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High-throughput screening identifies a trafficking corrector for long QT syndrome–associated KCNQ1 variants
Katherine R. Clowes Moster, Carlos G. Vanoye, Ana C. Chang-Gonzalez, Ian M. Romaine, Katherine M. Stefanski, Mason C. Wilkinson, Joshua A. Bauer, Thomas P. Hasaka, Emily L. Days, Reshma R. Desai, Kathryn R. Butcher, Gary A. Sulikowski, Alex G. Waterson, Jens Meiler, Kaitlyn V. Ledwitch, Alfred L. George Jr., Charles R. Sanders
Katherine R. Clowes Moster, Carlos G. Vanoye, Ana C. Chang-Gonzalez, Ian M. Romaine, Katherine M. Stefanski, Mason C. Wilkinson, Joshua A. Bauer, Thomas P. Hasaka, Emily L. Days, Reshma R. Desai, Kathryn R. Butcher, Gary A. Sulikowski, Alex G. Waterson, Jens Meiler, Kaitlyn V. Ledwitch, Alfred L. George Jr., Charles R. Sanders
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Research Article Cardiology Genetics

High-throughput screening identifies a trafficking corrector for long QT syndrome–associated KCNQ1 variants

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Abstract

Congenital long QT syndrome (LQTS) promotes risk for life-threatening cardiac arrhythmia and sudden death in children and young adults. Pathogenic variants in the voltage-gated potassium channel KCNQ1 are the most frequently discovered genetic cause. Most LQTS-associated KCNQ1 variants cause loss of function secondary to impaired trafficking of the channel to the plasma membrane. There are currently no therapeutic approaches that address this underlying molecular defect. Using a high-throughput screening paradigm, we identified VU0494372, a small molecule that increases total and cell surface levels and trafficking efficiency of WT KCNQ1 as well as three LQTS-associated variants. Additionally, 16-hour treatment of cells with VU0494372 increased IKs (KCNQ1-KCNE1 current) for WT KCNQ1 and the LQTS-associated variant V207M in cells coexpressing KCNE1. VU0494372 had no impact on KCNQ1 transcription, degradation, or thermal stability, and increased the rate of KCNQ1 reaching the cell surface. We identified a potential direct interaction site with KCNQ1 at or near the binding site of the KCNQ1 potentiator ML277. Together, these findings demonstrate that small molecules can increase the expression levels and cell surface trafficking efficiency of KCNQ1 and introduce a potential new pharmacological approach for treating LQTS.

Authors

Katherine R. Clowes Moster, Carlos G. Vanoye, Ana C. Chang-Gonzalez, Ian M. Romaine, Katherine M. Stefanski, Mason C. Wilkinson, Joshua A. Bauer, Thomas P. Hasaka, Emily L. Days, Reshma R. Desai, Kathryn R. Butcher, Gary A. Sulikowski, Alex G. Waterson, Jens Meiler, Kaitlyn V. Ledwitch, Alfred L. George Jr., Charles R. Sanders

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Figure 6.

Computational docking, electrophysiology data, and competition assays provide support for possible direct interaction between VU0494372 and KCNQ1.

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Computational docking, electrophysiology data, and competition assays pr...
(A) Overlay of PDB 7XNK showing ML277 (magenta) bound to voltage sensor–active, pore-open KCNQ1 and the top 10 docked poses of VU0494372 (assorted colors) ranked by RosettaLigand interface score. VSD, voltage-sensing domain; PD, pore domain; CaM, calmodulin. (B) Zoomed and rotated view of A. Docked VU0494372 poses overlap with bound ML277 in KCNQ1. Labeled residues line the predicted pocket and interact with VU0494372. (C) Four poses from B of the most frequently observed orientation of VU0494372 docked to KCNQ1. (D) Competition between ML277 and VU0494372 as determined with a flow cytometry–based trafficking assay. Cell surface (left) and total (right) mycKCNQ1 levels in LLP-int cells were determined with and without ML277 and VU0494372. N = 6. P values were determined with Kruskal-Wallis non-parametric test with Dunn’s multiple-comparison test for follow-up. (E) Rotated and zoomed view of C to illustrate the orientation of VU0494372. (F) Cell surface levels (left), total levels (middle), and trafficking efficiency (right) of WT KCNQ1 in an LLP-int WT KCNQ1–expressing cell line after treatment with 10 μM VU0494372, VU0489336, or VU0963991 (or 0.1% DMSO as a control) for 16 hours, quantified with a flow cytometry–based trafficking assay. N = 3. Compound structures are shown on the far right. P values were determined with Kruskal-Wallis non-parametric test with Dunn’s multiple-comparison test for follow-up.

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