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Molecular Pharmacology

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Research ArticleArticle

A High-Throughput Screening Assay to Identify Drugs that Can Treat Long QT Syndrome Caused by Trafficking-Deficient KV11.1 (hERG) Variants

Christian L. Egly, Daniel J. Blackwell, Jeffrey Schmeckpeper, Brian P. Delisle, C. David Weaver and Björn C. Knollmann
Molecular Pharmacology April 2022, 101 (4) 236-245; DOI: https://doi.org/10.1124/molpharm.121.000421
Christian L. Egly
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (C.L.E., D.J.B., J.S., B.C.K.); Department of Physiology, University of Kentucky, Lexington, Kentucky (B.P.D.); and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee (C.D.W.)
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Daniel J. Blackwell
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (C.L.E., D.J.B., J.S., B.C.K.); Department of Physiology, University of Kentucky, Lexington, Kentucky (B.P.D.); and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee (C.D.W.)
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Jeffrey Schmeckpeper
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (C.L.E., D.J.B., J.S., B.C.K.); Department of Physiology, University of Kentucky, Lexington, Kentucky (B.P.D.); and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee (C.D.W.)
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Brian P. Delisle
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (C.L.E., D.J.B., J.S., B.C.K.); Department of Physiology, University of Kentucky, Lexington, Kentucky (B.P.D.); and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee (C.D.W.)
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C. David Weaver
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (C.L.E., D.J.B., J.S., B.C.K.); Department of Physiology, University of Kentucky, Lexington, Kentucky (B.P.D.); and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee (C.D.W.)
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Björn C. Knollmann
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (C.L.E., D.J.B., J.S., B.C.K.); Department of Physiology, University of Kentucky, Lexington, Kentucky (B.P.D.); and Department of Pharmacology, Vanderbilt University, Nashville, Tennessee (C.D.W.)
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Abstract

Loss-of-function (LOF) variants in the KV11.1 potassium channel cause long QT syndrome (LQTS). Most variants disrupt intracellular channel transport (trafficking) to the cell membrane. Since some channel inhibitors improve trafficking of KV11.1 variants, a high-throughput screening (HTS) assay to detect trafficking enhancement would be valuable to the identification of drug candidates. The thallium (Tl+) flux assay technique, widely used for drug screening, was optimized using human embryonic kidney (HEK-293) cells expressing a trafficking-deficient KV11.1 variant in 384-well plates. Assay quality was assessed using Z prime (Z’) scores comparing vehicle to E-4031, a drug that increases KV11.1 membrane trafficking. The optimized assay was validated by immunoblot, electrophysiology experiments, and a pilot drug screen. The combination of: 1) truncating the trafficking-deficient variant KV11.1-G601S (KV11.1-G601S-G965*X) with the addition of 2) KV11.1 channel activator (VU0405601) and 3) cesium (Cs+) to the Tl+ flux assay buffer resulted in an outstanding Z’ of 0.83. To validate the optimized trafficking assay, we carried out a pilot screen that identified three drugs (ibutilide, azaperone, and azelastine) that increase KV11.1 trafficking. The new assay exhibited 100% sensitivity and specificity. Immunoblot and voltage-clamp experiments confirmed that all three drugs identified by the new assay improved membrane trafficking of two additional LQTS KV11.1 variants. We report two new ways to increase target-specific activity in trafficking assays—genetic modification and channel activation—that yielded a novel HTS assay for identifying drugs that improve membrane expression of pathogenic KV11.1 variants.

SIGNIFICANCE STATEMENT This manuscript reports the development of a high-throughput assay (thallium flux) to identify drugs that can increase function in KV11.1 variants that are trafficking-deficient. Two key aspects that improved the resolving power of the assay and could be transferable to other ion channel trafficking–related assays include genetic modification and channel activation.

Footnotes

    • Received October 4, 2021.
    • Accepted January 1, 2022.
  • This work was supported in part by National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI) [Grant R35-HL144980] (B.C.K.), [Grant T32-5T32GM007569-44] (B.C.K., C.L.E.), Shared Instrumentation [Grant 1S10OD021734] (Panoptic), and NHLBI [Grant F32-HL140874] (D.J.B.); the Leducq Foundation [Grant 18CVD05] (B.C.K.); the American Heart Association [Grant 19SFRN34830019] (B.C.K.); and a PhRMA Foundation Postdoctoral Award (C.L.E.).

  • Conflict of Interest Disclosure: CDW is an owner of ION Biosciences and WaveFront Biosciences. ION and WaveFront sell the thallium-sensitive indicator, Thallos and the Panoptic plate reader used in these studies, respectively.

  • https://doi.org/10.1124/molpharm.121.000421.

  • ↵Embedded ImageThis article has supplemental material available at molpharm.aspetjournals.org.

  • Copyright © 2022 by The American Society for Pharmacology and Experimental Therapeutics
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Molecular Pharmacology: 101 (4)
Molecular Pharmacology
Vol. 101, Issue 4
1 Apr 2022
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Research ArticleArticle

HTS to Find Drugs that Improve KV11.1 Trafficking

Christian L. Egly, Daniel J. Blackwell, Jeffrey Schmeckpeper, Brian P. Delisle, C. David Weaver and Björn C. Knollmann
Molecular Pharmacology April 1, 2022, 101 (4) 236-245; DOI: https://doi.org/10.1124/molpharm.121.000421

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Research ArticleArticle

HTS to Find Drugs that Improve KV11.1 Trafficking

Christian L. Egly, Daniel J. Blackwell, Jeffrey Schmeckpeper, Brian P. Delisle, C. David Weaver and Björn C. Knollmann
Molecular Pharmacology April 1, 2022, 101 (4) 236-245; DOI: https://doi.org/10.1124/molpharm.121.000421
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