Molecular and Functional Characterization of Rare CACNA1C Variants in Sudden Unexplained Death in the Young.

Abstract:

INTRODUCTION:Perturbations in the CACNA1C-encoded L-type calcium channel α-subunit have been linked recently to heritable arrhythmia syndromes, including Timothy syndrome, Brugada syndrome, early repolarization syndrome, and long QT syndrome. These heritable arrhythmia syndromes may serve as a pathogenic basis for autopsy-negative sudden unexplained death in the young (SUDY). However, the contribution of CACNA1C mutations to SUDY is unknown. OBJECTIVE:We set out to determine the spectrum, prevalence, and pathophysiology of rare CACNA1C variants in SUDY. METHODS:Mutational analysis of CACNA1C was conducted in 82 SUDY cases using polymerase chain reaction, denaturing high-performance liquid chromatography, and direct sequencing. Identified variants were engineered using site-directed mutagenesis, and heterologously expressed in TSA-201 or HEK293 cells. RESULTS:Two SUDY cases (2.4%) harbored functional variants in CACNA1C. The E850del and N2091S variants involve highly conserved residues and localize to the II-III linker and C-terminus, respectively. Although observed in publically available exome databases, both variants confer abnormal CaV 1.2 electrophysiological characteristics. Examination of the electrophysiological properties revealed the E850del mutation in CACNA1C led to a 95% loss-of-function in ICa , and the N2091S variant led to a 105% gain-of-function in ICa. Additionally, N2091S led to minor kinetic alterations including a -3.4 mV shift in V1/2 of activation. CONCLUSION:This study provides molecular and functional evidence that rare CACNA1C genetic variants may contribute to the underlying pathogenic basis for some cases of SUDY in either a gain or loss-of-function mechanism.

journal_name

Congenit Heart Dis

journal_title

Congenital heart disease

authors

Sutphin BS,Boczek NJ,Barajas-Martínez H,Hu D,Ye D,Tester DJ,Antzelevitch C,Ackerman MJ

doi

10.1111/chd.12371

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

683-692

issue

6

eissn

1747-079X

issn

1747-0803

journal_volume

11

pub_type

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