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Ramsey K, Britt M, Maramba J, Ushijima B, Moller E, Anishkin A, Häse C, Sukharev S. The dynamic hypoosmotic response of Vibrio cholerae relies on the mechanosensitive channel MscS. iScience 2024; 27:110001. [PMID: 38868203 PMCID: PMC11167432 DOI: 10.1016/j.isci.2024.110001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/04/2024] [Accepted: 05/14/2024] [Indexed: 06/14/2024] Open
Abstract
Vibrio cholerae adapts to osmotic down-shifts by releasing metabolites through two mechanosensitive (MS) channels, low-threshold MscS and high-threshold MscL. To investigate each channel's contribution to the osmotic response, we generated ΔmscS, ΔmscL, and double ΔmscL ΔmscS mutants in V. cholerae O395. We characterized their tension-dependent activation in patch-clamp, and the millisecond-scale osmolyte release kinetics using a stopped-flow light scattering technique. We additionally generated numerical models describing osmolyte and water fluxes. We illustrate the sequence of events and define the parameters that characterize discrete phases of the osmotic response. Survival is correlated to the extent of cell swelling, the rate of osmolyte release, and the completeness of post-shock membrane resealing. Not only do the two channels interact functionally, but there is also an up-regulation of MscS in the ΔmscL strain, suggesting transcriptional crosstalk. The data reveal the role of MscS in the termination of the osmotic permeability response in V. cholerae.
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Affiliation(s)
- Kristen Ramsey
- Department of Biology, University of Maryland, College Park, MD, USA
- Department of Microbial Pathogenesis, Yale School of Medicine, New Haven, CT, USA
| | - Madolyn Britt
- Department of Biology, University of Maryland, College Park, MD, USA
- Biophysics Graduate Program, University of Maryland, College Park, MD, USA
| | - Joseph Maramba
- Department of Biology, University of Maryland, College Park, MD, USA
| | - Blake Ushijima
- Biology and Marine Biology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Elissa Moller
- Department of Biology, University of Maryland, College Park, MD, USA
- Biophysics Graduate Program, University of Maryland, College Park, MD, USA
| | - Andriy Anishkin
- Department of Biology, University of Maryland, College Park, MD, USA
| | - Claudia Häse
- Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - Sergei Sukharev
- Department of Biology, University of Maryland, College Park, MD, USA
- Biophysics Graduate Program, University of Maryland, College Park, MD, USA
- Institute for Physical Science and Technology, University of Maryland, College Park, MD, USA
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Moller E, Britt M, Zhou F, Yang H, Anshkin A, Ernst R, Sukharev S, Matthies D. Polymer-extracted structure of the mechanosensitive channel MscS reveals the role of protein-lipid interactions in the gating cycle. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.22.576751. [PMID: 38328078 PMCID: PMC10849555 DOI: 10.1101/2024.01.22.576751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Membrane protein structure determination is not only technically challenging but is further complicated by the removal or displacement of lipids, which can result in non-native conformations or a strong preference for certain states at the exclusion of others. This is especially applicable to mechanosensitive channels (MSC's) that evolved to gate in response to subtle changes in membrane tension transmitted through the lipid bilayer. E. coli MscS, a model bacterial system, is an ancestral member of the large family of MSCs found across all phyla of walled organisms. As a tension sensor, MscS is very sensitive and highly adaptive; it readily opens under super-threshold tension and closes under no tension, but under lower tensions, it slowly inactivates and can only recover when tension is released. However, existing cryo-EM structures do not explain the entire functional gating cycle of open, closed, and inactivated states. A central question in the field has been the assignment of the frequently observed non-conductive conformation to either a closed or inactivated state. Here, we present a 3 Å MscS structure in native nanodiscs obtained with Glyco-DIBMA polymer extraction, eliminating the lipid removal step that is common to all previous structures. Besides the protein in the non-conductive conformation, we observe well-resolved densities of four endogenous phospholipid molecules intercalating between the lipid-facing and pore-lining helices in preferred orientations. Mutations of positively charged residues coordinating these lipids inhibit MscS inactivation, whereas removal of a negative charge near the lipid-filled crevice increases inactivation. The functional data allows us to assign this class of structures to the inactivated state. This structure reveals preserved lipids in their native locations, and the functional effects of their destabilization illustrate a novel inactivation mechanism based on an uncoupling of the peripheral tension-sensing helices from the gate.
