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RESEARCH ARTICLE
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Drug trapping in hERG K+ channels: (not) a matter
of drug size?†
Cite this: Med. Chem. Commun.,
2016, 7, 512
Tobias Linder,‡a Harald Bernsteiner,‡a Priyanka Saxena,‡a Florian Bauer,b
Thomas Erker,b Eugen Timin,a Steffen Heringa and Anna Stary-Weinzinger*a
Inhibition of hERG K+ channels by structurally diverse drugs prolongs the ventricular action potential and
increases the risk of torsade de pointes arrhythmias and sudden cardiac death. The capture of drugs behind
Received 2nd October 2015,
Accepted 18th December 2015
DOI: 10.1039/c5md00443h
www.rsc.org/medchemcomm
closed channel gates, so-called drug trapping, is suggested to harbor an increased pro-arrhythmic risk. In
this study, the trapping mechanisms of a trapped hERG blocker propafenone and a bulky derivative (MW:
647.24 g mol−1) were studied by making use of electrophysiological measurements in combination with
molecular dynamics simulations. Our study suggests that the hERG cavity is able to accommodate very
bulky compounds without disturbing gate closure.
Introduction
hERG K+ channels (Kv11.1) are critical for the repolarization
of the cardiac ventricular action potential and thus are essential for the regulation of a normal electrical heart rhythm.1
Loss of channel function due to inherited mutations2 or more
commonly due to unwanted binding of small molecules3 can
lead to long QT intervals. In the worst case scenario, this
channel malfunction can cause deadly arrhythmia.4 These
‘off-target’ effects led to intense efforts devoted towards understanding how drug molecules physically bind to and block
the pore of a hERG channel to reduce K+ ion flux.5
It was proposed that many drugs that block hERG can become trapped within the central cavity when the activation
gate closes due to membrane repolarization.6–10 This phenomenon, referred to as ‘drug-trapping’, can explain why certain drugs cannot be washed off when channels are held in a
closed state.11 Strong evidence for drug trapping came from
studies with a mutant D540K, which can reopen at
hyperpolarized membrane potentials, enabling almost complete recovery of otherwise trapped compounds.6
a
Department of Pharmacology and Toxicology, University of Vienna, Austria.
E-mail: anna.stary@univie.ac.at
b
Department of Pharmaceutical Chemistry, University of Vienna, Austria
† The authors declare no competing interests.
‡ Contributed equally.
512 | Med. Chem. Commun., 2016, 7, 512–518
Trapping is not unique to hERG K+ channels and was
first described for quaternary ammonium (QA) blockers by
Armstrong in 1971.12 We have previously provided insights
into the structural mechanisms of trapping of a medium
size (MW: 242.46 g/mol) QA blocker. Our atomistic molecular dynamics simulations provided insights into the dynamics of the trapping process for tetrabutylammonium (TBA)
in hERG K+ channels. Our simulations proposed that trapping
can influence the dynamics of the high affinity binding determinant F656. In particular, our simulations suggested
that F656 presents a physical barrier for the drug dissociation of TBA. Further, our simulations revealed that drug
trapping of this compound does not influence the closure
mechanism per se, nor does it change the structure of the
gate.13
It was previously suggested for other K+ channels that
larger compounds might disrupt closure of the activation
gate, without really becoming trapped within the central cavity. This mechanism was termed ‘foot in the door’.12 This
phenomenon was first described by Armstrong in 1971,
where it was shown that trapping correlated with the size of
QA blockers. While smaller molecules fitted into the cavity,
larger QA compounds were unable to be trapped and had to
dissociate before deactivation, presumably due to the limited
cavity size.12
The hERG K+ channel cavity is rather unique, since it is
able to bind many structurally diverse chemicals of various
sizes with high affinity.5 In order to investigate if larger compounds influence or prevent proper channel closure in hERG,
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we made use of a well-studied class Ic antiarrhythmic drug,
propafenone,14 which is known to be trapped in the hERG
channel,8 and synthesized a novel bulky derivative (Fig. 1A).
By combining two-electrode voltage clamp analysis and molecular dynamics simulations, we provide detailed insights
into drug trapping in relation to compound size in hERG
channels.
