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Brugada syndrome trafficking–defective Nav1.5 channels can trap cardiac Kir2.1/2.2 channels
Marta Pérez-Hernández, … , Ricardo Caballero, Eva Delpón
Marta Pérez-Hernández, … , Ricardo Caballero, Eva Delpón
Published September 20, 2018
Citation Information: JCI Insight. 2018;3(18):e96291. https://doi.org/10.1172/jci.insight.96291.
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Research Article Cardiology Cell biology

Brugada syndrome trafficking–defective Nav1.5 channels can trap cardiac Kir2.1/2.2 channels

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Abstract

Cardiac Nav1.5 and Kir2.1–2.3 channels generate Na (INa) and inward rectifier K (IK1) currents, respectively. The functional INa and IK1 interplay is reinforced by the positive and reciprocal modulation between Nav15 and Kir2.1/2.2 channels to strengthen the control of ventricular excitability. Loss-of-function mutations in the SCN5A gene, which encodes Nav1.5 channels, underlie several inherited arrhythmogenic syndromes, including Brugada syndrome (BrS). We investigated whether the presence of BrS-associated mutations alters IK1 density concomitantly with INa density. Results obtained using mouse models of SCN5A haploinsufficiency, and the overexpression of native and mutated Nav1.5 channels in expression systems — rat ventricular cardiomyocytes and human induced pluripotent stem cell–derived cardiomyocytes (hiPSC-CMs) — demonstrated that endoplasmic reticulum (ER) trafficking–defective Nav1.5 channels significantly decreased IK1, since they did not positively modulate Kir2.1/2.2 channels. Moreover, Golgi trafficking–defective Nav1.5 mutants produced a dominant negative effect on Kir2.1/2.2 and thus an additional IK1 reduction. Moreover, ER trafficking–defective Nav1.5 channels can be partially rescued by Kir2.1/2.2 channels through an unconventional secretory route that involves Golgi reassembly stacking proteins (GRASPs). Therefore, cardiac excitability would be greatly affected in subjects harboring Nav1.5 mutations with Golgi trafficking defects, since these mutants can concomitantly trap Kir2.1/2.2 channels, thus unexpectedly decreasing IK1 in addition to INa.

Authors

Marta Pérez-Hernández, Marcos Matamoros, Silvia Alfayate, Paloma Nieto-Marín, Raquel G. Utrilla, David Tinaquero, Raquel de Andrés, Teresa Crespo, Daniela Ponce-Balbuena, B. Cicero Willis, Eric N. Jiménez-Vazquez, Guadalupe Guerrero-Serna, Andre M. da Rocha, Katherine Campbell, Todd J. Herron, F. Javier Díez-Guerra, Juan Tamargo, José Jalife, Ricardo Caballero, Eva Delpón

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Figure 1

Heterozygous deletion of the SCN5A gene in mice concomitantly decreased the inward rectifier current, and Kir2.1 overexpression rescued the sodium current.

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Heterozygous deletion of the SCN5A gene in mice concomitantly decreased ...
(A) Inward rectifier current (IK1) traces recorded in ventricular cardiomyocytes (CMs) from WT, Kcnj2OE+/–, and Kcnj2OE+/–-Scn5a+/– mice. (B) Mean current density-voltage curves for IK1 recorded in ventricular CMs from 3 WT (black circles), 4 Scn5a+/– (white circles), 3 Kcnj2OE+/– (black squares), and 3 Kcnj2OE+/–-Scn5a+/– (white squares) mice. (C) Sodium current (INa) traces recorded in ventricular CMs from WT, Scn5a+/-, and Kcnj2OE+/–-Scn5a+/– mice. (D) Mean current density-voltage curves for INa recorded in ventricular CMs from 3 WT (black circles), 3 Scn5a+/–, and 3 Kcnj2OE+/–-Scn5a+/– mice. Each point represents the mean ± SEM of n cells. One-way ANOVA followed by Newman-Keuls and multilevel mixed-effects model were used for comparisons. *P < 0.05 vs. WT; #P < 0.05 vs. Kcnj2OE+/–-Scn5a+/–.

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