# Patent

## Title
Mice lacking inward-rectifying potassium channel Kir6.1

## Abstract

Mice homozygous for the lack of inward-rectifying potassium channel Kir6.1 gene are disclosed. The mice causes a high incidence of sudden death associated with arrhythmia (atrioventricular block) caused by spontaneous cardiac ischemia, a condition similar to Prinzmetal angina (variant angina) in human, representing an animal model of Prinzmetal angina. Mice heterozygous for the lack of inward-rectifying potassium channel Kir6.1 gene are also disclosed, which are used as parent mice for reproduction of the homozygous mice.

## Background
FIELD OF THE INVENTION
The present invention relates to mice lacking inward-rectifying potassium (K+) channel Kir6.1 and serving as model animals of Prinzmetal angina (variant angine or vasospastic angina) in human.
BACKGROUND OF THE INVENTION
Inward-rectifying potassium channels (Kir) are playing a number of physiologically important roles (1). Based on their mutual sequence similarity, the Kir family is currently divided into seven subfamilies, Kir1.x–Kir7.x (1–3, 27). Unlike the other members of the Kir family, the members of Kir6.x subfamily, including Kir6.1 and Kir6.2, are unique in that they cannot form functional K+ channels by themselves on the surface of cell membranes and that they require a regulatory SUR subunit) (4–6), which is the receptor for sulfonylurea compounds widely used for the treatment of Type II diabetes mellitus (noninsulin-dependent diabetes mellitus). The sulfonylurea receptor has two isoforms, SUR1 and SUR2 (7), derived from two different genes (7). In addition, there are several splicing variants of SUR2, among which major ones are SUR2A (7) and SUR2B (8). Co-expression of Kir6.2 subunit with SUR1, SUR2A or SUR2B or one of other SUR2 variant subunits produces KATP channel currents with distinct nucleotide and pharmacological sensitivities in heterologous expression systems (4–6). The Kir6.2 subunit and the SUR1 subunit constitute the KATP channel in pancreatic β-cells (9) and in the glucose-responsive neurons (GRNs) in ventromedial hypothalamus (VMH) (10). The Kir6.2 subunit and the SUR2A subunit constitute KATP channels in cardiomyocytes and probably also in skeletal muscle cells (7). The Kir6.1 subunit and the SUR2B subunit constitute KATP channels in non-vascular smooth muscles (8). Studies of Kir6.2 knockout mice have clarified a variety of physiological roles of Kir6.2-containing KATP channels. For example, the Kir6.2/SUR1 channels in pancreatic β-cells are critical in both glucose-induced and sulfonylurea insulin secretion (11), while in VMH, Kir 6.2/SUR1 channels are involved in glucagon secretion during hypoglycemia (10) through autonomic neurons. Studies of SUR1 knockout mice confirm the importance of Kir6.2/SUR1 channels in insulin secretion (12). Kir6.2/SUR2A channels mediate the depression of cardiac excitability and contractility induced by K+ channel openers (KCOs) (13), and contribute in part to ischemic preconditioning (14). In addition, in studies of SUR2 knockout mice, Kir6.2-containing KATP channels in skeletal muscle have been shown to be involved in glucose uptake (15). While Kir6.1 subunits and SUR1 (16, 17), SUR2A (18), or SUR2B (19–21) subunits have been shown to generate K+-channel currents with different electrophysiological and pharmacological properties, the actual combinations of Kir6.1 and SUR subunits naturally occurring in tissues, as well as their physiological roles, have not been determined.
