1
|
Zaytseva AK, Kulichik OE, Kostareva AA, Zhorov BS. Biophysical mechanisms of myocardium sodium channelopathies. Pflugers Arch 2024; 476:735-753. [PMID: 38424322 DOI: 10.1007/s00424-024-02930-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
Genetic variants of gene SCN5A encoding the alpha-subunit of cardiac voltage-gated sodium channel Nav1.5 are associated with various diseases, including long QT syndrome (LQT3), Brugada syndrome (BrS1), and progressive cardiac conduction disease (PCCD). In the last decades, the great progress in understanding molecular and biophysical mechanisms of these diseases has been achieved. The LQT3 syndrome is associated with gain-of-function of sodium channels Nav1.5 due to impaired inactivation, enhanced activation, accelerated recovery from inactivation or the late current appearance. In contrast, BrS1 and PCCD are associated with the Nav1.5 loss-of-function, which in electrophysiological experiments can be manifested as reduced current density, enhanced fast or slow inactivation, impaired activation, or decelerated recovery from inactivation. Genetic variants associated with congenital arrhythmias can also disturb interactions of the Nav1.5 channel with different proteins or drugs and cause unexpected reactions to drug administration. Furthermore, mutations can affect post-translational modifications of the channels and their sensitivity to pH and temperature. Here we briefly review the current knowledge on biophysical mechanisms of LQT3, BrS1 and PCCD. We focus on limitations of studies that use heterologous expression systems and induced pluripotent stem cells (iPSC) derived cardiac myocytes and summarize our understanding of genotype-phenotype relations of SCN5A mutations.
Collapse
Affiliation(s)
- Anastasia K Zaytseva
- Almazov National Medical Research Centre, St. Petersburg, Russia.
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, St. Petersburg, Russia.
| | - Olga E Kulichik
- Almazov National Medical Research Centre, St. Petersburg, Russia
| | | | - Boris S Zhorov
- Almazov National Medical Research Centre, St. Petersburg, Russia
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, St. Petersburg, Russia
- McMaster University, Hamilton, Canada
| |
Collapse
|
2
|
Pannone L, Bisignani A, Osei R, Gauthey A, Sorgente A, Monaco C, Della Rocca DG, Del Monte A, Strazdas A, Mojica J, Al Housari M, Miraglia V, Mouram S, Vetta G, Paparella G, Ramak R, Overeinder I, Bala G, Almorad A, Ströker E, Pappaert G, Sieira J, de Ravel T, La Meir M, Sarkozy A, Brugada P, Chierchia GB, Van Dooren S, de Asmundis C. Genetic Testing in Brugada Syndrome: A 30-Year Experience. Circ Arrhythm Electrophysiol 2024; 17:e012374. [PMID: 38426305 DOI: 10.1161/circep.123.012374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND A pathogenic/likely pathogenic variant can be found in 20% to 25% of patients with Brugada syndrome (BrS) and a pathogenic/likely pathogenic variant in SCN5A is associated with a worse prognosis. The aim of this study is to define the diagnostic yield of a large gene panel with American College of Medical Genetics and Genomics variant classification and to assess prognosis of SCN5A and non-SCN5A variants. METHODS All patients with BrS, were prospectively enrolled in the Universitair Ziekenhuis Brussel registry between 1992 and 2022. Inclusion criteria for the study were (1) BrS diagnosis; (2) genetic analysis performed with a large gene panel; (3) classification of variants following American College of Medical Genetics and Genomics guidelines. Patients with a pathogenic/likely pathogenic variant in SCN5A were defined as SCN5A+. Patients with a reported variant in a non-SCN5A gene or with no reported variants were defined as patients with SCN5A-. All variants were classified as missense or predicted loss of function. RESULTS A total of 500 BrS patients were analyzed. A total of 104 patients (20.8%) were SCN5A+ and 396 patients (79.2%) were SCN5A-. A non-SCN5A gene variant was found in 75 patients (15.0%), of whom, 58 patients (77.3%) had a missense variant and 17 patients (22.7%) had a predicted loss of function variant. At a follow-up of 84.0 months, 48 patients (9.6%) experienced a ventricular arrhythmia (VA). Patients without any variant had higher VA-free survival, compared with carriers of a predicted loss of function variant in SCN5A+ or non-SCN5A genes. There was no difference in VA-free survival between patients without any variant and missense variant carriers in SCN5A+ or non-SCN5A genes. At Cox analysis, SCN5A+ or non-SCN5A predicted loss of function variant was an independent predictor of VA. CONCLUSIONS In a large BrS cohort, the yield for SCN5A+ is 20.8%. A predicted loss of function variant carrier is an independent predictor of VA.
Collapse
Affiliation(s)
- Luigi Pannone
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Antonio Bisignani
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Randy Osei
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics (R.O., T.d.R., S.V.D.)
| | - Anaïs Gauthey
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Antonio Sorgente
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Cinzia Monaco
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Domenico Giovanni Della Rocca
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Alvise Del Monte
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Antanas Strazdas
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Joerelle Mojica
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Maysam Al Housari
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Vincenzo Miraglia
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Sahar Mouram
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Giampaolo Vetta
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Gaetano Paparella
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Robbert Ramak
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Ingrid Overeinder
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Gezim Bala
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Alexandre Almorad
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Erwin Ströker
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Gudrun Pappaert
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Juan Sieira
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Thomy de Ravel
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics (R.O., T.d.R., S.V.D.)
| | - Mark La Meir
- Cardiac Surgery Department, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel (M.L.M.)
| | - Andrea Sarkozy
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Pedro Brugada
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Gian Battista Chierchia
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| | - Sonia Van Dooren
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics (R.O., T.d.R., S.V.D.)
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, Research Group Reproduction and Genetics, Brussels Interuniversity Genomics High Throughput Core (BRIGHTcore), Belgium (S.V.D.)
| | - Carlo de Asmundis
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology & Pacing, Universitair Ziekenhuis Brussel - Vrije Universiteit Brussel, European Reference Networks Guard-Heart (L.P., A.B., A.G., A. Sorgente, C.M., D.G.D.R., A.D.M., A.S., J.M., M.A.H., V.M., S.M., G.V., G. Paparella, R.R., I.O., G.B., A.A., E.S., G. Pappaert, J.S., A. Sarkozy, P.B., G.B.C., C.d.A.)
| |
Collapse
|
3
|
Shi J, Pan X, Wang Z, Yi M, Xie S, Zhang X, Tao D, Yang Y, Liu Y. SCN5A-L256del and L1621F exhibit loss-of-function properties related to autosomal recessive congenital cardiac disorders presenting as sick sinus syndrome, dilated cardiomyopathy, and sudden cardiac death. Gene 2024; 898:148093. [PMID: 38123004 DOI: 10.1016/j.gene.2023.148093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/30/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023]
Abstract
Pathogenic mutations in SCN5A could result in dysfunctions of Nav1.5 and consequently lead to a wide range of inherited cardiac diseases. However, the presence of numerous SCN5A-related variants with unknown significance (VUS) and the comprehensive genotype-phenotype relationship pose challenges to precise diagnosis and genetic counseling for affected families. Here, we functionally identified two novel compound heterozygous variants (L256del and L1621F) in SCN5A in a Chinese family exhibiting complex congenital cardiac phenotypes from sudden cardiac death to overlapping syndromes including sick sinus syndrome and dilated cardiomyopathy in an autosomal recessive pattern. In silico tools predicted decreased stability and hydrophobicity of the two mutated proteins due to conformational changes. Patch-clamp electrophysiology revealed slightly decreased sodium currents, accelerated inactivation, and reduced sodium window current in the Nav1.5-L1621F channels as well as no sodium currents in the Nav1.5-L256del channels. Western blotting analysis demonstrated decreased expression levels of mutated Nav1.5 on the plasma membrane, despite enhanced compensatory expression of the total Nav1.5 expression levels. Immunofluorescence imaging showed abnormal condensed spots of the mutated channels within the cytoplasm instead of normal membrane distribution, indicating impaired trafficking. Overall, we identified the loss-of-function characteristics exhibited by the two variants, thereby providing further evidence for their pathogenic nature. Our findings not only extended the variation and phenotype spectrums of SCN5A, but also shed light on the crucial role of patch-clamp electrophysiology in the functional analysis of VUS in SCN5A, which have significant implications for the clinical diagnosis, management, and genetic counseling in affected individuals with complex cardiac phenotypes.
Collapse
Affiliation(s)
- Jiaying Shi
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xueqi Pan
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| | - Zhaokun Wang
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ming Yi
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shengyu Xie
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xinyue Zhang
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Dachang Tao
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yuan Yang
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Yunqiang Liu
- Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China.
| |
Collapse
|
4
|
Iamshanova O, Hämmerli AF, Ramaye E, Seljmani A, Ross-Kaschitza D, Schärz N, Essers M, Guichard S, Rougier JS, Abriel H. The dispensability of 14-3-3 proteins for the regulation of human cardiac sodium channel Nav1.5. PLoS One 2024; 19:e0298820. [PMID: 38452156 PMCID: PMC10919853 DOI: 10.1371/journal.pone.0298820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/30/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND 14-3-3 proteins are ubiquitous proteins that play a role in cardiac physiology (e.g., metabolism, development, and cell cycle). Furthermore, 14-3-3 proteins were proposed to regulate the electrical function of the heart by interacting with several cardiac ion channels, including the voltage-gated sodium channel Nav1.5. Given the many cardiac arrhythmias associated with Nav1.5 dysfunction, understanding its regulation by the protein partners is crucial. AIMS In this study, we aimed to investigate the role of 14-3-3 proteins in the regulation of the human cardiac sodium channel Nav1.5. METHODS AND RESULTS Amongst the seven 14-3-3 isoforms, only 14-3-3η (encoded by YWHAH gene) weakly co-immunoprecipitated with Nav1.5 when heterologously co-expressed in tsA201 cells. Total and cell surface expression of Nav1.5 was however not modified by 14-3-3η overexpression or inhibition with difopein, and 14-3-3η did not affect physical interaction between Nav1.5 α-α subunits. The current-voltage relationship and the amplitude of Nav1.5-mediated sodium peak current density were also not changed. CONCLUSIONS Our findings illustrate that the direct implication of 14-3-3 proteins in regulating Nav1.5 is not evident in a transformed human kidney cell line tsA201.
Collapse
Affiliation(s)
- Oksana Iamshanova
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Anne-Flore Hämmerli
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Elise Ramaye
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Arbresh Seljmani
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
- medi—Center for Medical Education, Bern, Switzerland
| | - Daniela Ross-Kaschitza
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Noëlia Schärz
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
- medi—Center for Medical Education, Bern, Switzerland
| | - Maria Essers
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Sabrina Guichard
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Jean-Sébastien Rougier
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| | - Hugues Abriel
- Faculty of Medicine, Institute of Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
5
|
Martínez-Moreno R, Carreras D, Sarquella-Brugada G, Pérez GJ, Selga E, Scornik FS, Brugada R. Loss of sodium current caused by a Brugada syndrome-associated variant is determined by patient-specific genetic background. Heart Rhythm 2024; 21:331-339. [PMID: 38008367 DOI: 10.1016/j.hrthm.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Brugada syndrome (BrS) is an inherited cardiac arrhythmogenic disease that predisposes patients to sudden cardiac death. It is associated with mutations in SCN5A, which encodes the cardiac sodium channel alpha subunit (NaV1.5). BrS-related mutations have incomplete penetrance and variable expressivity within families. OBJECTIVE The purpose of this study was to determine the role of patient-specific genetic background on the cellular and clinical phenotype among carriers of NaV1.5_p.V1525M. METHODS We studied sodium currents from patient-specific human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) and heterologously transfected human embryonic kidney (HEK) tsA201 cells using the whole-cell patch-clamp technique. We determined gene and protein expression by quantitative polymerase chain reaction, RNA sequencing, and western blot and performed a genetic panel for arrhythmogenic diseases. RESULTS Our results showed a large reduction in INa density in hiPSC-CM derived from 2 V1525M single nucleotide variant (SNV) carriers compared with hiPSC-CM derived from a noncarrier, suggesting a dominant-negative effect of the NaV1.5_p.V1525M channel. INa was not affected in hiPSC-CMs derived from a V1525M SNV carrier who also carries the NaV1.5_p.H558R polymorphism. Heterozygous expression of V1525M in HEK-293T cells produced a loss of INa function, not observed when this variant was expressed together with H558R. In addition, the antiarrhythmic drug mexiletine rescued INa function in hiPSC-CM. SCN5A expression was increased in the V1525M carrier who also expresses NaV1.5_p.H558R. CONCLUSION Our results in patient-specific hiPSC-CM point to a dominant-negative effect of NaV1.5_p.V1525M, which can be reverted by the presence of NaV1.5_p.H558R. Overall, our data points to a role of patient-specific genetic background as a determinant for incomplete penetrance in BrS.
Collapse
Affiliation(s)
- Rebecca Martínez-Moreno
- Departament de Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain; Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
| | - David Carreras
- Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain
| | - Georgia Sarquella-Brugada
- Departament de Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain; Arrhythmia, Inherited Cardiac Diseases and Sudden Death Unit, Hospital Sant Joan de Déu, Esplugues, Barcelona, Spain; Arrítmies pediàtriques, cardiologia genètica i mort sobtada. Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Guillermo J Pérez
- Departament de Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain; Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
| | - Elisabet Selga
- Departament de Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain; Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
| | - Fabiana S Scornik
- Departament de Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain; Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
| | - Ramon Brugada
- Departament de Ciències Mèdiques, Facultat de Medicina, Universitat de Girona, Girona, Spain; Cardiovascular Genetics Center, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta, Girona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Josep Trueta, Girona, Spain
| |
Collapse
|
6
|
Blair GA, Wu X, Bain C, Warren M, Hoeker GS, Poelzing S. Mannitol and hyponatremia regulate cardiac ventricular conduction in the context of sodium channel loss of function. Am J Physiol Heart Circ Physiol 2024; 326:H724-H734. [PMID: 38214908 DOI: 10.1152/ajpheart.00211.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/13/2024]
Abstract
Scn5a heterozygous null (Scn5a+/-) mice have historically been used to investigate arrhythmogenic mechanisms of diseases such as Brugada syndrome (BrS) and Lev's disease. Previously, we demonstrated that reducing ephaptic coupling (EpC) in ex vivo hearts exacerbates pharmacological voltage-gated sodium channel (Nav)1.5 loss of function (LOF). Whether this effect is consistent in a genetic Nav1.5 LOF model is yet to be determined. We hypothesized that loss of EpC would result in greater reduction in conduction velocity (CV) for the Scn5a+/- mouse relative to wild type (WT). In vivo ECGs and ex vivo optical maps were recorded from Langendorff-perfused Scn5a+/- and WT mouse hearts. EpC was reduced with perfusion of a hyponatremic solution, the clinically relevant osmotic agent mannitol, or a combination of the two. Neither in vivo QRS duration nor ex vivo CV during normonatremia was significantly different between the two genotypes. In agreement with our hypothesis, we found that hyponatremia severely slowed CV and disrupted conduction for 4/5 Scn5a+/- mice, but 0/6 WT mice. In addition, treatment with mannitol slowed CV to a greater extent in Scn5a+/- relative to WT hearts. Unexpectedly, treatment with mannitol during hyponatremia did not further slow CV in either genotype, but resolved the disrupted conduction observed in Scn5a+/- hearts. Similar results in guinea pig hearts suggest the effects of mannitol and hyponatremia are not species specific. In conclusion, loss of EpC through either hyponatremia or mannitol alone results in slowed or disrupted conduction in a genetic model of Nav1.5 LOF. However, the combination of these interventions attenuates conduction slowing.NEW & NOTEWORTHY Cardiac sodium channel loss of function (LOF) diseases such as Brugada syndrome (BrS) are often concealed. We optically mapped mouse hearts with reduced sodium channel expression (Scn5a+/-) to evaluate whether reduced ephaptic coupling (EpC) can unmask conduction deficits. Data suggest that conduction deficits in the Scn5a+/- mouse may be unmasked by treatment with hyponatremia and perinexal widening via mannitol. These data support further investigation of hyponatremia and mannitol as novel diagnostics for sodium channel loss of function diseases.
Collapse
Affiliation(s)
- Grace A Blair
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, Virginia, United States
- Center for Vascular and Heart Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, United States
| | - Xiaobo Wu
- Center for Vascular and Heart Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, United States
| | - Chandra Bain
- Center for Vascular and Heart Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, United States
| | - Mark Warren
- Center for Vascular and Heart Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, United States
| | - Gregory S Hoeker
- Center for Vascular and Heart Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, United States
| | - Steven Poelzing
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Roanoke, Virginia, United States
- Center for Vascular and Heart Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, United States
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, United States
| |
Collapse
|
7
|
Vašků A, Novotný T, Špinar J. Polymorphic Variants of SCN5A Gene (rs41312433 and rs1805124) Associated with Coronary Artery Affliction in Patients with Severe Arrhythmias. Genes (Basel) 2024; 15:200. [PMID: 38397190 PMCID: PMC10887539 DOI: 10.3390/genes15020200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Several mutations in this gene for the α subunit of the cardiac sodium channel have been identified in a heterogeneous subset of cardiac rhythm syndromes, including Brugada syndrome, progressive cardiac conduction defect, sick sinus node syndrome, atrial fibrillation and dilated cardiomyopathy. The aim of our study was to associate some SCN5A polymorphic variants directly with confirmed coronary stenoses in patients with non-LQTS ventricular fibrillation/flutter treated by an implantable cardioverter defibrillator. MATERIALS AND METHODS A group of 32 unrelated individuals, aged 63 ± 12 years, was included in the study. All the patients were examined, diagnosed and treated with an implantable cardioverter defibrillator at the Department of Internal Cardiology Medicine, Faculty Hospital Brno. The control group included 87 persons of similar age without afflicted coronary circulation, which was confirmed coronagraphically. Genomic DNA was extracted from samples of peripheral blood according to the standard protocol. Two SCN5A polymorphisms-IVS9-3C/A (rs41312433) and A1673G (rs1805124, H558R)-were examined in association with coronary artery stenosis in the patients. RESULTS In the case-control study, no significant differences in genotype distribution/allelic frequencies were observed for IVS9-3c>a and A1673G gene polymorphisms between patients with severe arrhythmias and healthy persons. The distribution of SCN5A double genotypes was not significantly different among different types of arrhythmias according to their ejection fraction in arrhythmic patients (p = 0.396). The ventricular arrhythmias with an ejection fraction below 40% were found to be 10.67 times more frequent in patients with multiple coronary stenosis with clinically valid sensitivity, specificity and power tests. In the genotype-phenotype study, we observed a significant association of both SCN5A polymorphisms with the stenosis of coronary vessels in the patients with severe arrhythmia. The double genotype of polymorphisms IVS9-3C/A together with A1673G (CCAA) as well as their simple genotypes were associated with significant multiple stenosis of coronary arteries (MVS) with high sensitivity and specificity (p = 0.05; OR = 5 (95% CI 0.99-23.34); sensitivity 0.70; specificity 0.682; power test 0.359) Moreover, when a concrete stenotic coronary artery was associated with SCN5A genotypes, the CCAA double genotype was observed to be five times more frequent in patients with significant stenosis in the right coronary artery (RCA) compared to those without affliction of this coronary artery (p = 0.05; OR = 5 (95% CI 0.99-23.34); sensitivity 0.682; specificity 0.700; power test 0.359). The CCAA genotype was also more frequent in patients without RCA affliction with MVS (p = 0.008); in patients with ACD affliction but without MVS (p = 0.008); and in patients with both ACD affliction and MVS compared to those without ACD affliction and MVS (p = 0.005). CONCLUSIONS Our study presents a highly sensitive and specific association of two polymorphisms in SCN5A with significant coronary artery stenoses in patients with potentially fatal ventricular arrhythmias. At the same time, these polymorphisms were not associated with arrhythmias themselves. Thus, SCN5A gene polymorphic variants may form a part of germ cell gene predisposition to ischemia.
