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<article xml:lang="en" article-type="research-article" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Molecular Medicine Reports</journal-id>
<journal-title-group>
<journal-title>Molecular Medicine Reports</journal-title></journal-title-group>
<issn pub-type="ppub">1791-2997</issn>
<issn pub-type="epub">1791-3004</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/mmr.2015.4704</article-id>
<article-id pub-id-type="publisher-id">mmr-13-02-1725</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Myricetin inhibits K<sub>v</sub>1.5 channels in HEK293 cells</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>OU</surname><given-names>XIANHONG</given-names></name><xref rid="af1-mmr-13-02-1725" ref-type="aff">1</xref><xref rid="af2-mmr-13-02-1725" ref-type="aff">2</xref><xref rid="fn1-mmr-13-02-1725" ref-type="author-notes">&#x0002A;</xref></contrib>
<contrib contrib-type="author">
<name><surname>BIN</surname><given-names>XIAOHONG</given-names></name><xref rid="af1-mmr-13-02-1725" ref-type="aff">1</xref><xref rid="af2-mmr-13-02-1725" ref-type="aff">2</xref><xref rid="fn1-mmr-13-02-1725" ref-type="author-notes">&#x0002A;</xref></contrib>
<contrib contrib-type="author">
<name><surname>WANG</surname><given-names>LUZHEN</given-names></name><xref rid="af1-mmr-13-02-1725" ref-type="aff">1</xref><xref rid="af2-mmr-13-02-1725" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>LI</surname><given-names>MIAOLING</given-names></name><xref rid="af1-mmr-13-02-1725" ref-type="aff">1</xref><xref rid="af2-mmr-13-02-1725" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>YANG</surname><given-names>YAN</given-names></name><xref rid="af1-mmr-13-02-1725" ref-type="aff">1</xref><xref rid="af2-mmr-13-02-1725" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>FAN</surname><given-names>XINRONG</given-names></name><xref rid="af1-mmr-13-02-1725" ref-type="aff">1</xref><xref rid="af2-mmr-13-02-1725" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author">
<name><surname>ZENG</surname><given-names>XIAORONG</given-names></name><xref rid="af1-mmr-13-02-1725" ref-type="aff">1</xref><xref rid="af2-mmr-13-02-1725" ref-type="aff">2</xref><xref ref-type="corresp" rid="c1-mmr-13-02-1725"/></contrib></contrib-group>
<aff id="af1-mmr-13-02-1725">
<label>1</label>The Key Laboratory of Medical Electrophysiology, Ministry of Education of China, Luzhou Medical College, Sichuan 646000, P.R. China</aff>
<aff id="af2-mmr-13-02-1725">
<label>2</label>Department of Electrophysiology, The Institute of Cardiovascular Research, Luzhou Medical College, Luzhou, Sichuan 646000, P.R. China</aff>
<author-notes>
<corresp id="c1-mmr-13-02-1725">Correspondence to: Professor Xiaorong Zeng, Department of Electrophysiology, The Institute of Cardiovascular Research, Luzhou Medical College, 319 Zhongshan Road, Luzhou, Sichuan 646000, P.R. China, E-mail: <email>zxr8818@vip.sina.com</email></corresp><fn id="fn1-mmr-13-02-1725">
<label>&#x0002A;</label>
<p>Contributed equally</p></fn></author-notes>
<pub-date pub-type="ppub">
<month>02</month>
<year>2016</year></pub-date>
<pub-date pub-type="epub">
<day>22</day>
<month>12</month>
<year>2015</year></pub-date>
<volume>13</volume>
<issue>2</issue>
<fpage>1725</fpage>
<lpage>1731</lpage>
<history>
<date date-type="received">
<day>22</day>
<month>10</month>
<year>2014</year></date>
<date date-type="accepted">
<day>10</day>
<month>07</month>
<year>2015</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2016, Spandidos Publications</copyright-statement>
<copyright-year>2016</copyright-year></permissions>
<abstract>
<p>Myricetin (Myr) is a flavonoid that exerts anti-arrhythmic effects. However, its potential effects on ion channels have remained elusive. The aim of the present study was to investigate the effects of Myr on K<sub>v</sub>1.5 channels in HEK293 cells. The current of K<sub>v</sub>1.5 channels (<italic>I</italic><sub>kur</sub>) in HEK293 cells was recorded using the whole-cell patch-clamp technique and the expression of the K<sub>v</sub>1.5 protein was measured using western blot analysis 24 h after treatment with Myr. The results showed that 5 <italic>&#x000B5;</italic>M Myr significantly reduced <italic>I</italic><sub>kur</sub> from 215.04&#x000B1;40.59 