Towards the Development of AgoKirs: New Pharmacological Activators to Study Kir2.x Channel and Target Cardiac Disease

Int J Mol Sci. 2020 Aug 11;21(16):5746. doi: 10.3390/ijms21165746.

Abstract

Inward rectifier potassium ion channels (IK1-channels) of the Kir2.x family are responsible for maintaining a stable negative resting membrane potential in excitable cells, but also play a role in processes of non-excitable tissues, such as bone development. IK1-channel loss-of-function, either congenital or acquired, has been associated with cardiac disease. Currently, basic research and specific treatment are hindered by the absence of specific and efficient Kir2.x channel activators. However, twelve different compounds, including approved drugs, show off-target IK1 activation. Therefore, these compounds contain valuable information towards the development of agonists of Kir channels, AgoKirs. We reviewed the mechanism of IK1 channel activation of these compounds, which can be classified as direct or indirect activators. Subsequently, we examined the most viable starting points for rationalized drug development and possible safety concerns with emphasis on cardiac and skeletal muscle adverse effects of AgoKirs. Finally, the potential value of AgoKirs is discussed in view of the current clinical applications of potentiators and activators in cystic fibrosis therapy.

Keywords: Andersen syndrome; IK1; Kir2; agonist; heart failure; inward rectifier channel.

Publication types

  • Review

MeSH terms

  • Animals
  • Heart Diseases / drug therapy*
  • Humans
  • Ion Channel Gating
  • Potassium Channels, Inwardly Rectifying / agonists*
  • Potassium Channels, Inwardly Rectifying / chemistry

Substances

  • Potassium Channels, Inwardly Rectifying