Collapse
Affiliation(s)
- Anna Vašků
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - Tomáš Novotný
- Department of Internal Medicine and Cardiology, University Hospital Brno, Masaryk University, 62500 Brno, Czech Republic;
| | - Jindřich Špinar
- First Department of Internal Medicine—Cardioangiology, St. Anne’s University Hospital, Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic;
| |
Collapse
|
8
|
Semino F, Darche FF, Bruehl C, Koenen M, Skladny H, Katus HA, Frey N, Draguhn A, Schweizer PA. GPD1L-A306del modifies sodium current in a family carrying the dysfunctional SCN5A-G1661R mutation associated with Brugada syndrome. Pflugers Arch 2024; 476:229-242. [PMID: 38036776 DOI: 10.1007/s00424-023-02882-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023]
Abstract
Loss-of-function variants of SCN5A, encoding the sodium channel alpha subunit Nav1.5 are associated with high phenotypic variability and multiple cardiac presentations, while underlying mechanisms are incompletely understood. Here we investigated a family with individuals affected by Brugada Syndrome (BrS) of different severity and aimed to unravel the underlying genetic and electrophysiological basis.Next-generation sequencing was used to identify the genetic variants carried by family members. The index patient, who was severely affected by arrhythmogenic BrS, carried previously uncharacterized variants of Nav1.5 (SCN5A-G1661R) and glycerol-3-phosphate dehydrogenase-1-like protein (GPD1L-A306del) in a double heterozygous conformation. Family members exclusively carrying SCN5A-G1661R showed asymptomatic Brugada ECG patterns, while another patient solely carrying GPD1L-A306del lacked any clinical phenotype.To assess functional mechanisms, Nav1.5 channels were transiently expressed in HEK-293 cells in the presence and absence of GPD1L. Whole-cell patch-clamp recordings revealed loss of sodium currents after homozygous expression of SCN5A-G1661R, and reduction of current amplitude to ~ 50% in cells transfected with equal amounts of wildtype and mutant Nav1.5. Co-expression of wildtype Nav1.5 and GPD1L showed a trend towards increased sodium current amplitudes and a hyperpolarizing shift in steady-state activation and -inactivation compared to sole SCN5A expression. Application of the GPD1L-A306del variant shifted steady-state activation to more hyperpolarized and inactivation to more depolarized potentials.In conclusion, SCN5A-G1661R produces dysfunctional channels and associates with BrS. SCN5A mediated currents are modulated by co-expression of GDP1L and this interaction is altered by mutations in both proteins. Thus, additive genetic burden may aggravate disease severity, explaining higher arrhythmogenicity in double mutation carriers.
Collapse
Affiliation(s)
- Francesca Semino
- Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany
- Institute of Physiology and Pathophysiology, Heidelberg University, Heidelberg, Germany
| | - Fabrice F Darche
- Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany
| | - Claus Bruehl
- Institute of Physiology and Pathophysiology, Heidelberg University, Heidelberg, Germany
| | - Michael Koenen
- Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany
- Department of Molecular Neurobiology, Max Planck Institute for Medical Research, Heidelberg, Germany
| | - Heyko Skladny
- SYNLAB MVZ Humangenetik Mannheim GmbH, Mannheim, Germany
| | - Hugo A Katus
- Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Norbert Frey
- Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Andreas Draguhn
- Institute of Physiology and Pathophysiology, Heidelberg University, Heidelberg, Germany
| | - Patrick A Schweizer
- Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Heidelberg, Germany.
| |
Collapse
|
9
|
Qi M, Ma S, Liu J, Liu X, Wei J, Lu WJ, Zhang S, Chang Y, Zhang Y, Zhong K, Yan Y, Zhu M, Song Y, Chen Y, Hao G, Wang J, Wang L, Lee AS, Chen X, Wang Y, Lan F. In Vivo Base Editing of Scn5a Rescues Type 3 Long QT Syndrome in Mice. Circulation 2024; 149:317-329. [PMID: 37965733 DOI: 10.1161/circulationaha.123.065624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/17/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Pathogenic variants in SCN5A can result in long QT syndrome type 3, a life-threatening genetic disease. Adenine base editors can convert targeted A T base pairs to G C base pairs, offering a promising tool to correct pathogenic variants. METHODS We generated a long QT syndrome type 3 mouse model by introducing the T1307M pathogenic variant into the Scn5a gene. The adenine base editor was split into 2 smaller parts and delivered into the heart by adeno-associated virus serotype 9 (AAV9-ABEmax) to correct the T1307M pathogenic variant. RESULTS Both homozygous and heterozygous T1307M mice showed significant QT prolongation. Carbachol administration induced Torsades de Pointes or ventricular tachycardia for homozygous T1307M mice (20%) but not for heterozygous or wild-type mice. A single intraperitoneal injection of AAV9-ABEmax at postnatal day 14 resulted in up to 99.20% Scn5a transcripts corrected in T1307M mice. Scn5a mRNA correction rate >60% eliminated QT prolongation; Scn5a mRNA correction rate <60% alleviated QT prolongation. Partial Scn5a correction resulted in cardiomyocytes heterogeneity, which did not induce severe arrhythmias. We did not detect off-target DNA or RNA editing events in ABEmax-treated mouse hearts. CONCLUSIONS These findings show that in vivo AAV9-ABEmax editing can correct the variant Scn5a allele, effectively ameliorating arrhythmia phenotypes. Our results offer a proof of concept for the treatment of hereditary arrhythmias.
Collapse
Affiliation(s)
- Man Qi
- Shenzhen Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Fuwai Hospital, Shenzhen, China (M.Q., S.M., X.L., Y. Chang, Y.Z., Y.Y., M.Z., L.W.)
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
- Chinese PLA General Hospital, College of Pulmonary & Critical Care Medicine, Beijing Key Laboratory of OTIR, Beijing, China (M.Q.)
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China (M.Q., Y. Chen)
| | - Shuhong Ma
- Shenzhen Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Fuwai Hospital, Shenzhen, China (M.Q., S.M., X.L., Y. Chang, Y.Z., Y.Y., M.Z., L.W.)
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
| | - Jingtong Liu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China (J.L., Y.W.)
| | - Xujie Liu
- Shenzhen Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Fuwai Hospital, Shenzhen, China (M.Q., S.M., X.L., Y. Chang, Y.Z., Y.Y., M.Z., L.W.)
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
- National Health Commission Key Laboratory of Cardiovascular Regenerative Medicine, Fuwai Central-China Hospital, Central-China Branch of National Center for Cardiovascular Diseases, Zhengzhou, China (X.L., F.L.)
| | - Jingjing Wei
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
| | - Wen-Jing Lu
- Beijing Laboratory for Cardiovascular Precision Medicine, The Key Laboratory of Biomedical Engineering for Cardiovascular Disease Research, Ministry of Education, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (W.-J.L., S.Z., F.L.)
| | - Siyao Zhang
- Beijing Laboratory for Cardiovascular Precision Medicine, The Key Laboratory of Biomedical Engineering for Cardiovascular Disease Research, Ministry of Education, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (W.-J.L., S.Z., F.L.)
| | - Yun Chang
- Shenzhen Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Fuwai Hospital, Shenzhen, China (M.Q., S.M., X.L., Y. Chang, Y.Z., Y.Y., M.Z., L.W.)
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
| | - Yongshuai Zhang
- Shenzhen Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Fuwai Hospital, Shenzhen, China (M.Q., S.M., X.L., Y. Chang, Y.Z., Y.Y., M.Z., L.W.)
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
| | - Kejia Zhong
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
| | - Yuting Yan
- Shenzhen Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Fuwai Hospital, Shenzhen, China (M.Q., S.M., X.L., Y. Chang, Y.Z., Y.Y., M.Z., L.W.)
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
| | - Min Zhu
- Shenzhen Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Fuwai Hospital, Shenzhen, China (M.Q., S.M., X.L., Y. Chang, Y.Z., Y.Y., M.Z., L.W.)
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
| | - Yabing Song
- School of Life Sciences, Tsinghua University, Beijing, China (Y.S., J. Wang)
| | - Yundai Chen
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China (M.Q., Y. Chen)
| | - Guoliang Hao
- Henan Academy of Innovations in Medical Science, Zhengzhou, China (G.H.)
| | - Jianbin Wang
- School of Life Sciences, Tsinghua University, Beijing, China (Y.S., J. Wang)
| | - Li Wang
- Shenzhen Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Fuwai Hospital, Shenzhen, China (M.Q., S.M., X.L., Y. Chang, Y.Z., Y.Y., M.Z., L.W.)
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
| | - Andrew S Lee
- Institute for Cancer Research, Shenzhen Bay Laboratory, Shenzhen, China (A.S.L.)
| | - Xiangbo Chen
- Hangzhou Rongze Biotechnology Group Co, Ltd, Hangzhou, China (X.C.)
| | - Yongming Wang
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Zhongshan Hospital, Fudan University, Shanghai, China (J.L., Y.W.)
| | - Feng Lan
- Key Laboratory of Pluripotent Stem Cells in Cardiac Repair and Regeneration, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China (M.Q., S.M., X.L., J. Wei, Y. Chang, Y.Z., K.Z., Y.Y., M.Z., L.W., F.L.)
- National Health Commission Key Laboratory of Cardiovascular Regenerative Medicine, Fuwai Central-China Hospital, Central-China Branch of National Center for Cardiovascular Diseases, Zhengzhou, China (X.L., F.L.)
- Beijing Laboratory for Cardiovascular Precision Medicine, The Key Laboratory of Biomedical Engineering for Cardiovascular Disease Research, Ministry of Education, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (W.-J.L., S.Z., F.L.)
| |
Collapse
|
10
|
Chiang DY, Verkerk AO, Victorio R, Shneyer BI, van der Vaart B, Jouni M, Narendran N, Kc A, Sampognaro JR, Vetrano-Olsen F, Oh JS, Buys E, de Jonge B, Shah DA, Kiviniemi T, Burridge PW, Bezzina CR, Akhmanova A, MacRae CA. The Role of MAPRE2 and Microtubules in Maintaining Normal Ventricular Conduction. Circ Res 2024; 134:46-59. [PMID: 38095085 DOI: 10.1161/circresaha.123.323231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Brugada syndrome is associated with loss-of-function SCN5A variants, yet these account for only ≈20% of cases. A recent genome-wide association study identified a novel locus within MAPRE2, which encodes EB2 (microtubule end-binding protein 2), implicating microtubule involvement in Brugada syndrome. METHODS A mapre2 knockout zebrafish model was generated using CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/clustered regularly interspaced short palindromic repeat-associated protein 9) and validated by Western blot. Larval hearts at 5 days post-fertilization were isolated for voltage mapping and immunocytochemistry. Adult fish hearts were used for ECG, patch clamping, and immunocytochemistry. Morpholinos were injected into embryos at 1-cell stage for knockdown experiments. A transgenic zebrafish line with cdh2 tandem fluorescent timer was used to study adherens junctions. Microtubule plus-end tracking and patch clamping were performed in human induced pluripotent stem cell derived cardiomyocytes (iPSC-CMs) with MAPRE2 knockdown and knockout, respectively. RESULTS Voltage mapping of mapre2 knockout hearts showed a decrease in ventricular maximum upstroke velocity of the action potential and conduction velocity, suggesting loss of cardiac voltage-gated sodium channel function. ECG showed QRS prolongation in adult knockout fish, and patch clamping showed decreased sodium current density in knockout ventricular myocytes and arrhythmias in knockout iPSC-CMs. Confocal imaging showed disorganized adherens junctions and mislocalization of mature Ncad (N-cadherin) with mapre2 loss of function, associated with a decrease of detyrosinated tubulin. MAPRE2 knockdown in iPSC-CMs led to an increase in microtubule growth velocity and distance, indicating changes in microtubule dynamics. Finally, knockdown of ttl encoding tubulin tyrosine ligase in mapre2 knockout larvae rescued tubulin detyrosination and ventricular maximum upstroke velocity of the action potential. CONCLUSIONS Genetic ablation of mapre2 led to a decrease in voltage-gated sodium channel function, a hallmark of Brugada syndrome, associated with disruption of adherens junctions, decrease of detyrosinated tubulin as a marker of microtubule stability, and changes in microtubule dynamics. Restoration of the detyrosinated tubulin fraction with ttl knockdown led to rescue of voltage-gated sodium channel-related functional parameters in mapre2 knockout hearts. Taken together, our study implicates microtubule dynamics in the modulation of ventricular conduction.
Collapse
Affiliation(s)
- David Y Chiang
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| | - Arie O Verkerk
- Department of Experimental Cardiology, Heart Center (A.O.V., C.R.B.), Academic Medical Center, Amsterdam UMC, the Netherlands
| | - Rachelle Victorio
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| | - Boris I Shneyer
- Cell Biology, Neurobiology and Biophysics, Department of Biology, Faculty of Science, Utrecht University, the Netherlands (B.I.S., B.v.d.V., A.A.)
| | - Babet van der Vaart
- Cell Biology, Neurobiology and Biophysics, Department of Biology, Faculty of Science, Utrecht University, the Netherlands (B.I.S., B.v.d.V., A.A.)
| | - Mariam Jouni
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL (M.J., D.A.S., P.W.B.)
| | - Nakul Narendran
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| | - Ashmita Kc
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| | - James R Sampognaro
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| | - Franki Vetrano-Olsen
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| | - John S Oh
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| | - Eva Buys
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| | - Berend de Jonge
- Department of Medical Biology (B.d.J.), Academic Medical Center, Amsterdam UMC, the Netherlands
| | - Disheet A Shah
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL (M.J., D.A.S., P.W.B.)
| | - Tuomas Kiviniemi
- Heart Center, Turku University Hospital and University of Turku, Finland (T.K.)
| | - Paul W Burridge
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL (M.J., D.A.S., P.W.B.)
| | - Connie R Bezzina
- Department of Experimental Cardiology, Heart Center (A.O.V., C.R.B.), Academic Medical Center, Amsterdam UMC, the Netherlands
| | - Anna Akhmanova
- Cell Biology, Neurobiology and Biophysics, Department of Biology, Faculty of Science, Utrecht University, the Netherlands (B.I.S., B.v.d.V., A.A.)
| | - Calum A MacRae
- Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.Y.C., R.V., N.N., A.K., J.R.S., F.V.-O., J.S.O., E.B., C.A.M.)
| |
Collapse
|
11
|
Xu K, Zhuang XX, Shi XW. Overexpression of SCN5A overcomes ABC transporter-mediated multidrug resistance in acute myeloid leukemia through promoting apoptosis. Expert Rev Hematol 2024; 17:87-94. [PMID: 38230679 DOI: 10.1080/17474086.2024.2305363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/26/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND This study aimed to explore the effect and mechanism of SCN5A overcoming ATP-binding cassette (ABC) transporter-mediated multidrug resistance (MDR) in acute myeloid leukemia (AML) through promoting apoptosis. RESEARCH DESIGN AND METHODS The tissues derived from AML patients were divided into Sensitive group and Resistance group according to the presence of drug-resistance. Human AML cell line HL-60 and drug-resistant strain HL-60/ADR were divided into HL-60/ADR-vector group, HL-60/ADR-SCN5A group, HL-60-vector group and HL-60-SCN5A group. RT-qPCR was used to detect the mRNA expression level of SCN5A; MTT assay to assess the survival rate and proliferation level of cells; flow cytometry to determine the apoptosis level; and western blot to check the levels of SCN5A, P-glycoprotein (P-gp), MDR protein 1 (MRP1), MDR gene 1 (MDR1), breast cancer resistance protein (BCRP), Bcl-2-associated X protein (Bax), and B-cell lymphoma 2 (Bcl-2) proteins in cells. RESULTS SCN5A expressed lowly in drug-resistant AML tissues and cells. Up-regulation of SCN5A inhibited MDR in HL-60 cells, enhanced the chemosensitivity of HL-60/ADR, and increased the apoptosis levels of HL-60 and HL-60/ADR cells. However, over-expression of SCN5A inhibited the expression of MDR-related proteins. CONCLUSIONS SCN5A may overcome ABC transporter-mediated MDR in AML through enhancing the apoptosis and inhibiting the expression of MDR proteins.
Collapse
MESH Headings
- Humans
- ATP Binding Cassette Transporter, Subfamily G, Member 2
- ATP-Binding Cassette Transporters/genetics
- ATP-Binding Cassette Transporters/pharmacology
- Drug Resistance, Neoplasm/genetics
- Neoplasm Proteins/genetics
- Drug Resistance, Multiple/genetics
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/metabolism
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism
- Apoptosis/genetics
- NAV1.5 Voltage-Gated Sodium Channel/genetics
Collapse
Affiliation(s)
- Kun Xu
- Department of Pharmacy, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Xian-Xu Zhuang
- Department of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Xiao-Wei Shi
- Department of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China
| |
Collapse
|
12
|
Errata: Rare Compound Heterozygous Missense Mutation of the SCN5A Gene with Childhood-Onset Sick Sinus Syndrome in Two Chinese Sisters: A Case Report. Int Heart J 2024; 65:169. [PMID: 38296574 DOI: 10.1536/ihj.65-1_Errata] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
An error appeared in the article entitled "Rare Compound Heterozygous Missense Mutation of the SCN5A Gene with Childhood-Onset Sick Sinus Syndrome in Two Chinese Sisters: A Case Report" by Yanyun Wang, Siyu Long, Chenxi Wei, and Xiaoqin Wang (Vol. 64 No.2, 299-305, 2023). The name of the first affiliation on page 299 was wrong. It should be "Laboratory of Molecular Translational Medicine, Center for Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, China" and not "Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Sichuan University, Chengdu, China".
Collapse
|
13
|
Pham HM, Nguyen DP, Ta TD, Le TP, Phan PH, Trinh HA, Tran TV, Luong TLA, Nguyen HM, Bui T, Tran TH, Ta TV, Tran V. In silico validation revealed the role of SCN5A mutations and their genotype-phenotype correlations in Brugada syndrome. Mol Genet Genomic Med 2023; 11:e2263. [PMID: 37547970 PMCID: PMC10724507 DOI: 10.1002/mgg3.2263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/03/2023] [Accepted: 07/19/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Brugada syndrome (BrS) is a rare genetic disease that causes sudden cardiac death (SCD) and arrhythmia. SCN5A pathogenic variants (about 30% of diagnosed patients) are responsible for BrS. AIMS Lack of knowledge regarding molecular characteristics and the correlation between genotype and phenotype interfere with the risk stratification and finding the optimal treatment in Vietnam. Therefore, we identified SCN5A variants and evaluated the genotype-phenotype correlation of BrS on 117 Vietnamese probands. MATERIALS AND METHODS The clinical characteristics and blood samples of BrS patients were collected. To determine SCN5A variants, Sanger sequencing was conducted, and subsequently, these variants were analyzed by bioinformatic tools. RESULTS In this cohort, the overall rate of detected variants in SCN5A was 25.6%, which could include both pathogenic and benign variants. In genetic testing, 21 SCN5A variants were identified, including eight novels and 15 published variants. Multiple bioinformatic tools were used to predict variant effect with c.551A>G, c.1890+14G>A, c.3338C>T, c.3578G>A, and c.5484C>T as benign, while other variants were predicted as disease-causing. The family history of SCD (risk ratio [RR] = 4.324, 95% CI: 2.290-8.269, p < 0.001), syncope (RR = 3.147, 95% CI: 1.668-5.982, p = 0.0004), and ventricular tachycardia/ventricular fibrillation (RR = 3.406, 95% CI: 1.722-5.400, p = 0.0035) presented a significantly higher risk in the SCN5A (+) group, consisting of individuals carrying any variant in the SCN5A gene, compared to SCN5A (-) individuals. CONCLUSION The results contribute to clarifying the impact of SCN5A variants on these phenotypes. Further follow-up studies need to be carried out to understand the functional effects of these SCN5A variants on the severity of BrS.