to 77.72&#x000B1;17.94 pA/pF (P&lt;0.05; n=5). Myr increased the current suppression from 0 to 0.31&#x000B1;0.12 and 0.55&#x000B1;0.11 over 5 or 20 min, respectively. In addition, <italic>I</italic><sub>kur</sub> decreased from 376.23&#x000B1;1.30 to 270.19&#x000B1;4.28 pA/pF when the frequency was increased from 0.5 to 4 Hz in HEK293 cells treated with 10 <italic>&#x000B5;</italic>M Myr for 5 min. Furthermore, Myr reduced hK<sub>v</sub>1.5 protein expression in a dose-dependent manner. These results demonstrated that Myr inhibited <italic>I</italic><sub>kur</sub> and the expression of hK<sub>v</sub>1.5 in HEK293 cells in a dose-, time- and frequency-dependent manner. These observations partly explained the mechanisms by which Myr exerts anti-arrhythmic effect.</p></abstract>
<kwd-group>
<kwd>myricetin</kwd>
<kwd><italic>I</italic><sub>kur</sub></kwd>
<kwd>K<sub>v</sub>1.5</kwd>
<kwd>blockade</kwd>
<kwd>potassium channel</kwd>
<kwd>patch clamp</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Atrial fibrillation (AF) is a common type of tachyarrhythmia (<xref rid="b1-mmr-13-02-1725" ref-type="bibr">1</xref>), and has drawn the attention of researchers due to its high incidence and serious complications (<xref rid="b2-mmr-13-02-1725" ref-type="bibr">2</xref>,<xref rid="b3-mmr-13-02-1725" ref-type="bibr">3</xref>). However, the optimal method of treating AF has remained controversial (<xref rid="b4-mmr-13-02-1725" ref-type="bibr">4</xref>,<xref rid="b5-mmr-13-02-1725" ref-type="bibr">5</xref>). Therefore, it is crucial to identify more effective and safer treatments, particularly those using atrial-selective blockers.</p>
<p>The current of K<sub>v</sub>1.5 channels (<italic>I</italic><sub>kur</sub>) is the main outward ion flow during atrial action potential re-polarization. The <italic>KCNA5</italic> gene encodes the K<sub>v</sub>1.5 sub-unit, which is the main molecular component of <italic>I</italic><sub>kur</sub>. <italic>I</italic><sub>kur</sub> is present in the atrium (<xref rid="b6-mmr-13-02-1725" ref-type="bibr">6</xref>), but not in ventricles (<xref rid="b7-mmr-13-02-1725" ref-type="bibr">7</xref>); therefore, <italic>I</italic><sub>kur</sub> is a potential target for atrium-specific arrhythmia therapy.</p>
<p>Myricetin (Myr) is a flavonoid compound present in numerous plants, including <italic>Myrica rubra</italic> (Lour.) Zucc. Its chemical structure is shown in <xref rid="f1-mmr-13-02-1725" ref-type="fig">Fig. 1A</xref>. Myr has a variety of pharmacological effects, including anti-bacterial (<xref rid="b8-mmr-13-02-1725" ref-type="bibr">8</xref>), analgesic (<xref rid="b8-mmr-13-02-1725" ref-type="bibr">8</xref>), anti-tumor (<xref rid="b9-mmr-13-02-1725" ref-type="bibr">9</xref>,<xref rid="b10-mmr-13-02-1725" ref-type="bibr">10</xref>), anti-allergic (<xref rid="b11-mmr-13-02-1725" ref-type="bibr">11</xref>-<xref rid="b13-mmr-13-02-1725" ref-type="bibr">13</xref>), anti-oxidant (<xref rid="b14-mmr-13-02-1725" ref-type="bibr">14</xref>,<xref rid="b15-mmr-13-02-1725" ref-type="bibr">15</xref>), blood sugar-lowering (<xref rid="b16-mmr-13-02-1725" ref-type="bibr">16</xref>) and hepatoprotective actions (<xref rid="b17-mmr-13-02-1725" ref-type="bibr">17</xref>). It also exerts protective effects against cardiovascular diseases, including atherosclerosis (<xref rid="b18-mmr-13-02-1725" ref-type="bibr">18</xref>), ischemia-reperfusion injury (<xref rid="b19-mmr-13-02-1725" ref-type="bibr">19</xref>), myocardial infarction (<xref rid="b20-mmr-13-02-1725" ref-type="bibr">20</xref>) and hypertension (<xref rid="b21-mmr-13-02-1725" ref-type="bibr">21</xref>,<xref rid="b22-mmr-13-02-1725" ref-type="bibr">22</xref>). However, the mechanisms by which Myr exerts anti-arrhythmic effects have remained elusive. It has been indicated that a Myr derivative, hexamethyl Myr, is able to inhibit <italic>I</italic><sub>kur</sub> (<xref rid="b23-mmr-13-02-1725" ref-type="bibr">23</xref>); therefore, the present study examined whether Myr also inhibits <italic>I</italic><sub>kur</sub> and investigated the underlying mechanisms.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>Reagents</title>
