Patient-Specific and Genome-Edited Induced Pluripotent Stem Cell–Derived Cardiomyocytes Elucidate Single-Cell Phenotype of Brugada Syndrome

Ping Liang, Karim Sallam, Haodi Wu, Yingxin Li, Ilanit Itzhaki, Priyanka Garg, Ying Zhang, Vittavat Vermglinchan, Feng Lan, Mingxia Gu, Tingyu Gong, Yan Zhuge, Chunjiang He, Antje D. Ebert, Veronica Sanchez-Freire, Jared Churko, Shijun Hu, Arun Sharma, Chi Keung Lam, Melvin M. Scheinman & 2 others Donald M Bers, Joseph C. Wu

Research output: Contribution to journalArticle

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Abstract

Background Brugada syndrome (BrS), a disorder associated with characteristic electrocardiogram precordial ST-segment elevation, predisposes afflicted patients to ventricular fibrillation and sudden cardiac death. Despite marked achievements in outlining the organ level pathophysiology of the disorder, the understanding of human cellular phenotype has lagged due to a lack of adequate human cellular models of the disorder. Objectives The objective of this study was to examine single cell mechanism of Brugada syndrome using induced pluripotent stem cell–derived cardiomyocytes (iPSC-CMs). Methods This study recruited 2 patients with type 1 BrS carrying 2 different sodium voltage-gated channel alpha subunit 5 variants as well as 2 healthy control subjects. We generated iPSCs from their skin fibroblasts by using integration-free Sendai virus. We used directed differentiation to create purified populations of iPSC-CMs. Results BrS iPSC-CMs showed reductions in inward sodium current density and reduced maximal upstroke velocity of action potential compared with healthy control iPSC-CMs. Furthermore, BrS iPSC-CMs demonstrated increased burden of triggered activity, abnormal calcium (Ca2+) transients, and beating interval variation. Correction of the causative variant by genome editing was performed, and resultant iPSC-CMs showed resolution of triggered activity and abnormal Ca2+ transients. Gene expression profiling of iPSC-CMs showed clustering of BrS compared with control subjects. Furthermore, BrS iPSC-CM gene expression correlated with gene expression from BrS human cardiac tissue gene expression. Conclusions Patient-specific iPSC-CMs were able to recapitulate single-cell phenotype features of BrS, including blunted inward sodium current, increased triggered activity, and abnormal Ca2+ handling. This novel human cellular model creates future opportunities to further elucidate the cellular disease mechanism and identify novel therapeutic targets.

Original languageEnglish (US)
Pages (from-to)2086-2096
Number of pages11
JournalJournal of the American College of Cardiology
Volume68
Issue number19
DOIs
StatePublished - Nov 8 2016

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Brugada Syndrome
Cardiac Myocytes
Genome
Phenotype
Gene Expression
Sodium
Voltage-Gated Sodium Channels
Sendai virus
Sudden Cardiac Death
Gene Expression Profiling
Ventricular Fibrillation
Action Potentials
Cluster Analysis
Healthy Volunteers
Electrocardiography
Fibroblasts
Calcium
Skin

Keywords

  • action potential
  • arrhythmia
  • Ca transient
  • gene expression
  • genome editing
  • SCN5A

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Patient-Specific and Genome-Edited Induced Pluripotent Stem Cell–Derived Cardiomyocytes Elucidate Single-Cell Phenotype of Brugada Syndrome. / Liang, Ping; Sallam, Karim; Wu, Haodi; Li, Yingxin; Itzhaki, Ilanit; Garg, Priyanka; Zhang, Ying; Vermglinchan, Vittavat; Lan, Feng; Gu, Mingxia; Gong, Tingyu; Zhuge, Yan; He, Chunjiang; Ebert, Antje D.; Sanchez-Freire, Veronica; Churko, Jared; Hu, Shijun; Sharma, Arun; Lam, Chi Keung; Scheinman, Melvin M.; Bers, Donald M; Wu, Joseph C.

