Click here to close
Hello! We notice that you are using Internet Explorer, which is not supported by Xenbase and may cause the site to display incorrectly.
We suggest using a current version of Chrome,
FireFox, or Safari.
Front Physiol
2013 Jun 26;4:153. doi: 10.3389/fphys.2013.00153.
Show Gene links
Show Anatomy links
Characterization of N-terminally mutated cardiac Na(+) channels associated with long QT syndrome 3 and Brugada syndrome.
Gütter C
,
Benndorf K
,
Zimmer T
.
???displayArticle.abstract???
Mutations in SCN5A, the gene encoding the cardiac voltage-gated Na(+) channel hNav1.5, can result in life-threatening arrhythmias including long QT syndrome 3 (LQT3) and Brugada syndrome (BrS). Numerous mutant hNav1.5 channels have been characterized upon heterologous expression and patch-clamp recordings during the last decade. These studies revealed functionally important regions in hNav1.5 and provided insight into gain-of-function or loss-of-function channel defects underlying LQT3 or BrS, respectively. The N-terminal region of hNav1.5, however, has not yet been investigated in detail, although several mutations were reported in the literature. In the present study we investigated three mutant channels, previously associated with LQT3 (G9V, R18W, V125L), and six mutant channels, associated with BrS (R18Q, R27H, G35S, V95I, R104Q, K126E). We applied both the two-microelectrode voltage clamp technique, using cRNA-injected Xenopus oocytes, and the whole-cell patch clamp technique using transfected HEK293 cells. Surprisingly, four out of the nine mutations did not affect channel properties. Gain-of-function, as typically observed in LQT3 mutant channels, was observed only in R18W and V125L, whereas loss-of-function, frequently found in BrS mutants, was found only in R27H, R104Q, and K126E. Our results indicate that the hNav1.5 N-terminus plays an important role for channel kinetics and stability. At the same time, we suggest that additional mechanisms, as e.g., disturbed interactions of the Na(+) channel N-terminus with other proteins, contribute to severe clinical phenotypes.
Figure 1. Schematic representation of hNav1.5 and the N-terminal mutations investigated in this study. (A) Proposed hNav1.5 topology. Affected residues are indicated in white (LQT3) and light grey (BrS). The schematic structure also highlights some important structural features (DI to DIV—domain I to IV, IFM—residues isoleucine, phenylalanine, and methionine of the inactivation gate, IQ—calmodulin binding motif, EF—Ca++ binding EF hand domain). (B) Alignment of the N-terminal sequences of human Nav1.1—Nav1.9. Mutations associated with LQT3 or BrS are underlined or indicated in italics, respectively. Most of the eight affected residues are conserved among the Nav1 subfamily. Residues at position 35 are variable, and position 125 is occupied by isoleucine in all other human Na+ channels. All eight residues affected by a SCN5A mutation are identical in Nav1.5 of human, rat, mouse, and dog (not shown). The N-terminal region of the first putative membrane spanning segment DI-S1 is indicated in light grey. References: G9V (Millat et al., 2006), R18W (Tester et al., 2005), R18Q (Kapplinger et al., 2010), R27H (Priori et al., 2002), G35S (Levy-Nissenbaum et al., 2001), V95I (Liang et al., 2006), R104Q (Levy-Nissenbaum et al., 2001), V125L (Tester et al., 2005), K126E (Vatta et al., 2002a).
Figure 2. Whole-cell Na+ currents upon expression in HEK293 of hNav1.5 mutant channels associated with LQT3. (A) Current families. Currents were elicited by test potentials from −80 mV to various test pulses in 5 or 10 mV increments at a pulsing frequency of 1.0 Hz. (B) Persistent currents at −20 mV. The non-inactivating current fraction was similarly small in both wild-type and mutant hNav1.5 channels. For individual values see Table 1. Mutant ΔKQP channels were used as a positive control.
Figure 3. Electrophysiological properties in HEK293 cells of mutant hNav1.5 channels associated with LQT3. (A) Inactivation time constants τh (ms) as function of voltage. At −50 mV both R18W and V125L channels inactivated more slowly compared to hNav1.5 (*indicates p < 0.05). G9V channel inactivation was indistinguishable from hNav1.5 (data not shown). (B) Steady-state activation and inactivation in V125L channels. The figure shows the mean of 4 representative measurements for each. (C) Window current in hNav1.5 (grey area, solid lines) and V125L (dark grey area, dotted lines). (D) Recovery from inactivation was accelerated in V125L (* indicates p < 0.05 vs. hNav1.5). For individual values see Table 2.
