Key result
NCAM-1 deficiency disrupts ventricular conduction system patterning and prolongs QRS duration in mice.
NCAM-1 and its post-translational polysialylation are critically required for the normal development and electrophysiological integrity of the ventricular conduction system.
Hypothesis-generating for NCAM-1 in human conduction disease; extends IgSF-CAM roles in VCS but requires clinical validation.
The most distal portion of the ventricular conduction system (VCS) contains cardiac Purkinje cells (PCs), which are essential for synchronous activation of the ventricular myocardium. Contactin-2 (CNTN2), a member of the immunoglobulin superfamily of cell adhesion molecules (IgSF-CAMs), was previously identified as a marker of the VCS. Through differential transcriptional profiling, we discovered two additional highly enriched IgSF-CAMs in the VCS: NCAM-1 and ALCAM. Immunofluorescence staining showed dynamic expression patterns for each IgSF-CAM during embryonic and early postnatal stages, but ultimately all three proteins became highly enriched in mature PCs. Mice deficient in NCAM-1, but not CNTN2 or ALCAM, exhibited defects in PC gene expression and VCS patterning, as well as cardiac conduction disease. Moreover, using ST8sia2 and ST8sia4 knockout mice, we show that inhibition of post-translational modification of NCAM-1 by polysialic acid leads to disrupted trafficking of sarcolemmal intercalated disc proteins to junctional membranes and abnormal expansion of the extracellular space between apposing PCs. Taken together, our data provide insights into the complex developmental biology of the ventricular conduction system.
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Delgado et al. (2021) studied Ventricular conduction system development. Ncam-1 knockout or polysialic acid deficiency vs. Wild-type littermate controls was evaluated on Ventricular conduction system patterning and QRS duration. NCAM-1 deficiency and inhibition of its polysialylation in mice led to disrupted ventricular conduction system patterning, mislocalized intercalated disc proteins, and prolonged QRS duration.
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