In: Journal of the American College of Cardiology, Vol. 68, No. 19, 08.11.2016, p. 2086-2096.

Research output: Contribution to journalArticle

Liang, P, Sallam, K, Wu, H, Li, Y, Itzhaki, I, Garg, P, Zhang, Y, Vermglinchan, V, Lan, F, Gu, M, Gong, T, Zhuge, Y, He, C, Ebert, AD, Sanchez-Freire, V, Churko, J, Hu, S, Sharma, A, Lam, CK, Scheinman, MM, Bers, DM & Wu, JC 2016, 'Patient-Specific and Genome-Edited Induced Pluripotent Stem Cell–Derived Cardiomyocytes Elucidate Single-Cell Phenotype of Brugada Syndrome', Journal of the American College of Cardiology, vol. 68, no. 19, pp. 2086-2096. https://doi.org/10.1016/j.jacc.2016.07.779
Liang, Ping ; Sallam, Karim ; Wu, Haodi ; Li, Yingxin ; Itzhaki, Ilanit ; Garg, Priyanka ; Zhang, Ying ; Vermglinchan, Vittavat ; Lan, Feng ; Gu, Mingxia ; Gong, Tingyu ; Zhuge, Yan ; He, Chunjiang ; Ebert, Antje D. ; Sanchez-Freire, Veronica ; Churko, Jared ; Hu, Shijun ; Sharma, Arun ; Lam, Chi Keung ; Scheinman, Melvin M. ; Bers, Donald M ; Wu, Joseph C. / Patient-Specific and Genome-Edited Induced Pluripotent Stem Cell–Derived Cardiomyocytes Elucidate Single-Cell Phenotype of Brugada Syndrome. In: Journal of the American College of Cardiology. 2016 ; Vol. 68, No. 19. pp. 2086-2096.
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abstract = "Background Brugada syndrome (BrS), a disorder associated with characteristic electrocardiogram precordial ST-segment elevation, predisposes afflicted patients to ventricular fibrillation and sudden cardiac death. Despite marked achievements in outlining the organ level pathophysiology of the disorder, the understanding of human cellular phenotype has lagged due to a lack of adequate human cellular models of the disorder. Objectives The objective of this study was to examine single cell mechanism of Brugada syndrome using induced pluripotent stem cell–derived cardiomyocytes (iPSC-CMs). Methods This study recruited 2 patients with type 1 BrS carrying 2 different sodium voltage-gated channel alpha subunit 5 variants as well as 2 healthy control subjects. We generated iPSCs from their skin fibroblasts by using integration-free Sendai virus. We used directed differentiation to create purified populations of iPSC-CMs. Results BrS iPSC-CMs showed reductions in inward sodium current density and reduced maximal upstroke velocity of action potential compared with healthy control iPSC-CMs. Furthermore, BrS iPSC-CMs demonstrated increased burden of triggered activity, abnormal calcium (Ca2+) transients, and beating interval variation. Correction of the causative variant by genome editing was performed, and resultant iPSC-CMs showed resolution of triggered activity and abnormal Ca2+ transients. Gene expression profiling of iPSC-CMs showed clustering of BrS compared with control subjects. Furthermore, BrS iPSC-CM gene expression correlated with gene expression from BrS human cardiac tissue gene expression. Conclusions Patient-specific iPSC-CMs were able to recapitulate single-cell phenotype features of BrS, including blunted inward sodium current, increased triggered activity, and abnormal Ca2+ handling. This novel human cellular model creates future opportunities to further elucidate the cellular disease mechanism and identify novel therapeutic targets.",
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AU - Liang, Ping

AU - Sallam, Karim

AU - Wu, Haodi

AU - Li, Yingxin

AU - Itzhaki, Ilanit

AU - Garg, Priyanka

AU - Zhang, Ying

AU - Vermglinchan, Vittavat

AU - Lan, Feng

AU - Gu, Mingxia

AU - Gong, Tingyu

AU - Zhuge, Yan

AU - He, Chunjiang

AU - Ebert, Antje D.

