A Novel mutation L619F in the cardiac Na+ channel SCN5A associated with long‐QT syndrome (LQT3): a role for the I‐II linker in inactivation gating

XHT Wehrens, T Rossenbacker, RJ Jongbloed… - Human …, 2003 - Wiley Online Library
XHT Wehrens, T Rossenbacker, RJ Jongbloed, M Gewillig, H Heidbüchel, PA Doevendans…
Human Mutation, 2003Wiley Online Library
Congenital long QT syndrome type 3 (LQT3) is caused by mutations in the gene SCN5A
encoding the α‐subunit of the cardiac Na+ channel (Nav1. 5). Functional studies of SCN5A
mutations in the linker between domains III and IV, and more recently the C‐terminus, have
been shown to alter inactivation gating. Here we report a novel LQT3 mutation, L619F (LF),
located in the domain I‐II linker. In an infant with prolonged QTc intervals, mutational
analysis identified a heterozygous missense mutation (L619F) in the domain I‐II linker of the …
Abstract
Congenital long QT syndrome type 3 (LQT3) is caused by mutations in the gene SCN5A encoding the α‐subunit of the cardiac Na+ channel (Nav1.5). Functional studies of SCN5A mutations in the linker between domains III and IV, and more recently the C‐terminus, have been shown to alter inactivation gating. Here we report a novel LQT3 mutation, L619F (LF), located in the domain I‐II linker. In an infant with prolonged QTc intervals, mutational analysis identified a heterozygous missense mutation (L619F) in the domain I‐II linker of the cardiac Na+ channel. Wild‐type (WT) and mutant channels were studied by whole‐cell patch‐clamp analysis in transiently expressed HEK cells. LF channels increase maintained Na+ current (0.79 pA/pF for LF ; 0.26 pA/pF for WT) during prolonged depolarization. We found a +5.8mV shift in steady state inactivation in LF channels compared to WT (WT, V1/2=−64.0 mV; LF, V1/2=−58.2 mV). The positive shift of inactivation, without a corresponding shift in activation, increases the overlap window current in LF relative to WT (1.09 vs. 0.58 pA/pF), as measured using a positive voltage ramp protocol (−100 to +50 mV in 2s). The increase in window current, combined with an increase in non‐inactivating Na+ current, may act to prolong the AP plateau and is consistent with the disease phenotype observed in patients. Moreover, the defective inactivation imposed by the L619F mutation implies a role for the I‐II linker in the Na+ channel inactivation process. © 2003 Wiley‐Liss, Inc.
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