Research Article
Methods
Synthesis of 1-[2-(2-hydroxy-3-(4-tritylpiperazin-1-yl)-propoxy)phenyl]3-phenylpropan-1-one (FB213)
All chemicals obtained from commercial suppliers were used
as-received and were of analytical grade. Melting points were
determined on a Kofler hot stage apparatus and were
uncorrected. 1H- and 13C-NMR spectra were recorded on a
Bruker Avance DPx200 (200 and 50 MHz).
A mixture of 1-[2-(oxiran-2-ylmethoxy)phenyl]-3-phenylpropan-1-one (0.576 g, 2.04 mmol) and 1-tritylpiperazine
(0.688 g, 2.09 mmol) in 2-propanol was heated to reflux for 6
hours. Upon completion of the reaction, the solvent was
evaporated and the residue was recrystallized from ethyl acetate to obtain the title compound as a white solid (yield:
0.854 g, 68.5%).
The analysis of this material gave the following results:
Mp 162–165 °C; 1H-NMR (CDCl3): 7.78–7.65 (m, 1H), 7.58–
7.10 (m, 21H), 7.05–6.85 (m, 2H), 4.18–3.81 (m, 3H), 3.58–
2.20 (m, 10H), 1.60 (s-br, 2H); 13C-NMR (CDCl3): 201.4, 158.0,
141.8, 133.6, 130.6, 129.5, 128.5, 128.3, 127.7, 126.2, 126.0,
121.1, 112.7, 77.0, 70.9, 65.2, 61.0, 47.9, 45.9, 30.4. MS m/z
411 [0.1%], 125 [13%], 99 [100%]. Anal. calcd for C41H42N2O3:
C, 80.62; H, 6.93; N, 4.59. Found: C, 80.41; H, 6.83; N, 4.55.
Fig. 1 WT hERG channels inhibition by Fb213. (A) Chemical structure
of FB213; (B) voltage pulse protocol shown; (C) superimposed current
traces recorded in the absence (control) and after attaining a steadystate block with increasing concentrations of FB213 at 0.3 Hz; (D) the
concentration–response relationship for the block of the hERG tail
current by FB213; (E) superimposed current traces of the first (control, black) and last (‘steady-state block’, green) pulses during a conditioning train of 1 Hz after application of 150 μM FB213 Recovery
current from the FB213 block in the continued presence of drug at
rest, resulting from a single test pulse after 330 s resting time is
depicted as red, washout of the FB213 block is shown in blue; (F)
mean normalized peak tail current amplitudes in the presence of 150
μM FB213 is plotted against time. The section ‘block’ shows the development of inhibition during a 1 Hz pulse train. The grey
highlighted section ‘recovery’ maps the amount of recovery after a
330 s resting time; (G) repetitive stimulation accelerates wash-out of
FB213. The hERG channels were inhibited by a 1 Hz pulse train, as described in Fig. 1F. After reaching steady state of inhibition, the drug
was washed out. During the wash-out process, pulses were applied
at 0.3 Hz frequency. Peak tail currents were normalized to control
the currents (amplitude before drug application) and plotted against
time.
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Electrophysiology
All experiments involving animals were approved by the Austrian Animal Experimentation Ethics Board in accordance
with the European convention for protection of vertebrate animals used for experimental and other scientific purposes
ETS no. 123. cDNAs of hERG (accession number NP000229)
was kindly provided by Prof. Sanguinetti (University of Utah,
UT, USA). Synthesis of capped runoff complementary
ribonucleic acid (cRNA) transcripts from linearized cDNA
(cDNA) templates and injection of cRNA were performed as
described in detail by Sanguinetti et al.2 Oocytes from a South
African clawed frog, Xenopus laevis (NASCO, Fort Atkinson,
WI, USA), were prepared as follows: after a 15-min exposure of
a female Xenopus laevis to an anesthetic (0.2% solution of MS222, the methanesulfonate salt of 3-aminobenzoic acid ethyl
ester; Sigma), parts of the ovary tissue were surgically removed. Defolliculation was achieved by enzymatic treatment
with 2 mg mL−1 collagenase type 1A (Sigma) and mechanical
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Research Article
removal of the follicular layer using forceps. Stage V–VI oocytes were selected and injected with the WT and mutant
hERG-encoding cRNA. Injected oocytes were stored at 18 °C
in ND96 bath solution (96 mM sodium chloride, 2 mM potassium chloride, 1 mM magnesium chloride, 5 mM HEPES, 1.8
mM CaCl2; pH 7.5, titrated with NaOH) containing 1%
penicillin-streptomycin solution. All chemicals used were purchased from Sigma-Aldrich Chemie GmbH, Taufkirchen,
Germany.
