Why the study?
The structural details and mechanisms by which auxiliary proteins CaM and FHFs limit pathogenic persistent currents in NaV1.5 were not clear.
Calmodulin and fibroblast growth factor homologous factors limit arrhythmogenic persistent sodium currents in cardiac NaV1.5 channels by stabilizing the interaction between the III-IV linker and the C-terminal domain, providing a molecular mechanism for LQT3 mutations.
Defines molecular basis for CaM/FHF suppression of persistent NaV current; leaves open targeted CTD interventions for arrhythmia syndromes.
Voltage gated sodium channel (VGSC) activation drives the action potential upstroke in cardiac myocytes, skeletal muscles, and neurons. After opening, VGSCs rapidly enter a non-conducting, inactivated state. Impaired inactivation causes persistent inward current and underlies cardiac arrhythmias. VGSC auxiliary proteins calmodulin (CaM) and fibroblast growth factor homologous factors (FHFs) bind to the channel's C-terminal domain (CTD) and limit pathogenic persistent currents. The structural details and mechanisms mediating these effects are not clear. Building on recently published cryo-EM structures, we show that CaM and FHF limit persistent currents in the cardiac NaV1.5 VGSC by stabilizing an interaction between the channel's CTD and III-IV linker region. Perturbation of this intramolecular interaction increases persistent current and shifts the voltage dependence of steady-state inactivation. Interestingly, the NaV1.5 residues involved in the interaction are sites mutated in the arrhythmogenic long QT3 syndrome (LQT3). Along with electrophysiological investigations of this interaction, we present structural models that suggest how CaM and FHF stabilize the interaction and thereby limit the persistent current. The critical residues at the interaction site are conserved among VGSC isoforms, and subtle substitutions provide an explanation for differences in inactivation among the isoforms.
No takes yet. Share an insight, caveat, or question.
Gade et al. (2019) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: