Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-26T23:01:28.660Z Has data issue: false hasContentIssue false

Inhibition of HERG channels by the local anaesthetic articaine

Published online by Cambridge University Press:  29 August 2006

C. C. Siebrands
Affiliation:
University Medical Center Hamburg-Eppendorf, Department of Anaesthesiology, Hamburg, Germany University Medical Center Hamburg-Eppendorf, Institute for Neural Signal Transduction, Hamburg, Germany
P. Friederich
Affiliation:
University Medical Center Hamburg-Eppendorf, Department of Anaesthesiology, Hamburg, Germany
Get access

Abstract

Summary

Background and objective: Articaine is an amide local anaesthetic widely used in dentistry. Human ether-a-go-go-related gene (HERG) potassium channels constitute potential targets involved in cardiotoxic side-effects of various pharmacological agents including amide local anaesthetics. The aim of this study was to determine the sensitivity of HERG channels to the inhibitory action of articaine and to further evaluate the effect of the mutations Y652A and F656A in the putative drug-binding region of HERG on the sensitivity for articaine. Methods: We examined the inhibition of wild-type and mutant HERG channels, transiently expressed in Chinese hamster ovary cells by articaine. Whole cell patch-clamp recordings were performed at room temperature. Results: Inhibition of HERG wild-type and HERG Y652A channels by articaine was concentration dependent and reversible. The concentration-response data were described by Hill functions (wild type: IC50 = 224 ± 6 μmol L−1, Hill coefficient h = 1.17 ± 0.03, n = 23; Y652A: IC50 = 360 ± 48 μmol L−1, h = 0.93 ± 0.08, n = 26). The mutation Y5652A decreased the sensitivity by factor 1.6. The mutation F656A decreased inhibition of inward tail currents by 300 μmol L−1 articaine in 100 mmol extracellular K+ 3-fold. Conclusions: Our results indicate that the local anaesthetic articaine does not inhibit HERG channels at clinically relevant concentrations. Articaine may therefore constitute a safer alternative for local and regional anaesthesia. The aromatic amino acid F656 rather than Y652 in the S6 region might play a role in interaction of the drug with the channel.

Type
Original Article
Copyright
2007 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

