Why the study?
KCNQ1 loss-of-function mutations cause long QT syndrome predisposing to lethal ventricular arrhythmia, but how small-molecule activators ML277 and R-L3 interact with KCNQ1 and why auxiliary subunit KCNE1 confers insensitivity remained to be elucidated.
ML277 and R-L3 activate KCNQ1 channels through distinct mechanisms, offering mechanistic insights for developing targeted therapies for long QT syndrome.
May limit ML277/R-L3 utility in native IKs; leaves open need for KCNE1-inclusive models in LQT1 activator development.
ML277 and R-L3 are two small-molecule activators of KCNQ1, the pore-forming subunit of the slowly activating potassium channel I Ks . KCNQ1 loss-of-function mutations prolong cardiac action potential duration and are associated with long QT syndrome, which predispose patients to lethal ventricular arrhythmia. ML277 and R-L3 enhance KCNQ1 current amplitude and slow deactivation. However, the presence of KCNE1, an auxiliary subunit of I Ks channels, renders the channel insensitive to both activators. We found that ML277 effects are dependent on several residues in the KCNQ1 pore domain. Some of these residues are also necessary for R-L3 effects. These residues form a putative hydrophobic pocket located between two adjacent KCNQ1 subunits, where KCNE1 subunits are thought to dwell, thus providing an explanation for how KCNE1 renders the I Ks channel insensitive to these activators. Our experiments showed that the effect of R-L3 on voltage sensor movement during channel deactivation was much more prominent than that of ML277. Simulations using a KCNQ1 kinetic model showed that the effects of ML277 and R-L3 could be reproduced through two different effects on channel gating: ML277 enhances KCNQ1 channel function through a pore-dependent and voltage sensor–independent mechanism, while R-L3 affects both channel pore and voltage sensor.
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Chen et al. (2022) studied this question.
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