Key result
LQT2 S4 missense mutations disrupt KCNH2 trafficking by destabilizing the selectivity filter.
Why the study?
Most KV 11.1 missense mutations with loss-of-function phenotypes in LQT2 result from impaired trafficking from the endoplasmic reticulum to the plasma membrane, but the molecular basis of these defects was not defined.
Molecular dynamics simulations reveal that LQT2-associated mutations in the Kv11.1 channel impair trafficking by allosterically disrupting the structural integrity of the selectivity filter.
Does not support changes in LQT2 management; leaves open whether allosteric selectivity filter modulation offers variant-specific therapeutic targets.
1 Abstract Long QT syndrome Type 2 (LQT2) is a genetic disorder caused by missense mutations in the KCNH2 gene that encodes the potassium channel K V 11.1. Previous studies have shown that most K V 11.1 missense mutations with loss-of-function phenotypes result from impaired trafficking from the endoplasmic reticulum to the plasma membrane. To investigate the molecular basis of these defects, we used molecular dynamics simulations to analyze two sets of disease-associated missense mutations: those that suppress and those that maintain normal channel trafficking. We focused initially on the conformational and dynamics differences between wild-type and several mutants of K V 11.1 via molecular dynamics simulations when two K + were placed in the selectivity filter (SF). Our study reveals that missense mutations in the S4 helix allosterically disrupt the selectivity filter, a critical determinant for proper channel trafficking. Trafficking-competent variants largely retained a wild-type selectivity filter structure, whereas trafficking-deficient mutants exhibited pronounced structural perturbations in this region. These findings suggest that certain LQT2-associated missense mutations in KCNH2 impair channel trafficking by compromising the structural integrity of the selectivity filter. We additionally found that second-site variants Y652C in the drug binding vestibule can correct structural defects associated with some mistrafficking variants.
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Kongmeneck et al. (2026) studied Long QT syndrome Type 2 (LQT2). LQT2-associated missense mutations in the S4 helix (e.g., R534C, R534L) vs. Wild-type Kv11.1 channel and trafficking-competent variants was evaluated on Structural and dynamic conformational changes in the selectivity filter. Trafficking-deficient LQT2-associated KCNH2 missense mutations in the S4 helix impair channel trafficking by allosterically compromising the structural integrity of the selectivity filter and increasing its abnormal coupling with the C-linker.
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