Kir6.1 (its amino acid sequence is set forth as SEQ ID NO:1) shares 63.7% amino acid identity with its isoform Kir6.2. In addition, while inward-rectifier K+ channels generally have the Gly-Tyr-Gly motif in their ion permeable region (H5), both Kir6.1 and Kir6.2 have the Gly-Phe-Gly motif in the region (6). Thus, Kir6.1 and Kir6.2 are structurally very similar. While the electrophysiological and pharmacological properties of Kir6.2-containing K+ channels have been well characterized in reconstituted systems (7–9) and native cells (10, 11, 13), those of Kir6.1-containing K+ channels are not fully understood. Co-expression of Kir6.1 and SUR1 in HEK293 cells produces tolbutamide-sensitive K+ channel currents (16), and co-expression of Kir6.1 and SUR2A in COS7 cells produces currents that are responsive to very high concentrations of UDP (18). Their physiological significance, however, is not known. Co-expression of Kir6.1 and SUR2B, which is a splice variant of SUR2A in HEK293T cells, produces a K+ current which is insensitive to ATP, activated by nucleoside diphosphates such as UDP, and inhibited by sulfonylurea glibenclamide (19). These properties are similar with those of KNDP channels in native vascular smooth muscle (28). The KNDP channel in vascular smooth muscle was originally called the smooth muscle KATP channel as it is closed by glibenclamide (29), a KATP channel blocker, but it has become designated as KNDP channel because of its insensitivity to ATP (28). Since the KNDP channels are opened by K+ channel openers having vasodilating effects, such as cromakalim and pinacidil, the channels are thought to be involved in the vasodilatation response of vascular smooth muscles. However, it is unknown whether Kir6.1 is a component of the KNDP channels in native vascular smooth muscle.
On the other hand, there is a type of human angina pectoris called Prinzmetal angina (also called variant angina or vasospastic angina), which is accompanied by a reversible, tentative of ST elevation during angina attacks in the resting state. Attacks of Prinzmetal angina occurs in the resting state, especially from the night to early morning while one is sleeping. It is characterized by ST segment elevation on electrocardiogram upon attack with a lead which generally should record lowered ST segment in a typical angina pectoris, and it often shows arrhythmia such as ventricular extrasystole, atrioventricular block, ventricular fibrillation, etc. The attack is considered to be caused by sharp decrease of the coronary blood flow due to a spasm of a thick coronary artery.
SUMMARY OF THE INVENTION
The objective of the present invention is to provide model animals useful as means for elucidating physiological role of Kir6.1-containing K+ channel and also for searching agents for treatment of diseases associated with dysfunctioning of Kir6.1, in particular Prinzmetal angina.
The present inventors generated mice homozygous for lack of Kir6.1 gene (Kir6.1−/− mice) by disrupting the gene using the gene targeting technique. Further, using the mice expressing no Kir6.1 gene product, the inventors also found that the Kir6.1-containing channel is critical in the regulation of vascular tonus, and that its genetic disruption in mice causes a high incidence of sudden death associated with arrhythmia (atrioventricular block) caused by spontaneous cardiac ischemia, a condition similar to Prinzmetal angina (variant angina) in human.
Thus, the present invention provides mice homozygous for the lack of inward-rectifying potassium channel Kir6.1 gene (Kir6.1−/− mice). The homozygous mice can be used for elucidation of the mechanism of development of Prinzmetal angina, as well as for screening of agents for its treatment.
The present invention further provides mice heterozygous for the lack of inward-rectifying potassium channel Kir6.1 gene (Kir6.1+/− mice). The heterozygous mice can be used as parent mice for reproduction of the above-identified homozygous mice, by crossing them with one another and then sorting the offspring.
The present invention further provides organs such as the heart and the like and tissues, in particular myocardial tissue and vascular tissues such as vascular smooth muscle tissue of the aorta and the like, as well as cells such as cardiac cells, vascular smooth muscle cells and the like. These tissues, organs and cells can be used for screening of agents for the treatment of Prinzmetal angina and other diseases associated with the abnormality of Kir6.1.
As mentioned later, K+ channel opener pinacidil did not induce K+ currents in vascular smooth muscle cells of Kir6.1−/− mice, and the Kir6.1−/− mice lacked vasodilation response to pinacidil. Administration of methylergometrine, a vasoconstrictive agent, induced ST elevation followed by cardiac death in Kir6.1−/− mice, but not in wild type (Kir6.1+/+) mice. This indicates that Kir6.1−/− mice bear a phenotype resembling Prinzmetal angina in human characterized by hypercontractility of coronary arteries. These results indicates that Kir6.1-containing K+ channel is critical in the regulation of vascular tonus, especially in the coronary arteries, and its disruption is involved in Prinzmetal angina.



BRIEF DESCRIPTION OF THE FIGURES
FIG. 1 illustrates maps of the Kir6.1 locus, targeting vector and the resulting targeted locus, which has been site-specifically disrupted. The open, shaded, filled and gray boxes indicate untranslated exon, protein-coding exon, neomycin resistant gene and thymidine kinase gene, respectively. “B” denotes BamHI site.
FIG. 2 shows Southern blot analysis of genomic DNA digested with BamHI from wild-type (Kir6.1+/+), heterozygous (Kir6.1+/−), and homozygous (Kir6.1−/−) mutants. The probe indicated in FIG. 1 was used.
FIG. 3 shows Northern blot analysis of RNAs from Kir6.1+/+ and Kir6.1−/− mice.
FIG. 4 is a graph illustrating the survival rates (%) after birth of Kir6.1+/+ (thick line, n=36), Kir6.1+/− (dotted line, n=67), and Kir6.1−/−n=27) mice.
FIG. 5 shows Normal ECGs from Kir6.1+/+ (upper) and Kir6.1−/− (lower).
FIG. 6 shows spontaneous ST elevation in ECG recorded from a Kir6.1−/− mice.
FIG. 7 shows the 1st (top), 2nd (middle) and 3rd (bottom) AV block, and ST elevation (left) preceding each occurrence. “P” indicates P wave.
FIG. 8 is shows representative ECG of marked bradycardia in one of two Kir6.1−/− mice that died during ECG monitoring.
FIG. 9 shows an example of records of whole-cell membrane currents of Kir6.1+/+ mice (upper) and Kir6.1−/− mice (lower), showing the effects of pinacidil and glibenclamide on whole-cell membrane currents. PIN=pinacidil, GLB=glibenclamide
FIG. 10 shows measured effects of pinacidil and glibenclamide on action potentials in Kir6.1+/+ mice (left) and Kir6.1−/− mice (right).
FIG. 11 is a graph showing the effects of pinacidil on mean arterial pressure (MAP) in anesthetized mice. The changes in pressure are expressed as the deference from the basal value.
FIG. 12 shows the effects of pinacidil (PIN) and glibenclamide (GBL) on vasodilation in aortic rings from Kir6.1+/+ mice (upper) and Kir6.1−/− mice (lower). NE=norepinephrine. The numbers 0.3, 1, 3 and 10 indicate the concentration (μM) of pinacidil applied.
FIG. 13 is a graph showing dose (pinacidil)-response (dilation) relationship in aortic rings from Kir6.1+/+ mice (◯) and Kir6.1−/− mice (●).
FIG. 14 shows recordings of pinacidil-induced, glibenclamide-sensitive currents in aortic smooth muscles of Kir6.1+/+ mice (upper) and Kir6.1−/− mice (lower).
FIG. 15 is a graph showing the densities of glibenclamide-sensitive currents after 10 μM pinacidil application.
FIG. 16 shows ECGs before and after intravenous injection methylergometrine in Kir6.1−/− mice in vivo.
FIG. 17 shows ECGs before and after intravenous injection methylergometrine in Kir6.1−/− mice in vitro.



DETAILED DESCRIPTION OF THE INVENTION
The present invention will be described in further detail below with reference to examples. However, it is not intended that the present invention be limited to those examples.
EXAMPLES
[Generation of Kir6.1−/− Mice]
<Gene Targeting for Kir6.1−/− Mice>
The preset inventors generated mice lacking Kir6.1 by replacing a part of intron 2 and exon 3 of the Kir6.1 gene that includes the pore-forming region of the channel (FIG. 1). Briefly, the 129Sv mouse genomic library (in λDASH phage library) was screened using a full length of the coding region of mouse Kir6.1 cDNA (SEQ ID NO:2) (nt. 1-1275). Twelve positive clones were isolated and the restriction enzyme map was constructed. Based on the restriction enzyme map thus obtained, a targeting vector was constructed by replacing, with the neomycin resistant-gene cassette, a fragment ranging from Xbal site in intron 2 located about 1.2 kb upstream of exon 3 to MroI site in exon 3 of the mouse Kir6.1 gene. Genomic 3.8 kb and 7.0 kb fragments were used as 5′- and 3′-arms, respectively. For negative selection, a thymidine kinase cassette was added in the 3′ end of the targeting vector. The targeting vector was introduced into an ES cell line (R1) by electroporation and 130 surviving clones were picked up on the 8th day after the transfection. Clones having undergone homologous recombination were identified by Southern blotting. As a probe, a genomic 2.4 kb fragment (SphI-XhoI fragment) upstream of the 5′-arm of the targeting vector was used, and the genomic DNA was digested with SphI. Fourteen ES cell clones were shown to have undergone homologous recombination. Using these clones, chimeric mice were generated by aggregation and 4 independent mouse lines were obtained. Disruption of Kir6.1 gene was confirmed by genomic Southern blotting and Northern blotting. Those mice were backcrossed to a mouse strain C57BL6.
Homozygous knockout mice (Kir6.1−/−) were generated by cross-breeding of the heterozygous. (Kir6.1+/−) mice. Homologous recombination was confirmed by Southern blot analysis of genomic DNA isolated from the tail as described below (FIG. 2). Also confirmed was the lack of Kir6.1 mRNA expression. Changes in the mRNA expression levels of various KATP channel subunits (Kir6.2, SUR1 and SUR2) were examined by Northern blotting as described below (FIG. 3). The mRNA expression levels of Kir6.2, SUR1 and SUR2 were similar in wild-type (Kir6.1+/+) and Kir6.1−/− mice. This indicates that their regulation is independent of Kir6.1 and that the other subunits are unable to compensate for the loss of Kir6.1 at the transcription level.
<Methods of Southern- and Northern-Blot Analysis>
Genomic DNA (for Southern blotting) and total RNA (for Northern blotting) were prepared from mice tails and tissues following standard procedures. DNA (10 μg) or RNA (20 μg) was subjected to electrophoresis on a 1% agarose gel and blotted onto a nylon membrane. Hybridization was performed under highly stringent conditions with 32P-labeled probes. The probe used for the Southern blotting was a genomic fragment of Kir6.1 as shown in FIG. 1 (from SphI site to BamI site) (SEQ ID NO:3). The probes used for the Northern blotting were as follows.
(1) a cDNA fragment of mouse Kir6.1 [the fragment corresponding to the nucleotides 1–1330 of the nucleotide sequence of GenBank Accession No. D88159 (SEQ ID NO:4) (including nucleotides 1–203 in the 5′-untranslated region and nucleotides 1479–1712 in the 3′-untranslated region).
(2) a cDNA fragment of mouse Kir6.2 [the fragment corresponding to the nucleotides +134–+1064 of the nucleotide sequence of GenBank Accession No. NM—010602 (SEQ ID NO:5)]
(3) a cDNA fragment of human SUR1 [the fragment corresponding to the nucleotides 185–1250 of the nucleotide sequence of GenBank Accession No. AF087138 (SEQ ID NO:6)]
(3) cDNA fragment of rat SUR2 [rat SUR2A, the fragment corresponding to the nucleotides 39–1118 of the nucleotide sequence of GenBank Accession No. NM—013040 (SEQ ID NO:7)]
[Rearing and Observation of Kir6.1−/− Mice]
Analysis of 136 offspring mice showed that the number of Kir6.1−/− mice was only slightly less than what was expected according to Mendel's laws (approximately 5%). However, Kir6.1−/− mice were prone to premature death, the majority dying between 5 and 6 weeks after birth (FIG. 4). Those animals were found dead, so-called sudden death, within 24 hours after they were observed to be normal in behavior and activity levels.
[Drugs]
The following drugs were used in the experiments described below: pinacidil (SIGMA), glibenclamide (SIGMA CHEMICAL). Pinacidil was dissolved in physiological saline containing 0.1 N hydrochloric acid. Glibenclamide was dissolved in DMSO (final concentration of the solvent less than 0.1% in the tests).
[Statistical Analysis]
All the data in the experiments were presented as mean±SE. Statistical analysis of the data was performed using an analysis of variance (ANOVA) to the difference among wild-type and Kir6.1−/− mice, regarding p-values of <0.05 as being significant.
[Electrophysiological Examination of Mouse Heart by Electrocardiograph]
To determine if cardiac electrophysiological dysfunction contribute to sudden death of Kir6.1−/− mice, electrocardiograms (ECGs) from wild (Kir6.1+/+) mice and Kir6.1−/− mice were monitored using implantable radio telemetry (FIGS. 5–8).
ECG recordings of conscious mice under unrestricted conditions were obtained using an implantable radio frequency transmitter (TA10ETA-F20) (DATA SCIENCES, St. Paul, Minn.), with subcutaneous leads placed in the conventional lead II position. ECGs of anesthetized mice and isolated hearts (Langendorff-perfused heart) were recorded with leads placed on the body surface (lead II) or epicardium.
