MIR448 antagomir reduces arrhythmic risk after myocardial infarction by upregulating the cardiac sodium channel

• DOI: 10.1172/jci.insight.140759
• Publication Date: 2020-10-27T16:56:16Z
• Authors: Gyeoung-Jin Kang; An Xie; Hong Liu; Samuel C. Dudley
• Keywords: Male; 0301 basic medicine; Myocardium; Sodium; Cardiology; R; Myocardial Infarction; Myocardial Ischemia; Antagomirs; Arrhythmias, Cardiac; NAV1.5 Voltage-Gated Sodium Channel; 3. Good health; Mice, Inbred C57BL; Mice; MicroRNAs; 03 medical and health sciences; Gene Expression Regulation; Heart Rate; Medicine; Animals; Humans; Myocytes, Cardiac; Research Article

Cardiac ischemia is associated with arrhythmias; however, effective therapies are currently limited. The cardiac voltage-gated sodium channel α subunit (SCN5A), encoding the Nav1.5 current, plays a key role in the cardiac electrical conduction and arrhythmic risk. Here, we show that hypoxia reduces Nav1.5 through effects on a miR, miR-448. miR-448 expression is increased in ischemic cardiomyopathy. miR-448 has a conserved binding site in 3'-UTR of SCN5A. miR-448 binding to this site suppressed SCN5A expression and sodium currents. Hypoxia-induced HIF-1α and NF-κB were major transcriptional regulators for MIR448. Moreover, hypoxia relieved MIR448 transcriptional suppression by RE1 silencing transcription factor. Therefore, miR-448 inhibition reduced arrhythmic risk after myocardial infarction. Here, we show that ischemia drove miR-448 expression, reduced Nav1.5 current, and increased arrhythmic risk. Arrhythmic risk was improved by preventing Nav1.5 downregulation, suggesting a new approach to antiarrhythmic therapy.