Molecular determinants for high-affinity block of human EAG potassium channels by antiarrhythmic agents

Undesired block of human ERG1 potassium channels is the basis for cardiac side effects of many different types of drugs. Therefore, it is important to know exactly why some drugs particularly bind to these channels with high affinity. Upon expression in mammalian cells and Xenopus laevis oocytes, we investigated the inhibition of the closely related hEAG1 and hEAG2 channels by agents that have previously been reported to block hERG1 channels. Clofilium inhibited hEAG1 and hERG1 with the same potency, whereas hEAG2 was about 150-fold less sensitive to this antiarrhythmic agent. The molecular determinants for this difference are residues Ser436 and Val437 in the inner cavity of the pore and Ala453, which is located in S6 (i.e., remote from the inner cavity). A modeling approach that allowed for partial conformational relaxation of hEAG model structures upon ligand docking suggests that high-affinity block of ether à go-go channels is mediated by an anchoring of the clofilium alkane tail between S6 and the pore helices. In qualitative agreement with experiments, the mutations of hEAG1 residues Ser436 and Val437 to the corresponding larger hEAG2 residues (Thr432, Ile433) resulted in reduced sterical fit between the ligand and the binding cavity. The model is further supported by functional assays involving (+)-N-[1'-(6-cyano-1,2,3,4-tetrahydro-2(R)-naphthalenyl)-3,4-dihydro-4(R)-hydroxyspiro(2H-1-benzopyran-2,4'-piperidin)-6-yl]methanesulfonamide monohydrochloride (MK-499), terfenadine, quinidine, and tetrabutylammonium that are differentially affected by mutations in the pore pocket.