Arrhythmogenic calmodulin mutations impede activation of small-conductance calcium-activated potassium current

Background Apamin-sensitive small-conductance calcium-activated potassium (SK) channels are gated by intracellular Ca²⁺ through a constitutive interaction with calmodulin. Objective We hypothesize that arrhythmogenic human calmodulin mutations impede activation of SK channels. Methods We studied 5 previously published calmodulin mutations (N54I, N98S, D96V, D130G, and F90L). Plasmids encoding either wild-type or mutant calmodulin were transiently transfected into human embryonic kidney 293 cells that stably express subtype 2 of SK protein channels (SK2 cells). Whole-cell voltage-clamp recording was used to determine apamin-sensitive current densities. We also performed optical mapping studies in normal murine hearts to determine the effects of apamin in hearts with (n=7) or without (n=3) pretreatment with sea anemone toxin. Results SK2 cells transfected with wild-type calmodulin exhibited an apamin-sensitive current density of 33.6 pA/pF (31.4–36.5 pA/pF) (median and confidence interval 25th–75th percentile), which was significantly higher than that observed for cells transfected with N54I (17.0 pA/pF [14.0–27.7 pA/pF]; P = .016), F90L (22.6 pA/pF [20.3–24.3 pA/pF]; P = .011), D96V (13.0 pA/pF [10.9–15.8 pA/pF]; P = .003), N98S (13.7 pA/pF [8.8–20.4 pA/pF]; P = .005), and D130G (17.6 pA/pF [13.8–24.6 pA/pF]; P = .003). The decrease in SK2 current densities was not associated with a decrease in membrane protein expression or intracellular distribution of the channel protein. Apamin increased the ventricular action potential duration at 80% repolarization (from 79.6 ms [63.4–93.3 ms] to 121.8 ms [97.9–127.2 ms]; P = .010) in hearts pretreated with anemone toxin but not in control hearts. Conclusion Human arrhythmogenic calmodulin mutations impede the activation of SK2 channels in human embryonic kidney 293 cells.