Collapse
Affiliation(s)
- Hung Manh Pham
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
- Vietnam National Heart InstituteBach Mai HospitalHanoiVietnam
| | - Duy Phuong Nguyen
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
- Ho Chi Minh City Heart InstituteHo Chi MinhVietnam
| | - Thanh Dat Ta
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
| | - Thi Phuong Le
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
| | - Phong Hai Phan
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
- Vietnam National Heart InstituteBach Mai HospitalHanoiVietnam
| | | | - Tuan Viet Tran
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
- Vietnam National Heart InstituteBach Mai HospitalHanoiVietnam
| | - Thi Lan Anh Luong
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
| | - Ha Minh Nguyen
- Hue Central HospitalHueVietnam
- Pham Ngoc Thanh UniversityHo Chi MinhVietnam
| | - The‐Hung Bui
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
- Center for Molecular Medicine, Clinical Genetics UnitKarolinska Institutet, Karolinska University HospitalStockholmSweden
| | - Thinh Huy Tran
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
| | - Thanh Van Ta
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
| | - Van‐Khanh Tran
- Center for Gene and Protein ResearchHanoi Medical UniversityHanoiVietnam
| |
Collapse
|
14
|
Tonelli L, Balla C, Farnè M, Margutti A, Maniscalchi ET, De Feo G, Di Domenico A, De Raffele M, Percesepe A, Uliana V, Barili V, Serra W, Sassone B, Virzì S, De Maria E, Parmeggiani G, Assenza GE, Biagini E, Parisi V, Biffi M, Carinci V, Perugini E, Imbrici P, Ferlini A, Bertini M, Selvatici R, Gualandi F. SCN5A mutation is associated with a higher Shanghai Score in patients with type 1 Brugada ECG pattern. J Cardiovasc Med (Hagerstown) 2023; 24:864-870. [PMID: 37942788 DOI: 10.2459/jcm.0000000000001560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
AIMS Brugada syndrome (BrS) is an inherited arrhythmic disease characterized by a coved ST-segment elevation in the right precordial electrocardiogram leads (type 1 ECG pattern) and is associated with a risk of malignant ventricular arrhythmias and sudden cardiac death. In order to assess the predictive value of the Shanghai Score System for the presence of a SCN5A mutation in clinical practice, we studied a cohort of 125 patients with spontaneous or fever/drug-induced BrS type 1 ECG pattern, variably associated with symptoms and a positive family history. METHODS The Shanghai Score System items were collected for each patient and PR and QRS complex intervals were measured. Patients were genotyped through a next-generation sequencing (NGS) custom panel for the presence of SCN5A mutations and the common SCN5A polymorphism (H558R). RESULTS The total Shanghai Score was higher in SCN5A+ patients than in SCN5A- patients. The 81% of SCN5A+ patients and the 100% of patients with a SCN5A truncating variant exhibit a spontaneous type 1 ECG pattern. A significant increase in PR (P = 0.006) and QRS (P = 0.02) was detected in the SCN5A+ group. The presence of the common H558R polymorphism did not significantly correlate with any of the items of the Shanghai Score, nor with the total score of the system. CONCLUSION Data from our study suggest the usefulness of Shanghai Score collection in clinical practice in order to maximize genetic test appropriateness. Our data further highlight SCN5A mutations as a cause of conduction impairment in BrS patients.
Collapse
Affiliation(s)
- Laura Tonelli
- Unit of Medical Genetics, Department of Medical Sciences and Department of Mother and Child, University Hospital S. Anna Ferrara, Ferrara
| | - Cristina Balla
- Cardiology Department, University Hospital S. Anna Ferrara, Ferrara
| | - Marianna Farnè
- Unit of Medical Genetics, Department of Medical Sciences and Department of Mother and Child, University Hospital S. Anna Ferrara, Ferrara
| | - Alice Margutti
- Unit of Medical Genetics, Department of Medical Sciences and Department of Mother and Child, University Hospital S. Anna Ferrara, Ferrara
| | - Eugenia Tiziana Maniscalchi
- Unit of Medical Genetics, Department of Medical Sciences and Department of Mother and Child, University Hospital S. Anna Ferrara, Ferrara
| | - Gaetano De Feo
- Unit of Medical Genetics, Department of Medical Sciences and Department of Mother and Child, University Hospital S. Anna Ferrara, Ferrara
| | | | | | - Antonio Percesepe
- Unit of Medical Genetics, University Hospital of Parma, Parma
- Department of Medicine and Surgery, University of Parma, Parma
| | - Vera Uliana
- Unit of Medical Genetics, University Hospital of Parma, Parma
| | - Valeria Barili
- Unit of Medical Genetics, University Hospital of Parma, Parma
| | - Walter Serra
- Unit of Cardiology, University Hospital of Parma, Parma
| | - Biagio Sassone
- Cardiology Division, SS.ma Annunziata Hospital, Department of Emergency, AUSL Ferrara, Cento (Ferrara)
| | - Santo Virzì
- Cardiology Division, SS.ma Annunziata Hospital, Department of Emergency, AUSL Ferrara, Cento (Ferrara)
| | | | - Giulia Parmeggiani
- Medical Genetics Unit, Department of Clinical Pathology, AUSL Romagna, Cesena
| | | | - Elena Biagini
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | - Vanda Parisi
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna
| | - Mauro Biffi
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna
| | | | | | - Paola Imbrici
- Department of Pharmacy-Drug Sciences, University of Bari 'Aldo Moro', Bari, Italy
| | - Alessandra Ferlini
- Unit of Medical Genetics, Department of Medical Sciences and Department of Mother and Child, University Hospital S. Anna Ferrara, Ferrara
| | - Matteo Bertini
- Cardiology Department, University Hospital S. Anna Ferrara, Ferrara
| | - Rita Selvatici
- Unit of Medical Genetics, Department of Medical Sciences and Department of Mother and Child, University Hospital S. Anna Ferrara, Ferrara
| | - Francesca Gualandi
- Unit of Medical Genetics, Department of Medical Sciences and Department of Mother and Child, University Hospital S. Anna Ferrara, Ferrara
| |
Collapse
|
15
|
Tarantino A, Ciconte G, Ghiroldi A, Mastrocinque F, Micaglio E, Boccellino A, Negro G, Piccoli M, Cirillo F, Vicedomini G, Santinelli V, Anastasia L, Pappone C. Challenges in Brugada Syndrome Stratification: Investigating SCN5A Mutation Localization and Clinical Phenotypes. Int J Mol Sci 2023; 24:16658. [PMID: 38068978 PMCID: PMC10706434 DOI: 10.3390/ijms242316658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
Brugada Syndrome (BrS) is a genetic heart condition linked to sudden cardiac death. Though the SCN5A gene is primarily associated with BrS, there is a lack of comprehensive studies exploring the connection between SCN5A mutation locations and the clinical presentations of the syndrome. This study aimed to address this gap and gain further understanding of the syndrome. The investigation classified 36 high-risk BrS patients based on SCN5A mutations within the transmembrane/structured (TD) and intra-domain loops (IDLs) lacking a 3D structure. We characterized the intrinsically disordered regions (IDRs) abundant in IDLs, using bioinformatics tools to predict IDRs and post-translational modifications (PTMs) in NaV1.5. Interestingly, it was found that current predictive tools often underestimate the impacts of mutations in IDLs and disordered regions. Moreover, patients with SCN5A mutations confined to IDL regions-previously deemed 'benign'-displayed clinical symptoms similar to those carrying 'damaging' variants. Our research illuminates the difficulty in stratifying patients based on SCN5A mutation locations, emphasizing the vital role of IDLs in the NaV1.5 channel's functioning and protein interactions. We advocate for caution when using predictive tools for mutation evaluation in these regions and call for the development of improved strategies in accurately assessing BrS risk.
Collapse
Affiliation(s)
- Adriana Tarantino
- Institute for Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (A.T.); (M.P.); (F.C.)
- School of Medicine, University Vita-Salute San Raffaele, Via Olgettina 58, 20132 Milan, Italy;
| | - Giuseppe Ciconte
- School of Medicine, University Vita-Salute San Raffaele, Via Olgettina 58, 20132 Milan, Italy;
- Arrhythmology Department, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (F.M.); (E.M.); (A.B.); (G.N.); (G.V.); (V.S.)
| | - Andrea Ghiroldi
- Institute for Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (A.T.); (M.P.); (F.C.)
| | - Flavio Mastrocinque
- Arrhythmology Department, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (F.M.); (E.M.); (A.B.); (G.N.); (G.V.); (V.S.)
| | - Emanuele Micaglio
- Arrhythmology Department, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (F.M.); (E.M.); (A.B.); (G.N.); (G.V.); (V.S.)
| | - Antonio Boccellino
- Arrhythmology Department, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (F.M.); (E.M.); (A.B.); (G.N.); (G.V.); (V.S.)
| | - Gabriele Negro
- Arrhythmology Department, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (F.M.); (E.M.); (A.B.); (G.N.); (G.V.); (V.S.)
| | - Marco Piccoli
- Institute for Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (A.T.); (M.P.); (F.C.)
| | - Federica Cirillo
- Institute for Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (A.T.); (M.P.); (F.C.)
| | - Gabriele Vicedomini
- Arrhythmology Department, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (F.M.); (E.M.); (A.B.); (G.N.); (G.V.); (V.S.)
| | - Vincenzo Santinelli
- Arrhythmology Department, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (F.M.); (E.M.); (A.B.); (G.N.); (G.V.); (V.S.)
| | - Luigi Anastasia
- Institute for Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (A.T.); (M.P.); (F.C.)
- School of Medicine, University Vita-Salute San Raffaele, Via Olgettina 58, 20132 Milan, Italy;
| | - Carlo Pappone
- School of Medicine, University Vita-Salute San Raffaele, Via Olgettina 58, 20132 Milan, Italy;
- Arrhythmology Department, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097 Milan, Italy; (F.M.); (E.M.); (A.B.); (G.N.); (G.V.); (V.S.)
| |
Collapse
|
16
|
Yoon JY, Greiner AM, Jacobs JS, Kim YR, Rasmussen TP, Kutschke WJ, Matasic DS, Vikram A, Gaddam RR, Mehdi H, Irani K, London B. SUMOylation of the cardiac sodium channel Na V1.5 modifies inward current and cardiac excitability. Heart Rhythm 2023; 20:1548-1557. [PMID: 37543305 DOI: 10.1016/j.hrthm.2023.07.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 07/07/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Decreased peak sodium current (INa) and increased late sodium current (INa,L), through the cardiac sodium channel NaV1.5 encoded by SCN5A, cause arrhythmias. Many NaV1.5 posttranslational modifications have been reported. A recent report concluded that acute hypoxia increases INa,L by increasing a small ubiquitin-like modifier (SUMOylation) at K442-NaV1.5. OBJECTIVE The purpose of this study was to determine whether and by what mechanisms SUMOylation alters INa, INa,L, and cardiac electrophysiology. METHODS SUMOylation of NaV1.5 was detected by immunoprecipitation and immunoblotting. INa was measured by patch clamp with/without SUMO1 overexpression in HEK293 cells expressing wild-type (WT) or K442R-NaV1.5 and in neonatal rat cardiac myocytes (NRCMs). SUMOylation effects were studied in vivo by electrocardiograms and ambulatory telemetry using Scn5a heterozygous knockout (SCN5A+/-) mice and the de-SUMOylating protein SENP2 (AAV9-SENP2), AAV9-SUMO1, or the SUMOylation inhibitor anacardic acid. NaV1.5 trafficking was detected by immunofluorescence. RESULTS NaV1.5 was SUMOylated in HEK293 cells, NRCMs, and human heart tissue. HyperSUMOylation at NaV1.5-K442 increased INa in NRCMs and in HEK cells overexpressing WT but not K442R-Nav1.5. SUMOylation did not alter other channel properties including INa,L. AAV9-SENP2 or anacardic acid decreased INa, prolonged QRS duration, and produced heart block and arrhythmias in SCN5A+/- mice, whereas AAV9-SUMO1 increased INa and shortened QRS duration. SUMO1 overexpression enhanced membrane localization of NaV1.5. CONCLUSION SUMOylation of K442-Nav1.5 increases peak INa without changing INa,L, at least in part by altering membrane abundance. Our findings do not support SUMOylation as a mechanism for changes in INa,L. Nav1.5 SUMOylation may modify arrhythmic risk in disease states and represents a potential target for pharmacologic manipulation.
Collapse
Affiliation(s)
- Jin-Young Yoon
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Alexander M Greiner
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - Julia S Jacobs
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - Young-Rae Kim
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - Tyler P Rasmussen
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - William J Kutschke
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - Daniel S Matasic
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - Ajit Vikram
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Ravinder R Gaddam
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Haider Mehdi
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Kaikobad Irani
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa; Fraternal Order of Eagles Diabetes Research Center, Pappajohn Biomedical Institute, and Heart and Vascular Center, University of Iowa, Iowa City, Iowa.
| | - Barry London
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa; Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa.
| |
Collapse
|
17
|
Needs D, Wu T, Nguyen HX, Henriquez CS, Bursac N. Prokaryotic voltage-gated sodium channels are more effective than endogenous Na v1.5 channels in rescuing cardiac action potential conduction: an in silico study. Am J Physiol Heart Circ Physiol 2023; 325:H1178-H1192. [PMID: 37737736 PMCID: PMC10908372 DOI: 10.1152/ajpheart.00287.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
Methods to augment Na+ current in cardiomyocytes hold potential for the treatment of various cardiac arrhythmias involving conduction slowing. Because the gene coding cardiac Na+ channel (Nav1.5) is too large to fit in a single adeno-associated virus (AAV) vector, new gene therapies are being developed to enhance endogenous Nav1.5 current (by overexpression of chaperon molecules or use of multiple AAV vectors) or to exogenously introduce prokaryotic voltage-gated Na+ channels (BacNav) whose gene size is significantly smaller than that of the Nav1.5. In this study, based on experimental measurements in heterologous expression systems, we developed an improved computational model of the BacNav channel, NavSheP D60A. We then compared in silico how NavSheP D60A expression vs. Nav1.5 augmentation affects the electrophysiology of cardiac tissue. We found that the incorporation of BacNav channels in both adult guinea pig and human cardiomyocyte models increased their excitability and reduced action potential duration. When compared with equivalent augmentation of Nav1.5 current in simulated settings of reduced tissue excitability, the addition of the BacNav current was superior in improving the safety of conduction under conditions of current source-load mismatch, reducing the vulnerability to unidirectional conduction block during premature pacing, preventing the instability and breakup of spiral waves, and normalizing the conduction and ECG in Brugada syndrome tissues with mutated Nav1.5. Overall, our studies show that compared with a potential enhancement of the endogenous Nav1.5 current, expression of the BacNav channels with their slower inactivation kinetics can provide greater anti-arrhythmic benefits in hearts with compromised action potential conduction.NEW & NOTEWORTHY Slow action potential conduction is a common cause of various cardiac arrhythmias; yet, current pharmacotherapies cannot augment cardiac conduction. This in silico study compared the efficacy of recently proposed antiarrhythmic gene therapy approaches that increase peak sodium current in cardiomyocytes. When compared with the augmentation of endogenous sodium current, expression of slower-inactivating bacterial sodium channels was superior in preventing conduction block and arrhythmia induction. These results further the promise of antiarrhythmic gene therapies targeting sodium channels.
Collapse
Affiliation(s)
- Daniel Needs
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | - Tianyu Wu
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | - Hung X Nguyen
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | - Craig S Henriquez
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| | - Nenad Bursac
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States
| |
Collapse
|
18
|
Jameson MB, Ríos-Pérez EB, Liu F, Eichel CA, Robertson GA. Pairwise biosynthesis of ion channels stabilizes excitability and mitigates arrhythmias. Proc Natl Acad Sci U S A 2023; 120:e2305295120. [PMID: 37816059 PMCID: PMC10589643 DOI: 10.1073/pnas.2305295120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/14/2023] [Indexed: 10/12/2023] Open
Abstract
Coordinated expression of ion channels is crucial for cardiac rhythms, neural signaling, and cell cycle progression. Perturbation of this balance results in many disorders including cardiac arrhythmias. Prior work revealed association of mRNAs encoding cardiac NaV1.5 (SCN5A) and hERG1 (KCNH2), but the functional significance of this association was not established. Here, we provide a more comprehensive picture of KCNH2, SCN5A, CACNA1C, and KCNQ1 transcripts collectively copurifying with nascent hERG1, NaV1.5, CaV1.2, or KCNQ1 channel proteins. Single-molecule fluorescence in situ hybridization (smFISH) combined with immunofluorescence reveals that the channel proteins are synthesized predominantly as heterotypic pairs from discrete molecules of mRNA, not as larger cotranslational complexes. Puromycin disrupted colocalization of mRNA with its encoded protein, as expected, but remarkably also pairwise mRNA association, suggesting that transcript association relies on intact translational machinery or the presence of the nascent protein. Targeted depletion of KCHN2 by specific shRNA resulted in concomitant reduction of all associated mRNAs, with a corresponding reduction in the encoded channel currents. This co-knockdown effect, originally described for KCNH2 and SCN5A, thus appears to be a general phenomenon among transcripts encoding functionally related proteins. In multielectrode array recordings, proarrhythmic behavior arose when IKr was reduced by the selective blocker dofetilide at IC50 concentrations, but not when equivalent reductions were mediated by shRNA, suggesting that co-knockdown mitigates proarrhythmic behavior expected from the selective reduction of a single channel species. We propose that coordinated, cotranslational association of functionally related ion channel mRNAs confers electrical stability by co-regulating complementary ion channels in macromolecular complexes.
Collapse
Affiliation(s)
- Margaret B. Jameson
- Department of Neuroscience, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI53705
| | - Erick B. Ríos-Pérez
- Department of Neuroscience, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI53705
| | - Fang Liu
- Department of Neuroscience, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI53705
| | - Catherine A. Eichel
- Department of Neuroscience, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI53705
| | - Gail A. Robertson
- Department of Neuroscience, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI53705
| |
Collapse
|
19
|
Frosio A, Micaglio E, Polsinelli I, Calamaio S, Melgari D, Prevostini R, Ghiroldi A, Binda A, Carrera P, Villa M, Mastrocinque F, Presi S, Salerno R, Boccellino A, Anastasia L, Ciconte G, Ricagno S, Pappone C, Rivolta I. Unravelling Novel SCN5A Mutations Linked to Brugada Syndrome: Functional, Structural, and Genetic Insights. Int J Mol Sci 2023; 24:15089. [PMID: 37894777 PMCID: PMC10606416 DOI: 10.3390/ijms242015089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Brugada Syndrome (BrS) is a rare inherited cardiac arrhythmia causing potentially fatal ventricular tachycardia or fibrillation, mainly occurring during rest or sleep in young individuals without heart structural issues. It increases the risk of sudden cardiac death, and its characteristic feature is an abnormal ST segment elevation on the ECG. While BrS has diverse genetic origins, a subset of cases can be conducted to mutations in the SCN5A gene, which encodes for the Nav1.5 sodium channel. Our study focused on three novel SCN5A mutations (p.A344S, p.N347K, and p.D349N) found in unrelated BrS families. Using patch clamp experiments, we found that these mutations disrupted sodium currents: p.A344S reduced current density, while p.N347K and p.D349N completely abolished it, leading to altered voltage dependence and inactivation kinetics when co-expressed with normal channels. We also explored the effects of mexiletine treatment, which can modulate ion channel function. Interestingly, the p.N347K and p.D349N mutations responded well to the treatment, rescuing the current density, while p.A344S showed a limited response. Structural analysis revealed these mutations were positioned in key regions of the channel, impacting its stability and function. This research deepens our understanding of BrS by uncovering the complex relationship between genetic mutations, ion channel behavior, and potential therapeutic interventions.
Collapse
Affiliation(s)
- Anthony Frosio
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
| | - Emanuele Micaglio
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
- Arrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (F.M.); (A.B.)
| | - Ivan Polsinelli
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
| | - Serena Calamaio
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
| | - Dario Melgari
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
| | - Rachele Prevostini
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
| | - Andrea Ghiroldi
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
- Laboratory of Stem Cells for Tissue Engineering, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Anna Binda
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48, 20900 Monza, Italy;
| | - Paola Carrera
- Laboratory of Clinical Molecular Genetics and Cytogenetics, Unit of Genomics for Diagnosis of Human Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (P.C.); (S.P.)
| | - Marco Villa
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
| | - Flavio Mastrocinque
- Arrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (F.M.); (A.B.)
| | - Silvia Presi
- Laboratory of Clinical Molecular Genetics and Cytogenetics, Unit of Genomics for Diagnosis of Human Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (P.C.); (S.P.)
| | - Raffaele Salerno
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, Italy;
| | - Antonio Boccellino
- Arrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (F.M.); (A.B.)
| | - Luigi Anastasia
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
- Laboratory of Stem Cells for Tissue Engineering, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, Italy;
| | - Giuseppe Ciconte
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
- Arrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (F.M.); (A.B.)
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, Italy;
| | - Stefano Ricagno
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
- Department of Biosciences, Università degli Studi di Milano, Via Celoria, 26, 20133 Milan, Italy
| | - Carlo Pappone
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
- Arrhythmia and Electrophysiology Department, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (F.M.); (A.B.)
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, Italy;
| | - Ilaria Rivolta
- Institute of Molecular and Translational Cardiology (IMTC), IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy; (A.F.); (E.M.); (I.P.); (S.C.); (D.M.); (R.P.); (A.G.); (M.V.); (L.A.); (G.C.); (S.R.); (C.P.)