Figure 4. Whole-cell Na+ currents upon expression in HEK293 of hNav1.5 mutant channels associated with BrS. Currents were elicited from −80 mV to various test pulses in 5 or 10 mV increments at a pulsing frequency of 1.0 Hz (holding potential −120 mV). For average peak current densities see Table 1. Expression of R104Q did not result in functional channels in the mammalian expression system.
Figure 5. Electrophysiological properties in HEK293 cells of mutant hNav1.5 channels associated with BrS. (A) Inactivation time constants τh (ms) as function of voltage. K126E channels inactivated more slowly at −50 mV (**), R27H inactivated more slowly from −50 to −25 mV (*), when compared to hNav1.5. R18Q, G35S, and V95I channels were indistinguishable from hNav1.5 (data not shown). (B) Steady-state activation and steady-state inactivation curves. Mid-activation potentials (Vm) were significantly shifted towards depolarized potentials in both R27H and K126E. Mid-inactivation potential Vh was shifted only in K126E. The figure was drawn using the mean of 4 representative measurements for each. Vm and Vh of the other mutant channels, R18Q, G35S and V95I, were indistinguishable from the respective hNav1.5 values. For data and statistics see Table 2.
Figure 6. Electrophysiological properties of R104Q in Xenopus oocytes. (A) Whole-cell Na+ currents. Peak current amplitudes were significantly reduced in R104Q (see Table 1). Currents were elicited from −80 mV to various test pulses in 5 or 10 mV increments at a pulsing frequency of 1.0 Hz (holding potential −120 mV). (B) Steady-state activation and inactivation curves. In R104Q, steady-state availability was significantly reduced. (C) Recovery from inactivation was slower in R104Q (* indicates p < 0.05 vs. hNav1.5). For individual values see Table 3.
Alings,
"Brugada" syndrome: clinical data and suggested pathophysiological mechanism.
1999, Pubmed
Alings,
"Brugada" syndrome: clinical data and suggested pathophysiological mechanism.
1999,
Pubmed
Atack,
Informatic and functional approaches to identifying a regulatory region for the cardiac sodium channel.
2011,
Pubmed
Baroudi,
Novel mechanism for Brugada syndrome: defective surface localization of an SCN5A mutant (R1432G).
2001,
Pubmed
,
Xenbase
Baroudi,
SCN5A mutation (T1620M) causing Brugada syndrome exhibits different phenotypes when expressed in Xenopus oocytes and mammalian cells.
2000,
Pubmed
,
Xenbase
Bennett,
Molecular mechanism for an inherited cardiac arrhythmia.
1995,
Pubmed
,
Xenbase
Blechschmidt,
Voltage-gated Na+ channel transcript patterns in the mammalian heart are species-dependent.
2008,
Pubmed
Camacho,
Modulation of Nav1.5 channel function by an alternatively spliced sequence in the DII/DIII linker region.
2006,
Pubmed
Chandra,
Multiple effects of KPQ deletion mutation on gating of human cardiac Na+ channels expressed in mammalian cells.
1998,
Pubmed
Clancy,
Non-equilibrium gating in cardiac Na+ channels: an original mechanism of arrhythmia.
2003,
Pubmed
Clancy,
Defective cardiac ion channels: from mutations to clinical syndromes.
2002,
Pubmed
Clatot,
Dominant-negative effect of SCN5A N-terminal mutations through the interaction of Na(v)1.5 α-subunits.
2012,
Pubmed
Dumaine,
Multiple mechanisms of Na+ channel--linked long-QT syndrome.
1996,
Pubmed
,
Xenbase
Gellens,
Primary structure and functional expression of the human cardiac tetrodotoxin-insensitive voltage-dependent sodium channel.
1992,
Pubmed
,
Xenbase
Gui,
Multiple loss-of-function mechanisms contribute to SCN5A-related familial sick sinus syndrome.
2010,
Pubmed
,
Xenbase
Itoh,
A novel missense mutation in the SCN5A gene associated with Brugada syndrome bidirectionally affecting blocking actions of antiarrhythmic drugs.
2005,
Pubmed
Kapplinger,
An international compendium of mutations in the SCN5A-encoded cardiac sodium channel in patients referred for Brugada syndrome genetic testing.
2010,
Pubmed
Kehl,
Images in cardiovascular medicine. Life-threatening neonatal arrhythmia: successful treatment and confirmation of clinically suspected extreme long QT-syndrome-3.
2004,
Pubmed
Keller,
Brugada syndrome and fever: genetic and molecular characterization of patients carrying SCN5A mutations.
2005,
Pubmed
Kyndt,
Novel SCN5A mutation leading either to isolated cardiac conduction defect or Brugada syndrome in a large French family.
