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Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy

Bibliographic Details
Main Author: Camara, Mahamadou D.
Publication Date: 2024
Other Authors: Zhou, Yitian, Dara, Antoine, Tékété, Mamadou M., de Sousa, Taís Nóbrega, Sissoko, Sékou, Dembélé, Laurent, Ouologuem, Nouhoun, Togo, Amadou Hamidou, Alhousseini, Mohamed L., Fofana, Bakary, Sagara, Issaka, Djimde, Abdoulaye A., Gil, Pedro J., Lauschke, Volker M.
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/172875
Summary: Funding Information: The study was supported by European and Developing Countries Clinical Trial Partnership (grant number RIA2017T-2018), Medicines for Malaria Venture (Geneva, Switzerland), UK Medical Research Council, Swedish International Development Cooperation Agency, German Ministry for Education and Research, University Claude Bernard (Lyon, France), Malaria Research and Training Centre (Bamako, Mali), Centre National de Recherche et de Formation sur le Paludisme (Burkina Faso), Institut de Recherche en Sciences de la Sant. (Bobo-Dioulasso, Burkina Faso), and Centre National de Formation et de Recherche en Sant. Rurale (Republic of Guinea). In addition, the authors received support from the Swedish Research Council (grant numbers 2019-01837, 2021-02801, 2021-05666, and 2021-06048), the Grants, Innovation and Product Development Unit of the South African Medical Research Council with funds received from Novartis and GSK R&D for Project Africa GRADIENT (grant numbers GSKNVS2/202101/004), the Robert Bosch Foundation, Stuttgart, Germany, and Conselho Nacional de Desenvolvimento Cient\u00EDfico e Tecnol\u00F3gico (CNPq), Brazil (grant number 200075/2022\u20135). T.N.S. is a CNPq Research Productivity Fellow. M.D.C. performed sequencing, analyzed the data, and conducted statistical analyses. Y.Z. conducted computational variant analyses. M.M.T. was involved in the acquisition of drug concentrations. A.D. and S.S. contributed to bioinformatics analyses. N.O. was the cardiologist responsible for cardiac toxicity assessment. A.H.T, M.L.A., B.F., and I.S. oversaw clinical patient recruitment and management. A.A.D. coordinated and oversaw the WANECAM study and critically reviewed the manuscript. P.J.G. and V.M.L designed and supervised the study. M.D.C. and V.M.L. wrote the manuscript. All authors read, reviewed, and approved of the final version of the manuscript. Funding Information: The study was supported by European and Developing Countries Clinical Trial Partnership (grant number RIA2017T-2018), Medicines for Malaria Venture (Geneva, Switzerland), UK Medical Research Council, Swedish International Development Cooperation Agency, German Ministry for Education and Research, University Claude Bernard (Lyon, France), Malaria Research and Training Centre (Bamako, Mali), Centre National de Recherche et de Formation sur le Paludisme (Burkina Faso), Institut de Recherche en Sciences de la Sant. (Bobo-Dioulasso, Burkina Faso), and Centre National de Formation et de Recherche en Sant. Rurale (Republic of Guinea). In addition, the authors received support from the Swedish Research Council (grant numbers 2019-01837, 2021-02801, 2021-05666, and 2021-06048), the Grants, Innovation and Product Development Unit of the South African Medical Research Council with funds received from Novartis and GSK R&D for Project Africa GRADIENT (grant numbers GSKNVS2/202101/004), the Robert Bosch Foundation, Stuttgart, Germany, and Conselho Nacional de Desenvolvimento e Tecnol\u00F3gico (CNPq), Brazil (grant number 200075/2022\u20135). T.N.S. is a CNPq Research Productivity Fellow. Publisher Copyright: Copyright © 2024 Camara et al.
