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Do Sodium Channel α-α Interactions Contribute to Loss-of-Function
Observed in Brugada Syndrome?
Krekwit
Xi
2,3
Du,
• Brugada syndrome (BrS) is an inherited cardiac
disease with an autosomal dominant pattern which
however also displays incomplete penetrance.
Eckhard
2Heart
2
Ficker,
and Isabelle
1,2,3
Deschênes
3Department
METHODS
• Using site directed mutagenesis, we introduced the
BrS mutations SCN5A-L325R and SCN5A-L567Q,
and the SCN5A-H558R polymorphism on the human
cardiac sodium channel, hNav1.5 (Fig. 1)
• The pathogenesis of BrS has mainly been
associated with mutations in the cardiac sodium
channel gene, SCN5A, which ultimately result in a
decrease in sodium currents.
• Recently, the L325R mutation has been proposed to
cause BrS through a dominant-negative effect.
• Dominant-negative effects are usually the
consequence of mutant subunits assembling with
wild-type (WT) into non-functional channel
multimers.
• In contrast, sodium channel α-subunits are not
believed to oligomerize.
• However, increasing bodies of evidence tend to
suggest that there is, contrary to traditional beliefs, a
sodium channel α-α interaction:
2. It has previously been shown that a common
sodium channel polymorphism located on a
separate allele can restore the function of a
disease causing mutation.3
2
Liu,
of Physiology & Biophysics,
& Vascular Research Center, and
of Biomedical Engineering,
MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio
INTRODUCTION
1. Single-channel experiments have demonstrated
a tendency for even numbers of channels to
occur within a patch. Importantly, no single
opening peak was present in an amplitude
distribution histogram.1,2
Haiyan
RESULTS
WT (0.3 µg) WT (0.15 µg)WT+L325R L325R
-200
*
-400
*
-600
-800
-1000
Figure 1: Diagram of hNav1.5. Circles represent the mutations
and/or polymorphisms that are characterized in this study.
Figure 3: Binomial analysis of subunit
composition. Binomial analysis was used to
determine subunit composition in a channel
complex using 10:1, 4:1 and 1:1 WT:L325R
ratios. Interestingly, it is shown that
normalized mean current densities (■)
measured in cells transfected with different
WT:L325R cDNA ratios are best fit by the
dimer configuration.
Tetramer
Trimer
Dimer
• We transiently transfected HEK-293 cells with
recombinant:
- SCN5A-WT
- SCN5A-L325R
- SCN5A-WT + SCN5A-L325R (10:1, 1:1, and 4:1)
- SCN5A-L567Q
- SCN5A-H558R + SCN5A-L567Q (1:1)
- SCN5A-WT + SCN5A-L567Q (1:1)
SUMMARY
Figure 2: Current densities of WT (0.3 μg),
WT (0.15 μg), WT (0.15 μg) + SCN5A-L325R
(0.15 μg), and SCN5A-L325R (0.3 μg). No
Sodium currents were present in L325R
transfected cells. Interestingly, when WT and
L325R channels were co-transfected in 1:1
ratio, the peak current density was reduced to
only 29.8±6.2% of the control condition
where 100% of WT channels were expressed.
This finding suggests that the L325R alleles
exerts a dominant negative effect on WT
channels.
n = 6-10 cells per each group, *p<0.05.
0
Current Density @ -20 mV (pA/pF)
1Department
1,2
Shinlapawittayatorn,
SCN5A-WT (n=12)
SCN5A-L567Q (n=9)
• Using a binomial distribution, our results indicate that sodium
channels can organize as a multi-channel complex with a
configuration suggesting an interaction of two a-subunits.
• The BrS SCN5A-L567Q mutation did not produce significant
biophysical changes compared to WT. Biophysical
properties remained unchanged when SCN5A-L567Q was
co-expressed with either SCN5A-H558R or SCN5A-WT.