AU - Sanchez-Freire, Veronica

AU - Churko, Jared

AU - Hu, Shijun

AU - Sharma, Arun

AU - Lam, Chi Keung

AU - Scheinman, Melvin M.

AU - Bers, Donald M

AU - Wu, Joseph C.

PY - 2016/11/8

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N2 - Background Brugada syndrome (BrS), a disorder associated with characteristic electrocardiogram precordial ST-segment elevation, predisposes afflicted patients to ventricular fibrillation and sudden cardiac death. Despite marked achievements in outlining the organ level pathophysiology of the disorder, the understanding of human cellular phenotype has lagged due to a lack of adequate human cellular models of the disorder. Objectives The objective of this study was to examine single cell mechanism of Brugada syndrome using induced pluripotent stem cell–derived cardiomyocytes (iPSC-CMs). Methods This study recruited 2 patients with type 1 BrS carrying 2 different sodium voltage-gated channel alpha subunit 5 variants as well as 2 healthy control subjects. We generated iPSCs from their skin fibroblasts by using integration-free Sendai virus. We used directed differentiation to create purified populations of iPSC-CMs. Results BrS iPSC-CMs showed reductions in inward sodium current density and reduced maximal upstroke velocity of action potential compared with healthy control iPSC-CMs. Furthermore, BrS iPSC-CMs demonstrated increased burden of triggered activity, abnormal calcium (Ca2+) transients, and beating interval variation. Correction of the causative variant by genome editing was performed, and resultant iPSC-CMs showed resolution of triggered activity and abnormal Ca2+ transients. Gene expression profiling of iPSC-CMs showed clustering of BrS compared with control subjects. Furthermore, BrS iPSC-CM gene expression correlated with gene expression from BrS human cardiac tissue gene expression. Conclusions Patient-specific iPSC-CMs were able to recapitulate single-cell phenotype features of BrS, including blunted inward sodium current, increased triggered activity, and abnormal Ca2+ handling. This novel human cellular model creates future opportunities to further elucidate the cellular disease mechanism and identify novel therapeutic targets.

AB - Background Brugada syndrome (BrS), a disorder associated with characteristic electrocardiogram precordial ST-segment elevation, predisposes afflicted patients to ventricular fibrillation and sudden cardiac death. Despite marked achievements in outlining the organ level pathophysiology of the disorder, the understanding of human cellular phenotype has lagged due to a lack of adequate human cellular models of the disorder. Objectives The objective of this study was to examine single cell mechanism of Brugada syndrome using induced pluripotent stem cell–derived cardiomyocytes (iPSC-CMs). Methods This study recruited 2 patients with type 1 BrS carrying 2 different sodium voltage-gated channel alpha subunit 5 variants as well as 2 healthy control subjects. We generated iPSCs from their skin fibroblasts by using integration-free Sendai virus. We used directed differentiation to create purified populations of iPSC-CMs. Results BrS iPSC-CMs showed reductions in inward sodium current density and reduced maximal upstroke velocity of action potential compared with healthy control iPSC-CMs. Furthermore, BrS iPSC-CMs demonstrated increased burden of triggered activity, abnormal calcium (Ca2+) transients, and beating interval variation. Correction of the causative variant by genome editing was performed, and resultant iPSC-CMs showed resolution of triggered activity and abnormal Ca2+ transients. Gene expression profiling of iPSC-CMs showed clustering of BrS compared with control subjects. Furthermore, BrS iPSC-CM gene expression correlated with gene expression from BrS human cardiac tissue gene expression. Conclusions Patient-specific iPSC-CMs were able to recapitulate single-cell phenotype features of BrS, including blunted inward sodium current, increased triggered activity, and abnormal Ca2+ handling. This novel human cellular model creates future opportunities to further elucidate the cellular disease mechanism and identify novel therapeutic targets.

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