During most of the monitoring period, the heart rate (HR, bpm), QRS time (ms), and PR interval (ms) in Kir6.1−/− mice (n=4) were similar to those in Kir6.1+/+ mice (n=4) (FIG. 5). However, all of the Kir6.1−/− mice (4/4) exhibited spontaneous elevation of ST segment lasting for several seconds to almost a minute (FIG. 6). After a latency period ranging from several seconds to a few minutes from onset of ST elevation, atrioventricular (AV) blocks of various degrees occurred in all cases (FIGS. 6–8). The 1st, 2nd or 3rd AV blocks were observed in all of the Kir6.1−/− mice (4/4), but no ST-T change or AV block appeared in the Kir6.1+/+ mice (0/4). Two Kir6.1−/− mice out of the four died during the recording period, showing spontaneous ST elevation leading to a persistent 3rd AV block, during which the R-R intervals gradually lengthened until cessation of heart beat. Thus, the cause of death in Kir6.1−/− mice seems to be associated with myocardial ischemia.
[Electrophysiological Studies of Cardiomyocytes]
Kir6.1 is expressed most abundantly in the heart (24), and is present in cardiomyocytes (25). Therefore, electrophysiological properties of ventricular myocytes isolated from Kir6.1+/+ and Kir6.1−/− mice were compared. The quasi-steady-state membrane currents were recorded using a ramp-pulse protocol.
Briefly, single ventricular cells of the heart were enzymatically isolated and whole-cell membrane currents were recorded by the patch-clamp method (13). The pipette solution was composed of 20 mM KCl, 1 mM MgCl2, 1 mM phosphocreatine-K2, 110 mM K1-aspartate, 1 mM K2-ATP, 1.0 mM EGTA, 5 mM HEPES (pCa 8.0, pH 7.4). The external solution used was a HEPES-Tyrode solution containing 143 mM NaCl, 5.4 mM KCl, 1.8 mM CaCl2, 0.5 mM MgCl2, 0.33 mM NaHPO4, 0.55 mM glucose, 5 mM HEPES (pH 7.4). Voltage- and current-clamp experiments in heart cells were performed at 36.0° C.
Results:
The reversal potential was close to the potassium equilibrium potential in ventricular cells of both Kir6.1+/+ (6 cells from 3 animals) and Kir6.1−/− (5 cells from 3 animals) mice (FIG. 9). In both groups of cells, a K channel opener pinacidil produced concentration-dependent increases of an outward current, which was blocked by 1 μM glibenclamide, indicating and ATP-sensitive K+ current (IK,ATP). There were no significant differences in the density of the outward current between Kir6.1+/+ and Kir6.1−/− mice at 0 mV, either under control condition or after 1, 10 or 100 μM pinacidil, and 100 μM pinacidil plus 1 μM glibenclamide. There were no significant differences in baseline action potential parameters between Kir6.1+/+ and Kir6.1−/− ventricular cells. Pinacidil shortened the action potential duration (APD) in both Kir6.1+/+ (14 cells from 4 animals) and Kir6.1−/− (9 cells from 4 animals) ventricular cells (FIG. 10). APD at 90% repolarization level (APD90) of Kir6.1+/+ and Kir6.1−/− cells were shortened significantly from 31.6±2.3 ms to 18.3±2.2 ms and from 31.1±4.2 ms to 18.3±3.9 ms, respectively, by 100 μM pinacidil, which reversed to control levels after addition of 1 μM glibenclamide.
[Measurement of Aortic Blood Pressure]
K+ channel openers are known to lower arterial blood pressure by relaxing vascular smooth muscles by opening vascular KATP channels. The present inventors examined the vasodilation response to the K+ channel opener pinacidil in Kir6.1+/+ and Kir6.1−/− mice, in vivo at first.
Hemodynamic measurements were carried out according to the method described by, Suzuki, et al. (12). Changes of mean arterial pressure (MAP) after intravenous injection of 0.3 mg/kg pinacidil are indicated on the ordinate. The points show mean±SE of 6 animals for both groups.
Results:
Basal hemodynamic values of the mice, including heart rate (HR) and mean arterial pressure (MAP), were comparable between Kir6.1+/+ and Kir6.1−/− mice under anesthesia with urethane [HR: 602±28 beats/min for Kir6.1+/+ mice and 659±17 beats/min for Kir6.1−/− mice, MAP: 65±9 mmHg for Kir6.1+/+ mice and 67±7 mmHg for Kir6.1−/− mice]. Intravenous injection of pinacidil (0.3 mg/kg) caused decrease in MAP by about 30 mmHg within 5 minutes in Kir6.1+/+ mice but not in Kir6.1−/− mice (FIG. 11).