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Britt M, Moller E, Maramba J, Anishkin A, Sukharev S. MscS inactivation and recovery are slow voltage-dependent processes sensitive to interactions with lipids. Biophys J 2024; 123:195-209. [PMID: 38098232 PMCID: PMC10808034 DOI: 10.1016/j.bpj.2023.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/28/2023] [Accepted: 12/07/2023] [Indexed: 12/26/2023] Open
Abstract
Mechanosensitive channel MscS, the major bacterial osmolyte release valve, shows a characteristic adaptive behavior. With a sharp onset of activating tension the channel population readily opens, but under prolonged action of moderate tension it inactivates. The inactivated state is non-conductive and tension insensitive, which suggests that the gate becomes uncoupled from the lipid-facing domains. Because the distinct opening and inactivation transitions are both driven from the closed state by tension transmitted through the lipid bilayer, here we explore how mutations of two conserved positively charged lipid anchors, R46 and R74, affect 1) the rates of opening and inactivation and 2) the voltage dependences of these transitions. Previously estimated kinetic rates for opening-closing transitions in wild-type MscS at low voltages were 3-6 orders of magnitude higher than the rates for inactivation and recovery. Here we show that MscS activation exhibits a shallow nearly symmetric dependence on voltage, whereas inactivation is substantially augmented and recovery is slowed down by depolarization. Conversely, hyperpolarization impedes inactivation and speeds up recovery. Mutations of R46 and R74 anchoring the lipid-facing helices to the inner interface to an aromatic residue (W) do not substantially change the activation energy and closing rates, but instead change the kinetics of both inactivation and recovery and essentially eliminate their voltage dependence. Uncharged polar substitutions (S or Q) for these anchors produce functional channels but increase the inactivation and reduce the recovery rates. The data clearly delineate the activation-closing and the inactivation-recovery pathways and strongly suggest that only the latter involves extensive rearrangements of the protein-lipid boundary associated with the uncoupling of the lipid-facing helices from the gate. The discovery that hyperpolarization robustly assists MscS recovery suggests that membrane potential is one of the factors that regulates osmolyte release valves by putting them either on "ready" or "standby" based on the cell's metabolic state.
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Affiliation(s)
- Madolyn Britt
- Department of Biology, University of Maryland, College Park, Maryland; Maryland Biophysics Program, University of Maryland, College Park, Maryland
| | - Elissa Moller
- Department of Biology, University of Maryland, College Park, Maryland; Maryland Biophysics Program, University of Maryland, College Park, Maryland
| | - Joseph Maramba
- Department of Biology, University of Maryland, College Park, Maryland
| | - Andriy Anishkin
- Department of Biology, University of Maryland, College Park, Maryland
| | - Sergei Sukharev
- Department of Biology, University of Maryland, College Park, Maryland; Instiute for Physical Science and Technology, University of Maryland, College Park, Maryland; Maryland Biophysics Program, University of Maryland, College Park, Maryland.
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Çetiner U, Raz O, Britt M, Sukharev S. Dissipation during the Gating Cycle of the Bacterial Mechanosensitive Ion Channel Approaches the Landauer Limit. ENTROPY (BASEL, SWITZERLAND) 2023; 25:e25050779. [PMID: 37238534 DOI: 10.3390/e25050779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023]
Abstract
The Landauer principle sets a thermodynamic bound of kBT ln 2 on the energetic cost of erasing each bit of information. It holds for any memory device, regardless of its physical implementation. It was recently shown that carefully built artificial devices can attain this bound. In contrast, biological computation-like processes, e.g., DNA replication, transcription and translation use an order of magnitude more than their Landauer minimum. Here, we show that reaching the Landauer bound is nevertheless possible with biological devices. This is achieved using a mechanosensitive channel of small conductance (MscS) from E. coli as a memory bit. MscS is a fast-acting osmolyte release valve adjusting turgor pressure inside the cell. Our patch-clamp experiments and data analysis demonstrate that under a slow switching regime, the heat dissipation in the course of tension-driven gating transitions in MscS closely approaches its Landauer limit. We discuss the biological implications of this physical trait.