<p>Myr (98% purity) was provided by Dr Yong Ye (College of Pharmacy, Guangxi Medical University, Nanning, China). It was prepared as a 10-mM stock solution in dimethyl sulfoxide (DMSO; Sigma-Aldrich, St. Louis, MO, USA) and stored in aliquots at 4&#x000B0;C prior to use. For use in the subsequent experiments, it was diluted to 0.5, 3 or 10 <italic>&#x000B5;</italic>M with extracellular fluid, as described below.</p></sec>
<sec>
<title>Solutions</title>
<p>The <italic>I</italic><sub>kur</sub> recording solution (extracellular solution) consisted of 130 mM NaCl and 0.33 mM Na<sub>2</sub>HPO<sub>4</sub> x12H<sub>2</sub>O (both from KeLong Chemical, Chengdu, China) as well as 5.4 mM KCl, 1 mM CaCl<sub>2</sub>, 1 mM MgCl<sub>2</sub> and 10 mM 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid (HEPES) (all from Sangon Biotech Co. Ltd., Shanghai, China), 5.5 mM glucose (Bio Basic Inc, Markham, OT, Canada) and NaOH (Jinshan Chemical Reagent Co. Ltd, Chengdu, China) to adjust the pH to 7.4. The electrode solution contained 110 mM <sc>l</sc>-aspartate (Sigma-Aldrich), 110 mM KOH (Sangon Biotech Co. Ltd.), 20 mM KCl, 8 mM NaCl, 1 mM MgCl<sub>2</sub>, 1 mM CaCl<sub>2</sub>, 10 mM ethylene glycol tetraacetic acid (all from Sigma-Aldrich), 10 mM HEPES (Sangon Biotech Co. Ltd.) and KOH to adjust the pH to 7.2; 5 mM Mg-adenosine triphosphate (Sigma-Aldrich) was added immediately prior to use, and the solution was filtered through 0.22-<italic>&#x000B5;</italic>m microporous membranes (Merck Millipore, Carrigtwohill, Republic of Ireland). The lysis buffer consisted of 250 mM glucose, 20 mM 3-(<italic>N</italic>-morpholino)propanesulfonic acid and l mM dithiothreitol (Sigma-Aldrich); 1% (v/v) protease inhibitor (Calbiochem; EMD Millipore, Billerica, MA, USA) was added prior to use.</p></sec>
<sec>
<title>Cell culture and transfection</title>
<p>HEK293 cells (American Type Tissue Collection, Manassas, VA, USA) were cultured in RPMI-1640 medium (Thermo Fisher Scientific, Waltham, MA, USA) supplemented with 10% fetal bovine serum (Thermo Fisher Scientific) and penicillin/streptomycin (Sigma-Aldrich). Cells were transiently transfected with hK<sub>v</sub>1.5-overexpression vector in six-well plates (Corning-Costar, Corning, NY, USA) using 3 <italic>&#x000B5;</italic>l Entranster&#x02122;-H transfection reagent (Engreen Biosystem Co. Ltd, Beijing, China) and 3 <italic>&#x000B5;</italic>g of hK<sub>v</sub>1.5 cDNA in pEGFP-N1 vector (Sangon Biotech Co. Ltd.). A pEGFP-N1 was used as a negative control. Subsequent assays were performed at 24 h subsequent to transfection. Cells used for electrophysiology experiments were seeded at a density of 1&#x000D7;10<sup>4</sup> cells/35-mm dish with glass cover slips.</p></sec>
<sec>
<title>MTT assay</title>
<p>MTT assays were used to assess the toxicity of Myr. Logarithmically growing cells were seeded at a density of 1&#x02013;5&#x000D7;10<sup>4</sup> cells/well in 96-well plates (Corning-Costar) and were allowed to adhere for 24 h at 37&#x000B0;C. The medium was then replaced with fresh medium containing various concentrations of Myr. The cells were maintained for two days and the toxicity of Myr was determined using MTT (Amresco LLC, Solon, OH, USA). Ten microliters of MTT (5 mg/ml stock) was added to each well followed by incubation for 4 h. The seeding medium was then discarded and 0.15 ml DMSO was added to each well. The absorbance (A) was read using a multimode microplate reader (Infinite M200; Tecan Group, Ltd., M&#x000E4;nnedorf, Switzerland) at 570 nm and the cell viability was determined as follows: (1&#x02212;A<sub>treated group</sub>/A<sub>control group</sub> &#x000D7;100.</p></sec>
<sec>
<title>Western blot analysis</title>
<p>Cells (4&#x000D7;10<sup>5</sup>/ml) were incubated with or without Myr (0&#x02013;100 <italic>&#x000B5;</italic>M) for 24 h in six-well plates. Cells were collected and lysed in lysis buffer. After sonication in ice water, crude lysates were cleared by centrifugation at 12,000 &#x000D7;g for 5 min at 4&#x000B0;C. The total protein concentration of the lysates was measured using a bicinchoninic acid protein assay kit (Solarbio, Beijing, China). Lysates were diluted at a 4:1 ratio with 5X loading buffer (Beyotime Institute of Biotechnology, Haimen, China) and boiled for 5 min. Equal amounts of protein (10 <italic>&#x000B5;</italic>g) were loaded onto 10% SDS-polyacrylamide gels and separated by