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48, 20900 Monza, Italy;
| |
Collapse
|
20
|
Li S, Fraser S, Ranpura G, Lim S, Singer ES, Parker JDK, Crowe J, Bagnall RD, Laksman Z, Semsarian C. Generation of an induced pluripotent stem cell line from a patient with conduction disease and recurrent ventricular fibrillation with a sodium voltage-gated channel alpha subunit 5 (SCN5A) gene c.392 + 3A > G splice-site variant. Stem Cell Res 2023; 71:103153. [PMID: 37385135 DOI: 10.1016/j.scr.2023.103153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
Variants in the sodium voltage-gated channel alpha subunit 5 gene (SCN5A) produce variable cardiac phenotypes including Brugada syndrome, conduction disease and cardiomyopathy. These phenotypes can lead to life-threatening arrhythmias, heart failure, and sudden cardiac death. Novel variants in splice-site regions of SCN5A require functional studies to characterise their pathogenicity as they are poorly understood. The generation of an induced pluripotent stem cell line provides a valuable resource to investigate the functional effects of potential splice-disrupting variants in SCN5A.
Collapse
Affiliation(s)
- Serena Li
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Stuart Fraser
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia
| | - Ginell Ranpura
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Seakcheng Lim
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma S Singer
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jeremy D K Parker
- Center for Heart Lung Innovation, University of British Columbia, Vancouver, Canada
| | - Joshua Crowe
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Richard D Bagnall
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Zachary Laksman
- Center for Heart Lung Innovation, University of British Columbia, Vancouver, Canada; Heart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
| |
Collapse
|
21
|
Nasilli G, Yiangou L, Palandri C, Cerbai E, Davis RP, Verkerk AO, Casini S, Remme CA. Beneficial effects of chronic mexiletine treatment in a human model of SCN5A overlap syndrome. Europace 2023; 25:euad154. [PMID: 37369559 PMCID: PMC10299896 DOI: 10.1093/europace/euad154] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
AIMS SCN5A mutations are associated with various cardiac phenotypes, including long QT syndrome type 3 (LQT3), Brugada syndrome (BrS), and cardiac conduction disease (CCD). Certain mutations, such as SCN5A-1795insD, lead to an overlap syndrome, with patients exhibiting both features of BrS/CCD [decreased sodium current (INa)] and LQT3 (increased late INa). The sodium channel blocker mexiletine may acutely decrease LQT3-associated late INa and chronically increase peak INa associated with SCN5A loss-of-function mutations. However, most studies have so far employed heterologous expression systems and high mexiletine concentrations. We here investigated the effects of a therapeutic dose of mexiletine on the mixed phenotype associated with the SCN5A-1795insD mutation in HEK293A cells and human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). METHODS AND RESULTS To assess only the chronic effects on trafficking, HEK293A cells transfected with wild-type (WT) SCN5A or SCN5A-1795insD were incubated for 48 h with 10 µm mexiletine followed by wash-out, which resulted in an increased peak INa for both SCN5A-WT and SCN5A-1795insD and an increased late INa for SCN5A-1795insD. Acute re-exposure of HEK293A cells to 10 µm mexiletine did not impact on peak INa but significantly decreased SCN5A-1795insD late INa. Chronic incubation of SCN5A-1795insD hiPSC-CMs with mexiletine followed by wash-out increased peak INa, action potential (AP) upstroke velocity, and AP duration. Acute re-exposure did not impact on peak INa or AP upstroke velocity, but significantly decreased AP duration. CONCLUSION These findings demonstrate for the first time the therapeutic benefit of mexiletine in a human cardiomyocyte model of SCN5A overlap syndrome.
Collapse
Affiliation(s)
- Giovanna Nasilli
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Loukia Yiangou
- Department of Anatomy and Embryology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Chiara Palandri
- Department NeuroFarBa, University of Florence, Viale Gaetano Pieraccini 6, 50139, Florence, Italy
| | - Elisabetta Cerbai
- Department NeuroFarBa, University of Florence, Viale Gaetano Pieraccini 6, 50139, Florence, Italy
| | - Richard P Davis
- Department of Anatomy and Embryology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
- The Novo Nordisk Foundation Center for Stem Cell Medicine (reNEW), Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Arie O Verkerk
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
- Department of Medical Biology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Simona Casini
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| | - Carol Ann Remme
- Department of Experimental Cardiology, Amsterdam University Medical Center, University of Amsterdam, Heart Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure & Arrhythmias, Amsterdam, The Netherlands
| |
Collapse
|
22
|
Pannone L, Bisignani A, Osei R, Gauthey A, Sorgente A, Vergara P, Monaco C, Della Rocca DG, Del Monte A, Strazdas A, Mojica J, Al Housari M, Miraglia V, Mouram S, Paparella G, Ramak R, Overeinder I, Bala G, Almorad A, Ströker E, Pappaert G, Sieira J, de Ravel T, La Meir M, Brugada P, Chierchia GB, Van Dooren S, de Asmundis C. Genetic testing in children with Brugada syndrome: results from a large prospective registry. Europace 2023; 25:euad079. [PMID: 37061847 PMCID: PMC10227762 DOI: 10.1093/europace/euad079] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/07/2023] [Indexed: 04/17/2023] Open
Abstract
AIMS A pathogenic/likely pathogenic (P/LP) variant in SCN5A is found in 20-25% of patients with Brugada syndrome (BrS). However, the diagnostic yield and prognosis of gene panel testing in paediatric BrS is unclear. The aim of this study is to define the diagnostic yield and outcomes of SCN5A gene testing with ACMG variant classification in paediatric BrS patients compared with adults. METHODS AND RESULTS All consecutive patients diagnosed with BrS, between 1992 and 2022, were prospectively enrolled in the UZ Brussel BrS registry. Inclusion criteria were: (i) BrS diagnosis; (ii) genetic analysis performed with a large gene panel; and (iii) classification of gene variants following ACMG guidelines. Paediatric patients were defined as ≤16 years of age. The primary endpoint was ventricular arrhythmias (VAs). A total of 500 BrS patients were included, with 63 paediatric patients and 437 adult patients. Among children with BrS, 29 patients (46%) had a P/LP variant (P+) in SCN5A and no variants were found in 34 (54%) patients (P-). After a mean follow-up of 125.9 months, 8 children (12.7%) experienced a VA, treated with implanted cardioverter defibrillator shock. At survival analysis, P- paediatric patients had higher VA-free survival during the follow-up, compared with P+ paediatric patients. P+ status was an independent predictor of VA. There was no difference in VA-free survival between paediatric and adult BrS patients for both P- and P+. CONCLUSION In a large BrS cohort, the diagnostic yield for P/LP variants in the paediatric population is 46%. P+ children with BrS have a worse arrhythmic prognosis.
Collapse
Affiliation(s)
- Luigi Pannone
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Antonio Bisignani
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Randy Osei
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Brussels, Belgium
| | - Anaïs Gauthey
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Antonio Sorgente
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Pasquale Vergara
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Cinzia Monaco
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Domenico Giovanni Della Rocca
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Alvise Del Monte
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Antanas Strazdas
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Joerelle Mojica
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Maysam Al Housari
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Vincenzo Miraglia
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Sahar Mouram
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Gaetano Paparella
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Robbert Ramak
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Ingrid Overeinder
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Gezim Bala
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Alexandre Almorad
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Erwin Ströker
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Gudrun Pappaert
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Juan Sieira
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Thomy de Ravel
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Brussels, Belgium
| | - Mark La Meir
- Cardiac Surgery Department, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, Brussels, Belgium
| | - Pedro Brugada
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Gian Battista Chierchia
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| | - Sonia Van Dooren
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, Research Group Reproduction and Genetics, Centre for Medical Genetics, Brussels, Belgium
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, Research Group Reproduction and Genetics, Brussels Interuniversity Genomics High Throughput Core (BRIGHTcore), Brussels, Belgium
| | - Carlo de Asmundis
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel—Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan, 101 1090 Brussels, Belgium
| |
Collapse
|
23
|
Stutzman MJ, Gao X, Kim M, Ye D, Zhou W, Tester DJ, Giudicessi JR, Shannon K, Ackerman MJ. Functional characterization and identification of a therapeutic for a novel SCN5A-F1760C variant causing type 3 long QT syndrome refractory to all guideline-directed therapies. Heart Rhythm 2023; 20:709-717. [PMID: 36731785 DOI: 10.1016/j.hrthm.2023.01.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Pathogenic variants in the SCN5A-encoded Nav1.5 sodium channel cause type 3 long QT syndrome (LQT3). We present the case of an infant with severe LQT3 who was refractory to multiple pharmacologic therapies as well as bilateral stellate ganglionectomy. The patient's novel variant, p.F1760C-SCN5A, involves a critical residue of the Nav1.5's local anesthetic binding domain. OBJECTIVE The purpose of this study was to characterize functionally the p.F1760C-SCN5A variant using TSA-201 and patient-specific induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). METHODS Whole-cell patch clamp was used to assess p.F1760C-SCN5A associated sodium currents with/without lidocaine (Lido), flecainide, and phenytoin (PHT) in TSA-201 cells. p.F1760C-SCN5A and CRISPR-Cas9 variant-corrected isogenic control (IC) iPSC-CMs were generated. FluoVolt voltage dye was used to measure the action potential duration (APD) with/without mexiletine or PHT. RESULTS V1/2 of inactivation was right-shifted significantly in F1760C cells (-72.2 ± 0.7 mV) compared to wild-type (WT) cells (-86.3 ± 0.9 mV; P <.0001) resulting in a marked increase in window current. F1760C increased sodium late current 2-fold from 0.18% ± 0.04% of peak in WT to 0.49% ± 0.07% of peak in F1760C (P = .0005). Baseline APD to 90% repolarization (APD90) was increased markedly in F1760C iPSC-CMs (601 ± 4 ms) compared to IC iPSC-CMs (423 ± 15 ms; P <.0001). However, 4-hour treatment with 10 μM mexiletine failed to shorten APD90, and treatment with 5μM PHT significantly decreased APD90 of F1760C iPSC-CMs (453 ± 6 ms; P <.0001). CONCLUSION PHT rescued electrophysiological phenotype and APD of a novel p.F1760C-SCN5A variant. The antiepileptic drug PHT may be an effective alternative therapeutic for the treatment of LQT3, especially for variants that disrupt the Lido/mexiletine binding site.
Collapse
Affiliation(s)
- Marissa J Stutzman
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Xiaozhi Gao
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Maengjo Kim
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Dan Ye
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Wei Zhou
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota
| | - David J Tester
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota
| | - John R Giudicessi
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Kevin Shannon
- Department of Pediatrics, David Geffen UCLA School of Medicine, Los Angeles, California
| | - Michael J Ackerman
- Department of Cardiovascular Medicine, Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota.
| |
Collapse
|
24
|
Wang Y, Long S, Wei C, Wang X. Rare Compound Heterozygous Missense Mutation of the SCN5A Gene with Childhood-Onset Sick Sinus Syndrome in Two Chinese Sisters. Int Heart J 2023; 64:299-305. [PMID: 36927930 DOI: 10.1536/ihj.22-515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Sick sinus syndrome (SSS) is a group of syndromes characterized by pathological changes in the sinoatrial node and its adjacent tissues. Although several mutations in the SCN5A gene have been associated with early-onset SSS, pediatric patients are still less common. Here, we report a rare compound missense mutation in the SCN5A gene [c.2893C>T (p. R965C) and c.2431C>T (p. R811C) ] in two sisters with childhood-onset SSS in Chinese population. The proband (5 years and 5 months old) was the second child of a clinically normal and nonconsanguineous couple. Her elder sister was 12 years old and had been implanted with a pacemaker because of the diagnosis of SSS at another hospital one year ago. The proband was presented to the hospital with a slowed heart rate and reduced endurance exercise capacity for more than three months. After a comprehensive clinical examination, she was diagnosed with SSS and underwent pacemaker implantation. Exome and Sanger sequencing were used to determine the compound heterozygous missense mutation of [c.2893C>T (p. R965C) and c.2431C>T (p. R811C) ] in the SCN5A in the patient and her elder sister. Each healthy parent carried a different heterozygous missense mutation. The compound heterozygous mutation of c.2893C>T (p. R965C) and c.2431C>T (p. R811C) rather than the single mutation might be the primary cause of familial early-onset SSS in Chinese population. Our current findings expanded the current understanding of the SCN5A gene mutations. We further confirmed the essential role of the SCN5A gene on the diagnosis, family cascade screening, early intervention, and prognostic evaluation of SSS.
Collapse
Affiliation(s)
- Yanyun Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Sichuan University
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
- NHC Key Laboratory of Chronobiology (Sichuan University), West China Second University Hospital, Sichuan University
| | - Siyu Long
- Department of Immunology, West China School of Basic Medical Science and Forensic Medicine, Sichuan University
| | - Chenxi Wei
- Wu Yuzhang Honors College, Sichuan University
| | - Xiaoqin Wang
- NHC Key Laboratory of Chronobiology (Sichuan University), West China Second University Hospital, Sichuan University
- Department of Pediatric Cardiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
| |
Collapse
|
25
|
Campostrini G, Kosmidis G, Ward-van Oostwaard D, Davis RP, Yiangou L, Ottaviani D, Veerman CC, Mei H, Orlova VV, Wilde AAM, Bezzina CR, Verkerk AO, Mummery CL, Bellin M. Maturation of hiPSC-derived cardiomyocytes promotes adult alternative splicing of SCN5A and reveals changes in sodium current associated with cardiac arrhythmia. Cardiovasc Res 2023; 119:167-182. [PMID: 35394010 PMCID: PMC10022870 DOI: 10.1093/cvr/cvac059] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/07/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS Human-induced pluripotent stem cell-cardiomyocytes (hiPSC-CMs) are widely used to study arrhythmia-associated mutations in ion channels. Among these, the cardiac sodium channel SCN5A undergoes foetal-to-adult isoform switching around birth. Conventional hiPSC-CM cultures, which are phenotypically foetal, have thus far been unable to capture mutations in adult gene isoforms. Here, we investigated whether tri-cellular cross-talk in a three-dimensional (3D) cardiac microtissue (MT) promoted post-natal SCN5A maturation in hiPSC-CMs. METHODS AND RESULTS We derived patient hiPSC-CMs carrying compound mutations in the adult SCN5A exon 6B and exon 4. Electrophysiological properties of patient hiPSC-CMs in monolayer were not altered by the exon 6B mutation compared with isogenic controls since it is not expressed; further, CRISPR/Cas9-mediated excision of the foetal exon 6A did not promote adult SCN5A expression. However, when hiPSC-CMs were matured in 3D cardiac MTs, SCN5A underwent isoform switch and the functional consequences of the mutation located in exon 6B were revealed. Up-regulation of the splicing factor muscleblind-like protein 1 (MBNL1) drove SCN5A post-natal maturation in microtissues since its overexpression in hiPSC-CMs was sufficient to promote exon 6B inclusion, whilst knocking-out MBNL1 failed to foster isoform switch. CONCLUSIONS Our study shows that (i) the tri-cellular cardiac microtissues promote post-natal SCN5A isoform switch in hiPSC-CMs, (ii) adult splicing of SCN5A is driven by MBNL1 in these tissues, and (iii) this model can be used for examining post-natal cardiac arrhythmias due to mutations in the exon 6B. TRANSLATIONAL PERSPECTIVE The cardiac sodium channel is essential for conducting the electrical impulse in the heart. Postnatal alternative splicing regulation causes mutual exclusive inclusion of fetal or adult exons of the corresponding gene, SCN5A. Typically, immature hiPSCCMs fall short in studying the effect of mutations located in the adult exon. We describe here that an innovative tri-cellular three-dimensional cardiac microtissue culture promotes hiPSC-CMs maturation through upregulation of MBNL1, thus revealing the effect of a pathogenic genetic variant located in the SCN5A adult exon. These results help advancing the use of hiPSC-CMs in studying adult heart disease and for developing personalized medicine applications.
Collapse
Affiliation(s)
- Giulia Campostrini
- Department of Anatomy and Embryology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Georgios Kosmidis
- Department of Anatomy and Embryology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Dorien Ward-van Oostwaard
- Department of Anatomy and Embryology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Richard Paul Davis
- Department of Anatomy and Embryology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Loukia Yiangou
- Department of Anatomy and Embryology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Daniele Ottaviani
- Department of Biology, University of Padua, 35121 Padua, Italy
- Veneto Institute of Molecular Medicine, 35129 Padua, Italy
| | - Christiaan Cornelis Veerman
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam University Medical Centre, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Hailiang Mei
- Sequencing Analysis Support Core, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Valeria Viktorovna Orlova
- Department of Anatomy and Embryology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Arthur Arnold Maria Wilde
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam University Medical Centre, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Connie Rose Bezzina
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam University Medical Centre, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Arie Otto Verkerk
- Department of Clinical and Experimental Cardiology, Heart Centre, Amsterdam University Medical Centre, location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Christine Lindsay Mummery
- Department of Anatomy and Embryology, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
- Department of Applied Stem Cell Technologies, University of Twente, 7500 AE, Enschede, The Netherlands
| | | |
Collapse
|
26
|
Zhu J, Shen Y, Xiong H, Zha H, Zhang L, Peng H, Tian L. Identification of a novel missense SCN5A mutation in a Chinese Han family with Brugada syndrome. Biochem Biophys Res Commun 2023; 649:55-61. [PMID: 36745970 DOI: 10.1016/j.bbrc.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/16/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
Brugada syndrome is an inherited cardiac arrythmia causes sudden death usually associated with loss-of-function mutations of SCN5A, a gene encodes α subunit of cardiac sodium channel Nav1.5 which plays key role in cardiac function. SCN5A mutation screen is often applied to diagnosis of Brugada syndrome, while its genetic etiology remains not fully understood. In present study, we performed sequence analysis of SCN5A gene in a Chinese Han family with Brugada syndrome, and found a novel heterozygous mutation (c.4969 C > T, p.Leu1657Phe). Functional electrophysiological study showed that the mutation reduced ∼60% sodium current density and largely reduced Nav1.5 activation (positively shifted activation curve by 13.93 mV), which are the key features for the pathogenesis of Brugada syndrome. However, the mutation enhanced Nav1.5 function as it slightly decreased inactivation (positively shifted inactivation curve by 7.4 mV) and accelerated recovery (decreased fast recovery by 1.39 ms). In addition, the mutation acts in a dominant negatively manner as it reduced ∼49% sodium current densities in heterozygous state. In conclusion, the study describes a novel SCN5A mutation of p.Leu1657Phe associated with Brugada syndrome, the mutation reduced current density in a dominant negative manner and altered gating kinetics, which will benefit early clinical diagnosis of Brugada syndrome.
Collapse
Affiliation(s)
- Jianfang Zhu
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, PR China
| | - Ya Shen
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430019, PR China
| | - Hongbo Xiong
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, PR China
| | - Hui Zha
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, PR China
| | - Ling Zhang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, PR China
| | - Hua Peng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, PR China
| | - Li Tian
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, PR China.
| |
Collapse
|
27
|
Bersell KR, Yang T, Mosley JD, Glazer AM, Hale AT, Kryshtal DO, Kim K, Steimle JD, Brown JD, Salem JE, Campbell CC, Hong CC, Wells QS, Johnson AN, Short L, Blair MA, Behr ER, Petropoulou E, Jamshidi Y, Benson MD, Keyes MJ, Ngo D, Vasan RS, Yang Q, Gerszten RE, Shaffer C, Parikh S, Sheng Q, Kannankeril PJ, Moskowitz IP, York JD, Wang TJ, Knollmann BC, Roden DM. Transcriptional Dysregulation Underlies Both Monogenic Arrhythmia Syndrome and Common Modifiers of Cardiac Repolarization. Circulation 2023; 147:824-840. [PMID: 36524479 PMCID: PMC9992308 DOI: 10.1161/circulationaha.122.062193] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Brugada syndrome (BrS) is an inherited arrhythmia syndrome caused by loss-of-function variants in the cardiac sodium channel gene SCN5A (sodium voltage-gated channel alpha subunit 5) in ≈20% of subjects. We identified a family with 4 individuals diagnosed with BrS harboring the rare G145R missense variant in the cardiac transcription factor TBX5 (T-box transcription factor 5) and no SCN5A variant. METHODS We generated induced pluripotent stem cells (iPSCs) from 2 members of a family carrying TBX5-G145R and diagnosed with Brugada syndrome. After differentiation to iPSC-derived cardiomyocytes (iPSC-CMs), electrophysiologic characteristics were assessed by voltage- and current-clamp experiments (n=9 to 21 cells per group) and transcriptional differences by RNA sequencing (n=3 samples per group), and compared with iPSC-CMs in which G145R was corrected by CRISPR/Cas9 approaches. The role of platelet-derived growth factor (PDGF)/phosphoinositide 3-kinase (PI3K) pathway was elucidated by small molecule perturbation. The rate-corrected QT (QTc) interval association with serum PDGF was tested in the Framingham Heart Study cohort (n=1893 individuals). RESULTS TBX5-G145R reduced transcriptional activity and caused multiple electrophysiologic abnormalities, including decreased peak and enhanced "late" cardiac sodium current (INa), which were entirely corrected by editing G145R to wild-type. Transcriptional profiling and functional assays in genome-unedited and -edited iPSC-CMs showed direct SCN5A down-regulation caused decreased peak INa, and that reduced PDGF receptor (PDGFRA [platelet-derived growth factor receptor α]) expression and blunted signal transduction to PI3K was implicated in enhanced late INa. Tbx5 regulation of the PDGF axis increased arrhythmia risk due to disruption of PDGF signaling and was conserved in murine model systems. PDGF receptor blockade markedly prolonged normal iPSC-CM action potentials and plasma levels of PDGF in the Framingham Heart Study were inversely correlated with the QTc interval (P<0.001). CONCLUSIONS These results not only establish decreased SCN5A transcription by the TBX5 variant as a cause of BrS, but also reveal a new general transcriptional mechanism of arrhythmogenesis of enhanced late sodium current caused by reduced PDGF receptor-mediated PI3K signaling.
