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Molecular basis for class Ib anti-arrhythmic inhibition of cardiac sodium channels

Authors: Stephan A. Pless, Jason D. Galpin, Adam Frankel, Christopher A. Ahern , Lab of Chris Ahern, Cardiovascular Research Group, Department of  Cellular & Physiological Sciences & Anesthesiology, Pharmacology and Therapeutics

Published in Nature Communications 2, Article number: 351 doi:10.1038/ncomms1351

Abstract: Cardiac sodium channels are established therapeutic targets for the management of inherited and acquired arrhythmias by class I anti-arrhythmic drugs (AADs). These drugs share a common target receptor bearing two highly conserved aromatic side chains, and are subdivided by the Vaughan-Williams classification system into classes Ia-c based on their distinct effects on the electrocardiogram. How can these drugs elicit distinct effects on the cardiac action potential by binding to a common receptor? Here we use fluorinatedphenylalanine derivatives to test whether the electronegative surface potential of aromatic side chains contributes to inhibition by six class I AADs. Surprisingly, we find that class Ib AADs bind via a strong electrostatic cation–pi interaction, whereas class Ia and Ic AADs rely significantly less on this interaction. Our data shed new light on drug-target interactions underlying the inhibition of cardiac sodium channels by clinically relevant drugs and provide information for the directed design of AADs.


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