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      Evidence for the Capability of Roxadustat (FG-4592), an Oral HIF Prolyl-Hydroxylase Inhibitor, to Perturb Membrane Ionic Currents: An Unidentified yet Important Action

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          Abstract

          Roxadustat (FG-4592), an analog of 2-oxoglutarate, is an orally-administered, heterocyclic small molecule known to be an inhibitor of hypoxia inducible factor (HIF) prolyl hydroxylase. However, none of the studies have thus far thoroughly investigated its possible perturbations on membrane ion currents in endocrine or heart cells. In our studies, the whole-cell current recordings of the patch-clamp technique showed that the presence of roxadustat effectively and differentially suppressed the peak and late components of I K(DR) amplitude in response to membrane depolarization in pituitary tumor (GH 3) cells with an IC 50 value of 5.71 and 1.32 μM, respectively. The current inactivation of I K(DR) elicited by 10-sec membrane depolarization became raised in the presence of roxadustatt. When cells were exposed to either CoCl 2 or deferoxamine (DFO), the I K(DR) elicited by membrane depolarization was not modified; however, nonactin, a K +-selective ionophore, in continued presence of roxadustat, attenuated roxadustat-mediated inhibition of the amplitude. The steady-state inactivation of I K(DR) could be constructed in the presence of roxadustat. Recovery of I K(DR) block by roxadustat (3 and 10 μM) could be fitted by a single exponential with 382 and 523 msec, respectively. The roxadustat addition slightly suppressed erg-mediated K + or hyperpolarization-activated cation currents. This drug also decreased the peak amplitude of voltage-gated Na + current with a slowing in inactivation rate of the current. Likewise, in H9c2 heart-derived cells, the addition of roxadustat suppressed I K(DR) amplitude in combination with the shortening in inactivation time course of the current. In high glucose-treated H9c2 cells, roxadustat-mediated inhibition of I K(DR) remained unchanged. Collectively, despite its suppression of HIF prolyl hydroxylase, inhibitory actions of roxadustat on different types of ionic currents possibly in a non-genomic fashion might provide another yet unidentified mechanism through which cellular functions are seriously perturbed, if similar findings occur in vivo.

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          Roxadustat Treatment for Anemia in Patients Undergoing Long-Term Dialysis

          Roxadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor that stimulates erythropoiesis and regulates iron metabolism. Additional data are needed regarding the effectiveness and safety of roxadustat as compared with standard therapy (epoetin alfa) for the treatment of anemia in patients undergoing dialysis.
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            Roxadustat for Anemia in Patients with Kidney Disease Not Receiving Dialysis

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              Hypoxia as a therapy for mitochondrial disease.

              Defects in the mitochondrial respiratory chain (RC) underlie a spectrum of human conditions, ranging from devastating inborn errors of metabolism to aging. We performed a genome-wide Cas9-mediated screen to identify factors that are protective during RC inhibition. Our results highlight the hypoxia response, an endogenous program evolved to adapt to limited oxygen availability. Genetic or small-molecule activation of the hypoxia response is protective against mitochondrial toxicity in cultured cells and zebrafish models. Chronic hypoxia leads to a marked improvement in survival, body weight, body temperature, behavior, neuropathology, and disease biomarkers in a genetic mouse model of Leigh syndrome, the most common pediatric manifestation of mitochondrial disease. Further preclinical studies are required to assess whether hypoxic exposure can be developed into a safe and effective treatment for human diseases associated with mitochondrial dysfunction.
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                Author and article information

                Journal
                Int J Mol Sci
                Int J Mol Sci
                ijms
                International Journal of Molecular Sciences
                MDPI
                1422-0067
                29 November 2019
                December 2019
                : 20
                : 23
                : 6027
                Affiliations
                [1 ]Division of Cardiovascular Medicine, Chi-Mei Medical Center, Tainan 71004 Taiwan; cmcvecho2@ 123456gmail.com
                [2 ]Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 71004, Taiwan
                [3 ]Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
                [4 ]Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; yichlo@ 123456kmu.edu.tw
                [5 ]Department of Physiology, National Cheng Kung University Medical College, Tainan 70101, Taiwan; hhelen000111tw@ 123456gmail.com
                [6 ]Institute of Basic Medical Sciences, National Cheng Kung University Medical College, Tainan 70101, Taiwan
                [7 ]Department of Basic Medical Sciences, China Medical University Hospital, Taichung 40402, Taiwan
                Author notes
                [* ]Correspondence: snwu@ 123456mail.ncku.edu.tw ; Tel.: +886-6-2353535-5334/886-6-2362780
                Article
                ijms-20-06027
                10.3390/ijms20236027
                6928729
                31795416
                9369e3af-4dc1-4023-83d4-97fc76146d54
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 31 October 2019
                : 25 November 2019
                Categories
                Article

                Molecular biology
                roxadustat,delayed-rectifier k+ current,voltage-gated na+ current,current kinetics,pituitary cell and heart cell

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