Collapse
Affiliation(s)
- Kevin R Bersell
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Tao Yang
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Jonathan D Mosley
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Andrew M Glazer
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Andrew T Hale
- Biochemistry (A.T.H., J.D.Y.), Vanderbilt University, Nashville, TN
| | - Dmytro O Kryshtal
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Kyungsoo Kim
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Jeffrey D Steimle
- Departments of Pediatrics, Pathology, and Human Genetics, University of Chicago, IL (J.D.S., I.P.M.)
| | - Jonathan D Brown
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Joe-Elie Salem
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
- Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Pharmacology, CIC-1901, Sorbonne University, Paris, France (J-E.S.)
- Sorbonne Universités, UPMC Univ Paris 06, Faculty of Medicine, France (J-E.S.)
| | - Courtney C Campbell
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Charles C Hong
- Department of Medicine, University of Maryland School of Medicine, Baltimore (C.C.H.)
| | - Quinn S Wells
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
- Biomedical Informatics (Q.S.W., D.M.R.), Vanderbilt University, Nashville, TN
| | - Amanda N Johnson
- Molecular Physiology and Biophysics (A.N.J.), Vanderbilt University, Nashville, TN
| | - Laura Short
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Marcia A Blair
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | | | - Evmorfia Petropoulou
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Institute, St George's, University of London and St George's University Hospitals National Health Service Foundation Trust, London, UK (E.P., Y.J.)
| | - Yalda Jamshidi
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Institute, St George's, University of London and St George's University Hospitals National Health Service Foundation Trust, London, UK (E.P., Y.J.)
| | - Mark D Benson
- Cardiovascular Research Center (E.J.B., M.D.B., M.J.K., R.E.G.), Beth Israel Deaconess Hospital, Boston, MA
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (M.D.B.)
| | - Michelle J Keyes
- Cardiovascular Research Center (E.J.B., M.D.B., M.J.K., R.E.G.), Beth Israel Deaconess Hospital, Boston, MA
| | - Debby Ngo
- Division of Pulmonary and Cardiovascular Medicine (D.N., R.E.G.), Beth Israel Deaconess Hospital, Boston, MA
| | | | - Qiong Yang
- Boston University School of Medicine, MA (R.S.V., Q.Y.)
| | - Robert E Gerszten
- Cardiovascular Research Center (E.J.B., M.D.B., M.J.K., R.E.G.), Beth Israel Deaconess Hospital, Boston, MA
- Division of Pulmonary and Cardiovascular Medicine (D.N., R.E.G.), Beth Israel Deaconess Hospital, Boston, MA
| | - Christian Shaffer
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Shan Parikh
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | | | | | - Ivan P Moskowitz
- Departments of Pediatrics, Pathology, and Human Genetics, University of Chicago, IL (J.D.S., I.P.M.)
| | - John D York
- Biochemistry (A.T.H., J.D.Y.), Vanderbilt University, Nashville, TN
| | - Thomas J Wang
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Bjorn C Knollmann
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
| | - Dan M Roden
- Departments of Pharmacology (K.R.B., A.M.G., D.O.K., K.K., J-E.S., C.C.C., Q.S.W., S.P., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
- Medicine (T.Y., J.D.M., J.D.B., J-E.S., Q.S.W., L.S., M.A.B., C.S., T.J.W., B.C.K., D.M.R.), Vanderbilt University, Nashville, TN
- Biomedical Informatics (Q.S.W., D.M.R.), Vanderbilt University, Nashville, TN
| |
Collapse
|
28
|
Popa IP, Șerban DN, Mărănducă MA, Șerban IL, Tamba BI, Tudorancea I. Brugada Syndrome: From Molecular Mechanisms and Genetics to Risk Stratification. Int J Mol Sci 2023; 24:ijms24043328. [PMID: 36834739 PMCID: PMC9967917 DOI: 10.3390/ijms24043328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/13/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Brugada syndrome (BrS) is a rare hereditary arrhythmia disorder, with a distinctive ECG pattern, correlated with an increased risk of ventricular arrhythmias and sudden cardiac death (SCD) in young adults. BrS is a complex entity in terms of mechanisms, genetics, diagnosis, arrhythmia risk stratification, and management. The main electrophysiological mechanism of BrS requires further research, with prevailing theories centered on aberrant repolarization, depolarization, and current-load match. Computational modelling, pre-clinical, and clinical research show that BrS molecular anomalies result in excitation wavelength (k) modifications, which eventually increase the risk of arrhythmia. Although a mutation in the SCN5A (Sodium Voltage-Gated Channel Alpha Subunit 5) gene was first reported almost two decades ago, BrS is still currently regarded as a Mendelian condition inherited in an autosomal dominant manner with incomplete penetrance, despite the recent developments in the field of genetics and the latest hypothesis of additional inheritance pathways proposing a more complex mode of inheritance. In spite of the extensive use of the next-generation sequencing (NGS) technique with high coverage, genetics remains unexplained in a number of clinically confirmed cases. Except for the SCN5A which encodes the cardiac sodium channel NaV1.5, susceptibility genes remain mostly unidentified. The predominance of cardiac transcription factor loci suggests that transcriptional regulation is essential to the Brugada syndrome's pathogenesis. It appears that BrS is a multifactorial disease, which is influenced by several loci, each of which is affected by the environment. The primary challenge in individuals with a BrS type 1 ECG is to identify those who are at risk for sudden death, researchers propose the use of a multiparametric clinical and instrumental strategy for risk stratification. The aim of this review is to summarize the latest findings addressing the genetic architecture of BrS and to provide novel perspectives into its molecular underpinnings and novel models of risk stratification.
Collapse
Affiliation(s)
- Irene Paula Popa
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
| | - Dragomir N. Șerban
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Minela Aida Mărănducă
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ionela Lăcrămioara Șerban
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Bogdan Ionel Tamba
- Department of Pharmacology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Correspondence:
| | - Ionuț Tudorancea
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iași, Romania
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| |
Collapse
|
29
|
Miller JA, Moise N, Weinberg SH. Modeling incomplete penetrance in long QT syndrome type 3 through ion channel heterogeneity: an in silico population study. Am J Physiol Heart Circ Physiol 2023; 324:H179-H197. [PMID: 36487185 PMCID: PMC10072004 DOI: 10.1152/ajpheart.00430.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/16/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Abstract
Many cardiac diseases are characterized by an increased late sodium current, including heart failure, hypertrophic cardiomyopathy, and inherited long QT syndrome type 3 (LQT3). The late sodium current in LQT3 is caused by a gain-of-function mutation in the voltage-gated sodium channel Nav1.5. Despite a well-defined genetic cause of LQT3, treatment remains inconsistent because of incomplete penetrance of the mutation and variability of antiarrhythmic efficacy. Here, we investigate the relationship between LQT3-associated mutation incomplete penetrance and variability in ion channel expression, simulating a population of 1,000 individuals with the O'Hara-Rudy model of the human ventricular myocyte. We first simulate healthy electrical activity (i.e., in the absence of a mutation) and then incorporate heterozygous expression for three LQT3-associated mutations (Y1795C, I1768V, and ΔKPQ), to directly compare the effects of each mutation on individuals across a diverse population. For all mutations, we find that susceptibility, defined by either the presence of an early afterdepolarization (EAD) or prolonged action potential duration (APD), primarily depends on the balance between the conductance of IKr and INa, for which individuals with a higher IKr-to-INa ratio are less susceptible. Furthermore, we find distinct differences across the population, observing individuals susceptible to zero, one, two, or all three mutations. Individuals tend to be less susceptible with an appropriate balance of repolarizing currents, typically via increased IKs or IK1. Interestingly, the more critical repolarizing current is mutation specific. We conclude that the balance between key currents plays a significant role in mutant-specific presentation of the disease phenotype in LQT3.NEW & NOTEWORTHY An in silico population approach investigates the relationship between variability in ion channel expression and gain-of-function mutations in the voltage-gated sodium channel associated with the congenital disorder long QT syndrome type 3 (LQT3). We find that ion channel variability can contribute to incomplete penetrance of the mutation, with mutant-specific differences in ion channel conductances leading to susceptibility to proarrhythmic action potential duration prolongation or early afterdepolarizations.
Collapse
Affiliation(s)
- Jacob A Miller
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio
| | - Nicolae Moise
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio
| | - Seth H Weinberg
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio
- Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| |
Collapse
|
30
|
Plijter IS, Verkerk AO, Wilders R. The Antidepressant Paroxetine Reduces the Cardiac Sodium Current. Int J Mol Sci 2023; 24:ijms24031904. [PMID: 36768229 PMCID: PMC9915920 DOI: 10.3390/ijms24031904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/05/2023] [Accepted: 01/13/2023] [Indexed: 01/21/2023] Open
Abstract
A considerable amount of literature has been published on antidepressants and cardiac ion channel dysfunction. The antidepressant paroxetine has been associated with Brugada syndrome and long QT syndrome, albeit on the basis of conflicting findings. The cardiac voltage-gated sodium channel (NaV1.5) is related to both of these syndromes, suggesting that paroxetine may have an effect on this channel. In the present study, we therefore carried out patch clamp experiments to examine the effect of paroxetine on human NaV1.5 channels stably expressed in human embryonic kidney 293 (HEK-293) cells as well as on action potentials of isolated rabbit left ventricular cardiomyocytes. Additionally, computer simulations were conducted to test the functional effects of the experimentally observed paroxetine-induced changes in the NaV1.5 current. We found that paroxetine led to a decrease in peak NaV1.5 current in a concentration-dependent manner with an IC50 of 6.8 ± 1.1 µM. In addition, paroxetine caused a significant hyperpolarizing shift in the steady-state inactivation of the NaV1.5 current as well as a significant increase in its rate of inactivation. Paroxetine (3 µM) affected the action potential of the left ventricular cardiomyocytes, significantly decreasing its maximum upstroke velocity and amplitude, both of which are mainly regulated by the NaV1.5 current. Our computer simulations demonstrated that paroxetine substantially reduces the fast sodium current of human left ventricular cardiomyocytes, thereby slowing conduction and reducing excitability in strands of cells, in particular if conduction and excitability are already inhibited by a loss-of-function mutation in the NaV1.5 encoding SCN5A gene. In conclusion, paroxetine acts as an inhibitor of NaV1.5 channels, which may enhance the effects of loss-of-function mutations in SCN5A.
Collapse
Affiliation(s)
- Ingmar S. Plijter
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Arie O. Verkerk
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Department of Experimental Cardiology, Heart Center, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Ronald Wilders
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Correspondence:
| |
Collapse
|
31
|
Chen GX, Barajas-Martínez H, Ciconte G, Wu CI, Monasky MM, Xia H, Li B, Capra JA, Guo K, Zhang ZH, Chen X, Yang B, Jiang H, Tse G, Mak CM, Aizawa Y, Gollob MH, Antzelevitch C, Wilde AAM, Pappone C, Hu D. Clinical characteristics and electrophysiologic properties of SCN5A variants in fever-induced Brugada syndrome. EBioMedicine 2023; 87:104388. [PMID: 36516610 PMCID: PMC9768239 DOI: 10.1016/j.ebiom.2022.104388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 10/12/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Brugada syndrome (BrS) is a severe inherited arrhythmia syndrome that can be unmasked by fever. METHODS A multicentre clinical analysis was performed in 261 patients diagnosed with fever-induced BrS, including 198 (75.9%) and 27 (10.3%) patients who received next-generation genetic sequencing and epicardial arrhythmogenic substrate (AS) mapping, respectively. FINDINGS In fever-induced BrS patients, pathogenic or likely pathogenic (P/LP) SCN5A variant carriers developed fever-induced BrS at a younger age, and more often in females and those of Caucasian descent. They exhibited significant electrophysical abnormalities, including a larger epicardial AS area, and more prolonged abnormal epicardial electrograms. During a median follow-up of 50.5 months (quartiles 32.5-81.5 months) after the diagnosis, major cardiac events (MCE) occurred in 27 (14.4%) patients. Patients with P/LP SCN5A variants had a higher ratio of MCE compared with the rest. Additionally, history of syncope, QRS duration, and Tpe interval could also predict an increased risk for future MCE according to univariate analysis. Multivariate analysis indicated that only P/LP SCN5A variants were independent significant predictors of MCE. Computational structural modelling showed that most variants are destabilizing, suggesting that Nav1.5 structure destabilization caused by SCN5A missense variants may contribute to fever-induced BrS. INTERPRETATION In our cohort, P/LP SCN5A variant carriers with fever-induced BrS are more prevalent among patients of Caucasian descent, females, and younger patients. These patients exhibit aggressive electrophysiological abnormalities and worse outcome, which warrants closer monitoring and more urgent management of fever. FUNDING The current work was supported by the National Natural Science Foundation Project of China (Nos. 82270332 & 81670304), The Fundamental Research Funds for the Central Universities of China - Independent Research Project of Wuhan University (No. 2042022kf1217) from China; the National Institutes of Health of USA [NIH R56 (HL47678), NIH R01 (HL138103), and NIH R01 (HL152201)], the W. W. Smith Charitable Trust and the Wistar and Martha Morris Fund, Sharpe-Strumia Research Foundation, the American Heart Association Postdoctoral Fellowship (20POST35220002) from United States; the Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation, Dutch Federation of University Medical Centers, the Netherlands Organization for Health Research and Development, and the Royal Netherlands Academy of Sciences (PREDICT2) from the Netherlands.
Collapse
Affiliation(s)
- Gan-Xiao Chen
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, Hubei, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China
| | - Hector Barajas-Martínez
- Lankenau Institute for Medical Research and Lankenau Heart Institute, Wynnwood, PA, USA; Jefferson Medical College, Philadelphia, PA, USA
| | - Giuseppe Ciconte
- Arrhythmia and Electrophysiology Center, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy; Vita-Salute San Raffaele University, Milan, Italy; Institute of Molecular and Translational Cardiology (IMTC), San Donato Milanese, Milan, Italy
| | - Cheng-I Wu
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands; Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Michelle M Monasky
- Arrhythmia and Electrophysiology Center, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Hao Xia
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, Hubei, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China
| | - Bian Li
- Department of Biological Sciences and Center for Structural Biology, Vanderbilt University, Nashville, TN, USA
| | - John A Capra
- Bakar Computational Health Sciences Institute and Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Kai Guo
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhong-He Zhang
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, Hubei, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China
| | - Xiu Chen
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, Hubei, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China
| | - Bo Yang
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, Hubei, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China
| | - Hong Jiang
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, Hubei, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China; Kent and Medway Medical School, Canterbury, Kent, United Kingdom; School of Nursing and Health Studies, Metropolitan University, Hong Kong, China
| | - Chloe Miu Mak
- Department of Pathology, Hong Kong Children's Hospital, Hong Kong, China
| | - Yoshiyasu Aizawa
- Department of Cardiovascular Medicine, International University of Health and Welfare, School of Medicine, 4-3, Kozunomori, Narita, Chiba, Japan
| | - Michael H Gollob
- Department of Physiology and Division of Cardiology, University of Toronto, Toronto, ON, Canada
| | - Charles Antzelevitch
- Lankenau Institute for Medical Research and Lankenau Heart Institute, Wynnwood, PA, USA; Jefferson Medical College, Philadelphia, PA, USA
| | - Arthur A M Wilde
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Carlo Pappone
- Arrhythmia and Electrophysiology Center, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy; Vita-Salute San Raffaele University, Milan, Italy; Institute of Molecular and Translational Cardiology (IMTC), San Donato Milanese, Milan, Italy
| | - Dan Hu
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, Hubei, China; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China.
| |
Collapse
|
32
|
Gamal El-Din TM. When the Gates Swing Open Only: Arrhythmia Mutations That Target the Fast Inactivation Gate of Na v1.5. Cells 2022; 11:cells11233714. [PMID: 36496974 PMCID: PMC9735811 DOI: 10.3390/cells11233714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022] Open
Abstract
Nav1.5 is the main voltage-gated sodium channel found in cardiac muscle, where it facilitates the fast influx of Na+ ions across the cell membrane, resulting in the fast depolarization phase-phase 0 of the cardiac action potential. As a result, it plays a major role in determining the amplitude and the upstroke velocity of the cardiac impulse. Quantitively, cardiac sodium channel activates in less than a millisecond to trigger the cardiac action potential and inactivates within 2-3 ms to facilitate repolarization and return to the resting state in preparation for firing the next action potential. Missense mutations in the gene that encodes Nav1.5 (SCN5A), change these time constants which leads to a wide spectrum of cardiac diseases ranging from long QT syndrome type 3 (LQT3) to sudden cardiac death. In this mini-review I will focus on the missense mutations in the inactivation gate of Nav1.5 that results in arrhythmia, attempting to correlate the location of the missense mutation to their specific phenotype.
Collapse
|
33
|
Teng ACT, Gu L, Di Paola M, Lakin R, Williams ZJ, Au A, Chen W, Callaghan NI, Zadeh FH, Zhou YQ, Fatah M, Chatterjee D, Jourdan LJ, Liu J, Simmons CA, Kislinger T, Yip CM, Backx PH, Gourdie RG, Hamilton RM, Gramolini AO. Tmem65 is critical for the structure and function of the intercalated discs in mouse hearts. Nat Commun 2022; 13:6166. [PMID: 36257954 PMCID: PMC9579145 DOI: 10.1038/s41467-022-33303-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/07/2022] [Indexed: 12/24/2022] Open
Abstract
The intercalated disc (ICD) is a unique membrane structure that is indispensable to normal heart function, yet its structural organization is not completely understood. Previously, we showed that the ICD-bound transmembrane protein 65 (Tmem65) was required for connexin43 (Cx43) localization and function in cultured mouse neonatal cardiomyocytes. Here, we investigate the functional and cellular effects of Tmem65 reductions on the myocardium in a mouse model by injecting CD1 mouse pups (3-7 days after birth) with recombinant adeno-associated virus 9 (rAAV9) harboring Tmem65 shRNA, which reduces Tmem65 expression by 90% in mouse ventricles compared to scrambled shRNA injection. Tmem65 knockdown (KD) results in increased mortality which is accompanied by eccentric hypertrophic cardiomyopathy within 3 weeks of injection and progression to dilated cardiomyopathy with severe cardiac fibrosis by 7 weeks post-injection. Tmem65 KD hearts display depressed hemodynamics as measured echocardiographically as well as slowed conduction in optical recording accompanied by prolonged PR intervals and QRS duration in electrocardiograms. Immunoprecipitation and super-resolution microscopy demonstrate a physical interaction between Tmem65 and sodium channel β subunit (β1) in mouse hearts and this interaction appears to be required for both the establishment of perinexal nanodomain structure and the localization of both voltage-gated sodium channel 1.5 (NaV1.5) and Cx43 to ICDs. Despite the loss of NaV1.5 at ICDs, whole-cell patch clamp electrophysiology did not reveal reductions in Na+ currents but did show reduced Ca2+ and K+ currents in Tmem65 KD cardiomyocytes in comparison to control cells. We conclude that disrupting Tmem65 function results in impaired ICD structure, abnormal cardiac electrophysiology, and ultimately cardiomyopathy.