van Oss GE, Vree TB, Baars AM, Termond EF, Booij LH. Pharmacokinetics, metabolism, and renal excretion of articaine and its metabolite articainic acid in patients after epidural administration. Eur J Anaesthesiol 1989; 6: 4956.Google Scholar
Oertel R, Rahn R, Kirch W. Clinical pharmacokinetics of articaine. Clin Pharmacokinet 1997; 33: 417425.Google Scholar
Allman KG, Barker LL, Werrett GC, Gouws P, Sturrock GD, Wilson IH. Comparison of articaine and bupivacaine/lidocaine for peribulbar anaesthesia by inferotemporal injection. Br J Anaesth 2002; 88: 676678.Google Scholar
Allman KG, McFadyen JG, Armstrong J, Sturrock GD, Wilson IH. Comparison of articaine and bupivacaine/lidocaine for single medial canthus peribulbar anaesthesia. Br J Anaesth 2001; 87: 584587.Google Scholar
Gouws P, Galloway P, Jacob J, English W, Allman KG. Comparison of articaine and bupivacaine/lidocaine for sub-Tenon's anaesthesia in cataract extraction. Br J Anaesth 2004; 92: 228230.Google Scholar
Ozdemir M, Ozdemir G, Zencirci B, Oksuz H. Articaine versus lidocaine plus bupivacaine for peribulbar anaesthesia in cataract surgery. Br J Anaesth 2004; 92: 231234.Google Scholar
Grossmann M, Sattler G, Pistner Het al. Pharmacokinetics of articaine hydrochloride in tumescent local anesthesia for liposuction. J Clin Pharmacol 2004; 44: 12821289.Google Scholar
Simon MA, Vree TB, Gielen MJ, Booij LH. Comparison of the effects and disposition kinetics of articaine and lidocaine in 20 patients undergoing intravenous regional anaesthesia during day case surgery. Pharm World Sci 1998; 20: 8892.Google Scholar
Sanguinetti MC, Jiang C, Curran ME, Keating MT. A mechanistic link between an inherited and an acquired cardiac arrhythmia: HERG encodes the IKr potassium channel. Cell 1995; 81: 299307.Google Scholar
Mitcheson JS, Chen J, Sanguinetti MC. Trapping of a methanesulfonanilide by closure of the HERG potassium channel activation gate. J Gen Physiol 2000; 115: 229240.Google Scholar
Spector PS, Curran ME, Keating MT, Sanguinetti MC. Class III antiarrhythmic drugs block HERG, a human cardiac delayed rectifier K+ channel. Open-channel block by methanesulfonanilides. Circ Res 1996; 78: 499503.Google Scholar
Roy M, Dumaine R, Brown AM. HERG, a primary human ventricular target of the nonsedating antihistamine terfenadine. Circulation 1996; 94: 817823.Google Scholar
Suessbrich H, Waldegger S, Lang F, Busch AE. Blockade of HERG channels expressed in Xenopus oocytes by the histamine receptor antagonists terfenadine and astemizole. FEBS Lett 1996; 385: 7780.Google Scholar
Rampe D, Roy ML, Dennis A, Brown AM. A mechanism for the proarrhythmic effects of cisapride (Propulsid): high affinity blockade of the human cardiac potassium channel HERG. FEBS Lett 1997; 417: 2832.Google Scholar
Mohammad S, Zhou Z, Gong Q, January CT. Blockage of the HERG human cardiac K+ channel by the gastrointestinal prokinetic agent cisapride. Am J Physiol 1997; 273: H2534H2538.Google Scholar
Walker BD, Singleton CB, Bursill JAet al. Inhibition of the human ether-a-go-go-related gene (HERG) potassium channel by cisapride: affinity for open and inactivated states. Br J Pharmacol 1999; 128: 444450.Google Scholar
Stanat SJ, Carlton CG, Crumb JrWJ, Agrawal KC, Clarkson CW. Characterization of the inhibitory effects of erythromycin and clarithromycin on the HERG potassium channel. Mol Cell Biochem 2003; 254: 17.Google Scholar
Friederich P, Solth A, Schillemeit S, Isbrandt D. Local anaesthetic sensitivities of cloned HERG channels from human heart: comparison with HERG/MiRP1 and HERG/MiRP1 T8A. Br J Anaesth 2004; 92: 93101.Google Scholar
Gonzalez T, Arias C, Caballero Ret al. Effects of levobupivacaine, ropivacaine and bupivacaine on HERG channels: stereoselective bupivacaine block. Br J Pharmacol 2002; 137: 12691279.Google Scholar
Lipka LJ, Jiang M, Tseng GN. Differential effects of bupivacaine on cardiac K channels: role of channel inactivation and subunit composition in drug-channel interaction. J Cardiovasc Electrophysiol 1998; 9: 727742.Google Scholar
Siebrands CC, Schmitt N, Friederich P. Local anesthetic interaction with human ether-a-go-go-related gene (HERG) channels: role of aromatic amino acids Y652 and F656. Anesthesiology 2005; 103: 102112.Google Scholar
Mitcheson JS, Chen J, Lin M, Culberson C, Sanguinetti MC. A structural basis for drug-induced long QT syndrome. Proc Natl Acad Sci USA 2000; 97: 1232912333.Google Scholar
Fernandez D, Ghanta A, Kauffman GW, Sanguinetti MC. Physicochemical features of the HERG channel drug binding site. J Biol Chem 2004; 279: 1012010127.Google Scholar
Hancox JC, Levi AJ, Witchel HJ. Time course and voltage dependence of expressed HERG current compared with native ‘rapid’ delayed rectifier K current during the cardiac ventricular action potential. Pflugers Arch 1998; 436: 843853.Google Scholar
Wang S, Morales MJ, Liu S, Strauss HC, Rasmusson RL. Modulation of HERG affinity for E-4031 by [K+]o and C-type inactivation. FEBS Lett 1997; 417: 4347.Google Scholar
Strichartz GR, Sanchez V, Arthur GR, Chafetz R, Martin D. Fundamental properties of local anesthetics. II. Measured octanol:buffer partition coefficients and pKa values of clinically used drugs. Anesth Analg 1990; 71: 158170.Google Scholar
Kamiya K, Mitcheson JS, Yasui K, Kodama I, Sanguinetti MC. Open channel block of HERG K(+) channels by vesnarinone. Mol Pharmacol 2001; 60: 244253.Google Scholar
Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology 1979; 51: 285287.Google Scholar
Polley LS, Santos AC. Cardiac arrest following regional anesthesia with ropivacaine: here we go again! Anesthesiology 2003; 99: 12531254.Google Scholar
Kang J, Chen XL, Wang L, Rampe D. Interactions of the antimalarial drug mefloquine with the human cardiac potassium channels KvLQT1/minK and HERG. J Pharmacol Exp Ther 2001; 299: 290296.Google Scholar
Webster R, Leishman D, Walker D. Towards a drug concentration effect relationship for QT prolongation and torsades de pointes. Curr Opin Drug Discov Devel 2002; 5: 116126.Google Scholar
Redfern WS, Carlsson L, Davis ASet al. Relationships between preclinical cardiac electrophysiology, clinical QT interval prolongation and torsade de pointes for a broad range of drugs: evidence for a provisional safety margin in drug development. Cardiovasc Res 2003; 58: 3245.Google Scholar
Vree TB, Gielen MJ. Clinical pharmacology and the use of articaine for local and regional anaesthesia. Best Pract Res Clin Anaesthesiol 2005; 19: 293308.Google Scholar