Cardiac remodeling, which involves structural and electrical changes in the heart, may be impacted by altered expression and localization of Cx43 GJs. Decreased expression of Cx43 proteins and heterogeneous arrangement of channels can impair cardiac conduction and lead to supraventricular or ventricular arrhythmias [
40]. Cx channels are promising pharmacological targets because inhibitors of Cx channels could be useful for treating not only arrhythmias, but also other communication-dependent diseases affecting other body systems. The importance of Cx43 has been well established, particularly in the heart where a lack of Cx43 leads to abnormal cardiac development and death at birth [
41]. Abnormalities in Cx43 organization and regulation have also been linked to myocardial ischemia [
42]. Preservation of Cx43 in the intercalated discs joining cardiomyocytes may not only support conduction velocity but also impact the total normoxic Cx43 interactome [
43]. So, Cx43 is a considerable drug target, especially during heart ischemia and reperfusion [
14,
44,
45]. For example, Cx43 inhibitor digoxin (analyzed in QSAR here) isolated from
Digitalis lanata is well known in cardiology [
46]. It is used to treat both irregular heartbeat [
47] and heart failure [
48], but its side effects like gynecomastia also are significant which could be explained through its chemical similarity to estrogen [
49]. Another Cx43 inhibitor quinidine also is a popular antiarrhythmic drug [
50]. Another examined compound carbenoxolone is used for the treatment of peptic, esophageal and oral ulceration and inflammation; however, it also has been shown in humans to slow the myocardial conduction [
51]. An anti-malarial drug mefloquine may lead to complete heart arrest [
52] and number of neuropsychiatric effects including suicide [
53]. More recently, Cx inhibiting peptides (antiarrhythmic peptides AAP10, ZP123; GAP-134; RXP-E; and the Cx43 mimetic peptides Gap 26 and Gap 27) were suggested for treatment of arrhythmias in patients with ischaemic cardiomyopathy [
54]. On the other hand, peptides underperformed as drug candidates due to unfavorable characteristics mainly regarding their pharmacokinetic behavior, including plasma stability, membrane permeability, and circulation half-life [
55]. The discovery of new modulators of GJ channel function lacking similarity to steroid hormones to avoid side effects is of interest for human health [
14,
44,
45]. Also, a long-standing challenge in the study of GJs is the lack of specific, high-affinity activators and inhibitors of GJ channels [
56,
57]. Therefore, it is important to predict
in silico which substances could effectively modulate GJ conductance. This also could serve as an innovative approach in repurposing of licensed drugs with predicted new Cx inhibitory properties for other communication-dependent illnesses.
All top 3 Cx43 inhibitors docked into the same common docking site suggesting that this site should be explored further for more potent inhibitors. Thus, even if molecular docking accuracy is low it can be used in combination with QSAR. Using the developed QSAR model, the limonene log(pIC50) was calculated equal to 1.07 (Equation 3), and an experimental value of 1.41 was later determined by our patch-clamp experiments. Therefore, this new Cx43 inhibitor could be added the current GJ inhibitor nomenclature.