Abstract

BackgroundCelecoxib (Celebrex), a widely prescribed selective inhibitor of cyclooxygenase-2, can modulate ion channels independently of cyclooxygenase inhibition. Clinically relevant concentrations of celecoxib can affect ionic currents and alter functioning of neurons and myocytes. In particular, inhibition of Kv2.1 channels by celecoxib leads to arrhythmic beating of Drosophila heart and of rat heart cells in culture. However, the spectrum of ion channels involved in human cardiac excitability differs from that in animal models, including mammalian models, making it difficult to evaluate the relevance of these observations to humans. Our aim was to examine the effects of celecoxib on hERG and other human channels critically involved in regulating human cardiac rhythm, and to explore the mechanisms of any observed effect on the hERG channels.Methods and ResultsCelecoxib inhibited the hERG, SCN5A, KCNQ1 and KCNQ1/MinK channels expressed in HEK-293 cells with IC50s of 6.0 µM, 7.5 µM, 3.5 µM and 3.7 µM respectively, and the KCND3/KChiP2 channels expressed in CHO cells with an IC50 of 10.6 µM. Analysis of celecoxib's effects on hERG channels suggested gating modification as the mechanism of drug action.ConclusionsThe above channels play a significant role in drug-induced long QT syndrome (LQTS) and short QT syndrome (SQTS). Regulatory guidelines require that all new drugs under development be tested for effects on the hERG channel prior to first administration in humans. Our observations raise the question of celecoxib's potential to induce cardiac arrhythmias or other channel related adverse effects, and make a case for examining such possibilities.

Highlights

  • Coxibs, selective inhibitors of cyclooxygenase-2 (COX-2), were developed to replace ‘‘traditional’’ non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of arthritis and acute pain

  • The above channels play a significant role in drug-induced long QT syndrome (LQTS) and short QT syndrome (SQTS)

  • Regulatory guidelines require that all new drugs under development be tested for effects on the human ether-a-go-go related gene (hERG) channel prior to first administration in humans

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Summary

Introduction

Selective inhibitors of cyclooxygenase-2 (COX-2), were developed to replace ‘‘traditional’’ non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of arthritis and acute pain. We have shown that celecoxib can directly inhibit K+ channels in fruit flies, and K+ and Na+ channels in mammals, with strong effects on cardiomyocyte and neuronal function [6,7]. We have shown that celecoxib and SC-791 (a highly selective COX-2 inhibitor) can inhibit Kv2.1 channels expressed in HEK-293 cells via modification of gating and channel block [8,9]. Celecoxib (Celebrex), a widely prescribed selective inhibitor of cyclooxygenase-2, can modulate ion channels independently of cyclooxygenase inhibition. Our aim was to examine the effects of celecoxib on hERG and other human channels critically involved in regulating human cardiac rhythm, and to explore the mechanisms of any observed effect on the hERG channels

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