Currents through the hERG channels were studied 1 to 4
days after the microinjection of cRNA using the twomicroelectrode voltage clamp technique. ND96 was used as
the extracellular recording solution. Voltage-recording and
current-injecting microelectrodes were filled with 3 M KCl and
had resistances between 0.3 and 2 MΩ. Endogenous currents
(estimated in oocytes injected with DEPC water) did not exceed
0.15 μA. Currents >5 μA were discarded to minimize voltage
clamp errors. Ionic currents were recorded with a Turbo Tec
03X amplifier (npi electronic, GmbH, Tamm, Germany) and
digitized with a Digidata 1322A (Axon Instruments Inc., Union
City, CA, USA). The pClamp software package version 9.2 (Axon
Instruments Inc.) was used for data acquisition. Microcal
Origin 7.0 was employed for analysis and curve fitting.
A precondition for all the measurements was the achievement of stable peak current amplitudes over periods of 10
min after an initial run-up period. A frequency of 0.3 Hz was
used for all the voltage clamp experiments. Drugs were applied by means of a perfusion system enabling solution exchange within 100 ms.26 Control measurements for 30–35 minutes after an initial ‘run up’ phase were performed and no
significant changes in current amplitude were observed. The
flow rate was ≈8 μl s−1, preventing run down during the experiments (data not shown). The oocytes were kept for 5 min
at a holding potential of −100 mV to equilibrate drug diffusion. The tail current was measured at −50 mV after a step to
+20 mV. A use-dependent hERG channel block was estimated
as the peak tail current inhibition. Data are presented as
means ± s.e. from at least four oocytes from ≥2 batches. The
studied compound (FB213) was dissolved in the ND96 extracellular recording solution to prepare a 10 μM stock on the
day of the experiments. The drug stock solution was further
diluted to the required concentration. All experiments involving animals were approved by the Austrian Animal Experimentation Ethics Board in accordance with the European
convention for protection of vertebrate animals used for experimental and other scientific purposes ETS no. 123.
Molecular docking
The hERG homology model termed “model 6” from our recently published analysis of structural hERG models was
used for docking.18 The modeling procedures and validation
are described in detail in our previous paper. Briefly, Modeller 7v7 (ref. 29) was used to generate a 3D model of the open
conformation of hERG1, based on the crystal structure of
KvAP30 and the refined model thereof.31
514 | Med. Chem. Commun., 2016, 7, 512–518
MedChemComm
Docking was performed using the program Gold 4.0.1 and
the implemented Gold scoring function. The binding site was
defined by selecting Y652 and F656 of all four subunits as
the center and including all residues within a radius of 10 Å
of these two residues. The Gold rotamer library was used to
account for side chain flexibility.15 For both drugs, the central nitrogen was protonated and used in its charged form.
The 20 best-ranked poses of each drug docking run were visually inspected and the most frequent binding mode was used
as the starting conformation for ED simulations. General amber force field parameters16 for the drugs were generated by
making use of Gaussian 09 (ref 27) and antechamber.28
Essential dynamics simulations (ED)
The ED technique was described previously.17 Briefly, an eigenvector representing the transition between open and closed
hERG channel states was obtained from a principal component analysis by comparing the backbone atoms of both states.
