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一种新的 KCNH2 突变导致长 QT 综合征 2 型中 hERG 钾通道功能丧失。

A novel mutation in KCNH2 yields loss-of-function of hERG potassium channel in long QT syndrome 2.

机构信息

Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.

Department of Physiology, Nanjing Medical University, 101 Longmian Ave, Nanjing, 211166, China.

出版信息

Pflugers Arch. 2021 Feb;473(2):219-229. doi: 10.1007/s00424-021-02518-1. Epub 2021 Jan 15.

DOI:10.1007/s00424-021-02518-1
PMID:33449212
Abstract

Mutations in hERG (human ether-à-go-go-related gene) potassium channel are closely associated with long QT syndromes. By direct Sanger sequencing, we identified a novel KCNH2 mutation W410R in the patient with long QT syndrome 2 (LQT2). However, the electrophysiological functions of this mutation remain unknown. In comparison to hERG channels, hERG channels have markedly decreased total and surface expressions. W410R mutation dramatically reduces hERG channel currents (I) and shifts its steady-state activation curve to depolarization. Moreover, hERG channels make dominant-negative effects on hERG channels. Significantly, we find hERG channel blocker E-4031 could partially rescue the function of hERG channels by increasing the membrane expression. By using in silico model, we reveal that hERG channels obviously elongate the repolarization of human ventricular myocyte action potentials. Collectively, W410R mutation decreases the currents of hERG channel, because of diminished membrane expression of mutant channels, that subsequently leads to elongated repolarization of cardiomyocyte, which might induce the pathogenesis of LQT2. Furthermore, E-4031 could partially rescue the decreased activity of hERG channels. Thus, our work identifies a novel loss-of-function mutation in KCNH2 gene, which might provide a rational basis for the management of LQT2.

摘要

hERG(人 ether-à-go-go 相关基因)钾通道突变与长 QT 综合征密切相关。通过直接 Sanger 测序,我们在长 QT 综合征 2 型(LQT2)患者中发现了一种新的 KCNH2 突变 W410R。然而,这种突变的电生理功能仍不清楚。与 hERG 通道相比,hERG 通道的总表达和表面表达明显减少。W410R 突变显著降低 hERG 通道电流(I),并将其稳态激活曲线向去极化方向移动。此外,hERG 通道对 hERG 通道具有显性负性作用。值得注意的是,我们发现 hERG 通道阻滞剂 E-4031 可通过增加膜表达部分挽救 hERG 通道的功能。通过使用计算机模型,我们发现 hERG 通道明显延长了人心室肌细胞动作电位的复极。总之,W410R 突变由于突变通道的膜表达减少而降低 hERG 通道的电流,这继而导致心肌细胞复极延长,可能引发 LQT2 的发病机制。此外,E-4031 可部分挽救 hERG 通道活性的降低。因此,我们的工作确定了 KCNH2 基因中的一种新的功能丧失突变,这可能为 LQT2 的治疗提供合理的依据。

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