Collapse
Affiliation(s)
- Allen C T Teng
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Translational Biology and Engineering Program, Ted Rogers Centre for Heart Research, Toronto, ON, M5G 1M1, Canada.
| | - Liyang Gu
- Translational Biology and Engineering Program, Ted Rogers Centre for Heart Research, Toronto, ON, M5G 1M1, Canada
| | - Michelle Di Paola
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Translational Biology and Engineering Program, Ted Rogers Centre for Heart Research, Toronto, ON, M5G 1M1, Canada
| | - Robert Lakin
- Department of Biology, York University, Toronto, ON, M3J 1P3, Canada
| | - Zachary J Williams
- The Center for Heart and Reparative Medicine, Fralin Biomedical Research Institute at Virginia Tech. Carilion, Roanoke, VA, 24016, USA
- Translational Biology Medicine and Health Graduate Program, Virginia Tech, Roanoke, VA, 24016, USA
| | - Aaron Au
- Institute of Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, M5S 3G9, Canada
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada
| | - Wenliang Chen
- Department of Biology, York University, Toronto, ON, M3J 1P3, Canada
| | - Neal I Callaghan
- Translational Biology and Engineering Program, Ted Rogers Centre for Heart Research, Toronto, ON, M5G 1M1, Canada
- Institute of Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, M5S 3G9, Canada
| | - Farigol Hakem Zadeh
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Translational Biology and Engineering Program, Ted Rogers Centre for Heart Research, Toronto, ON, M5G 1M1, Canada
| | - Yu-Qing Zhou
- Translational Biology and Engineering Program, Ted Rogers Centre for Heart Research, Toronto, ON, M5G 1M1, Canada
- Institute of Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, M5S 3G9, Canada
| | - Meena Fatah
- The Labatt Family Heart Centre (Dept. of Pediatrics) and Translational Medicine, The Hospital for Sick Children & Research Institute, University of Toronto, Toronto, ON., M5G 1X8, Canada
| | - Diptendu Chatterjee
- The Labatt Family Heart Centre (Dept. of Pediatrics) and Translational Medicine, The Hospital for Sick Children & Research Institute, University of Toronto, Toronto, ON., M5G 1X8, Canada
| | - L Jane Jourdan
- The Center for Heart and Reparative Medicine, Fralin Biomedical Research Institute at Virginia Tech. Carilion, Roanoke, VA, 24016, USA
- Virginia Tech Carilion School of Medicine, Roanoke, VA, 24016, USA
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
| | - Jack Liu
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Craig A Simmons
- Translational Biology and Engineering Program, Ted Rogers Centre for Heart Research, Toronto, ON, M5G 1M1, Canada
- Institute of Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, M5S 3G9, Canada
| | - Thomas Kislinger
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, M5G 1L7, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, M5G 1L7, Canada
| | - Christopher M Yip
- Institute of Biomedical Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, M5S 3G9, Canada
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada
| | - Peter H Backx
- Department of Biology, York University, Toronto, ON, M3J 1P3, Canada
| | - Robert G Gourdie
- The Center for Heart and Reparative Medicine, Fralin Biomedical Research Institute at Virginia Tech. Carilion, Roanoke, VA, 24016, USA
- Virginia Tech Carilion School of Medicine, Roanoke, VA, 24016, USA
- Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24060, USA
| | - Robert M Hamilton
- The Labatt Family Heart Centre (Dept. of Pediatrics) and Translational Medicine, The Hospital for Sick Children & Research Institute, University of Toronto, Toronto, ON., M5G 1X8, Canada
| | - Anthony O Gramolini
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Translational Biology and Engineering Program, Ted Rogers Centre for Heart Research, Toronto, ON, M5G 1M1, Canada.
| |
Collapse
|
34
|
Yang JX, Ma N, Chen GY, Li X, Liu N, Tang RB, Jia CQ, Feng L. [Multifocal ectopic Purkinje-related premature contractions associated with SCN5A mutation: a case report]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:923-925. [PMID: 36096712 DOI: 10.3760/cma.j.cn112148-20220711-00539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- J X Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - N Ma
- Department of Medical Ultrasonics, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - G Y Chen
- Department of Cardiology, Suihua First Hospital, Suihua 152001, China
| | - X Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - N Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - R B Tang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - C Q Jia
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - L Feng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| |
Collapse
|
35
|
Durkina AV, Bernikova OG, Gonotkov MA, Mikhaleva NJ, Sedova KA, Malykhina IA, Kuzmin VS, Velegzhaninov IO, Azarov JE. Melatonin treatment improves ventricular conduction via upregulation of Nav1.5 channel proteins and sodium current in the normal rat heart. J Pineal Res 2022; 73:e12798. [PMID: 35384053 DOI: 10.1111/jpi.12798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Abstract
Melatonin treatment was reported to reduce the risk of cardiac arrhythmias, and crucial for this antiarrhythmic action was the effect of melatonin on activation spread. The aim of the present study was evaluation of the mechanisms of this activation enhancement. Experiments were performed in a total of 123 control and melatonin-treated (10 mg/kg, daily, for 7 days) male Wistar rats. In epicardial mapping studies (64 leads, interlead distance 0.5 mm) in the anesthetized animals, activation times (ATs) were determined in each lead as dV/dt minimum during QRS complex under sinus rhythm. Epicardial pacing was performed to measure conduction velocity (CV) across the mapped area. Average left ventricular ATs were shorter in the treated animals as compared to the controls, whereas the minimal epicardial ATs indicating the duration of activation propagation via the ventricular conduction system did not differ between the groups. CV was higher in the treated groups indicating that melatonin affected conduction via contractile myocardium The area of Cx43-derived fluorescence, as well as the expression of Cx43 protein, was similar in ventricles in the control and melatonin-treated groups. Expression of Gja1 gene transcripts encoding Cx43, was increased in the last group. An uncoupling agent octanol modified myocardial conduction properties (time of activation, action potential upstroke velocity, passive electrotonic phase duration) similarly in both groups. On the other hand, the expression of both Scn5a gene transcripts encoding Nav1.5 proteins, as well as peak density of transmembrane sodium current were increased in the ventricular myocytes from the melatonin-treated animals. Thus, a week-long melatonin treatment caused the increase of conduction velocity via enhancement of sodium channel proteins expression and increase of sodium current in the ventricular myocytes.
Collapse
Affiliation(s)
- Aleksandra V Durkina
- Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch, Russian Academy of Sciences, Syktyvkar, Russia
| | - Olesya G Bernikova
- Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch, Russian Academy of Sciences, Syktyvkar, Russia
| | - Mikhail A Gonotkov
- Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch, Russian Academy of Sciences, Syktyvkar, Russia
| | - Natalia J Mikhaleva
- Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch, Russian Academy of Sciences, Syktyvkar, Russia
| | - Ksenia A Sedova
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Inna A Malykhina
- Department of Human and Animal Physiology, Biological Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Vladislav S Kuzmin
- Department of Human and Animal Physiology, Biological Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Ilya O Velegzhaninov
- Department of Radioecology, Institute of Biology, Komi Scientific Centre, Ural Branch, Russian Academy of Sciences, Syktyvkar, Russia
| | - Jan E Azarov
- Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch, Russian Academy of Sciences, Syktyvkar, Russia
| |
Collapse
|
36
|
Suzuki K, Sonoda K, Aoki H, Nakamura Y, Watanabe S, Yoshida Y, Hoshino K, Ozawa J, Imamura T, Aiba T, Kato K, Makiyama T, Kusano K, Horie M, Ohno S. Association Between Deleterious SCN5A Variants and Ventricular Septal Defect in Young Patients With Brugada Syndrome. JACC Clin Electrophysiol 2022; 8:297-305. [PMID: 35331424 DOI: 10.1016/j.jacep.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/06/2021] [Accepted: 01/01/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study aimed to investigate the clinical characteristics of young patients with Brugada syndrome (BrS) with ventricular septal defect (VSD) and explore their genetic backgrounds. BACKGROUND VSD is the most frequently occurring congenital heart disease among children. In contrast, BrS is a rare hereditary disease that is responsible for ventricular fibrillation and sudden cardiac death. Owing to their low incidence, the genetic background and clinical characteristics of patients with BrS with VSD have not been elucidated yet. METHODS This study enrolled 36 individuals who were diagnosed with BrS when they were <20 years of age and performed genetic screening for SCN5A. The functional alteration in mutant Na+ channels was confirmed by patch clamp technique. RESULTS Among the 36 patients with BrS, 5 had been diagnosed with VSD. This study found 14 heterozygous SCN5A variants in 15 unrelated patients. The 5 patients with VSD carried SCN5A variants, including R367S, R535∗, R893C, W1345C, and G1743R. The 3 missense variants (R893C, W1345C, and G1743R) have been proved to reduce peak Na+ current to <10%. A functional analysis of SCN5A R367S was performed and the variant was found to be nonfunctional. CONCLUSIONS This study identified 5 loss-of-function SCN5A variants in 5 young patients with BrS with VSD. The study hypothesizes that altered blood flow in the right ventricular outflow tract leads to fibrosis and electrophysiological changes, predisposing the patients to earlier clinical presentation of BrS. In patients with VSD and ST-segment elevation in the right precordial leads, BrS should be considered and appropriate screening should be pursued accordingly.
Collapse
Affiliation(s)
- Keisuke Suzuki
- Division of Cardiology, Sendai City Hospital, Sendai, Japan; Department of Medical Engineering and Cardiology, Institute of Development Aging and Cancer, Tohoku University, Sendai, Japan
| | - Keiko Sonoda
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Hisaaki Aoki
- Department of Pediatric Cardiology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Yuko Nakamura
- Department of Pediatrics, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Seiichi Watanabe
- Department of Pediatrics, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Yoko Yoshida
- Department of Pediatric Electrophysiology, Osaka City General Hospital, Osaka, Japan
| | - Kenji Hoshino
- Department of Pediatric Cardiology, Saitama Children's Medical Center, Saitama, Japan
| | - Junichi Ozawa
- Department of Pediatrics, Niigata University School of Medicine, Niigata, Japan
| | - Tomohiko Imamura
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Saitama, Japan; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koichi Kato
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Minoru Horie
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan.
| |
Collapse
|
37
|
Nguyen HX, Wu T, Needs D, Zhang H, Perelli RM, DeLuca S, Yang R, Pan M, Landstrom AP, Henriquez C, Bursac N. Engineered bacterial voltage-gated sodium channel platform for cardiac gene therapy. Nat Commun 2022; 13:620. [PMID: 35110560 PMCID: PMC8810800 DOI: 10.1038/s41467-022-28251-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/11/2022] [Indexed: 12/19/2022] Open
Abstract
Therapies for cardiac arrhythmias could greatly benefit from approaches to enhance electrical excitability and action potential conduction in the heart by stably overexpressing mammalian voltage-gated sodium channels. However, the large size of these channels precludes their incorporation into therapeutic viral vectors. Here, we report a platform utilizing small-size, codon-optimized engineered prokaryotic sodium channels (BacNav) driven by muscle-specific promoters that significantly enhance excitability and conduction in rat and human cardiomyocytes in vitro and adult cardiac tissues from multiple species in silico. We also show that the expression of BacNav significantly reduces occurrence of conduction block and reentrant arrhythmias in fibrotic cardiac cultures. Moreover, functional BacNav channels are stably expressed in healthy mouse hearts six weeks following intravenous injection of self-complementary adeno-associated virus (scAAV) without causing any adverse effects on cardiac electrophysiology. The large diversity of prokaryotic sodium channels and experimental-computational platform reported in this study should facilitate the development and evaluation of BacNav-based gene therapies for cardiac conduction disorders.
Collapse
Affiliation(s)
- Hung X Nguyen
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Tianyu Wu
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Daniel Needs
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Hengtao Zhang
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Robin M Perelli
- Department of Pediatrics, Division of Cardiology, Duke University School of Medicine, Durham, NC, USA
- Department of Cell Biology, Duke University School of Medicine, Durham, NC, USA
| | - Sophia DeLuca
- Department of Cell Biology, Duke University School of Medicine, Durham, NC, USA
| | - Rachel Yang
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Michael Pan
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Andrew P Landstrom
- Department of Pediatrics, Division of Cardiology, Duke University School of Medicine, Durham, NC, USA
- Department of Cell Biology, Duke University School of Medicine, Durham, NC, USA
| | - Craig Henriquez
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Nenad Bursac
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.
| |
Collapse
|
38
|
Peters S, Thompson BA, Perrin M, James P, Zentner D, Kalman JM, Vandenberg JI, Fatkin D. Arrhythmic Phenotypes Are a Defining Feature of Dilated Cardiomyopathy-Associated SCN5A Variants: A Systematic Review. Circ Genom Precis Med 2022; 15:e003432. [PMID: 34949099 DOI: 10.1161/circgen.121.003432] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Variants in the SCN5A gene, that encodes the cardiac sodium channel, Nav1.5, are associated with a highly arrhythmogenic form of dilated cardiomyopathy (DCM). Our aim was to review the phenotypes, natural history, functional effects, and treatment outcomes of DCM-associated rare SCN5A variants. METHODS A systematic review of reported DCM-associated rare SCN5A variants was undertaken using PubMed and Embase. RESULTS Eighteen SCN5A rare variants in 29 families with DCM (173 affected individuals) were identified. Eleven variants had undergone experimental evaluation, with 7 of these resulting in increased sustained current flow during the action potential (eg, increased window current) and at resting membrane potentials (eg, creation of a new gating pore current). These variants were located in transmembrane voltage-sensing domains and had a consistent phenotype characterized by frequent multifocal narrow and broad complex ventricular premature beats (VPB; 72% of affected relatives), ventricular arrhythmias (33%), atrial arrhythmias (32%), sudden cardiac death (13%), and DCM (56%). This VPB-predominant phenotype was not seen with 1 variant that increased late sodium current, or with variants that reduced peak current density or had mixed effects. In the latter groups, affected individuals mainly showed sinus node dysfunction, conduction defects, and atrial arrhythmias, with infrequent VPB and ventricular arrhythmias. DCM did not occur in the absence of arrhythmias for any variant. Twelve studies (23 total patients) reported treatment success in the VPB-predominant cardiomyopathy using sodium channel-blocking drug therapy. CONCLUSIONS SCN5A variants can present with a diverse spectrum of primary arrhythmic features. A majority of DCM-associated variants cause a multifocal VPB-predominant cardiomyopathy that is reversible with sodium channel blocking drug therapy. Early recognition of the distinctive phenotype and prompt genetic testing to identify variant carriers are needed. Our findings have implications for interpretation and management of SCN5A variants found in DCM patients with and without arrhythmias.
Collapse
Affiliation(s)
- Stacey Peters
- Department of Cardiology (S.P., M.P., D.Z., J.M.K.), Royal Melbourne Hospital
- Department of Genomic Medicine (S.P., B.A.T., M.P., P.J., D.Z.), Royal Melbourne Hospital
- Department of Medicine, University of Melbourne (S.P., P.J., D.Z., J.M.K.)
| | - Bryony A Thompson
- Department of Genomic Medicine (S.P., B.A.T., M.P., P.J., D.Z.), Royal Melbourne Hospital
- Department of Pathology (B.A.T.), Royal Melbourne Hospital
| | - Mark Perrin
- Department of Genomic Medicine (S.P., B.A.T., M.P., P.J., D.Z.), Royal Melbourne Hospital
| | - Paul James
- Department of Genomic Medicine (S.P., B.A.T., M.P., P.J., D.Z.), Royal Melbourne Hospital
- Department of Medicine, University of Melbourne (S.P., P.J., D.Z., J.M.K.)
- Familial Cancer Centre, Peter MacCallum Centre, Melbourne, Victoria (P.J.)
| | - Dominica Zentner
- Department of Genomic Medicine (S.P., B.A.T., M.P., P.J., D.Z.), Royal Melbourne Hospital
- Department of Medicine, University of Melbourne (S.P., P.J., D.Z., J.M.K.)
| | - Jonathan M Kalman
- Department of Medicine, University of Melbourne (S.P., P.J., D.Z., J.M.K.)
| | - Jamie I Vandenberg
- Molecular Cardiology Division, Victor Chang Cardiac Research Institute (J.I.V., D.F.)
- St. Vincent's Clinical School, Faculty of Medicine, UNSW Sydney (J.I.V., D.F.)
| | - Diane Fatkin
- Molecular Cardiology Division, Victor Chang Cardiac Research Institute (J.I.V., D.F.)
- St. Vincent's Clinical School, Faculty of Medicine, UNSW Sydney (J.I.V., D.F.)
- Cardiology Department, St. Vincent's Hospital, Sydney, New South Wales, Australia (D.F.)
| |
Collapse
|
39
|
Daimi H, Lozano-Velasco E, Aranega A, Franco D. Genomic and Non-Genomic Regulatory Mechanisms of the Cardiac Sodium Channel in Cardiac Arrhythmias. Int J Mol Sci 2022; 23:1381. [PMID: 35163304 PMCID: PMC8835759 DOI: 10.3390/ijms23031381] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/30/2021] [Accepted: 01/06/2022] [Indexed: 12/19/2022] Open
Abstract
Nav1.5 is the predominant cardiac sodium channel subtype, encoded by the SCN5A gene, which is involved in the initiation and conduction of action potentials throughout the heart. Along its biosynthesis process, Nav1.5 undergoes strict genomic and non-genomic regulatory and quality control steps that allow only newly synthesized channels to reach their final membrane destination and carry out their electrophysiological role. These regulatory pathways are ensured by distinct interacting proteins that accompany the nascent Nav1.5 protein along with different subcellular organelles. Defects on a large number of these pathways have a tremendous impact on Nav1.5 functionality and are thus intimately linked to cardiac arrhythmias. In the present review, we provide current state-of-the-art information on the molecular events that regulate SCN5A/Nav1.5 and the cardiac channelopathies associated with defects in these pathways.
Collapse
Affiliation(s)
- Houria Daimi
- Biochemistry and Molecular Biology Laboratory, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Estefanía Lozano-Velasco
- Department of Experimental Biology, University of Jaen, 23071 Jaen, Spain; (E.L.-V.); (A.A.); (D.F.)
- Medina Foundation, Technology Park of Health Sciences, Av. del Conocimiento, 34, 18016 Granada, Spain
| | - Amelia Aranega
- Department of Experimental Biology, University of Jaen, 23071 Jaen, Spain; (E.L.-V.); (A.A.); (D.F.)
- Medina Foundation, Technology Park of Health Sciences, Av. del Conocimiento, 34, 18016 Granada, Spain
| | - Diego Franco
- Department of Experimental Biology, University of Jaen, 23071 Jaen, Spain; (E.L.-V.); (A.A.); (D.F.)
- Medina Foundation, Technology Park of Health Sciences, Av. del Conocimiento, 34, 18016 Granada, Spain
| |
Collapse
|
40
|
Novelli V, Memmi M, Malovini A, Mazzanti A, Liu N, Yanfei R, Bongianino R, Denegri M, Monteforte N, Bloise R, Morini M, Napolitano C. The role of CACNA1C in Brugada syndrome: prevalence and phenotype of probands referred for genetic testing. Heart Rhythm 2022; 19:798-806. [PMID: 34999275 DOI: 10.1016/j.hrthm.2021.12.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 12/07/2021] [Accepted: 12/27/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Contradictory evidence is available on the role of the CACNA1C gene, encoding for the α-subunit of the cardiac L-type calcium channel (CaV1.2), as a cause of the BrS3 variant of Brugada syndrome (BrS). OBJECTIVE We aimed at tackling this issue in a large BrS cohort to define the yield of molecular screening and to address the hypothesis if an appropriate patient selection could improve the clinical utility. METHODS A total of 709 patients entered this study. BrS probands (n= 563, consecutively referred) underwent CACNA1C sequencing. Two matched cohorts where defined: discovery cohort (n = 200 patients) and confirmation cohort (n = 363 patients). Furthermore, the clinical phenotypes of a matched SCN5A positive BrS cohort (n= 146) were included for comparative genotype-phenotype correlation. RESULTS In the discovery cohort, we identified 11 different rare variants in 9 patients of whom 10 (5%) were considered potentially causative based on their frequency in the general population. However, ACMG criteria were unable to classify the majority (80%) of them eventually labeled as variants of unknown significance (VUS). Functional studies revealed a loss of function for 9 variants pointing to a prevalence of CACNA1C causative variants in 4% in the discovery cohort. Genotype-phenotype correlation showed that pathogenic variants are significantly more frequent in patients with a shorter QTc (12.9 % vs 2.2 % in patients with QTc < 390 ms). CONCLUSION CACNA1C is an infrequent but definitive cause of BrS typically associated with short QT. Functional studies are highly relevant to improve variant interpretation.