electrophoresis using an electrophoresis apparatus (Bio-Rad Laboratories, Inc., Hercules, CA, USA). The separated proteins were then electrotransferred onto polyvinylidene fluoride (PVDF) membranes (Immun-Blot<sup>&#x000AE;</sup> PVDF membrane; Bio-Rad Laboratories, Inc.). Following electrotransfer, the membranes were blocked with 5% non-fat milk (Yili Industrial Group Co. Ltd, Inner Mongolia, China) in Tris-buffered saline with Tween 20 for 60 min on an orbital shaker (Qilinbeier Instrument and Manufacture Co. Ltd, Haimen, China) and then incubated with rabbit polyclonal primary antibodies against K<sub>v</sub>1.5 (A03K0017; 1:200 dilution; BlueGene Biotech Co., Ltd., Shanghai, China) overnight at 4&#x000B0;C followed by biotin (AP132B; 1:10,000; EMD Millipore) for 1 h and goat anti-rabbit horseradish peroxidase-conjugated antibodies (sc-2004; 1:50,000; Santa Cruz Biotechnology, Dallas, TX, USA) for 30 min at room temperature. Rabbit polyclonal antibody of the endogenous protein GAPDH (Santa Cruz Biotechnology) was used as a loading control. Protein bands were detected using enhanced chemiluminescence western blotting substrate (Pierce Biotechnology Inc, Rockford, IL, USA), imaged using the Universal Hood II system (Bio-Rad Laboratories, Inc.) and quantified using Quantity one software v4.6.2 (Bio-Rad Laboratories, Inc.).</p></sec>
<sec>
<title>Patch-clamp recordings</title>
<p>Currents were recorded using the whole-cell patch-clamp technique at room temperature (~22&#x000B0;C). The protocol used 200-msec voltage steps between &#x02212;50 mV and +60 mV from a holding potential of &#x02212;80 mV, followed by a return to &#x02212;40 mV (<xref rid="f2-mmr-13-02-1725" ref-type="fig">Fig. 2A</xref>). The current amplitude was measured from 150 msec to the end of the depolarization step. Borosilicate glass electrodes (1.2 mm optical density) were pulled using a Brown-Flaming puller (model P-97; Sutter Instrument Co, Novato, CA, USA); they had a tip resistance of 5&#x02013;7 M&#x003A9; when filled with the electrode solution. The membrane current was recorded in voltage-clamp mode using an EPC-10 amplifier and Pulse software (Heka Elektronik, Lambrecht, Germany). A 3 M NaCl-agar salt bridge was used as the reference electrode. The tip potential was set to zero before the patch pipette touched the cell. After a G&#x003A9; seal was obtained, the cell membrane was ruptured using gentle suction to establish the whole-cell configuration. The series resistance (Rs) and membrane capacitance were compensated prior to the onset of recordings. The membrane capacity (Cm) was recorded using 10-msec voltage steps to &#x02212;65 mV from a holding potential of &#x02212;60 mV, followed by a return to &#x02212;60 mV (<xref rid="f2-mmr-13-02-1725" ref-type="fig">Fig. 2B</xref>). The formula used to calculate the membrane capacity was as follows: Cm=0.98&#x000D7; A &#x000D7; &#x003C4;/5, with amp as the current amplitude and &#x003C4; as the time constant. <italic>I</italic><sub>kur</sub> was recorded at various time-points in the presence of various concentrations of Myr, and Myr-untreated cells were used as a control. Prior to measurements, cells were perfused with extracellular solution containing various concentrations of Myr at a rate of 3 ml/min. The perfusion volume was ~15 ml per experiment so that the original solution was replaced completely. The Myr incubation time-dependency was analyzed using the mean &#x000B1; standard error of the current suppression ratio (<italic>I</italic><sub>C</sub>&#x02212;<italic>I</italic><sub>A</sub>)/<italic>I</italic><sub>C</sub>, where <italic>I</italic><sub>C</sub> represents the <italic>I</italic><sub>kur</sub> in the control group and <italic>I</italic><sub>A</sub> stands for <italic>I</italic><sub>kur</sub> in the presence of Myr.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Electrophysiological data were analyzed using Patchmaster (Heka Elektronik), Clampfit 10.0 (Axon Instruments, Molecular Devices, Sunnyvale, CA, USA), and Origin 9 software (OriginLab, Northampton, MA, USA). The results were analyzed using SPSS 13.0 (SPSS, Inc., Chicago, IL, USA), and values are expressed as the mean &#x000B1; standard error. Statistical comparisons were made using Student's <italic>t</italic>-tests for two groups of data, or analysis of variance for multiple groups of data. P&lt;0.05 was considered to indicate a statistically significant difference.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Toxicity of Myr</title>
