TOPIC

Translational Studies on Anti-Atrial Fibrillatory Action of Oseltamivir by its in vivo and in vitro Electropharmacological Analyses

Journal

Frontiers in Pharmacology

Author(s)

Ryuichi Kambayashi, Hiroko Izumi-Nakaseko, Ai Goto, Kazuya Tsurudome, Hironori Ohshiro, Taku Izumi, Mihoko Hagiwara-Nagasawa, Koki Chiba, Ryota Nishiyama, Satomi Oyama, Yoshio Nunoi, Yoshinori Takei, Akio Matsumoto, Atsushi Sugiyama

Year

2021

Oseltamivir has been shown to prolong the atrial conduction time and effective refractory period and to suppress the onset of burst pacing-induced atrial fibrillation in vitro. To better predict its potential clinical benefit as an anti-atrial fibrillatory drug, we performed translational studies by assessing¬†in vivo¬†anti-atrial fibrillatory effect along with¬†in vivo¬†and¬†in vitro electropharmacological analyses. Oseltamivir in intravenous doses of 3 (n = 6) and 30¬†mg/kg (n = 7) was administered in a conscious state to the persistent atrial fibrillation model dogs to confirm its anti-atrial fibrillatory action. The model was prepared by tachypacing to the atria of chronic atrioventricular block dogs for > 6¬†weeks. Next, oseltamivir in doses of 0.3, 3 and 30¬†mg/kg was intravenously administered to the halothane-anesthetized intact dogs to analyze its¬†in vivo¬†electrophysiological actions (n = 4). Finally, its¬†in vitro¬†effects of 10‚Äď1,000¬†őľM on IK,ACh, IKur, IKr, INa¬†and ICaL¬†were analyzed by using cell lines stably expressing Kir3.1/3.4, KV1.5, hERG, NaV1.5 or CaV1.2, respectively (n = 3 for IK,ACh¬†and IKr¬†or n = 6 for IKr, INa¬†and ICaL). Oseltamivir in doses of 3 and 30¬†mg/kg terminated the atrial fibrillation in 1 out of 6 and in 6 out of 7 atrial fibrillation model dogs, respectively without inducing any lethal ventricular arrhythmia. Its 3 and 30¬†mg/kg delayed inter-atrial conduction in a frequency-dependent manner, whereas they prolonged atrial effective refractory period in a reverse frequency-dependent manner in the intact dogs. The current assay indicated that IC50¬†values for IK,ACh¬†and IKr¬†were 160 and 231¬†őľM, respectively, but 1,000¬†¬ĶM inhibited INa, ICaL¬†and IKur¬†by 22, 19 and 13%, respectively. The extent of INa blockade was enhanced at a faster beating rate and more depolarized resting membrane potential. Oseltamivir effectively terminated the persistent atrial fibrillation, which may be largely due to the prolongation of the atrial effective refractory period and inter-atrial conduction time induced by IK,ACh¬†and IKr¬†inhibitions along with INa¬†suppression. Thus, oseltamivir can exert a powerful anti-atrial fibrillatory action through its ideal multi-channel blocking property; and oseltamivir would become a promising seed compound for developing efficacious and safe anti-atrial fibrillatory drugs.

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