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Published on: March 12, 2013
Clinical phenotype and functional characterization of CASQ2 mutations associated with catecholaminergic polymorphic
Marina Raffaele di Barletta1, Serge Viatchenko-Karpinski, Alessandra Nori
1Molecular Cardiology, IRCCS Fondazione Maugeri, University of Pavia, Via Ferrata 8 27100, Pavia, Italy.
Background:
Four distinct mutations in the human cardiac calsequestrin gene (CASQ2) have been linked to catecholaminergic polymorphic ventricular tachycardia (CPVT). The mechanisms leading to the clinical phenotype are still poorly understood because only 1 CASQ2 mutation has been characterized in vitro.
Methods And Results:
We identified a homozygous 16-bp deletion at position 339 to 354 leading to a frame shift and a stop codon after 5aa (CASQ2(G112+5X)) in a child with stress-induced ventricular tachycardia and cardiac arrest. The same deletion was also identified in association with a novel point mutation (CASQ2(L167H)) in a highly symptomatic CPVT child who is the first CPVT patient carrier of compound heterozygous CASQ2 mutations. We characterized in vitro the properties of CASQ2 mutants: CASQ2(G112+5X) did not bind Ca2+, whereas CASQ2(L167H) had normal calcium-binding properties. When expressed in rat myocytes, both mutants decreased the sarcoplasmic reticulum Ca2+-storing capacity and reduced the amplitude of I(Ca)-induced Ca2+ transients and of spontaneous Ca2+ sparks in permeabilized myocytes. Exposure of myocytes to isoproterenol caused the development of delayed afterdepolarizations in CASQ2(G112+5X).
Conclusions:
CASQ2(L167H) and CASQ2(G112+5X) alter CASQ2 function in cardiac myocytes, which leads to reduction of active sarcoplasmic reticulum Ca2+ release and calcium content. In addition, CASQ2(G112+5X) displays altered calcium-binding properties and leads to delayed afterdepolarizations. We conclude that the 2 CASQ2 mutations identified in CPVT create distinct abnormalities that lead to abnormal intracellular calcium regulation, thus facilitating the development of tachyarrhythmias.
Insights
Two new mutations in the cardiac calsequestrin gene (CASQ2) were identified in children with catecholaminergic polymorphic ventricular tachycardia (CPVT). These mutations disrupt intracellular calcium regulation, leading to dangerous heart rhythms.
Area of Science:
- Cardiovascular Genetics
- Molecular Cardiology
- Arrhythmogenesis
Background:
- Four mutations in the human cardiac calsequestrin gene (CASQ2) are linked to catecholaminergic polymorphic ventricular tachycardia (CPVT).
- Understanding the mechanisms of CPVT caused by CASQ2 mutations is limited due to insufficient in vitro characterization of identified mutants.
Purpose of the Study:
- To identify and characterize novel CASQ2 mutations associated with CPVT.
- To investigate the functional consequences of these mutations on cardiac myocyte calcium handling and arrhythmogenesis.
Main Methods:
- Genetic sequencing to identify CASQ2 mutations in CPVT patients.
- In vitro characterization of CASQ2 mutant protein function, including calcium binding.
- Expression of mutant CASQ2 in rat myocytes to assess sarcoplasmic reticulum calcium storage and calcium transients.
- Electrophysiological studies to evaluate the impact of mutations on arrhythmogenic events.
Main Results:
- A homozygous 16-bp deletion (CASQ2(G112+5X)) and a compound heterozygous mutation (CASQ2(L167H)) were identified in CPVT patients.
- CASQ2(G112+5X) exhibited impaired calcium binding, while both mutants reduced sarcoplasmic reticulum calcium capacity in myocytes.
- Myocytes expressing mutants showed reduced I(Ca)-induced Ca2+ transients and spontaneous Ca2+ sparks; isoproterenol induced delayed afterdepolarizations in CASQ2(G112+5X) expressing myocytes.
Conclusions:
- The identified CASQ2(L167H) and CASQ2(G112+5X) mutations impair cardiac myocyte function by altering calcium regulation.
- These distinct abnormalities in intracellular calcium handling contribute to the development of tachyarrhythmias in CPVT patients.
- The study elucidates the molecular mechanisms underlying CPVT associated with novel CASQ2 mutations.
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