• Interestingly, when SCN5A-L567Q was co-expressed with
either the SCN5A-H558R polymorphism or the SCN5A-WT
channels, current densities were greatly reduced.
CONCLUSIONS
• While most BrS mutations produce loss-of-function in
sodium channels leading to a reduction in current density,
the SCN5A-L567Q mutation had no noticeable effect on
sodium current density.
SCN5A-H558R + SCN5A-L567Q (n=14)
SCN5A-WT + SCN5A-L567Q (n=9)
WT : L325 cDNA ratios
A
+60 mV
B
• Whole-cell sodium currents were measured at room
temperature using the patch clamp technique in the
whole-cell configuration.
-120 mV
• However, the reduction in current density observed when
the mutation was co-expressed with WT channels could
produce the BrS phenotype.
*
• Our results suggest that some BrS mutations, although
displaying minimal biophysical alterations, may produce the
clinical phenotype through an α-α interaction thus leading to
a reduction in sodium current density.
*
• Furthermore, binomial analysis was used to
determine subunit composition in a channel complex.
C
• Theoretically, since the biophysical properties of the mutated
channels were also not significantly altered, a BrS
phenotype would not be expected.
-80 mV
• Our experiments using BrS mutations, now suggest the idea
of a dimerization of sodium channel α-subunits.
D
ACKNOWLEDGEMENT
3. Disease-causing sodium channel mutations
have been shown to have a dominant negative
effect on wild type channels.4
This work was supported by an AHA Pre-Doctoral Fellowship
from the Great Rivers Affiliate (KS) and an AHA Scientist
Development Grant (ID).
-30 mV
-65 mV
-120
mV
HYPOTHESIS
Therefore, we hypothesized that the dominantnegative effect seen in some Brugada Syndrome
mutations is due to interactions between sodium
channel a-subunits.
• The BrS mutation SCN5A-L325R produced, as previously
described4, a dominant-negative effect on WT suggesting a
possible interaction between sodium channels a-subunits.
-120 mV
-140
mV
Table 1: Prediction of the response in channels expressed in
HEK-293 cells transfected with a 1:1 mixture of WT (○) and
mutant (●) channels.
-30 mV
Interpulse Interval
Figure 4: A. Current densities of WT (0.3 μg), SCN5A-L567Q (0.3 μg), SCN5A-H558R (0.15 μg) + SCN5A-L567Q
(0.15 μg), and SCN5A-WT (0.15 μg) + SCN5A-L567Q (0.15 μg). Electrophysiological characterization of: (●)
SCN5A-L567Q, (▲) SCN5A-H558R + SCN5A-L567Q, and (▼) SCN5A-WT + SCN5A-L567Q in which currents
were compared to (■) SCN5A-WT. B. I/V relationship. C. Steady State Inactivation. D. Recovery from Inactivation.
*p<0.05
REFERENCES
1. Aldrich RW, Corey DP, Stevens CF. A reinterpretation of mammalian sodium channel
gating based on single channel recording. Nature. 1983;306:436-41.
2.Undrovinas AI, Fleidervish IA, Makielski JC. Inward sodium current at resting potentials
in single cardiac myocytes induced by the ischemic metabolite lysophosphatidylcholine.
Circ Res. 1992;71:1231-41.
3. Poelzing S, Forleo C, Samodell M, Dudash L, Sorrentino S, Anaclerio M, Troccoli R,
Iacoviello M, Romito R, Guida P, Chahine M, Pitzalis M, Deschenes I. SCN5A
polymorphism restores trafficking of a Brugada syndrome mutation on a separate gene.
Circulation. 2006;114:368-76.
4. Keller DI, Rougier JS, Kucera JP, Benammar N, Fressart V, Guicheney P, Madle A,
Fromer M, Schlapfer J, Abriel H. Brugada syndrome and fever: genetic and molecular
characterization of patients carrying SCN5A mutations. Cardiovasc Res. 2005;67:510-9.