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Affiliation(s)
- Uğur Çetiner
- Maryland Biophysics Program, Institute for Physical Science and Technology, Department of Biology, University of Maryland, College Park, MD 20742, USA
| | - Oren Raz
- Department of Physics of Complex Systems, Faculty of Physics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Madolyn Britt
- Maryland Biophysics Program, Institute for Physical Science and Technology, Department of Biology, University of Maryland, College Park, MD 20742, USA
| | - Sergei Sukharev
- Maryland Biophysics Program, Institute for Physical Science and Technology, Department of Biology, University of Maryland, College Park, MD 20742, USA
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Britt M, Moller E, Maramba J, Anishkin A, Sukharev S. MscS inactivation and recovery are slow voltage-dependent processes sensitive to interactions with lipids. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.08.539870. [PMID: 37215046 PMCID: PMC10197514 DOI: 10.1101/2023.05.08.539870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Mechanosensitive channel MscS, the major bacterial osmolyte release valve, shows a characteristic adaptive behavior. With a sharp onset of activating tension, the channel population readily opens, but under prolonged action of moderate near-threshold tension, it inactivates. The inactivated state is non-conductive and tension-insensitive, which suggests that the gate gets uncoupled from the lipid-facing domains. The kinetic rates for tension-driven opening-closing transitions are 4-6 orders of magnitude higher than the rates for inactivation and recovery. Here we show that inactivation is augmented and recovery is slowed down by depolarization. Hyperpolarization, conversely, impedes inactivation and speeds up recovery. We then address the question of whether protein-lipid interactions may set the rates and influence voltage dependence of inactivation and recovery. Mutations of conserved arginines 46 and 74 anchoring the lipid-facing helices to the inner membrane leaflet to tryptophans do not change the closing transitions, but instead change the kinetics of both inactivation and recovery and essentially eliminate their voltage-dependence. Uncharged polar substitutions (S or Q) for these anchors produce functional channels but increase the inactivation and reduce the recovery rates. The data suggest that it is not the activation and closing transitions, but rather the inactivation and recovery pathways that involve substantial rearrangements of the protein-lipid boundary associated with the separation of the lipid-facing helices from the gate. The discovery that hyperpolarization robustly assists MscS recovery indicates that membrane potential can regulate osmolyte release valves by putting them either on the 'ready' or 'standby' mode depending on the cell's metabolic state.
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Moller E, Britt M, Schams A, Cetuk H, Anishkin A, Sukharev S. Mechanosensitive channel MscS is critical for termination of the bacterial hypoosmotic permeability response. J Gen Physiol 2023; 155:e202213168. [PMID: 37022337 PMCID: PMC10082366 DOI: 10.1085/jgp.202213168] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 02/06/2023] [Accepted: 03/20/2023] [Indexed: 04/07/2023] Open
Abstract
Free-living microorganisms are subjected to drastic changes in osmolarity. To avoid lysis under sudden osmotic down-shock, bacteria quickly expel small metabolites through the tension-activated channels MscL, MscS, and MscK. We examined five chromosomal knockout strains, ∆mscL, ∆mscS, a double knockout ∆mscS ∆mscK, and a triple knockout ∆mscL ∆mscS ∆mscK, in comparison to the wild-type parental strain. Stopped-flow experiments confirmed that both MscS and MscL mediate fast osmolyte release and curb cell swelling, but osmotic viability assays indicated that they are not equivalent. MscS alone was capable of rescuing the cell population, but in some strains, MscL did not rescue and additionally became toxic in the absence of both MscS and MscK. Furthermore, MscS was upregulated in the ∆mscL strain, suggesting either a crosstalk between the two genes/proteins or the influence of cell mechanics on mscS expression. The data shows that for the proper termination of the permeability response, the high-threshold (MscL) and the low-threshold (MscS/MscK) channels must act sequentially. In the absence of low-threshold channels, at the end of the release phase, MscL should stabilize membrane tension at around 10 mN/m. Patch-clamp protocols emulating the tension changes during the release phase indicated that the non-inactivating MscL, residing at its own tension threshold, flickers and produces a protracted leakage. The MscS/MscK population, when present, stays open at this stage to reduce tension below the MscL threshold and silence the large channel. When MscS reaches its own threshold, it inactivates and thus ensures proper termination of the hypoosmotic permeability response. This functional interplay between the high- and low-threshold channels is further supported by the compromised osmotic survival of bacteria expressing non-inactivating MscS mutants.