The fixed increment linear expansion method was used and
set to −1.69 × 10−6 nm per simulation step (2 fs). Five closing
ED simulations, each lasting 20 ns, were performed in the
presence of propafenone and FB213. Data for apo simulations
were taken from our previous publication.13
Results and discussion
FB213 inhibits hERG currents and is trapped in the cavity
hERG channels were expressed in Xenopus laevis oocytes and
K+ current was measured using the standard two-electrode
voltage clamp technique. A two-step pulse protocol was applied (Fig. 1B): 300 ms depolarization to +20 mV (prepulse)
induces slow activation and fast inactivation of the channels,
and potassium current during prepulse is small. Upon repolarization to −50 mV, the channels underwent rapid recovery
from inactivation, inducing large “tail” currents, and were
slowly deactivated (closure of the channel gate). Peak tail current amplitudes were used as a measure of the fraction of
channels free from drug inhibition. First, we determined the
sensitivity of FB213 to the WT hERG channels. A concentration inhibition relationship was estimated by plotting the
steady state values of current inhibition normalized to control (in a drug-free solution) versus cumulatively applied
FB213 concentrations (Fig. 1C and D). The concentration of
FB213 required to block 50% (IC50) of the hERG current was
47.1 ± 5.1 μM. The oocyte was exposed to the drug and after
5 min of equilibration, a train of pulses (with a frequency of
1 Hz) was applied, inducing “use-dependent” inhibition of
the hERG channels (Fig. 1F, block): peak tail currents were
gradually decreased and finally reached a steady state.
A state-dependent block was measured in the absence of
FB213 (control, Fig. 1E) and after a pre-incubation period of
330 s with 150 μM FB213 (3 × IC50) while holding the channels at −100 mV. Subsequently, 1 Hz pulse trains were applied until a steady state block was reached. A channel block
was developed in a ‘use-dependent’ manner. Prepulse and
tail currents were inhibited during the 1 Hz pulse train. The
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steady state block was achieved within 15 s (Fig. 1E green
trace and F). The development of the block during the channel activation at +20 mV suggests that FB213 blocks the
hERG channels in an open channel conformation. 150 μM
FB213 blocked the hERG channels by 69 ± 5% (Fig. 1F).
Further, we probed if FB213 is trapped inside the hERG
cavity. The criteria of drug trapping in the hERG channel cavity are: i) lack of recovery from the block at rest and ii) slow
recovery and acceleration of recovery during washout of the
drug.9 Recovery from the hERG channel block by FB213 was
determined by applying a test pulse after a resting period of
300 s at a holding potential of −100 mV, where the channels
are in a closed resting state. The first current amplitudes after this rest period recovered from the block are less than
1%, indicating that FB213 is trapped in the closed channel
conformation (Fig. 1E red trace and F). Previously, it has
been demonstrated that hERG channels inhibited by “nontrapped” drugs recover during ≈330 s even in the presence of
drugs.9,10 Subsequent frequent opening of the channel at 0.3
Hz during wash out induced substantial recovery from the
FB213 block to 47.5 ± 3.7% (Fig. 1E blue trace and G),
suggesting that trapped FB213 can leave the channel during
activation when the channels are in an open conformation.
To test if FB213 binds to the central cavity, as shown previously for other propafenone derivatives,10 we performed alanine mutation studies on Y652 and F656, which have been
shown to play a key role for the binding of different chemical
entities.6 The WT channel voltage protocol was utilized for
Y652A, while tail currents were measured at −140 mV for
F656A, as reported by Witchel et al.8 Y652A and F656A significantly reduced channel inhibition to 13.2 ± 4.4% and 18.3 ±
1.2%, respectively (Fig. 2A–C), suggesting that FB213 not only
can access the binding site inside the cavity, but further interacts with Y652 and F656, as shown for many well-known
hERG blockers.
Taken together, these results suggest that FB213 can bind
to the well-established receptor site located deeply in the
channel pore and does not dissociate from the channel at
rest. Washing out provided negligible recovery from the block
which is prominently enhanced by frequent stimulation.
Research Article
Fig. 2 FB213 interacts with binding sites Y652 and F656. (A, B)
Representative current traces and corresponding voltage protocols for
current measurements of mutants Y652A and F656A in the absence
(control) and presence of FB213, respectively. The tail currents of
F656A were recorded at −140 mV. (C) Normalized peak tail currents of
WT, Y652A, and F656A channels after the steady state block by 150 μM
FB213 (n = 4, error bars, ± SEM).
For comparison reasons, we included the well-studied
smaller propafenone (MW: 341.44 g mol−1) compound in our
ED investigations as well. As a starting point, the molecule
was docked into the open state, similar to FB213. The interactions are illustrated in Fig. 4B. In agreement with the experiment and previous docking studies,8,19 aromatic and hydrophobic interactions between propafenone and F656 and
Y652 were observed. Additionally, a hydrogen bond between
the basic nitrogen and S624 was seen.