<p>To determine an effective, non-toxic concentration of Myr for use in the patch-clamp assay, MTT assays were performed following treatment of HEK293 cells with Myr at a range of doses. Myr caused a dose-dependent decrease in cell growth between 2 and 6 mM with an IC<sub>50</sub> of 4.66 mM (<xref rid="f1-mmr-13-02-1725" ref-type="fig">Fig. 1B</xref>). However, no cell growth inhibition was observed at 0&#x02013;100 <italic>&#x000B5;</italic>M Myr, which was therefore used in the subsequent experiments.</p></sec>
<sec>
<title>Myr inhibits hK<sub>v</sub>1.5 protein expression in a dose-dependent manner</title>
<p>A K<sub>v</sub>1.5 wild-type overexpression plasmid was transiently transfected into HEK293 cells using Entranster&#x02122;-H transfection reagent (Engreen Biosystem Co., Ltd., Beijing, China) for 24 h (<xref rid="f2-mmr-13-02-1725" ref-type="fig">Fig. 2A</xref>), and the levels of K<sub>v</sub>1.5 protein were assessed using western blot analysis after treatment with Myr (0&#x02013;100 <italic>&#x000B5;</italic>M) for 24 h (<xref rid="f2-mmr-13-02-1725" ref-type="fig">Fig. 2B</xref>). Myr induced a dose-dependent decrease in the expression of K<sub>v</sub>1.5 after 24 h.</p></sec>
<sec>
<title>Myr inhibits I<sub>kur</sub></title>
<p>Patch clamp experiments on cells perfused with extracellular solution containing various concentrations of Myr showed that 5 <italic>&#x000B5;</italic>M Myr reduced the current amplitude from 215.01&#x000B1;40.59 to 77.72&#x000B1;17.94 pA/pF, suggesting that <italic>I</italic><sub>kur</sub> was significantly inhibited by Myr (P=0.011 vs. control; n=5) (<xref rid="f3-mmr-13-02-1725" ref-type="fig">Fig. 3</xref>).</p></sec>
<sec>
<title>Myr inhibits I<sub>kur</sub> in a dose-dependent manner</title>
<p>At a clamping voltage of 60 mV, the current density (Im/Cm, pA/pF) was 142.15&#x000B1;37.80, 103.75&#x000B1;29.32 and 77.72&#x000B1;17.94 in the presence of 3, 5 and 10 <italic>&#x000B5;</italic>M Myr, respectively (<xref rid="f4-mmr-13-02-1725" ref-type="fig">Fig. 4A&#x02013;C</xref>), which was significantly different from that in the control group (215.01&#x000B1;40.59 pA/pF; all P&lt;0.05; n=5). This suggested that Myr inhibited <italic>I</italic><sub>kur</sub> at concentrations of 3&#x02013;10 <italic>&#x000B5;</italic>M in a concentration-dependent manner.</p></sec>
<sec>
<title>Myr inhibits I<sub>kur</sub> in a time-dependent manner</title>
<p><italic>I</italic><sub>kur</sub> was recorded from 5 to 30 min after the addition of Myr to the chamber to evaluate the time-dependent effects of Myr on <italic>I</italic><sub>kur</sub>. The results indicated that the effects of Myr were time-dependent (<xref rid="f5-mmr-13-02-1725" ref-type="fig">Fig. 5A and B</xref>). The effects of time were analyzed using the mean &#x000B1; standard error of the current suppression ratio (IC-IA)/IC, where IC represents the <italic>I</italic><sub>kur</sub> in the control group and IA stands for <italic>I</italic><sub>kur</sub> in the presence of Myr. The (IC-IA)/IC was 0.3101&#x000B1;0.1234 at 5 min (n=7; P=0.046 vs. control), 0.4091&#x000B1;0.1180 at 10 min (n=7; P=0.066 vs. 5 min; P=0.013 vs. control), 0.05352&#x000B1;0.0978 at 15 min (n=7, P=0.004 vs. 10 min; P=0.009 vs. 5 min; P=0.002 vs. control), and 0.5497&#x000B1;0.1060 at 20 min (n=7; P=0.453 vs. 15 min; P=0.023 vs. 10 min; P=0.004 vs. control). These results demonstrated that the <italic>I</italic><sub>kur</sub> amplitude decreased with time and that the inhibitory effects of Myr increased over time.</p></sec>
<sec>
<title>Myr inhibits I<sub>kur</sub> in a frequency-dependent manner</title>