Collapse
Affiliation(s)
- Valeria Novelli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mirella Memmi
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Andrea Mazzanti
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Nian Liu
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Ruan Yanfei
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Rossana Bongianino
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Marco Denegri
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Nicola Monteforte
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Raffaella Bloise
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Massimo Morini
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Carlo Napolitano
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy.
| |
Collapse
|
41
|
Rubio-Alarcón M, Cámara-Checa A, Dago M, Crespo-García T, Nieto-Marín P, Marín M, Merino JL, Toquero J, Salguero-Bodes R, Tamargo J, Cebrián J, Delpón E, Caballero R. Zfhx3 Transcription Factor Represses the Expression of SCN5A Gene and Decreases Sodium Current Density (I Na). Int J Mol Sci 2021; 22:ijms222313031. [PMID: 34884836 PMCID: PMC8657907 DOI: 10.3390/ijms222313031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 02/02/2023] Open
Abstract
The ZFHX3 and SCN5A genes encode the zinc finger homeobox 3 (Zfhx3) transcription factor (TF) and the human cardiac Na+ channel (Nav1.5), respectively. The effects of Zfhx3 on the expression of the Nav1.5 channel, and in cardiac excitability, are currently unknown. Additionally, we identified three Zfhx3 variants in probands diagnosed with familial atrial fibrillation (p.M1260T) and Brugada Syndrome (p.V949I and p.Q2564R). Here, we analyzed the effects of native (WT) and mutated Zfhx3 on Na+ current (INa) recorded in HL-1 cardiomyocytes. ZFHX3 mRNA can be detected in human atrial and ventricular samples. In HL-1 cardiomyocytes, transfection of Zfhx3 strongly reduced peak INa density, while the silencing of endogenous expression augmented it (from −65.9 ± 8.9 to −104.6 ± 10.8 pA/pF; n ≥ 8, p < 0.05). Zfhx3 significantly reduced the transcriptional activity of human SCN5A, PITX2, TBX5, and NKX25 minimal promoters. Consequently, the mRNA and/or protein expression levels of Nav1.5 and Tbx5 were diminished (n ≥ 6, p < 0.05). Zfhx3 also increased the expression of Nedd4-2 ubiquitin-protein ligase, enhancing Nav1.5 proteasomal degradation. p.V949I, p.M1260T, and p.Q2564R Zfhx3 produced similar effects on INa density and time- and voltage-dependent properties in WT. WT Zfhx3 inhibits INa as a result of a direct repressor effect on the SCN5A promoter, the modulation of Tbx5 increasing on the INa, and the increased expression of Nedd4-2. We propose that this TF participates in the control of cardiac excitability in human adult cardiac tissue.
Collapse
Affiliation(s)
- Marcos Rubio-Alarcón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Anabel Cámara-Checa
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - María Dago
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
- Correspondence: (M.D.); (J.C.)
| | - Teresa Crespo-García
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Paloma Nieto-Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - María Marín
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - José Luis Merino
- Department of Cardiology, Hospital Universitario La Paz, Instituto de Investigación Sanitaria la Paz, CIBERCV, 28046 Madrid, Spain;
| | - Jorge Toquero
- Department of Cardiology, Hospital Universitario Puerta de Hierro, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, CIBERCV, Majadahonda, 28222 Madrid, Spain;
| | - Rafael Salguero-Bodes
- Department of Cardiology, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre, CIBERCV, 28041 Madrid, Spain;
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Jorge Cebrián
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
- Correspondence: (M.D.); (J.C.)
| | - Eva Delpón
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| | - Ricardo Caballero
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Gregorio Marañón, CIBERCV, 28040 Madrid, Spain; (M.R.-A.); (A.C.-C.);; (T.C.-G.); (P.N.-M.); (M.M.); (J.T.); (E.D.); (R.C.)
| |
Collapse
|
42
|
Sedaghat-Hamedani F, Rebs S, El-Battrawy I, Chasan S, Krause T, Haas J, Zhong R, Liao Z, Xu Q, Zhou X, Akin I, Zitron E, Frey N, Streckfuss-Bömeke K, Kayvanpour E. Identification of SCN5a p.C335R Variant in a Large Family with Dilated Cardiomyopathy and Conduction Disease. Int J Mol Sci 2021; 22:ijms222312990. [PMID: 34884792 PMCID: PMC8657717 DOI: 10.3390/ijms222312990] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/08/2021] [Accepted: 11/26/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction: Familial dilated cardiomyopathy (DCM) is clinically variable and has been associated with mutations in more than 50 genes. Rapid improvements in DNA sequencing have led to the identification of diverse rare variants with unknown significance (VUS), which underlines the importance of functional analyses. In this study, by investigating human-induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs), we evaluated the pathogenicity of the p.C335R sodium voltage-gated channel alpha subunit 5 (SCN5a) variant in a large family with familial DCM and conduction disease. Methods: A four-generation family with autosomal dominant familial DCM was investigated. Next-generation sequencing (NGS) was performed in all 16 family members. Clinical deep phenotyping, including endomyocardial biopsy, was performed. Skin biopsies from two patients and one healthy family member were used to generate human-induced pluripotent stem cells (iPSCs), which were then differentiated into cardiomyocytes. Patch-clamp analysis with Xenopus oocytes and iPSC-CMs were performed. Results: A SCN5a variant (c.1003T>C; p.C335R) could be detected in all family members with DCM or conduction disease. A novel truncating TTN variant (p.Ser24998LysfsTer28) could also be identified in two family members with DCM. Family members with the SCN5a variant (p.C335R) showed significantly longer PQ and QRS intervals and lower left ventricular ejection fractions (LV-EF). All four patients who received CRT-D were non-responders. Electrophysiological analysis with Xenopus oocytes showed a loss of function in SCN5a p.C335R. Na+ channel currents were also reduced in iPSC-CMs from DCM patients. Furthermore, iPSC-CM with compound heterozygosity (SCN5a p.C335R and TTNtv) showed significant dysregulation of sarcomere structures, which may be contributed to the severity of the disease and earlier onset of DCM. Conclusion: The SCN5a p.C335R variant is causing a loss of function of peak INa in patients with DCM and cardiac conduction disease. The co-existence of genetic variants in channels and structural genes (e.g., SCN5a p.C335R and TTNtv) increases the severity of the DCM phenotype.
Collapse
Affiliation(s)
- Farbod Sedaghat-Hamedani
- Department of Medicine III, Institute for Cardiomyopathies Heidelberg (ICH), University of Heidelberg, 69120 Heidelberg, Germany; (F.S.-H.); (S.C.); (T.K.); (J.H.); (E.Z.); (N.F.)
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
| | - Sabine Rebs
- Clinic for Cardiology and Pneumology, Georg-August-University Göttingen, 37073 Göttingen, Germany; (S.R.); (K.S.-B.)
- DZHK (German Centre for Cardiovascular Research), 37073 Göttingen, Germany
- Institute of Pharmacology and Toxicology, University of Würzburg, 97070 Würzburg, Germany
| | - Ibrahim El-Battrawy
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
- Department of Medicine, University Medical Centre Mannheim (UMM), 68159 Mannheim, Germany; (R.Z.); (Z.L.); (Q.X.)
| | - Safak Chasan
- Department of Medicine III, Institute for Cardiomyopathies Heidelberg (ICH), University of Heidelberg, 69120 Heidelberg, Germany; (F.S.-H.); (S.C.); (T.K.); (J.H.); (E.Z.); (N.F.)
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
| | - Tobias Krause
- Department of Medicine III, Institute for Cardiomyopathies Heidelberg (ICH), University of Heidelberg, 69120 Heidelberg, Germany; (F.S.-H.); (S.C.); (T.K.); (J.H.); (E.Z.); (N.F.)
| | - Jan Haas
- Department of Medicine III, Institute for Cardiomyopathies Heidelberg (ICH), University of Heidelberg, 69120 Heidelberg, Germany; (F.S.-H.); (S.C.); (T.K.); (J.H.); (E.Z.); (N.F.)
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
| | - Rujia Zhong
- Department of Medicine, University Medical Centre Mannheim (UMM), 68159 Mannheim, Germany; (R.Z.); (Z.L.); (Q.X.)
| | - Zhenxing Liao
- Department of Medicine, University Medical Centre Mannheim (UMM), 68159 Mannheim, Germany; (R.Z.); (Z.L.); (Q.X.)
| | - Qiang Xu
- Department of Medicine, University Medical Centre Mannheim (UMM), 68159 Mannheim, Germany; (R.Z.); (Z.L.); (Q.X.)
| | - Xiaobo Zhou
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
- Department of Medicine, University Medical Centre Mannheim (UMM), 68159 Mannheim, Germany; (R.Z.); (Z.L.); (Q.X.)
| | - Ibrahim Akin
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
- Department of Medicine, University Medical Centre Mannheim (UMM), 68159 Mannheim, Germany; (R.Z.); (Z.L.); (Q.X.)
| | - Edgar Zitron
- Department of Medicine III, Institute for Cardiomyopathies Heidelberg (ICH), University of Heidelberg, 69120 Heidelberg, Germany; (F.S.-H.); (S.C.); (T.K.); (J.H.); (E.Z.); (N.F.)
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
| | - Norbert Frey
- Department of Medicine III, Institute for Cardiomyopathies Heidelberg (ICH), University of Heidelberg, 69120 Heidelberg, Germany; (F.S.-H.); (S.C.); (T.K.); (J.H.); (E.Z.); (N.F.)
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
| | - Katrin Streckfuss-Bömeke
- Clinic for Cardiology and Pneumology, Georg-August-University Göttingen, 37073 Göttingen, Germany; (S.R.); (K.S.-B.)
- DZHK (German Centre for Cardiovascular Research), 37073 Göttingen, Germany
- Institute of Pharmacology and Toxicology, University of Würzburg, 97070 Würzburg, Germany
| | - Elham Kayvanpour
- Department of Medicine III, Institute for Cardiomyopathies Heidelberg (ICH), University of Heidelberg, 69120 Heidelberg, Germany; (F.S.-H.); (S.C.); (T.K.); (J.H.); (E.Z.); (N.F.)
- DZHK (German Centre for Cardiovascular Research), Heidelberg-Mannheim, 17475 Greifswald, Germany; (I.E.-B.); (X.Z.); (I.A.)
- Correspondence:
| |
Collapse
|
43
|
Xiong H, Bai X, Quan Z, Yu D, Zhang H, Zhang C, Liang L, Yao Y, Yang Q, Wang Z, Wang L, Huang Y, Li H, Ren X, Tu X, Ke T, Xu C, Wang QK. Mechanistic insights into the interaction of cardiac sodium channel Na v1.5 with MOG1 and a new molecular mechanism for Brugada syndrome. Heart Rhythm 2021; 19:478-489. [PMID: 34843967 DOI: 10.1016/j.hrthm.2021.11.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 11/14/2021] [Accepted: 11/20/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mutations in cardiac sodium channel Nav1.5 cause Brugada syndrome (BrS). MOG1 is a chaperone that binds to Nav1.5, facilitates Nav1.5 trafficking to the cell surface, and enhances the amplitude of sodium current INa. OBJECTIVE The purpose of this study was to identify structural elements involved in MOG1-Nav1.5 interaction and their relevance to the pathogenesis of BrS. METHODS Systematic analyses of large deletions, microdeletions, and point mutations, and glutathione S-transferases pull-down, co-immunoprecipitation, cell surface protein quantification, and patch-clamping of INa were performed. RESULTS Large deletion analysis defined the MOG1-Nav1.5 interaction domain to amino acids S476-H585 of Nav1.5 Loop I connecting transmembrane domains I and II. Microdeletion and point mutation analyses further defined the domain to F530T531F532R533R534R535. Mutations F530A, F532A, R533A, and R534A, but not T531A and R535A, significantly reduced MOG1-Nav1.5 interaction and eliminated MOG1-enhanced INa. Mutagenesis analysis identified D24, E36, D44, E53, and E101A of MOG1 as critical residues for interaction with Nav1.5 Loop I. We then characterized 3 mutations at the MOG1-Nav1.5 interaction domain: p.F530V, p.F532C, and p.R535Q reported from patients with long QT syndrome and BrS. We found that p.F532C reduced MOG1-Nav1.5 interaction and eliminated MOG1 function on INa; p.R535Q is also a loss-of-function mutation that reduces INa amplitude in a MOG1-independent manner, whereas p.F530V is benign as it does not have an apparent effect on MOG1 and INa. CONCLUSION Our findings define the MOG1-Nav1.5 interaction domain to a 5-amino-acid motif of F530T531F532R533R534 in Loop I. Mutation p.F532C associated with BrS abolishes Nav1.5 interaction with MOG1 and reduces MOG1-enhanced INa density, thereby uncovering a novel molecular mechanism for the pathogenesis of BrS.
Collapse
Affiliation(s)
- Hongbo Xiong
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Xuemei Bai
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Zhuang Quan
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Dong Yu
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Hongfu Zhang
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Chi Zhang
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Lina Liang
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Yufeng Yao
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Qin Yang
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Schoolof Medicine, Shanghai Jiao Tong University, Shanghai, P. R. China
| | - Zhijie Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Longfei Wang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, P. R. China
| | - Yuan Huang
- National "111" Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, P. R. China
| | - Hui Li
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Xiang Ren
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Xin Tu
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China
| | - Tie Ke
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China.
| | - Chengqi Xu
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China.
| | - Qing K Wang
- Center for Human Genome Research, Department of Biological Sciences, Key Laboratory of Molecular Biophysics of MOE, College of Life Science and Technology, Wuhan, P. R. China.
| |
Collapse
|
44
|
Rico Y, Ramis MF, Massot M, Torres-Juan L, Pons J, Fortuny E, Ripoll-Vera T, González R, Peral V, Rossello X, Heine Suñer D. Familial Dilated Cardiomyopathy and Sudden Cardiac Arrest: New Association with a SCN5A Mutation. Genes (Basel) 2021; 12:genes12121889. [PMID: 34946838 PMCID: PMC8701882 DOI: 10.3390/genes12121889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 12/19/2022] Open
Abstract
Dilated cardiomyopathy (DCM) has significant morbidity and mortality. Familial transmission is reported in 20–35% of cases, highlighting the role of genetics in this disorder. We present an interesting family in which the index case is a 64-year-old woman who survived a sudden cardiac arrest. She presented left ventricular dilatation and dysfunction, which indicated the presence of DCM, as well as a history of DCM and sudden arrest in her family (mother and sister). Genetic testing identified a heterozygous mutation c.74A > G missense change that causes an amino acid, p.Glu25Gly, change in the N-terminal domain of the SCN5A protein. After performing an exhaustive family medical history, we found that this previously not described mutation segregated within the family. All relatives with the DCM phenotype were carriers, whereas none of the noncarriers showed signs of heart disease, so this mutation is the most likely cause of the disease. This is the first time that a variant in the N-terminal domain of SCN5A has been associated with DCM.
Collapse
Affiliation(s)
- Yolanda Rico
- Cardiology Department, Hospital Universitari Son Espases, 07120 Palma, Spain; (M.F.R.); (J.P.); (E.F.); (R.G.); (V.P.); (X.R.)
- Correspondence:
| | - Maria Francisca Ramis
- Cardiology Department, Hospital Universitari Son Espases, 07120 Palma, Spain; (M.F.R.); (J.P.); (E.F.); (R.G.); (V.P.); (X.R.)
| | - Montse Massot
- Centre Hospitalier Universitaire de Toulouse, Hôpital de Rangueil, 31400 Toulouse, France;
| | - Laura Torres-Juan
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain; (L.T.-J.); (T.R.-V.); (D.H.S.)
- Unit of Molecular Diagnostics and Clinical Genetics, Hospital Universitari Son Espases, 07120 Palma, Spain
| | - Jaume Pons
- Cardiology Department, Hospital Universitari Son Espases, 07120 Palma, Spain; (M.F.R.); (J.P.); (E.F.); (R.G.); (V.P.); (X.R.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain; (L.T.-J.); (T.R.-V.); (D.H.S.)
| | - Elena Fortuny
- Cardiology Department, Hospital Universitari Son Espases, 07120 Palma, Spain; (M.F.R.); (J.P.); (E.F.); (R.G.); (V.P.); (X.R.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain; (L.T.-J.); (T.R.-V.); (D.H.S.)
| | - Tomas Ripoll-Vera
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain; (L.T.-J.); (T.R.-V.); (D.H.S.)
- Cardiology Department, Hospital Universitari Son Llatzer, 07198 Palma, Spain
| | - Rosa González
- Cardiology Department, Hospital Universitari Son Espases, 07120 Palma, Spain; (M.F.R.); (J.P.); (E.F.); (R.G.); (V.P.); (X.R.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain; (L.T.-J.); (T.R.-V.); (D.H.S.)
| | - Vicente Peral
- Cardiology Department, Hospital Universitari Son Espases, 07120 Palma, Spain; (M.F.R.); (J.P.); (E.F.); (R.G.); (V.P.); (X.R.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain; (L.T.-J.); (T.R.-V.); (D.H.S.)
| | - Xavier Rossello
- Cardiology Department, Hospital Universitari Son Espases, 07120 Palma, Spain; (M.F.R.); (J.P.); (E.F.); (R.G.); (V.P.); (X.R.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain; (L.T.-J.); (T.R.-V.); (D.H.S.)
| | - Damià Heine Suñer
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain; (L.T.-J.); (T.R.-V.); (D.H.S.)
- Unit of Molecular Diagnostics and Clinical Genetics, Hospital Universitari Son Espases, 07120 Palma, Spain
| |
Collapse
|
45
|
Satish H, Reddy M R. A Simulation Study on Electrical Activity of Ventricular Endocardial Tissue due to SCN5A L812Q Mutation. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:5543-5546. [PMID: 34892380 DOI: 10.1109/embc46164.2021.9630990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Brugada Syndrome is a rare arrhythmia, hereditary in nature. It is caused due to mutation in genes that encodes sodium ion channels and it results sudden cardiac death in young adults. This paper aims to model a two dimensional SCN5A L812Q mutated endocardial tissue by modifying the model equations for sodium ion channel in the Ten Tusscher model for human ventricular tissue. Results show that the propagation of electrical activity in the mutated cells is slower when compared to the normal cells of the endocardial tissue. From this it is concluded that there is a large reduction of sodium current in the mutated region of the endocardial tissue. This leads to reduction in the total ionic current as well and further reduces the membrane potential. It also leads to the slower propagation of action potential in the mutated region when compared to the normal endocardial tissue.Clinical Relevance- This establishes the propagation of electrical activity in endocardial tissue for SCN5A L812Q gene mutation that results in arrhythmia called Brugada Syndrome.
Collapse
|
46
|
Avula UMR, Dridi H, Chen BX, Yuan Q, Katchman AN, Reiken SR, Desai AD, Parsons S, Baksh H, Ma E, Dasrat P, Ji R, Lin Y, Sison C, Lederer WJ, Joca HC, Ward CW, Greiser M, Marks AR, Marx SO, Wan EY. Attenuating persistent sodium current-induced atrial myopathy and fibrillation by preventing mitochondrial oxidative stress. JCI Insight 2021; 6:e147371. [PMID: 34710060 PMCID: PMC8675199 DOI: 10.1172/jci.insight.147371] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 10/27/2021] [Indexed: 12/19/2022] Open
Abstract
Mechanistically driven therapies for atrial fibrillation (AF), the most common cardiac arrhythmia, are urgently needed, the development of which requires improved understanding of the cellular signaling pathways that facilitate the structural and electrophysiological remodeling that occurs in the atria. Similar to humans, increased persistent Na+ current leads to the development of an atrial myopathy and spontaneous and long-lasting episodes of AF in mice. How increased persistent Na+ current causes both structural and electrophysiological remodeling in the atria is unknown. We crossbred mice expressing human F1759A-NaV1.5 channels with mice expressing human mitochondrial catalase (mCAT). Increased expression of mCAT attenuated mitochondrial and cellular reactive oxygen species (ROS) and the structural remodeling that was induced by persistent F1759A-Na+ current. Despite the heterogeneously prolonged atrial action potential, which was unaffected by the reduction in ROS, the incidences of spontaneous AF, pacing-induced after-depolarizations, and AF were substantially reduced. Expression of mCAT markedly reduced persistent Na+ current-induced ryanodine receptor oxidation and dysfunction. In summary, increased persistent Na+ current in atrial cardiomyocytes, which is observed in patients with AF, induced atrial enlargement, fibrosis, mitochondrial dysmorphology, early after-depolarizations, and AF, all of which can be attenuated by resolving mitochondrial oxidative stress.