Structural investigation of FB213 block in hERG
To investigate the binding mode of FB213, we docked the
compound into our previously published open state hERG
homology model.18 Hydrogen bonds between two adjacent
hydroxyl groups of Y652 and the drug were observed. The
protonated nitrogen of FB213 is located beneath the selectivity filter, stabilized by helix dipole charges and a hydrogen
bond to Y652. The triphenyl moiety of the compound forms
hydrophobic and aromatic interactions with two adjacent
Y652 side chains and one F656 residue. As illustrated in
Fig. 3B, multiple hydrophobic and aromatic interactions between the compound and the side chains of Y652 and F656
were observed. This is in agreement with our experimental
observations.
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Trapping simulations with propafenone and FB213
To investigate if propafenone and FB213 can indeed become
physically trapped behind the activation gate, we performed
five independent essential dynamics (ED) gating simulations
with both drugs. The ED method was previously successfully
applied by our group to investigate activation/deactivation
gating in KcsA17 and to monitor drug trapping of TBA in
KcsA and hERG.13 In the first step, we compared the backbone atoms of the open and closed state hERG homology
models by principal component analysis. The resulting eigenvector was then used to enforce channel closure, while leaving all other degrees of freedom essentially unbiased. The
simulations enabled us to monitor drug trapping in atomistic
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Table 2 Analysis of the buried solvent-accessible surface area of the ligand. Calculations were performed with Surface Racer 5.0 (ref. 32)
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Buried solvent accessible surface areas (= SASA, Ångström2)
Fig. 3 Modelling of FB213 trapping. (A) Bottom view of FB213 (yellow
spheres) docked into the open state hERG model. (B) Side view of
FB213 interactions with the aromatic side chains of Y652 and F656.
Hydrogen bonds are depicted as green dotted lines. (C) Bottom view
of the trapped FB213 after 20 ns ED simulations. (D) Side view of the
compound in the closed state.
Table 1 Analysis of closing simulations. Minimal root mean square deviation (MinRMSD) and time to reach the closed state are listed
Total buried area
Polar
Non-polar
FB213
Run 1
Run 2
Run 3
Run 4
Run 5
Average buried SASA
450.17
414.16
443.52
408.39
456.21
434.49
130.3
104.08
128.47
117.35
126.36
121.31
319.86
310.09
315.05
291.06
329.84
313.18
Propafenone
Run 1
Run 2
Run 3
Run 4
Run 5
Average buried SASA
212.9
1.12
203.11
382.15
258.01
211.45
80.04
0.35
30.91
112.82
94.4
63.70
132.87
0.77
172.21
269.33
163.59
147.75
chain,13 we monitored the rotameric states of this residue
during closure simulations. As shown in Fig. 5, propafenone
as well as FB213 influence the dynamics of the side chain. In
particular, the bound propafenone stabilizes the down state
of F656, which is defined as χ1 angles ≤123°. Only at the end
of the simulation, the side chain of 1 subunit is found in the
up-state (χ1 ≤123°). These effects are similar as observed for
TBA trapping in our previous study.13 The situation is different for FB213. Due to the large size of this molecule, the
Closing simulations
FB213
Apo
Propafenone
MinRMSD
(Å)
Time
(ns)
MinRMSD
(Å)
Time
(ns)
MinRMSD
(Å)
Time
(ns)
3.13
2.33
3.07
2.74
2.62
16.2
18.4
9.7
13.2
14.9
2.90
2.92
3.41
3.15
2.62
15.2
14.5
10.7
14.2
18.7
2.81
2.79
3.51
2.38
2.79
19.7
18.9
8.3
18.0
16.7
detail on the nanosecond timescale. Closure of the activation
gate was monitored by calculating the RMSD (root mean
square deviation) of the protein compared to the closed state
homology model. As shown in Table 1, the RMSD value decreased steadily, reaching minima between 2.33 and 3.51 Å.
