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Published on: June 6, 2025
Voltage-Gated Ca2+-Channel α1-Subunit de novo Missense Mutations: Gain or Loss of Function - Implications for
1Department of Pharmacology and Toxicology, Institute of Pharmacy, Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria.
Abstract:
This review summarizes our current knowledge of human disease-relevant genetic variants within the family of voltage gated Ca2+ channels. Ca2+ channelopathies cover a wide spectrum of diseases including epilepsies, autism spectrum disorders, intellectual disabilities, developmental delay, cerebellar ataxias and degeneration, severe cardiac arrhythmias, sudden cardiac death, eye disease and endocrine disorders such as congential hyperinsulinism and hyperaldosteronism. A special focus will be on the rapidly increasing number of de novo missense mutations identified in the pore-forming α1-subunits with next generation sequencing studies of well-defined patient cohorts. In contrast to likely gene disrupting mutations these can not only cause a channel loss-of-function but can also induce typical functional changes permitting enhanced channel activity and Ca2+ signaling. Such gain-of-function mutations could represent therapeutic targets for mutation-specific therapy of Ca2+-channelopathies with existing or novel Ca2+-channel inhibitors. Moreover, many pathogenic mutations affect positive charges in the voltage sensors with the potential to form gating-pore currents through voltage sensors. If confirmed in functional studies, specific blockers of gating-pore currents could also be of therapeutic interest.
Insights
Genetic variants in voltage-gated calcium channels cause diverse diseases. Gain-of-function mutations offer potential therapeutic targets for calcium channelopathies.
Area of Science:
- Neuroscience
- Genetics
- Pharmacology
Background:
- Voltage-gated calcium channels (Ca2+) are crucial for cellular function.
- Dysfunction of these channels leads to a wide range of human diseases, termed Ca2+ channelopathies.
- These channelopathies include neurological, cardiac, ocular, and endocrine disorders.
Purpose of the Study:
- To review current knowledge on human disease-associated genetic variants in voltage-gated Ca2+ channels.
- To highlight the significance of de novo missense mutations in alpha-1 subunits.
- To explore potential therapeutic strategies targeting specific channel mutations.
Main Methods:
- Review of existing literature and genetic studies.
- Analysis of next-generation sequencing data from patient cohorts.
- Functional characterization of identified mutations (implied).
Main Results:
- Numerous disease-relevant genetic variants in Ca2+ channels have been identified.
- De novo missense mutations in alpha-1 subunits are increasingly recognized.
- These mutations can result in loss-of-function or gain-of-function, altering Ca2+ signaling.
- Pathogenic mutations affecting voltage sensors may lead to gating-pore currents.
Conclusions:
- Ca2+ channelopathies represent a significant group of genetic disorders.
- Gain-of-function mutations present opportunities for targeted therapies using Ca2+ channel inhibitors.
- Further research into gating-pore currents could yield novel therapeutic approaches.
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