[Measurement of Aortic Contraction in Isolated Aortic Preparation]
The vasodilation response of thoracic aorta to the K+ channel opener was further examined in vitro by measuring changes in the tension of aortic rings isolated from Kir6.1+/+ and Kir6.1−/− mice (FIG. 12).
In the same manner as described by Suzuki et al. (13), mechanical function studies of isolated thoracic aorta were carried out. Briefly, the thoracic aorta without the endothelium was removed and cut into rings (4 mm in length). For isometric tension recording, the rings were mounted in a thermostatic organ bath. The bath was perfused with Krebs-Henseleit solution gassed with 95% O2/5% CO2. The aortic rings were precontracted by 0.1 μM norepinephrine, and pinacidil was added in a cumulative manner.
Results:
In Kir6.1+/+ mice (5 samples from 4 animals), pinacidil produced a concentration-dependent vasodilating effect (FIG. 12, upper panel). In contrast, pinacidil din not elicit any KATP channel-mediated vasodilating effect on rings isolated from Kir6.1−/− mice (5 samples from 4 animals) (FIG. 12, lower panel).
[Electrophysiological Studies of Smooth Muscle Cells of the Aorta]
As Kir6.1−/− mice were found to lack a vasodilation response of aorta to K+ channel openers both in vivo and in vitro, a study was carried out to examine if glibenclamide sensitive KDNP channel currents (19) could be detected in the aortic vascular smooth muscles of Kir6.1+/+ mice.
Single smooth muscle cells of thoracic aorta were enzymatically isolated and electrophysiological studies were conducted in the same manner as performed in the cardiomyocytes.
The compositions of the extracellular high K+ solution and the pipette solution used in this smooth muscle cell experiment were as follows. The external high-K+ solution: 2.9 mM NaCl, 140 mM KCl, 2.2 mM CaCl2, 1.2 mM MgCl2, 14 mM glucose and 10 mM HEPES-KOH buffer (pH 7.4). The pipette solution: 140 mM KCl, 4 mM MgCl2, 1 mM ATP-K2, 10 mM EGTA and 10 mM HEPES-KOH solution (pH 7.2). The membrane current was measured at room temperature.
Effect of 10 mM pinacidil was tested on whole-cell membrane currents of aorta smooth muscle cells held at −40 mV in high K+ (140 mM) solution.
Results:
Pinacidil elicited significant inward K+ currents that were blocked by glibenclamide in Kir6.1+/+ smooth muscle cells of, but failed to evoke any appreciable K+ currents in Kir6.1−/− cells (9.53±2.32 pA/pF for Kir6.1+/+, 0.13±0.07 pA/pF for Kir6.1−/−, p<0.05) (FIG. 14). This clearly indicates the absence of the KNDP channel currents in the vascular smooth muscle isolated from the aorta of Kir6.1−/− mice.
[Induction of Spasm in Coronary Arteries by Methylergometrine in vivo and in vitro]
To link dysregulation of vascular tonus and sudden death in Kir6.1−/− mice, an examination was tried to induce vasospasm using methylergometrine, an ergot alkaloid that stimulates serotonergic receptors and directly triggers the vasoconstriction of vascular smooth muscles (26). Interestingly, intravenous injection of the ergometrine derivative methylergometrine (20 mg) in anesthetized Kir6.1−/− mice elicited prompt elevation (4 animals out of 8) (FIG. 16) and depression (1 animal out of 8) of ST segments on ECG, the former resembling that recorded by implantable radio telemetry in Kir6.1−/− mice (FIG. 6). Methylergometrine induced cardiac death concomitantly with changes in ECG (5 Kir6.1−/− mice out of 8), although none of 7 Kir6.1+/+ mice exhibited significant changes in ECG nor died after injection of the drug. Administration of methylergometrine also provoked similar changes in ECG in vitro in Langendorff-perfused hearts of Kir6.1−/− mice, and methylergometrine (20 mg) induced elevation of the ST segment in isolated hearts of Kir6.1−/− mice (4/4) but not in those of Kir6.1+/+ mice (0/5) (FIGS. 16 and 17).
