Rizzo Francesca, Ambrosino Paolo, Guacci Anna, Chetta Massimiliano, Marchese Giovanna, Rocco Teresa, Soldovieri Maria Virginia, Manocchio Laura, Mosca Ilaria, Casara Gianluca, Vecchi Marilena, Taglialatela Maurizio, Coppola Giangennaro, Weisz Alessandro
Laboratory of Molecular Medicine and Genomics, University of Salerno, Baronissi, (SA), Italy.
Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
Mol Cell Neurosci. 2016 Apr;72:54-63. doi: 10.1016/j.mcn.2016.01.004. Epub 2016 Jan 16.
The KCNT1 gene encodes for subunits contributing to the Na(+)-activated K(+) current (KNa), expressed in many cell types. Mutations in KCNT1 have been found in patients affected with a wide spectrum of early-onset epilepsies, including Malignant Migrating Partial Seizures in Infancy (MMPSI), a severe early-onset epileptic encephalopathy characterized by pharmacoresistant focal seizures migrating from one brain region or hemisphere to another and neurodevelopment arrest or regression, resulting in profound disability. In the present study we report identification by whole exome sequencing (WES) of two de novo, heterozygous KCNT1 mutations (G288S and, not previously reported, M516V) in two unrelated MMPSI probands. Functional studies in a heterologous expression system revealed that channels formed by mutant KCNT1 subunits carried larger currents when compared to wild-type KCNT1 channels, both as homo- and heteromers with these last. Both mutations induced a marked leftward shift in homomeric channel activation gating. Interestingly, the KCNT1 blockers quinidine (3-1000μM) and bepridil (0.03-10μM) inhibited both wild-type and mutant KCNT1 currents in a concentration-dependent manner, with mutant channels showing higher sensitivity to blockade. This latter result suggests two genotype-tailored pharmacological strategies to specifically counteract the dysfunction of KCNT1 activating mutations in MMPSI patients.
KCNT1基因编码构成钠激活钾电流(KNa)的亚基,该电流在多种细胞类型中表达。在患有多种早发性癫痫的患者中发现了KCNT1基因突变,包括婴儿恶性迁移性部分性癫痫(MMPSI),这是一种严重的早发性癫痫性脑病,其特征是药物难治性局灶性癫痫从一个脑区或半球迁移到另一个脑区,以及神经发育停滞或倒退,导致严重残疾。在本研究中,我们报告了通过全外显子组测序(WES)在两名无关的MMPSI先证者中鉴定出两个新生的杂合KCNT1突变(G288S和此前未报道的M516V)。在异源表达系统中的功能研究表明,与野生型KCNT1通道相比,由突变KCNT1亚基形成的通道携带更大的电流,无论是作为同聚体还是与野生型KCNT1形成异聚体。两种突变均导致同聚体通道激活门控明显向左移位。有趣的是,KCNT1阻滞剂奎尼丁(3 - 1000μM)和苄普地尔(0.03 - 10μM)以浓度依赖性方式抑制野生型和突变型KCNT1电流,突变型通道对阻断表现出更高的敏感性。后一结果提示了两种针对基因型的药理学策略,以特异性对抗MMPSI患者中KCNT1激活突变的功能障碍。