Cardiac potassium inward rectifier Kir2: Review of structure, regulation, pharmacology, and arrhythmogenesis.

Cardiac potassium inward rectifier Kir2: Review of structure, regulation, pharmacology, and arrhythmogenesis.
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DOI:
10.1016/j.hrthm.2021.04.008
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发表时间:
2021-08
期刊:
影响因子:
5.5
通讯作者:
Eckhardt LL
Eckhardt LL
中科院分区:
医学2区
文献类型:
--
作者:
Reilly L;Eckhardt LL

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钾内向整流通道 Kir2 是心脏终末复极和静息膜稳定性的重要组成部分。这种功能是平衡心脏兴奋性的一部分,也是可兴奋心脏膜的一个定义特征。 KCNJ2(编码 Kir2.1 的基因)中的“功能获得”或“功能丧失”突变会导致遗传性心源性猝死综合征,而 Kir2 电流 IK1 的丧失是导致人类心脏衰竭发生心律失常的主要因素。在这里,我们对 Kir2 通道的功能结构、生理学和药理学进行了当代综述。除了结构和功能关系之外,我们还将重点关注临床上使用的阻断该通道的药物的成分以及 IK1 阻断剂治疗心房颤动的影响。我们还将回顾与 KCNJ2 突变相关的临床疾病实体以及相关心律失常机制的不断发展的研究领域。最后,Kir2 通道的存在已成为诱导多能干细胞来源的心肌细胞 (iPS-CM) 电成熟的转折点,并强调了了解 iPS-CM 中的 Kir2 对于综合体外致心律失常测定和药物安全性测试的重要性。
Potassium inward rectifier channel Kir2 is an important component of terminal cardiac repolarization and resting membrane stability. This functionality is part of balanced cardiac excitability and is a defining feature of excitable cardiac membranes. “Gain-of-function” or “loss-of-function” mutations in KCNJ2, the gene encoding Kir2.1, cause genetic sudden cardiac death syndromes, and loss of the Kir2 current IK1 is a major contributing factor to arrhythmogenesis in failing human hearts. Here we provide a contemporary review of the functional structure, physiology, and pharmacology of Kir2 channels. Beyond the structure and functional relationships, we will focus on the elements of clinically used drugs that block the channel and the implications for treatment of atrial fibrillation with IK1-blocking agents. We will also review the clinical disease entities associated with KCNJ2 mutations and the growing area of research into associated arrhythmia mechanisms. Lastly, the presence of Kir2 channels has become a tipping point for electrical maturity in induced pluripotent stem cell-derived cardiomyocytes (iPS-CMs) and highlights the significance of understanding why Kir2 in iPS-CMs is important to consider for Comprehensive In Vitro Proarrhythmia Assay and drug safety testing.
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