<p>A train of 20 pulses, each with a 200-msec single voltage step, were used from a holding potential of &#x02212;80 mV to +50 mV at frequencies of 0.5, 1, 3 and 4 Hz (<xref rid="f6-mmr-13-02-1725" ref-type="fig">Fig. 6A</xref>). The inhibitory effects of Myr on <italic>I</italic><sub>kur</sub> increased with the continuous depolarization voltage pulses. In addition, the inhibition of <italic>I</italic><sub>kur</sub> by Myr was dependent on the number of pulses (<xref rid="f6-mmr-13-02-1725" ref-type="fig">Fig. 6B and C</xref>), which suggested that Myr inhibited <italic>I</italic><sub>kur</sub> in a rate- or frequency-dependent manner. Specifically, <italic>I</italic><sub>kur</sub> was 376.23&#x000B1;1.30, 340.01&#x000B1;4.25, 290.59&#x000B1;4.44 and 270.193&#x000B1;4.28 pA/pF at 0.5, 1, 3 and 4 Hz, respectively, and changes between each set of two groups were significant (n=5, P&lt;0.001). Furthermore, the inhibition of <italic>I</italic><sub>kur</sub> significantly increased when the frequency was increased from 0.5&#x02013;4 Hz (P&lt;0.05) (<xref rid="f6-mmr-13-02-1725" ref-type="fig">Fig. 6D</xref>). These results suggested that Myr inhibited <italic>I</italic><sub>kur</sub> in HEK293 cells in a frequency-dependent manner.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p><italic>I</italic><sub>kur</sub> participates in phases I and II of atrial re-polarization, and affects atrial rhythm and frequency by changing the action potential duration and effective refractory period. Therefore, abnormal electrical activity is closely associated with the occurrence and maintenance of AF. Furthermore, <italic>I</italic><sub>kur</sub> is present in the atria (<xref rid="b6-mmr-13-02-1725" ref-type="bibr">6</xref>), but not in the ventricles of the human heart (<xref rid="b11-mmr-13-02-1725" ref-type="bibr">11</xref>). Human atrial <italic>I</italic><sub>kur</sub> is encoded by the <italic>hK<sub>v</sub>1.5</italic> (or <italic>hKCNA5</italic>) gene (<xref rid="b7-mmr-13-02-1725" ref-type="bibr">7</xref>,<xref rid="b11-mmr-13-02-1725" ref-type="bibr">11</xref>,<xref rid="b24-mmr-13-02-1725" ref-type="bibr">24</xref>). Due to its atrial specificity, drugs that affect <italic>I</italic><sub>kur</sub> have atrium-specific effects without affecting ventricular function. Certain studies suggested that K<sub>v</sub>1.5 channels may represent novel targets for the treatment of AF (<xref rid="b25-mmr-13-02-1725" ref-type="bibr">25</xref>,<xref rid="b26-mmr-13-02-1725" ref-type="bibr">26</xref>). The present study demonstrated that Myr was able to block <italic>I</italic><sub>kur</sub> in a dose-, time- and frequency-dependent manner.</p>
<p>The treatment of AF using drug- or non-drug-associated methods, including catheter-based or surgical interventions, has received significant attention in recent years (<xref rid="b27-mmr-13-02-1725" ref-type="bibr">27</xref>). Catheter ablation has been proposed as an effective nonpharmacological alternative for AF that is often, however not always, the second-line treatment (<xref rid="b28-mmr-13-02-1725" ref-type="bibr">28</xref>). In addition, surgical ablation of AF is commonly performed in cases with other indications for cardiac surgery and it is limited to cases with low surgical risk (<xref rid="b29-mmr-13-02-1725" ref-type="bibr">29</xref>). However, non-drug treatments are limited by factors including their indications, medical conditions and costs. Therefore, drug-based therapies remain the primary method used to treat AF (<xref rid="b30-mmr-13-02-1725" ref-type="bibr">30</xref>). Western medicine is widely applied for anti-arrhythmic treatment; however, its effectiveness is only 30&#x02013;60%, and varying degrees of arrhythmogenic effects have been reported (<xref rid="b31-mmr-13-02-1725" ref-type="bibr">31</xref>). By contrast, Traditional Chinese Medicine comprises effective anti-arrhythmic treatments, which may provide novel anti-arrhythmia therapies for clinical use. Flavonoids are a class of compounds with the structure of 2-phenyl chromone, observed to be ubiquitously observed in food, including fruits, vegetables, nuts and plant-derived beverages (tea and wine) (<xref rid="b32-mmr-13-02-1725" ref-type="bibr">32</xref>,<xref rid="b33-mmr-13-02-1725" ref-type="bibr">33</xref>). Flavonoids possess a variety of pharmacological activities, including against infection (bacterial and viral diseases) and degenerative diseases such as cardiovascular diseases, cancer and additional age-associated diseases (<xref rid="b34-mmr-13-02-1725" ref-type="bibr">34</xref>). Epidemiological studies suggest that the beneficial cardiovascular health effects of diets high in fruit and vegetables are associated with their flavonoid