hERG protein trafficking deficiency has long been known in drug-induced long QT syndrome (LQTS). However, validated evidence from in vivo data kept scanty. Our goal was to investigate the proarrhythmic action of fluconazole and its underlying mechanism in an animal model. Twenty female Japanese long-eared white rabbits were randomly distributed into a control group and a fluconazole group for a chronic 2-week treatment. The control group was treated with 0.5% sodium carboxymethylcellulose (CMCNa), and the fluconazole group was treated with fluconazole. Electrocardiograms (ECGs) were recorded during the experimental period. Isolated arterially perfused left ventricular wedge preparations from the rabbits were made 2 weeks after treatment, and the arrhythmia events, the transmural ECG, and action potential from both the endocardium and epicardium were recorded. The changes in hERG protein expression were measured by western blot. The fluconazole group showed a longer QT interval 1 week after treatment (P < 0.05) and a higher arrhythmia occurrence 2 weeks after treatment (P < 0.05) than the control group. The fluconazole group also showed a longer transmural dispersion of repolarization and a higher occurrence of life-threatening torsades de pointes in arterially perfused left ventricular preparations. Furthermore, western blot analysis showed that the density of mature hERG protein was lower in the fluconazole group than that in the control group. Fluconazole can prolong the QT interval and possess proarrhythmic activity due to its inhibition of hERG protein trafficking in our experimental model. These findings may impact the clinical potential of fluconazole in humans.
基金:
National Natural Science Foundation of China [NSFC-30973601, NSFC-81370290]; Hubei Public Welfare Science Research Program of China [2013BCB023]; Program of Beijing High-caliber Talent from Overseas [BHTO201410007]
第一作者单位:[1]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Geriatr, 1095 Jiefang Ave, Wuhan 430030, Peoples R China
通讯作者:
通讯机构:[3]Capital Med Univ, Beijing Anzhen Hosp, Dept Cardiol, 2 Anzhen Rd, Beijing 100029, Peoples R China[4]St Davids Med Ctr, Texas Cardiac Arrhythmia Inst, Austin, TX USA
推荐引用方式(GB/T 7714):
Wang Jinli,Wang Guan,Quan Xiaoqing,et al.Fluconazole-induced long QT syndrome via impaired human ether-a-go-go-related gene (hERG) protein trafficking in rabbits[J].EUROPACE.2017,19(7):1244-1249.doi:10.1093/europace/euw091.
APA:
Wang, Jinli,Wang, Guan,Quan, Xiaoqing,Ruan, Lei,Liu, Yang...&Bai, Rong.(2017).Fluconazole-induced long QT syndrome via impaired human ether-a-go-go-related gene (hERG) protein trafficking in rabbits.EUROPACE,19,(7)
MLA:
Wang, Jinli,et al."Fluconazole-induced long QT syndrome via impaired human ether-a-go-go-related gene (hERG) protein trafficking in rabbits".EUROPACE 19..7(2017):1244-1249