The somewhat higher RMSD values in two closing simulations (3.51 Å and 3.13 Å) resulted from unwinding of the helix termini. However, this was not influenced by the bound
drug molecule, since the binding site was higher up in the
cavity (see Fig. 3A–D). Successful trapping was defined by a
decrease in the RMSD and visual inspection of the gating region formed by S6 segments. As listed in Table 1, all 10 closing runs with the drugs were successful. Our ED simulations
repeatedly show that the activation gate can close normally
with FB213, as illustrated in Fig. 3C and D.
Since we have previously found that closure with a bound
drug molecule can influence the dynamics of the F656 side
516 | Med. Chem. Commun., 2016, 7, 512–518
Fig. 4 Modelling of propafenone trapping. (A) Bottom view of
propafenone shown in yellow spheres docked into the open state
hERG model. (B) Side view of propafenone interactions with the side
chains of Y652, F656 and S624. Hydrogen bonds are depicted as green
dotted lines. (C) Bottom view of the trapped propafenone molecule
after 20 ns ED simulations. (D) Side view of the compound in the
closed state.
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considering hydrophobic side pockets, which have been recently suggested to be accessible for drug interactions.20,22,24
Interestingly, such a possibility has recently also been shown
for a QA blocker in the bacterial K+ channel KcsA.25
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Conclusions
Fig. 5 Analysis of rotameric states of F656. (A–B) Down states are
defined by χ1 angles ≤123°. The percentage of the down state was
calculated for each time step and plotted over time averaged over 5
trapping runs/drug.
behaviour of the F656 side chain is influenced. At the start,
only two F656 side chains are able to adopt a down-conformation, while the other two side chains have to adopt an ‘upward’ conformation. In all five closing simulations, this distribution of F656 rotameric states does not change during
closure. (Fig. 5).
During channel closure, the interactions between FB213
and the protein increase, compared to the observed open
state interactions (Table 2). Due to the rotation of the S6 helix during closure, the side chain of S649 is reoriented, enabling hydrogen bonds with the protonated nitrogen, additionally to the OH–group of Y652 as shown in Fig. 3B and D.
The location of the tertiary amine is only slightly different
from the open state. This is in contrast to a previous docking
study which suggested that the basic nitrogen might move
upward during channel closure.19
During channel closure with propafenone, no major
changes in the interactions compared to the open state were
observed (Fig. 4B and D). Again, the basic nitrogen remained
centrally located below the selectivity filter, stabilized by helix
dipole charges. As expected, due to size differences, the buried solvent accessible surface areas of FB213 compared to
propafenone is considerably higher, as shown in Table 2.
Interestingly, in ED run 2, propafenone did not displace any
solvent from the surface areas of the protein. In this run, the
ligand is forming a U-shaped conformation. This is in agreement with a recent study by Schmidtke et al.,20 suggesting
that drug interactions can become more favourable when the
cavity size is decreased. During channel closure, we often observe a 2-fold symmetry, irrespective of the drug bound. This
is also in line with closure simulations performed recently on
hERG homology models without drug molecules.20
It is remarkable that a molecule the size of FB213 seems
to be accommodated in the hERG cavity without any difficulties. This suggests that the cavity of hERG is quite different
from other potassium channels with smaller cavities, such as
Shaker.21 This underlines the uniqueness of the hERG cavity
in terms of size and possibly plasticity, which has recently
been recognized to play a major role in drug block as
well.15,20,22,23 It is conceivable that the hERG cavity might be
able to accommodate even larger/bulkier molecules when
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Our data suggests that pore blockers of different bulkiness
may serve as tools to probe the size of the HERG cavity.
We found that even large blockers do not hinder normal
gate closure. This indicates that the cavity of the hERG pore
is remarkably large, enabling trapping of compounds with
very high molecular weight (FB213: 647.24 g mol−1). Further,
we propose that for a propafenone-like scaffold, size does not
play a major role during drug trapping in hERG K+ channels.
Further studies will reveal if this holds true for structurally
unrelated trapped drugs in hERG.
Acknowledgements
This work was supported by the Austrian Science Fund (FWF;
grants P22395 and W1232; http://www.fwf.ac.at) and the Wiener Hochschuljubiläumsstiftung (grant H-304013/2014). The
computational results presented have been achieved using
the Vienna Scientific Cluster (VSC).
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