content (<xref rid="b35-mmr-13-02-1725" ref-type="bibr">35</xref>). Flavonoids such as apigenin have been reported to reduce the occurrence of various cardiovascular diseases including coronary disease, arrhythmia, atherosclerosis, hypertension, ischemic stroke and peripheral arteriopathy, congestive heart failure (<xref rid="b36-mmr-13-02-1725" ref-type="bibr">36</xref>). In addition, certain flavonoids such as luteolin-7-O-&#x003B2;-D-glucopyranoside (<xref rid="b36-mmr-13-02-1725" ref-type="bibr">36</xref>), catechin (<xref rid="b37-mmr-13-02-1725" ref-type="bibr">37</xref>), quercetin (<xref rid="b38-mmr-13-02-1725" ref-type="bibr">38</xref>), hesperidin/hesperetin (<xref rid="b39-mmr-13-02-1725" ref-type="bibr">39</xref>), silymarin (<xref rid="b40-mmr-13-02-1725" ref-type="bibr">40</xref>) and genistein (<xref rid="b41-mmr-13-02-1725" ref-type="bibr">41</xref>) exhibited cardioprotective effects. Acacetin, a natural flavone, has been reported to selectively inhibits human atrial repolarization potassium currents and prevents atrial fibrillation in dogs (<xref rid="b42-mmr-13-02-1725" ref-type="bibr">42</xref>). Ampelopsin exerts anti-arrhythmic effects in an aconitine-induced rat arrhythmic model, and the underlying electrophysiological mechanism was demonstrated to be partly associated with the inhibition of <italic>I</italic><sub>Na</sub> and enhancement of <italic>I</italic><sub>K1</sub>, and prolongation of action potential duration (<xref rid="b43-mmr-13-02-1725" ref-type="bibr">43</xref>). Myr is a natural flavonol identified to be present in onions, tea and other natural plants, is advantageous due to its cardioactive components (<xref rid="b44-mmr-13-02-1725" ref-type="bibr">44</xref>). Its chemical structure is similar to that of ampelopsin, which exerts anti-arrhythmic effects (<xref rid="b43-mmr-13-02-1725" ref-type="bibr">43</xref>). Previous studies have suggested that Myr possesses cardio-protective effects (<xref rid="b19-mmr-13-02-1725" ref-type="bibr">19</xref>,<xref rid="b20-mmr-13-02-1725" ref-type="bibr">20</xref>). The present study was designed to identify the possible anti-arrhythmic mechanism of action of Myr in order to provide a theoretical basis for anti-arrhythmic treatments using Myr and other Traditional Chinese Medicinal compounds.</p>
<p>The results of the present study revealed that Myr inhibited <italic>I</italic><sub>kur</sub> <italic>in vitro</italic>, which provided the basis for further <italic>in vivo</italic> experiments. However, the conclusions of the present study do not warrant effects on the human body due to the lack of knowledge of the complex regulatory mechanisms <italic>in vivo</italic>. Questions regarding the mechanisms of action of Myr, for example whether it functions by binding to binding sites, whether these include K<sub>v</sub>1.5 channels and whether it affects other ion channels, remain to be investigated in further studies.</p></sec></body>
<back>
<ack>
<title>Acknowledgments</title>
<p>The present study was funded by the China Postdoctoral Science Foundation. The authors would like to thank LetPub (<ext-link xlink:href="http://www.letpub.com" ext-link-type="uri">www.letpub.com</ext-link>) for its linguistic assistance during the preparation of the manuscript.</p></ack>
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<floats-group>
<fig id="f1-mmr-13-02-1725" position="float">
<label>Figure 1</label>
<caption>
<p>Toxicity of Myr. (A) Chemical structure of Myr. (B) Dose-dependent effects of Myr on the viability of HEK293 cells. Myr was non-toxic to HEK293 cells at doses of 0&#x02013;100 <italic>&#x000B5;</italic>M, which rendered it suitable for use in patch-clamp experiments at these concentrations. Results are representative of a minimum of three independent experiments. Myr, myricetin.</p></caption>
<graphic xlink:href="MMR-13-02-1725-g00.jpg"/></fig>
<fig id="f2-mmr-13-02-1725" position="float">
<label>Figure 2</label>
<caption>
