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A preclinical model of Brugada syndrome using CRISPR Repair in human cardiomyocytes from induced pluripotent stem cells: plattform for drug screening
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  • Ibrahim El-Battrawy,
  • Rujia Zhoang,
  • Lukas Cyganek,
  • Theresa Schimanski,
  • Feng Zhang,
  • Alyssa Hohn,
  • Qiang Xu,
  • Mengying Huang,
  • Zhanxing Laio,
  • Lin Qiao,
  • Zhen Yang,
  • Yingrui Li,
  • Zhihan Zhao,
  • Xin Li,
  • Sebastian Albers,
  • Lasse Maywald,
  • Jonas Mueller,
  • Hendrik Dinkel,
  • Ardan Saguner,
  • Hans Janssen,
  • Narasimha Swamy,
  • Yannic Xi,
  • Siegfried Lang,
  • Mandy Kleinsorge,
  • Firat Duru,
  • Martin Borggrefe,
  • Sebastian Diecke,
  • Ibrahim Akin,
  • Xiaobo Zhou
Ibrahim El-Battrawy
University Medical Centre Mannheim (UMM), University of Heidelberg

Corresponding Author:ibrahim.el-battrawy@medma.uni-heidelberg.de

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Rujia Zhoang
University Medical Centre Mannheim
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Lukas Cyganek
University Medical Center Göttingen
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Theresa Schimanski
University Medical Centre Mannheim
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Feng Zhang
University Medical Centre Mannheim
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Alyssa Hohn
University Medical Centre Mannheim
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Qiang Xu
University Medical Centre Mannheim
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Mengying Huang
University Medical Centre Mannheim
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Zhanxing Laio
University Medical Centre Mannheim
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Lin Qiao
University Medical Centre Mannheim
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Zhen Yang
University Medical Center Mannheim
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Yingrui Li
University Medical Centre Mannheim
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Zhihan Zhao
University Medical Centre Mannheim
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Xin Li
University Medical Centre Mannheim
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Sebastian Albers
University Medical Centre Mannheim
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Lasse Maywald
University Medical Center Mannheim
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Jonas Mueller
University Medical Centre Mannheim
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Hendrik Dinkel
University Medical Centre Mannheim
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Ardan Saguner
University Medical Centre Mannheim
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Hans Janssen
University of Heidelberg
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Narasimha Swamy
MCC Berlin
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Yannic Xi
University Medical Centre Mannheim
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Siegfried Lang
University Medical Centre Mannheim
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Mandy Kleinsorge
University Medical Centre Mannheim
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Firat Duru
University Medical Centre Mannheim
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Martin Borggrefe
University Medical Centre Mannheim
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Sebastian Diecke
MCC Berlin
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Ibrahim Akin
University Medical Centre Mannheim
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Xiaobo Zhou
Heidelberg University
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Abstract

Aims: Gene variants the calcium channels have been associated with Brugada syndrome (BrS). The investigation of the human cellular phenotype and the use of drugs for BrS is still lacking. Methods and results: This study recruited cells from a BrS patient carrying a missense variant (c.425C>T/p.S142F) in CACNB2 with uncertain significance as well as from three healthy persons. Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) generated from skin biopsies of healthy persons and the BrS patient (BrS-hiPSC-CMs) as well as CRISPR/Cas9 corrected cells (isogenic control, site-variant corrected) were used. HiPSC-CMs from the BrS patient showed a significantly reduced L-type calcium channel current (ICa-L). The inactivation curve was shifted to a more positive potential and the recovery from inactivation was accelerated. The protein expression of CACNB2 from the BrS-patient was significantly decreased. Moreover, the correction of the CACNB2 site-variant rescued the changes. In addition, the peak sodium current was significantly reduced as compared with the controls consistent with the reduction of the amplitude and upstroke velocity of action potentials in BrS-hiPSC-CMs. Arrhythmia events were more frequently detected in BrS-hiPSC-CMs. In cells without arrhythmic events, carbachol induced the occurrence of arrhythmias with a higher chance in BrS-hiPSC-CMs than in healthy cells. Whereas ajmaline (sodium channel blocker) did not increase arrhythmic events, bisoprolol (beta-blocker) at low concentration and quinidine decreased arrhythmic events. Conclusions: The CACNB2 variant (c.425C>T/p.S142F) causes a loss-of-function of L-type calcium channels and is pathogenic for this type of BrS. Bisoprolol and quinidine may be effective for treating BrS with this variant.