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H(1) antihistamine drug promethazine directly blocks hERG K(+) channel.
Pharmacol Res. 2009 Nov; 60(5):429-37.PR

Abstract

Promethazine is a phenothiazine derivative with antihistaminic (H(1)), sedative, antiemetic, anticholinergic, and antimotion sickness properties that can induce QT prolongation, which may lead to torsades de pointes. Since block of cardiac human ether-a-go-go-related gene (hERG) channels is one of the leading causes of acquired long QT syndrome, we investigated the acute effects of promethazine on hERG channels to determine the electrophysiological basis for its proarrhythmic potential. Promethazine increased the action potential duration at 90% of repolarization (APD(90)) in a concentration-dependent manner, with an IC(50) of 0.73microM when action potentials were elicited under current clamp in guinea pig ventricular myocytes. We examined the effects of promethazine on the hERG channels expressed in Xenopus oocytes and HEK293 cells using two-microelectrode voltage-clamp and patch-clamp techniques. Promethazine induced a concentration-dependent decrease of the current amplitude at the end of the voltage steps and hERG tail currents. The IC(50) of promethazine dependent hERG block in Xenopus oocytes decreased progressively relative to the degree of depolarization. The IC(50) for the promethazine-induced block of the hERG currents in HEK293 cells at 36 degrees C was 1.46microM at +20mV. Promethazine affected the channels in the activated and inactivated states but not in the closed states. The S6 domain mutations, Y652A and F656A partially attenuated (Y652A) or abolished (F656A) the hERG current block. These results suggest that promethazine is a blocker of the hERG channels, providing a molecular mechanism for the arrhythmogenic side effects during the clinical administration of promethazine.

Authors+Show Affiliations

Department of Physiology, Institute of Bioscience and Biotechnology, Kangwon National University College of Medicine, Chuncheon, Republic of Korea. suhyunjo@kangwon.ac.krNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19497368

Citation

Jo, Su-Hyun, et al. "H(1) Antihistamine Drug Promethazine Directly Blocks hERG K(+) Channel." Pharmacological Research, vol. 60, no. 5, 2009, pp. 429-37.
Jo SH, Hong HK, Chong SH, et al. H(1) antihistamine drug promethazine directly blocks hERG K(+) channel. Pharmacol Res. 2009;60(5):429-37.
Jo, S. H., Hong, H. K., Chong, S. H., Lee, H. S., & Choe, H. (2009). H(1) antihistamine drug promethazine directly blocks hERG K(+) channel. Pharmacological Research, 60(5), 429-37. https://doi.org/10.1016/j.phrs.2009.05.008
Jo SH, et al. H(1) Antihistamine Drug Promethazine Directly Blocks hERG K(+) Channel. Pharmacol Res. 2009;60(5):429-37. PubMed PMID: 19497368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - H(1) antihistamine drug promethazine directly blocks hERG K(+) channel. AU - Jo,Su-Hyun, AU - Hong,Hee-Kyung, AU - Chong,Seon Ha, AU - Lee,Hui Sun, AU - Choe,Han, Y1 - 2009/06/02/ PY - 2009/04/21/received PY - 2009/05/24/revised PY - 2009/05/25/accepted PY - 2009/6/6/entrez PY - 2009/6/6/pubmed PY - 2009/11/18/medline SP - 429 EP - 37 JF - Pharmacological research JO - Pharmacol Res VL - 60 IS - 5 N2 - Promethazine is a phenothiazine derivative with antihistaminic (H(1)), sedative, antiemetic, anticholinergic, and antimotion sickness properties that can induce QT prolongation, which may lead to torsades de pointes. Since block of cardiac human ether-a-go-go-related gene (hERG) channels is one of the leading causes of acquired long QT syndrome, we investigated the acute effects of promethazine on hERG channels to determine the electrophysiological basis for its proarrhythmic potential. Promethazine increased the action potential duration at 90% of repolarization (APD(90)) in a concentration-dependent manner, with an IC(50) of 0.73microM when action potentials were elicited under current clamp in guinea pig ventricular myocytes. We examined the effects of promethazine on the hERG channels expressed in Xenopus oocytes and HEK293 cells using two-microelectrode voltage-clamp and patch-clamp techniques. Promethazine induced a concentration-dependent decrease of the current amplitude at the end of the voltage steps and hERG tail currents. The IC(50) of promethazine dependent hERG block in Xenopus oocytes decreased progressively relative to the degree of depolarization. The IC(50) for the promethazine-induced block of the hERG currents in HEK293 cells at 36 degrees C was 1.46microM at +20mV. Promethazine affected the channels in the activated and inactivated states but not in the closed states. The S6 domain mutations, Y652A and F656A partially attenuated (Y652A) or abolished (F656A) the hERG current block. These results suggest that promethazine is a blocker of the hERG channels, providing a molecular mechanism for the arrhythmogenic side effects during the clinical administration of promethazine. SN - 1096-1186 UR - https://www.unboundmedicine.com/medline/citation/19497368/H_1__antihistamine_drug_promethazine_directly_blocks_hERG_K_+__channel_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1043-6618(09)00152-2 DB - PRIME DP - Unbound Medicine ER -