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Affiliation(s)
- Elissa Moller
- Department of Biology, University of Maryland, College Park, College Park, MD, USA
- Biophysics Graduate Program, University of Maryland, College Park, College Park, MD, USA
| | - Madolyn Britt
- Department of Biology, University of Maryland, College Park, College Park, MD, USA
- Biophysics Graduate Program, University of Maryland, College Park, College Park, MD, USA
| | - Anthony Schams
- Department of Biology, University of Maryland, College Park, College Park, MD, USA
| | - Hannah Cetuk
- Department of Biology, University of Maryland, College Park, College Park, MD, USA
| | - Andriy Anishkin
- Department of Biology, University of Maryland, College Park, College Park, MD, USA
| | - Sergei Sukharev
- Department of Biology, University of Maryland, College Park, College Park, MD, USA
- Institute for Physical Science and Technology, University of Maryland, College Park, College Park, MD, USA
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Moller E, Britt M, Schams A, Cetuk H, Anishkin A, Sukharev S. Mechanosensitive channel MscS is critical for termination of the bacterial hypoosmotic permeability response. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.27.530336. [PMID: 36909569 PMCID: PMC10002685 DOI: 10.1101/2023.02.27.530336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Free-living microorganisms are subjected to drastic changes in osmolarity. To avoid lysis under sudden osmotic down-shock, bacteria quickly expel small metabolites through the tension-activated channels MscL, MscS, and MscK. We examined five chromosomal knockout strains, Δ mscL , Δ mscS , a double knockout Δ mscS Δ mscK , and a triple knockout Δ mscL Δ mscS Δ mscK in comparison to the wild-type parental strain. Stopped-flow experiments confirmed that both MscS and MscL mediate fast osmolyte release and curb cell swelling, but osmotic viability assays indicated that they are not equivalent. MscS alone was capable of rescuing the cell population, but in some strains MscL did not rescue and additionally became toxic in the absence of both MscS and MscK. Furthermore, MscS was upregulated in the Δ mscL strain, suggesting either a cross-talk between the two genes/proteins or the influence of cell mechanics on mscS expression. The data shows that for the proper termination of the permeability response, the high-threshold (MscL) and the low-threshold (MscS/MscK) channels must act sequentially. In the absence of low-threshold channels, at the end of the release phase, MscL should stabilize membrane tension at around 10 mN/m. Patch-clamp protocols emulating the tension changes during the release phase indicated that the non-inactivating MscL, residing at its own tension threshold, flickers and produces a protracted leakage. The MscS/MscK population, when present, stays open at this stage to reduce tension below the MscL threshold and silence the large channel. When MscS reaches its own threshold, it inactivates and thus ensures proper termination of the hypoosmotic permeability response. This functional interplay between the high- and low-threshold channels is further supported by the compromised osmotic survival of bacteria expressing non-inactivating MscS mutants. Summary for the table of contents The kinetics of hypotonic osmolyte release from E. coli is analyzed in conjunction with bacterial survival. It is shown that MscL, the high-threshold 'emergency release valve', rescues bacteria from down-shocks only in the presence of MscS, MscK or other low-threshold channels that are necessary to pacify MscL at the end of the release phase.
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Cyclodextrins increase membrane tension and are universal activators of mechanosensitive channels. Proc Natl Acad Sci U S A 2021; 118:2104820118. [PMID: 34475213 DOI: 10.1073/pnas.2104820118] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 07/29/2021] [Indexed: 11/18/2022] Open
Abstract
The bacterial mechanosensitive channel of small conductance (MscS) has been extensively studied to understand how mechanical forces are converted into the conformational changes that underlie mechanosensitive (MS) channel gating. We showed that lipid removal by β-cyclodextrin can mimic membrane tension. Here, we show that all cyclodextrins (CDs) can activate reconstituted Escherichia coli MscS, that MscS activation by CDs depends on CD-mediated lipid removal, and that the CD amount required to gate MscS scales with the channel's sensitivity to membrane tension. Importantly, cholesterol-loaded CDs do not activate MscS. CD-mediated lipid removal ultimately causes MscS desensitization, which we show is affected by the lipid environment. While many MS channels respond to membrane forces, generalized by the "force-from-lipids" principle, their different molecular architectures suggest that they use unique ways to convert mechanical forces into conformational changes. To test whether CDs can also be used to activate other MS channels, we chose to investigate the mechanosensitive channel of large conductance (MscL) and demonstrate that CDs can also activate this structurally unrelated channel. Since CDs can open the least tension-sensitive MS channel, MscL, they should be able to open any MS channel that responds to membrane tension. Thus, CDs emerge as a universal tool for the structural and functional characterization of unrelated MS channels.
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Çetiner U, Raz O, Sukharev S, Jarzynski C. Recovery of Equilibrium Free Energy from Nonequilibrium Thermodynamics with Mechanosensitive Ion Channels in E. coli. PHYSICAL REVIEW LETTERS 2020; 124:228101. [PMID: 32567892 DOI: 10.1103/physrevlett.124.228101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/21/2020] [Indexed: 06/11/2023]
Abstract
In situ measurements of the free energy difference between the open and closed states of ion channels are challenging due to hysteresis effects and inactivation. Exploiting recent developments in statistical physics, we present a general formalism to extract the free energy difference ΔF between the closed and open states of mechanosensitive ion channels from nonequilibrium work distributions associated with the opening and closing of the channels (gating) in response to ramp stimulation protocols recorded in native patches. We show that the work distributions obtained from the gating of MscS channels in E. coli membrane satisfy the strong symmetry relation predicted by the Crooks fluctuation theorem. Our approach enables the determination of ΔF using patch-clamp experiments, which are often inherently restricted to the nonequilibrium regime.