[Discussion]
As described above, Kir6.1−/− mice exhibited a high rate of sudden cardiac death (SCD) that is associated with spontaneous ST elevation on ECG followed by a series of AV blocks. Sudden cardiac death (SCD) is thought to be the principal cause of unexpected, rapid death in adults and infants (30). Although most SCD occurs in patient with some cardiac disease such as coronary atherosclerosis, myocardial disease, and inflammatory cardiac disease, some SCD occur unexpectedly due to abrupt cardiac arrest caused by arrhythmia or myocardial ischemia. Genetic abnormalities of ion channels [K+ (KVLQT1, HERG, KCNE1 or MiRP1), Na+ or Ca2+ channel subunits] (31), a gap junction protein (connexin40) (32), and cardiac specific transcription factors (Nkx2.5 and HF-1b) (33) have so far been shown to be involved in SCD caused by lethal arrhythmia in human and mouse. Of these, abnormalities in K+, Na+, and Ca2+ channels affect depolarization and repolarization of cardiomyocytes and cause long-QT syndrome in human and mouse. In cardiomyocytes isolated from mouse models of long-QT syndrome (34–36), abnormal ion currents were detected on the plasma membrane. In Kir6.1−/− mice, however, no electrophysiological abnormality was found in the plasma membrane of cardiomyocytes, despite the fact that Kir6.1 is expressed most abundantly in the heart (24). In addition, it was found that normal KATP channels are present in cardiomyocytes of Kir6.1−/− mice. Accordingly, Kir6.2 but not Kir6.1 is a constituent of the KATP channels of the plasma membrane of cardiomyocytes. The lack of abnormality in the electrophysiological properties of cardiomyocytes of Kir6.1−/− mice indicates that the pathophysiology of the AV block in Kir6.1−/− mice differs from that of long-QT syndrome due to K+, Na+ or Ca2+ channel dysfunction. Alternatively, the AV block is due to the spontaneous ST elevation caused by myocardial ischemia. In contrast to the normal electrophysiological properties of Kir6.1−/− cardiomyocytes, it was found that the KNDP channels of the smooth muscle of the aortae were defective in Kir6.1−/− mice. The present inventors previously reported that KNDP channels in vascular smooth muscles are normal in Kir6.2 knockout mice (13). The present findings indicate that Kir6.1 is a constituent of the KNDP channel in plasma membrane of vascular smooth muscle cells. The lack of vasodilation response of Kir6.1−/− mice to pinacidil, both in vivo (blood pressure decrease) and in vitro (relaxation of aortic rings), indicates that the Kir6.1-containing KNDP channels play a critical role in the relaxation of vascular tonus.
The most remarkable finding in Kir6.1−/− mice is spontaneous coronary spasm leading to lethal AV block, a phenotype resembling Prinzmetal angina (or variant angina) in human. Prinzmetal angina is an unusual form of unstable angina reported by Prinzmetal et al. in 1959, which occurs almost exclusively at rest and is associated with elevation of ST segments on ECG during the attack (22). The pathophysiology of Prinzmetal angina is thought to be hyper contractility of epicardial coronary arteries, with or without atherosclerotic changes (23, 37). Although in most cases of Prinzmetal angina, the attack disappears spontaneously, it can lead to myocardial infarction, sever AV block, life threatening ventricular tachycardia, and sudden death if the coronary vasospasm is prolonged (38). Prinzmetal angina is diagnosed by detection of elevated ST segments on ECG during the attack or by induction of coronary spasm using ergot alkaloids or acetylcholine (23). Because sudden death of Kir6.1−/− mice is associated with spontaneous ST elevation (AV block), and administration of the ergot alkaloid methylergometrine elicited changes in ST segments (elevation or depression) in Kir6.1−/− mice both in vivo and in vitro, Kir6.1−/− mice represent an animal model of Prinzmetal angina.
The Kir6.1−/− mice of the present invention provide a means for elucidation of the mechanism of onset of coronary arteries spasm, as well as for screening of agents for disorders of coronary arteries such as Prinzmetal angina.
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The present disclosure relates to subject matter contained in priority Japanese Patent Application No.2002–076170, filed on Mar. 19, 2002, the contents of which is herein expressly incorporated by reference in its entirety.

## Claims

1. A transgenic mouse comprising a homozygous disruption in the endogenous Kir6.1 gene, wherein said transgenic mouse exhibits sudden cardiac death, atrioventricular blockage, spontaneous cardiac ischemia, or spontaneous cardiac spasms.