Collapse
Affiliation(s)
| | - Haikel Dridi
- Department of Physiology and Cellular Biophysics and Clyde & Helen Wu Center for Molecular Cardiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Bi-xing Chen
- Division of Cardiology, Department of Medicine, and
| | - Qi Yuan
- Department of Physiology and Cellular Biophysics and Clyde & Helen Wu Center for Molecular Cardiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | | | - Steven R. Reiken
- Department of Physiology and Cellular Biophysics and Clyde & Helen Wu Center for Molecular Cardiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | | | | | - Haajra Baksh
- Division of Cardiology, Department of Medicine, and
| | - Elaine Ma
- Division of Cardiology, Department of Medicine, and
| | | | - Ruiping Ji
- Division of Cardiology, Department of Medicine, and
| | - Yejun Lin
- Division of Cardiology, Department of Medicine, and
| | | | - W. Jonathan Lederer
- Center for Biomedical Engineering and Technology and Department of Physiology and
| | - Humberto C. Joca
- Center for Biomedical Engineering and Technology and Department of Physiology and
| | - Christopher W. Ward
- Center for Biomedical Engineering and Technology and Department of Physiology and
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Maura Greiser
- Center for Biomedical Engineering and Technology and Department of Physiology and
| | - Andrew R. Marks
- Department of Physiology and Cellular Biophysics and Clyde & Helen Wu Center for Molecular Cardiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Steven O. Marx
- Division of Cardiology, Department of Medicine, and
- Department of Molecular Pharmacology and Therapeutics, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | | |
Collapse
|
47
|
Milman A, Behr ER, Gray B, Johnson DC, Andorin A, Hochstadt A, Gourraud JB, Maeda S, Takahashi Y, Jm Juang J, Kim SH, Kamakura T, Aiba T, Postema PG, Mizusawa Y, Denjoy I, Giustetto C, Conte G, Huang Z, Sarquella-Brugada G, Mazzanti A, Jespersen CH, Arbelo E, Brugada R, Calo L, Corrado D, Casado-Arroyo R, Allocca G, Takagi M, Delise P, Brugada J, Tfelt-Hansen J, Priori SG, Veltmann C, Yan GX, Brugada P, Gaita F, Leenhardt A, Wilde AAM, Kusano KF, Nam GB, Hirao K, Probst V, Belhassen B. Genotype-Phenotype Correlation of SCN5A Genotype in Patients With Brugada Syndrome and Arrhythmic Events: Insights From the SABRUS in 392 Probands. Circ Genom Precis Med 2021; 14:e003222. [PMID: 34461752 DOI: 10.1161/circgen.120.003222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Brugada syndrome (BrS) is associated with mutations in the cardiac sodium channel gene, SCN5A. However, genetic studies of patients with BrS with arrhythmic events have been limited. We sought to compare various clinical, ECG, and electrophysiological parameters according to SCN5A genotype in a large cohort of BrS probands with first arrhythmic event. METHODS Survey on Arrhythmic Events in Brugada Syndrome is a survey of 10 Western and 4 Asian countries, gathering 678 patients with BrS with first arrhythmic event. Only probands were included, and SCN5A genotype adjudicated. Patients without appropriate genetic data were excluded. Associations of genotype with clinical features were analyzed. RESULTS The study group comprised 392 probands: 92 (23.5%) SCN5A+(44 pathogenic/likely pathogenic [P/LP] and 48 variants of unknown significance) and 300 (76.5%) SCN5A-.SCN5A missense variants and the patients hosting them were similar regardless of adjudication. A higher proportion of patients with P/LP were pediatric (<16 years) compared with SCN5A- (11.4% versus 3%, P=0.023). The proportion of females was higher among patients with P/LP compared with SCN5A- (18.2% versus 6.3%, P=0.013). P/LP probands were more likely to have a family history of sudden cardiac death compared with SCN5A- (41.9% versus 16.8%, P<0.001). A higher proportion of patients with P/LP were White compared with SCN5A- (87.5% versus 47%, P<0.001). Ethnicity (odds ratio, 5.41 [2.8-11.19], P<0.001) and family history of sudden cardiac death (odds ratio, 2.73 [1.28-5.82], P=0.009) were independent variables associated with P/LP genotype following logistic regression. CONCLUSIONS The genetic basis of BrS has a complex relationship with gender, ethnicity, and age. Probands hosting a P/LP variant tended to experience their first arrhythmic event at a younger age and to have events triggered by fever compared with patients with SCN5A-. In addition, they were more likely to be White and to have family history of sudden cardiac death. Among females, a P/LP variant suggests an increased risk of being symptomatic. This association should be further studied on an ethnically specific basis in large prospectively collected international cohorts.
Collapse
Affiliation(s)
- Anat Milman
- Leviev Heart Institute, The Chaim Sheba Medical Center, Tel Hashomer, Israel (A. Milman)
- Sackler School of Medicine, Tel Aviv University, Israel (A. Milman, A.H., B.B.)
| | - Elijah R Behr
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Cardiovascular Clinical Academic Group, St George's, University of London & St. George's University Hospitals NHS Foundation Trust, United Kingdom (E.R.B., B.G., D.C.J.)
| | - Belinda Gray
- Cardiovascular Clinical Academic Group, St George's, University of London & St. George's University Hospitals NHS Foundation Trust, United Kingdom (E.R.B., B.G., D.C.J.)
| | - David C Johnson
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Cardiovascular Clinical Academic Group, St George's, University of London & St. George's University Hospitals NHS Foundation Trust, United Kingdom (E.R.B., B.G., D.C.J.)
| | - Antoine Andorin
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Service de Cardiologie, CHU de Nantes, France (A.A., J.-B.G., V.P.)
| | - Aviram Hochstadt
- Sackler School of Medicine, Tel Aviv University, Israel (A. Milman, A.H., B.B.)
- Department of Cardiology, Tel-Aviv Sourasky Medical Center, Israel (A.H.)
| | - Jean-Baptiste Gourraud
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Service de Cardiologie, CHU de Nantes, France (A.A., J.-B.G., V.P.)
| | - Shingo Maeda
- Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan (S.M., Y.T., K.H.)
| | - Yoshihide Takahashi
- Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan (S.M., Y.T., K.H.)
| | - Jimmy Jm Juang
- Cardiovascular Center and Division of Cardiology, National Taiwan University Hospital & University College of Medicine, Taipei (J.J.M.J.)
| | - Sung-Hwan Kim
- Division of Cardiology, College of Medicine, The Catholic University of Korea, Seoul, Korea (S.-H.K.)
| | - Tsukasa Kamakura
- Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan (T.K., T.A., K.F.K.)
| | - Takeshi Aiba
- Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan (T.K., T.A., K.F.K.)
| | - Pieter G Postema
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Amsterdam UMC, University of Amsterdam, Heart Center; Department of Clinical & Experimental Cardiology, the Netherlands (P.G.P., Y.M., A.A.M.W.)
| | - Yuka Mizusawa
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Amsterdam UMC, University of Amsterdam, Heart Center; Department of Clinical & Experimental Cardiology, the Netherlands (P.G.P., Y.M., A.A.M.W.)
| | - Isabelle Denjoy
- Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat & Université Paris Diderot, Sorbonne, France (I.D., A.L.)
| | - Carla Giustetto
- Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Italy (C.G., F.G.)
- Heart Rhythm Management Centre, UZ-VUB, Brussels, Belgium (G.C., P.B.)
| | | | - Zhengrong Huang
- Department of Cardiology, the First Affiliated Hospital of Xiamen University, Fujian, China (Z.H.)
| | - Georgia Sarquella-Brugada
- Pediatric Arrhythmias, Electrophysiology and Sudden Death Unit Cardiology, Department Hospital Sant Joan de Déu, Barcelona - Universitat de Barcelona, Spain (G.S.-B.)
| | - Andrea Mazzanti
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy (A. Mazzanti, S.G.P.)
| | - Camilla H Jespersen
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- The Heart Centre, Copenhagen University Hospital, Denmark (C.H.J., J.T.-H.)
- Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark (C.H.J., J.T.-H.)
| | - Elena Arbelo
- Cardiovascular Institute, Hospital Clinic and IDIBAPS, Barcelona, Catalonia, Spain (E.A., J.B.)
| | - Ramon Brugada
- Cardiovascular Genetics Center, University of Girona-IDIBGI, Spain (R.B.)
- Medical Science Department, School of Medicine, University of Girona, Spain (R.B.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (R.B.)
| | - Leonardo Calo
- Division of Cardiology, Policlinico Casilino, Roma, Italy (L.C.)
| | - Domenico Corrado
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Department of Cardiac, Thoracic and Vascular Sciences University of Padova, Italy (D.C.)
| | - Ruben Casado-Arroyo
- Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium (R.C.-A.)
| | - Giuseppe Allocca
- Division of Cardiology, Hospital of Peschiera del Garda, Veneto, Italy (G.A., P.D.)
| | - Masahiko Takagi
- Division of Cardiac Arrhythmia, Kansai Medical University Medical Center, Moriguchi, Japan (M.T.)
| | - Pietro Delise
- Division of Cardiology, Hospital of Peschiera del Garda, Veneto, Italy (G.A., P.D.)
| | - Josep Brugada
- Cardiovascular Institute, Hospital Clinic and IDIBAPS, Barcelona, Catalonia, Spain (E.A., J.B.)
| | - Jacob Tfelt-Hansen
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- The Heart Centre, Copenhagen University Hospital, Denmark (C.H.J., J.T.-H.)
- Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark (C.H.J., J.T.-H.)
| | - Silvia G Priori
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy (A. Mazzanti, S.G.P.)
| | - Christian Veltmann
- Hannover Heart Rhythm Center, Department of Cardiology & Angiology, Hannover Medical School, Hannover, Germany (C.V.)
| | - Gan-Xin Yan
- Lankenau Medical Center, Wynnewood, PA (G.-X.Y.)
| | - Pedro Brugada
- Heart Rhythm Management Centre, UZ-VUB, Brussels, Belgium (G.C., P.B.)
| | - Fiorenzo Gaita
- Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Italy (C.G., F.G.)
| | - Antoine Leenhardt
- Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat & Université Paris Diderot, Sorbonne, France (I.D., A.L.)
| | - Arthur A M Wilde
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Amsterdam UMC, University of Amsterdam, Heart Center; Department of Clinical & Experimental Cardiology, the Netherlands (P.G.P., Y.M., A.A.M.W.)
| | - Kengo F Kusano
- Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan (T.K., T.A., K.F.K.)
| | - Gi-Byoung Nam
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (G.-B.N.)
| | - Kenzo Hirao
- Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan (S.M., Y.T., K.H.)
| | - Vincent Probst
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (E.R.B., D.C.J., A.A., J.-B.G., P.G.P., Y.M., A. Mazzanti, C.H.J., D.C., J.T.-H., S.G.P., A.A.M.W., V.P.)
- Service de Cardiologie, CHU de Nantes, France (A.A., J.-B.G., V.P.)
| | - Bernard Belhassen
- Sackler School of Medicine, Tel Aviv University, Israel (A. Milman, A.H., B.B.)
- Heart Institute, Hadassah University Hospital, Jerusalem, Israel (B.B.)
| |
Collapse
|
48
|
Takla M, Edling CE, Zhang K, Saadeh K, Tse G, Salvage SC, Huang CL, Jeevaratnam K. Transcriptional profiles of genes related to electrophysiological function in Scn5a +/- murine hearts. Physiol Rep 2021; 9:e15043. [PMID: 34617689 PMCID: PMC8495800 DOI: 10.14814/phy2.15043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/24/2022] Open
Abstract
The Scn5a gene encodes the major pore-forming Nav 1.5 (α) subunit, of the voltage-gated Na+ channel in cardiomyocytes. The key role of Nav 1.5 in action potential initiation and propagation in both atria and ventricles predisposes organisms lacking Scn5a or carrying Scn5a mutations to cardiac arrhythmogenesis. Loss-of-function Nav 1.5 genetic abnormalities account for many cases of the human arrhythmic disorder Brugada syndrome (BrS) and related conduction disorders. A murine model with a heterozygous Scn5a deletion recapitulates many electrophysiological phenotypes of BrS. This study examines the relationships between its Scn5a+/- genotype, resulting transcriptional changes, and the consequent phenotypic presentations of BrS. Of 62 selected protein-coding genes related to cardiomyocyte electrophysiological or homeostatic function, concentrations of mRNA transcribed from 15 differed significantly from wild type (WT). Despite halving apparent ventricular Scn5a transcription heterozygous deletion did not significantly downregulate its atrial expression, raising possibilities of atria-specific feedback mechanisms. Most of the remaining 14 genes whose expression differed significantly between WT and Scn5a+/- animals involved Ca2+ homeostasis specifically in atrial tissue, with no overlap with any ventricular changes. All statistically significant changes in expression were upregulations in the atria and downregulations in the ventricles. This investigation demonstrates the value of future experiments exploring for and clarifying links between transcriptional control of Scn5a and of genes whose protein products coordinate Ca2+ regulation and examining their possible roles in BrS.
Collapse
Affiliation(s)
- Michael Takla
- Faculty of Health and Medical ScienceUniversity of SurreyGuildfordUK
- Christ’s CollegeUniversity of CambridgeCambridgeUK
| | | | - Kevin Zhang
- Faculty of Health and Medical ScienceUniversity of SurreyGuildfordUK
- School of MedicineImperial College LondonLondonUK
| | - Khalil Saadeh
- Faculty of Health and Medical ScienceUniversity of SurreyGuildfordUK
- Clinical SchoolUniversity of CambridgeCambridgeUK
| | - Gary Tse
- Faculty of Health and Medical ScienceUniversity of SurreyGuildfordUK
- Second Hospital of Tianjin Medical UniversityTianjinChina
| | | | - Christopher L.‐H. Huang
- Faculty of Health and Medical ScienceUniversity of SurreyGuildfordUK
- Department of BiochemistryUniversity of CambridgeCambridgeUK
| | | |
Collapse
|
49
|
Ning S, Hua L, Ji Z, Fan D, Meng X, Li Z, Wang Q, Guo Z. Protein 4.1 family and ion channel proteins interact to regulate the process of heart failure in rats. Acta Histochem 2021; 123:151748. [PMID: 34271280 DOI: 10.1016/j.acthis.2021.151748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 02/06/2023]
Abstract
Heart failure (HF) is a major cause of death in cardiovascular diseases worldwide, and its molecular mechanisms and effective prevention strategies remain to be further studied. The myocardial cytoskeleton plays a pivotal role in many heart diseases. However, little is known about the function of the membrane cytoskeleton 4.1 protein family and related regulatory mechanisms in the pathogenesis of HF. In this study, we detected the localization and expression of the protein 4.1 family and ion channel proteins in a rat HF model induced by doxorubicin (DOX), and studied the interactions between them. Our results showed that compared with the control group, the HF group displayed an increased expression level of protein 4.1R and decreased levels of protein 4.1 G and 4.1 N. The Nav1.5 protein levels were significantly increased, while the SERCA2a and Cav1.2 protein levels were significantly decreased in the HF group. Furthermore, there is co-localization and interaction between protein 4.1R and Nav1.5, protein 4.1 G and SERCA2a, protein 4.1 N and Cav1.2, respectively. Taken together, the results indicated that the protein 4.1 family might be involved in the occurrence and development of HF through its interaction with ion channel proteins, suggesting that 4.1 proteins may serve as a novel therapeutic target for HF.
Collapse
Affiliation(s)
- Shuwei Ning
- Zhengzhou Key Laboratory, Zhengzhou No. 7 People's Hospital, Zhengzhou, 450016, China
| | - Lei Hua
- Zhengzhou Key Laboratory, Zhengzhou No. 7 People's Hospital, Zhengzhou, 450016, China
| | - Zhenyu Ji
- Henan Academy of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052, China
| | - Dandan Fan
- Henan Academy of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052, China
| | - Xiangguang Meng
- Zhengzhou Key Laboratory, Zhengzhou No. 7 People's Hospital, Zhengzhou, 450016, China
| | - Zhiying Li
- Zhengzhou Key Laboratory, Zhengzhou No. 7 People's Hospital, Zhengzhou, 450016, China
| | - Qian Wang
- Zhengzhou Key Laboratory, Zhengzhou No. 7 People's Hospital, Zhengzhou, 450016, China
| | - Zhikun Guo
- Zhengzhou Key Laboratory, Zhengzhou No. 7 People's Hospital, Zhengzhou, 450016, China; Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, 453003, China.
| |
Collapse
|
50
|
Al Sayed ZR, Canac R, Cimarosti B, Bonnard C, Gourraud JB, Hamamy H, Kayserili H, Girardeau A, Jouni M, Jacob N, Gaignerie A, Chariau C, David L, Forest V, Marionneau C, Charpentier F, Loussouarn G, Lamirault G, Reversade B, Zibara K, Lemarchand P, Gaborit N. Human model of IRX5 mutations reveals key role for this transcription factor in ventricular conduction. Cardiovasc Res 2021; 117:2092-2107. [PMID: 32898233 DOI: 10.1093/cvr/cvaa259] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/15/2020] [Accepted: 08/28/2020] [Indexed: 01/02/2023] Open
Abstract
AIMS Several inherited arrhythmic diseases have been linked to single gene mutations in cardiac ion channels and interacting proteins. However, the mechanisms underlying most arrhythmias, are thought to involve altered regulation of the expression of multiple effectors. In this study, we aimed to examine the role of a transcription factor (TF) belonging to the Iroquois homeobox family, IRX5, in cardiac electrical function. METHODS AND RESULTS Using human cardiac tissues, transcriptomic correlative analyses between IRX5 and genes involved in cardiac electrical activity showed that in human ventricular compartment, IRX5 expression strongly correlated to the expression of major actors of cardiac conduction, including the sodium channel, Nav1.5, and Connexin 40 (Cx40). We then generated human-induced pluripotent stem cells (hiPSCs) derived from two Hamamy syndrome-affected patients carrying distinct homozygous loss-of-function mutations in IRX5 gene. Cardiomyocytes derived from these hiPSCs showed impaired cardiac gene expression programme, including misregulation in the control of Nav1.5 and Cx40 expression. In accordance with the prolonged QRS interval observed in Hamamy syndrome patients, a slower ventricular action potential depolarization due to sodium current reduction was observed on electrophysiological analyses performed on patient-derived cardiomyocytes, confirming the functional role of IRX5 in electrical conduction. Finally, a cardiac TF complex was newly identified, composed by IRX5 and GATA4, in which IRX5 potentiated GATA4-induction of SCN5A expression. CONCLUSION Altogether, this work unveils a key role for IRX5 in the regulation of human ventricular depolarization and cardiac electrical conduction, providing therefore new insights into our understanding of cardiac diseases.
Collapse
Affiliation(s)
- Zeina R Al Sayed
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Robin Canac
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Bastien Cimarosti
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Carine Bonnard
- Institute of Medical Biology, A*STAR, 8A Biomedical Grove, Singapore 138648, Singapore
| | - Jean-Baptiste Gourraud
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Hanan Hamamy
- Department of Genetic Medicine and Development, Geneva University, 1 rue Michel-Servet, Geneva 1211, Switzerland
| | - Hulya Kayserili
- Medical Genetics Department, Koç University School of Medicine(KUSOM), Rumelifeneri Yolu 34450, Istanbul, Turkey
| | - Aurore Girardeau
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Mariam Jouni
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Nicolas Jacob
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Anne Gaignerie
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, 8 Quai Moncousu, F-44000 Nantes, France
| | - Caroline Chariau
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, 8 Quai Moncousu, F-44000 Nantes, France
| | - Laurent David
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, 8 Quai Moncousu, F-44000 Nantes, France
- Université de Nantes, INSERM, CRTI, 30 Bd Jean Monnet, F-44093 Nantes, France
- ITUN, CHU Nantes, 30 Bd Jean Monnet, F-44093 Nantes, France
| | - Virginie Forest
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Céline Marionneau
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Flavien Charpentier
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Gildas Loussouarn
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Guillaume Lamirault
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Bruno Reversade
- Institute of Medical Biology, A*STAR, 8A Biomedical Grove, Singapore 138648, Singapore
- Medical Genetics Department, Koç University School of Medicine(KUSOM), Rumelifeneri Yolu 34450, Istanbul, Turkey
- Department of Paediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore
- Institute of Molecular and Cellular Biology, A*STAR, 61 Biopolis Drive, Singapore 138673, Singapore
- Reproductive Biology Laboratory, Amsterdam UMC, Meibergdreef 9 1105, Amsterdam-Zuidoost, Netherlands
| | - Kazem Zibara
- ER045, Laboratory of stem cells, DSST, Biology department, Faculty of Sciences, Lebanese University, Rafic Hariri Campus - Hadath, Beirut 1700, Lebanon
| | - Patricia Lemarchand
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Nathalie Gaborit
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| |
Collapse
|