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Affiliation(s)
- Uğur Çetiner
- Institute for Physical Science and Technology, University of Maryland, College Park, Maryland 20742, USA
- Maryland Biophysics Program, University of Maryland, College Park, Maryland 20742, USA
- Department of Biology, University of Maryland, College Park, Maryland 20742, USA
| | - Oren Raz
- Department of Physics of Complex Systems, Faculty of Physics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Sergei Sukharev
- Institute for Physical Science and Technology, University of Maryland, College Park, Maryland 20742, USA
- Maryland Biophysics Program, University of Maryland, College Park, Maryland 20742, USA
- Department of Biology, University of Maryland, College Park, Maryland 20742, USA
| | - Christopher Jarzynski
- Institute for Physical Science and Technology, University of Maryland, College Park, Maryland 20742, USA
- Maryland Biophysics Program, University of Maryland, College Park, Maryland 20742, USA
- Department of Chemistry and Biochemistry, University of Maryland, College Park, Maryland 20742, USA
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
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Xue F, Cox CD, Bavi N, Rohde PR, Nakayama Y, Martinac B. Membrane stiffness is one of the key determinants of E. coli MscS channel mechanosensitivity. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2020; 1862:183203. [PMID: 31981589 DOI: 10.1016/j.bbamem.2020.183203] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/11/2020] [Accepted: 01/19/2020] [Indexed: 02/06/2023]
Abstract
Mechanosensitive (MS) channels have an intimate relationship with membrane lipids that underlie their mechanosensitivity. Membrane lipids may influence channel activity by directly interacting with MS channels or by influencing the global properties of the membrane such as elastic area expansion modulus or bending rigidity. Previous work has implicated membrane stiffness as a potential determinant of the mechanosensitivity of E. coli (Ec)MscS. Here we systematically tested this hypothesis using patch fluorometry of azolectin liposomes doped with lipids of increasing elastic area expansion modulus. Increasing dioleoylphosphatidylethanolamine (DOPE) content of azolectin liposomes made it more difficult to activate EcMscS by membrane tension (i.e. increased gating threshold). This effect was exacerbated by stiffer forms of phosphatidylethanolamine such as the branched chain lipid diphytanoylphosphoethanolamine (DPhPE) or the fully saturated lipid distearoyl-sn-glycero-3-phosphoethanolamine (DSPE). Furthermore, a comparison of the branched chain lipid diphytanoylphosphocholine (DPhPC) to the stiffer DPhPE indicated again that it was harder to activate EcMscS in the presence of the stiffer DPhPE. We show that these effects are not due to changes in membrane bending rigidity as the membrane tension threshold of EcMscS in membranes doped with PC18:1 and PC18:3 remained the same, despite a two-fold difference in their bending rigidity. We also show that after prolonged pressure application sudden removal of force in softer membranes caused a rebound reactivation of EcMscS and we discuss the relevance of this phenomenon to bacterial osmoregulation. Collectively, our data suggests that membrane stiffness (elastic area expansion modulus) is one of the key determinants of the mechanosensitivity of EcMscS.
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Affiliation(s)
- Feng Xue
- Victor Chang Cardiac Research Institute, Lowy Packer Building, 405 Liverpool St., Darlinghurst, NSW 2010, Australia
| | - Charles D Cox
- Victor Chang Cardiac Research Institute, Lowy Packer Building, 405 Liverpool St., Darlinghurst, NSW 2010, Australia; St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW 2010, Australia
| | - Navid Bavi
- Institute for Biophysical Dynamics, University of Chicago, Chicago, USA
| | - Paul R Rohde
- Victor Chang Cardiac Research Institute, Lowy Packer Building, 405 Liverpool St., Darlinghurst, NSW 2010, Australia
| | - Yoshitaka Nakayama
- Victor Chang Cardiac Research Institute, Lowy Packer Building, 405 Liverpool St., Darlinghurst, NSW 2010, Australia; St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW 2010, Australia.
| | - Boris Martinac
- Victor Chang Cardiac Research Institute, Lowy Packer Building, 405 Liverpool St., Darlinghurst, NSW 2010, Australia; St Vincent's Clinical School, University of New South Wales, Darlinghurst, NSW 2010, Australia.
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