Small-conductance (K Ca 2.2) and intermediate-conductance (K Ca 3.1) Ca 2+ -activated K + channels are gated by a Ca 2+ -calmodulin dependent mechanism. NS309 potentiates the activity of both K Ca 2.2 and K Ca 3.1, while rimtuzalcap selectively activates K Ca 2.2. Rimtuzalcap has been used in clinical trials for treatment of spinocerebellar ataxia and essential tremor. We report cryo-electron microscopy structures of K Ca 2.2 channels bound with NS309 and rimtuzalcap, in addition to K Ca 3.1 channels with NS309. The different conformations of calmodulin and the cytoplasmic HC helices in the two channels underlie the subtype-selectivity of rimtuzalcap for K Ca 2.2. Calmodulin’s N-lobes in the K Ca 2.2 structure are far apart and undergo conformational changes to accommodate either NS309 or rimtuzalcap. Calmodulin’s N-lobes in the K Ca 3.1 structure are closer to each other and are constrained by the HC helices of K Ca 3.1, which allows binding of NS309 but not of the bulkier rimtuzalcap. These structures provide a framework for structure-based drug design targeting K Ca 2.2 channels.
Nam et al. (Sun,) studied this question.