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spelling Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapycardiotoxicityhERGKv11.1long QTmalariaQT prolongationPharmacologyPharmacology (medical)Infectious DiseasesSDG 3 - Good Health and Well-beingFunding Information: The study was supported by European and Developing Countries Clinical Trial Partnership (grant number RIA2017T-2018), Medicines for Malaria Venture (Geneva, Switzerland), UK Medical Research Council, Swedish International Development Cooperation Agency, German Ministry for Education and Research, University Claude Bernard (Lyon, France), Malaria Research and Training Centre (Bamako, Mali), Centre National de Recherche et de Formation sur le Paludisme (Burkina Faso), Institut de Recherche en Sciences de la Sant. (Bobo-Dioulasso, Burkina Faso), and Centre National de Formation et de Recherche en Sant. Rurale (Republic of Guinea). In addition, the authors received support from the Swedish Research Council (grant numbers 2019-01837, 2021-02801, 2021-05666, and 2021-06048), the Grants, Innovation and Product Development Unit of the South African Medical Research Council with funds received from Novartis and GSK R&D for Project Africa GRADIENT (grant numbers GSKNVS2/202101/004), the Robert Bosch Foundation, Stuttgart, Germany, and Conselho Nacional de Desenvolvimento Cient\u00EDfico e Tecnol\u00F3gico (CNPq), Brazil (grant number 200075/2022\u20135). T.N.S. is a CNPq Research Productivity Fellow. M.D.C. performed sequencing, analyzed the data, and conducted statistical analyses. Y.Z. conducted computational variant analyses. M.M.T. was involved in the acquisition of drug concentrations. A.D. and S.S. contributed to bioinformatics analyses. N.O. was the cardiologist responsible for cardiac toxicity assessment. A.H.T, M.L.A., B.F., and I.S. oversaw clinical patient recruitment and management. A.A.D. coordinated and oversaw the WANECAM study and critically reviewed the manuscript. P.J.G. and V.M.L designed and supervised the study. M.D.C. and V.M.L. wrote the manuscript. All authors read, reviewed, and approved of the final version of the manuscript. Funding Information: The study was supported by European and Developing Countries Clinical Trial Partnership (grant number RIA2017T-2018), Medicines for Malaria Venture (Geneva, Switzerland), UK Medical Research Council, Swedish International Development Cooperation Agency, German Ministry for Education and Research, University Claude Bernard (Lyon, France), Malaria Research and Training Centre (Bamako, Mali), Centre National de Recherche et de Formation sur le Paludisme (Burkina Faso), Institut de Recherche en Sciences de la Sant. (Bobo-Dioulasso, Burkina Faso), and Centre National de Formation et de Recherche en Sant. Rurale (Republic of Guinea). In addition, the authors received support from the Swedish Research Council (grant numbers 2019-01837, 2021-02801, 2021-05666, and 2021-06048), the Grants, Innovation and Product Development Unit of the South African Medical Research Council with funds received from Novartis and GSK R&D for Project Africa GRADIENT (grant numbers GSKNVS2/202101/004), the Robert Bosch Foundation, Stuttgart, Germany, and Conselho Nacional de Desenvolvimento e Tecnol\u00F3gico (CNPq), Brazil (grant number 200075/2022\u20135). T.N.S. is a CNPq Research Productivity Fellow. Publisher Copyright: Copyright © 2024 Camara et al.Dihydroartemisinin-piperaquine is efficacious for the treatment of uncomplicated malaria and its use is increasing globally. Despite the positive results in fighting malaria, inhibition of the Kv11.1 channel (hERG; encoded by the KCNH2 gene) by piperaquine has raised concerns about cardiac safety. Whether genetic factors could modulate the risk of piperaquine-mediated QT prolongations remained unclear. Here, we first profiled the genetic landscape of KCNH2 variability using data from 141,614 individuals. Overall, we found 1,007 exonic variants distributed over the entire gene body, 555 of which were missense. By optimizing the gene-specific parametrization of 16 partly orthogonal computational algorithms, we developed a KCNH2-specific ensemble classifier that identified a total of 116 putatively deleterious missense variations. To evaluate the clinical relevance of KCNH2 variability, we then sequenced 293 Malian patients with uncomplicated malaria and identified 13 variations within the voltage sensing and pore domains of Kv11.1 that directly interact with channel blockers. Cross-referencing of genetic and electrocardiographic data before and after piperaquine exposure revealed that carriers of two common variants, rs1805121 and rs41314375, experienced significantly higher QT prolongations (ΔQTc of 41.8 ms and 61 ms, respectively, vs 14.4 ms in controls) with more than 50% of carriers having increases in QTc >30 ms. Furthermore, we identified three carriers of rare population-specific variations who experienced clinically relevant delayed ventricular repolarization. Combined, our results map population-scale genetic variability of KCNH2 and identify genetic biomarkers for piperaquine-induced QT prolongation that could help to flag at-risk patients and optimize efficacy and adherence to antimalarial therapy.Global Health and Tropical Medicine (GHTM)Instituto de Higiene e Medicina Tropical (IHMT)RUNCamara, Mahamadou D.Zhou, YitianDara, AntoineTékété, Mamadou M.de Sousa, Taís NóbregaSissoko, SékouDembélé, LaurentOuologuem, NouhounTogo, Amadou HamidouAlhousseini, Mohamed L.Fofana, BakarySagara, IssakaDjimde, Abdoulaye A.Gil, Pedro J.Lauschke, Volker M.2024-10-02T22:23:11Z2024-052024-05-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/172875eng0066-4804PURE: 100536907https://doi.org/10.1128/aac.01390-23info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-10-07T01:40:42Zoai:run.unl.pt:10362/172875Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T18:55:25.752691Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy
title Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy
spellingShingle Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy
Camara, Mahamadou D.
cardiotoxicity
hERG
Kv11.1
long QT
malaria
QT prolongation
Pharmacology
Pharmacology (medical)
Infectious Diseases
SDG 3 - Good Health and Well-being
title_short Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy
title_full Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy
title_fullStr Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy
title_full_unstemmed Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy
title_sort Population-specific variations in KCNH2 predispose patients to delayed ventricular repolarization upon dihydroartemisinin-piperaquine therapy
author Camara, Mahamadou D.
author_facet Camara, Mahamadou D.
Zhou, Yitian
Dara, Antoine
Tékété, Mamadou M.
de Sousa, Taís Nóbrega
Sissoko, Sékou
Dembélé, Laurent
Ouologuem, Nouhoun
Togo, Amadou Hamidou
Alhousseini, Mohamed L.
Fofana, Bakary
Sagara, Issaka
Djimde, Abdoulaye A.
Gil, Pedro J.
Lauschke, Volker M.
author_role author
author2 Zhou, Yitian
Dara, Antoine
Tékété, Mamadou M.
de Sousa, Taís Nóbrega
Sissoko, Sékou
Dembélé, Laurent
Ouologuem, Nouhoun
Togo, Amadou Hamidou
Alhousseini, Mohamed L.
Fofana, Bakary
Sagara, Issaka
Djimde, Abdoulaye A.
Gil, Pedro J.
Lauschke, Volker M.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Global Health and Tropical Medicine (GHTM)
Instituto de Higiene e Medicina Tropical (IHMT)
RUN
dc.contributor.author.fl_str_mv Camara, Mahamadou D.
Zhou, Yitian
Dara, Antoine
Tékété, Mamadou M.
de Sousa, Taís Nóbrega
Sissoko, Sékou
Dembélé, Laurent
Ouologuem, Nouhoun
Togo, Amadou Hamidou
Alhousseini, Mohamed L.
Fofana, Bakary
Sagara, Issaka
Djimde, Abdoulaye A.
Gil, Pedro J.
Lauschke, Volker M.
dc.subject.por.fl_str_mv cardiotoxicity
hERG
Kv11.1
long QT
malaria
QT prolongation
Pharmacology
Pharmacology (medical)
Infectious Diseases
SDG 3 - Good Health and Well-being
topic cardiotoxicity
hERG
Kv11.1
long QT
malaria
QT prolongation
Pharmacology
Pharmacology (medical)
Infectious Diseases
SDG 3 - Good Health and Well-being
description Funding Information: The study was supported by European and Developing Countries Clinical Trial Partnership (grant number RIA2017T-2018), Medicines for Malaria Venture (Geneva, Switzerland), UK Medical Research Council, Swedish International Development Cooperation Agency, German Ministry for Education and Research, University Claude Bernard (Lyon, France), Malaria Research and Training Centre (Bamako, Mali), Centre National de Recherche et de Formation sur le Paludisme (Burkina Faso), Institut de Recherche en Sciences de la Sant. (Bobo-Dioulasso, Burkina Faso), and Centre National de Formation et de Recherche en Sant. Rurale (Republic of Guinea). In addition, the authors received support from the Swedish Research Council (grant numbers 2019-01837, 2021-02801, 2021-05666, and 2021-06048), the Grants, Innovation and Product Development Unit of the South African Medical Research Council with funds received from Novartis and GSK R&D for Project Africa GRADIENT (grant numbers GSKNVS2/202101/004), the Robert Bosch Foundation, Stuttgart, Germany, and Conselho Nacional de Desenvolvimento Cient\u00EDfico e Tecnol\u00F3gico (CNPq), Brazil (grant number 200075/2022\u20135). T.N.S. is a CNPq Research Productivity Fellow. M.D.C. performed sequencing, analyzed the data, and conducted statistical analyses. Y.Z. conducted computational variant analyses. M.M.T. was involved in the acquisition of drug concentrations. A.D. and S.S. contributed to bioinformatics analyses. N.O. was the cardiologist responsible for cardiac toxicity assessment. A.H.T, M.L.A., B.F., and I.S. oversaw clinical patient recruitment and management. A.A.D. coordinated and oversaw the WANECAM study and critically reviewed the manuscript. P.J.G. and V.M.L designed and supervised the study. M.D.C. and V.M.L. wrote the manuscript. All authors read, reviewed, and approved of the final version of the manuscript. Funding Information: The study was supported by European and Developing Countries Clinical Trial Partnership (grant number RIA2017T-2018), Medicines for Malaria Venture (Geneva, Switzerland), UK Medical Research Council, Swedish International Development Cooperation Agency, German Ministry for Education and Research, University Claude Bernard (Lyon, France), Malaria Research and Training Centre (Bamako, Mali), Centre National de Recherche et de Formation sur le Paludisme (Burkina Faso), Institut de Recherche en Sciences de la Sant. (Bobo-Dioulasso, Burkina Faso), and Centre National de Formation et de Recherche en Sant. Rurale (Republic of Guinea). In addition, the authors received support from the Swedish Research Council (grant numbers 2019-01837, 2021-02801, 2021-05666, and 2021-06048), the Grants, Innovation and Product Development Unit of the South African Medical Research Council with funds received from Novartis and GSK R&D for Project Africa GRADIENT (grant numbers GSKNVS2/202101/004), the Robert Bosch Foundation, Stuttgart, Germany, and Conselho Nacional de Desenvolvimento e Tecnol\u00F3gico (CNPq), Brazil (grant number 200075/2022\u20135). T.N.S. is a CNPq Research Productivity Fellow. Publisher Copyright: Copyright © 2024 Camara et al.
publishDate 2024
dc.date.none.fl_str_mv 2024-10-02T22:23:11Z
2024-05
2024-05-01T00:00:00Z
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