorSusan Gammon
Date

July 12, 2017

Your heart beats about 35 million times in a single a year. That’s a whopping number of beats—each generated by electrical signals that make the heart contract. Occasionally problems with heart’s electrical system can cause irregular rhythms, or arrhythmias. Some types of arrhythmias are merely annoying; others can last long enough to affect how the heart works, or even cause sudden cardiac arrest.

Although certain arrhythmias can be successfully treated with medication, surgery and/or devices such as pacemakers, cardiac disorders and heart disease still account for more deaths than any other disease.

Finding new treatments for arrhythmias requires a deep understanding of how the heart beats, and specifically the intricate electrical system that prompts the heart to contract. It also requires a model to study. Is Drosophila melanogaster—a type of fruit fly—the answer?

Using flies to study the heart

Both the human heart and fly hearts have four chambers and both start out as linear tubes in embryos—but ours loops during development to form a more compact structure where as a the fly heart does not. Despite this structural difference there are many functional similarities between the fly and human heart.

“One of the similarities that we focus on in my lab is the way ion channels work—and don’t work—to fully understand how faulty ion channels contribute to heart arrhythmias,” says Karen Ocorr, PhD, assistant professor at SBP.

Ion channels are proteins found in cell membranes that allow specific ions such as potassium, sodium and calcium, to pass through cells. When ion currents travel into heart muscle cells, the muscle becomes depolarized, creating an electrical current that causes the heart to contract. A second set of channels are important in repolarization of the heart, which allows it to relax and refill with blood.

In her new paper published in PLOS Genetics, Ocorr describes how two repolarizing potassium ion channels called hERG and KCNQ control the rate and efficiency of fly heart contractions—similar to their role in human heart muscle. The research also shows that mutations in hERG and KCNQ lead to arrhythmias that worsen with age—as they do in humans.

“In humans, when hERG is compromised, either by drugs or inherited mutations, hearts can take longer than normal to recharge between beats, causing a potentially fatal condition called long QT syndrome. In fact, some anti-arrhythmia drugs actually cause long QT syndrome, hence the need for better, more specific therapies,” explains Ocorr.

The capacity for drugs to cause long QT syndrome has led the Food and Drug Administration (FDA) to recommend including the evaluation of new cardiac and non-cardiac drugs for this possible side effect. The FDA is the United States agency that provides licenses to market new drugs.

Interestingly, neither of the ion channels we identified in the fly heart play a major role in the adult mouse heart, ruling it out as useful model to screen for drug-related long QT effects,” says Ocorr.

“We are encouraged that Drosophila may become an easy, accurate tool to pre-clinically screen for adverse cardiac events associated new anti-arrhythmia therapies—potentially making the next drug discovery for patients happen sooner.”

Read the paper here

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Measuring heart toxicity of cancer drugs in a dish

AuthorJessica Moore
Date

February 22, 2017

A class of cancer drugs known as tyrosine kinase inhibitors (TKIs) are often damaging to the heart, sometimes to the degree that they can’t be used in patients. These toxic effects are not always predictable using current preclinical methods, so they may not be discovered until they make it to clinical trials.

New research could make it possible to tell which TKIs cause heart toxicity without putting any humans at risk. The collaborative study, involving Wesley McKeithan, a PhD student in the Sanford Burnham Prebys Medical Discovery Institute (SBP) graduate program and Mark Mercola, PhD, adjunct professor at SBP and a professor at Stanford University, used lab-grown heart muscle cells to assess the drugs’ potential to cause damaging effects.

“This new method of screening for cardiotoxicity should help pharma companies focus their efforts on TKIs that will be safe,” says Mercola, who collaborated with Joseph Wu, MD, PhD, also a professor at Stanford, on the study published in Science Translational Medicine. “That could mean better new TKIs will make it to the market, since we will be able to predict whether or not they cause heart problems early in the development process.”

TKIs with tolerable cardiac side effects, which include imatinib (Gleevec) and erlotinib (Tarceva), are widely used to treat multiple types of cancer. Because tumors often become resistant to these drugs, new compounds in this class continue to be developed to provide replacement treatments. Other TKIs can harm the heart in a variety of ways, from altering electrical patterns to causing arrhythmias, reducing pumping capacity, or even increasing risk of heart attacks.

Mercola and Wu’s team used heart muscle cells derived from induced pluripotent stem cells (iPSCs), which can be generated from adult skin or blood cells. After treating heart muscle cells with one of 21 TKIs, they assessed their survival, electrical activity, contractions (beating) and communication with adjacent cells. They used a new method for measuring heart cell contraction developed by the lab of Juan Carlos del Álamo, Ph.D., at UC San Diego to create a ‘cardiac safety index’, which correlates in vitro assay results with the drugs’ serum concentrations in humans. Importantly, the safety index values matched nicely with clinical reports on the cardiotoxicity of currently used TKIs.

The study also identified a possible way to protect heart muscle cells from impairment caused by TKIs—treating them with insulin or insulin-like growth factor. Although more research is needed, the findings suggest that it may be possible to alleviate some of the heart damage in patients receiving these chemotherapies.

Mercola adds, “By using cells derived from a broader group of individuals, this screening strategy could easily be adopted by the pharma industry to predict cardiotoxicity.”

This story is based in part on a press release from Stanford University School of Medicine.

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Doug Lewandowski, PhD, elected as a Fellow of the American Association for the Advancement of Science

AuthorJessica Moore
Date

April 28, 2016

The director of Translational Cardiovascular Research at SBP’s Lake Nona campus was recently named a Fellow of the American Association for the Advancement of Science (AAAS). E. Douglas Lewandowski, PhD, was one of 33 scientists selected to become a AAAS fellow in the Section on Medical Sciences, recognizing his “distinguished contributions to fundamental aspects of cardiac metabolism and their implications for heart disease.” Continue reading “Doug Lewandowski, PhD, elected as a Fellow of the American Association for the Advancement of Science”

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Novel model for cardiomyopathy paves the way for new therapies

Authorsgammon
Date

May 29, 2015

A new fruit fly model that captures key metabolic defects associated with cardiomyopathy could translate into more-effective treatments for this potentially deadly heart condition, according to a study conducted by researchers at Sanford-Burnham and the Universidad Autónoma de Madrid in Spain. The findings, published April 9 in Human Molecular Genetics, could also have broader clinical implications for human metabolic diseases affecting other organ systems such as the liver and skeletal muscle. Continue reading “Novel model for cardiomyopathy paves the way for new therapies”