2001,
Pubmed
Leoni,
Variable Na(v)1.5 protein expression from the wild-type allele correlates with the penetrance of cardiac conduction disease in the Scn5a(+/-) mouse model.
2010,
Pubmed
Levy-Nissenbaum,
Genetic analysis of Brugada syndrome in Israel: two novel mutations and possible genetic heterogeneity.
2001,
Pubmed
Liang,
[Novel SCN5A gene mutations associated with Brugada syndrome: V95I, A1649V and delF1617].
2006,
Pubmed
Millat,
Spectrum of pathogenic mutations and associated polymorphisms in a cohort of 44 unrelated patients with long QT syndrome.
2006,
Pubmed
Mohler,
Nav1.5 E1053K mutation causing Brugada syndrome blocks binding to ankyrin-G and expression of Nav1.5 on the surface of cardiomyocytes.
2004,
Pubmed
Murphy,
Developmentally regulated SCN5A splice variant potentiates dysfunction of a novel mutation associated with severe fetal arrhythmia.
2012,
Pubmed
O'Brien,
Interaction of voltage-gated sodium channel Nav1.6 (SCN8A) with microtubule-associated protein Map1b.
2012,
Pubmed
Potet,
Novel brugada SCN5A mutation leading to ST segment elevation in the inferior or the right precordial leads.
2003,
Pubmed
Priori,
Natural history of Brugada syndrome: insights for risk stratification and management.
2002,
Pubmed
Rivolta,
Inherited Brugada and long QT-3 syndrome mutations of a single residue of the cardiac sodium channel confer distinct channel and clinical phenotypes.
2001,
Pubmed
Rook,
Biology of cardiac sodium channel Nav1.5 expression.
2012,
Pubmed
Ruan,
Gating properties of SCN5A mutations and the response to mexiletine in long-QT syndrome type 3 patients.
2007,
Pubmed
Savio-Galimberti,
Voltage-gated sodium channels: biophysics, pharmacology, and related channelopathies.
2012,
Pubmed
Shang,
Tandem promoters and developmentally regulated 5'- and 3'-mRNA untranslated regions of the mouse Scn5a cardiac sodium channel.
2005,
Pubmed
Shang,
Human heart failure is associated with abnormal C-terminal splicing variants in the cardiac sodium channel.
2007,
Pubmed
Sharkey,
The ataxia3 mutation in the N-terminal cytoplasmic domain of sodium channel Na(v)1.6 disrupts intracellular trafficking.
2009,
Pubmed
Surber,
Combination of cardiac conduction disease and long QT syndrome caused by mutation T1620K in the cardiac sodium channel.
2008,
Pubmed
,
Xenbase
Tester,
Compendium of cardiac channel mutations in 541 consecutive unrelated patients referred for long QT syndrome genetic testing.
2005,
Pubmed
Valdivia,
A trafficking defective, Brugada syndrome-causing SCN5A mutation rescued by drugs.
2004,
Pubmed
Vatta,
Novel mutations in domain I of SCN5A cause Brugada syndrome.
2002,
Pubmed
,
Xenbase
Vatta,
Genetic and biophysical basis of sudden unexplained nocturnal death syndrome (SUNDS), a disease allelic to Brugada syndrome.
2002,
Pubmed
,
Xenbase
Walzik,
Alternative splicing of the cardiac sodium channel creates multiple variants of mutant T1620K channels.
2011,
Pubmed
Wang,
Cardiac sodium channel dysfunction in sudden infant death syndrome.
2007,
Pubmed
Watanabe,
Striking In vivo phenotype of a disease-associated human SCN5A mutation producing minimal changes in vitro.
2011,
Pubmed
Yan,
Cellular basis for the Brugada syndrome and other mechanisms of arrhythmogenesis associated with ST-segment elevation.
1999,
Pubmed
Zhang,
Sodium channel kinetic changes that produce Brugada syndrome or progressive cardiac conduction system disease.
2007,
Pubmed
Zhang,
Correlations between clinical and physiological consequences of the novel mutation R878C in a highly conserved pore residue in the cardiac Na+ channel.
2008,
Pubmed
,
Xenbase
Zimmer,
Functional expression of GFP-linked human heart sodium channel (hH1) and subcellular localization of the a subunit in HEK293 cells and dog cardiac myocytes.
2002,
Pubmed
Zimmer,
The beta1 subunit but not the beta2 subunit colocalizes with the human heart Na+ channel (hH1) already within the endoplasmic reticulum.
2002,
Pubmed
Zimmer,
SCN5A channelopathies--an update on mutations and mechanisms.
2008,
Pubmed
Zimmer,
Effects of tetrodotoxin on the mammalian cardiovascular system.
2010,
Pubmed