<p>Myr inhibits hK<sub>v</sub>1.5 protein expression. (A) Images of HEK293 cells subsequent to transient transfection with the human K<sub>v</sub>1.5 wild type plasmid (hK<sub>v</sub>1.5) using Entranster&#x02122;-H transfection reagent for 24 h. A pEGFP-N1 plasmid was used as a negative control. (B) Effect of Myr on K<sub>v</sub>1.5 expression. The levels of K<sub>v</sub>1.5 protein were assessed using western blot analysis following treatment with Myr (0&#x02013;100 <italic>&#x000B5;</italic>M) for 24 h. Myr induced a dose-dependent decrease in the expression of K<sub>v</sub>1.5 after 24 h. (C) Quantitative analysis of K<sub>v</sub>1.5 protein expression. The data are expressed as the mean &#x000B1; standard deviation. <sup>&#x0002A;</sup>P&lt;0.05 vs. control group (0 <italic>&#x000B5;</italic>M Myr). The data were calculated from three independent experiments. Myr, myricetin.</p></caption>
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<fig id="f3-mmr-13-02-1725" position="float">
<label>Figure 3</label>
<caption>
<p>Myr inhibits <italic>I<sub>kur</sub>.</italic> (A and B) Schematics representing the protocols used to record <italic>I</italic><sub>kur</sub> and membrane capacitance. (C and D) <italic>I</italic><sub>kur</sub> in a typical HEK293 cell transiently expressing the <italic>hK<sub>v</sub>1.5</italic> gene in (C) the absence (control) and (D) in the presence of 5 <italic>&#x000B5;</italic>M. <italic>I</italic><sub>kur</sub>, current of K<sub>v</sub>1.5 channels; Myr. Myr, myricetin.</p></caption>
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<fig id="f4-mmr-13-02-1725" position="float">
<label>Figure 4</label>
<caption>
<p>Myr inhibits <italic>I</italic><sub>kur</sub> in a dose-dependent manner. (A) The <italic>I</italic><sub>kur</sub> amplitude in the absence (control) and presence of various concentrations of Myr. (B) Current-voltage associations of <italic>I</italic><sub>kur</sub> in control cells and in the presence of 3, 5 or 10 <italic>&#x000B5;</italic>M Myr. (C) Values are expressed as <italic>I</italic><sub>kur</sub>, at 60 mV, Myr significantly reduced <italic>I</italic><sub>kur</sub> in a dose-dependent manner. Values are expressed as the mean &#x000B1; standard error. <sup>&#x0002A;</sup>P&lt;0.05 vs. control group; n=5. Myr, myricetin; <italic>I</italic><sub>kur</sub>, current of K<sub>v</sub>1.5 channels.</p></caption>
<graphic xlink:href="MMR-13-02-1725-g03.jpg"/></fig>
<fig id="f5-mmr-13-02-1725" position="float">
<label>Figure 5</label>
<caption>
<p>Myr inhibits <italic>I</italic><sub>kur</sub> in a time-dependent manner. (A) Time course of Ikur recorded in typical HEK293 cell transiently expressing hK<sub>v</sub>1.5 gene in the absence and presence of 5 <italic>&#x000B5;</italic>M Myr with a 200-ms test pulse from &#x02212;80 to +60 mV then back to &#x02212;40 mV. The inhibitory effect of Myr on <italic>I</italic><sub>kur</sub> is time-dependent. (B) Drug-sensitive current expressed as a proportion of the current in the absence (IC) or presence of Myr (IA). Time-dependency of (IC-IA)/IC. Values are expressed as the mean &#x000B1; standard error (n=7). Myr, myricetin; <italic>I</italic><sub>kur</sub>, current of K<sub>v</sub>1.5 channels; IC, <italic>I</italic><sub>kur</sub> in control group; IA, <italic>I</italic><sub>kur</sub> in the presence of Myr; (IC-IA)/IC, current suppression ratio.</p></caption>
<graphic xlink:href="MMR-13-02-1725-g04.jpg"/></fig>
<fig id="f6-mmr-13-02-1725" position="float">
<label>Figure 6</label>
<caption>
<p>Myr inhibits <italic>I</italic><sub>kur</sub> in a frequency-dependent manner. (A) Schematic depicting the protocol used to record <italic>I</italic><sub>kur</sub>. (B) <italic>I</italic><sub>kur</sub> traces recorded with 200-msec single voltage steps from a holding potential of &#x02212;80 mV to +50 mV using a train of 20 pulses at 3 Hz in cells exposed to 10 <italic>&#x000B5;</italic>M Myr for 5 min. The inhibition was stronger at pulse 20 compared with that at the earlier pulses, suggesting use-dependent inhibitory effects. (C) Inhibition of <italic>I</italic><sub>kur</sub> at various frequencies (0.5, 1, 3 and 4 Hz). The use-dependent effects increased as the depolarization frequency was raised. (D) <italic>I</italic><sub>kur</sub> at various pulse frequencies (0.5, 1, 3 and 4 Hz). Values are expressed as the mean &#x000B1; standard error (n=5). <sup>&#x0002A;</sup>P&lt;0.05 between each set of two groups. Myr, myricetin; <italic>I</italic><sub>kur</sub>, current of K<sub>v</sub>1.5 channels.</p></caption>
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