1. Epileptic encephalopathy in a patientwith a novel variant in the Kv7.2 S2 transmembrane segment: Clinical, genetic, and functional features
- Author
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Charu Venkatesan, Ilaria Mosca, Maurizio Taglialatela, Lorella M.T. Canzoniero, Maria Virginia Soldovieri, Francesco Miceli, Beth M. Kline-Fath, Cristina Franco, Edward C. Cooper, Paolo Ambrosino, Soldovieri, M. V., Ambrosino, P., Mosca, I., Miceli, F., Franco, C., Canzoniero, L. M. T., Kline-Fath, B., Cooper, E. C., Venkatesan, C., and Taglialatela, M.
- Subjects
0301 basic medicine ,Male ,Models, Molecular ,Protein Conformation ,Developmental Disabilities ,medicine.disease_cause ,lcsh:Chemistry ,chemistry.chemical_compound ,0302 clinical medicine ,Loss of Function Mutation ,Missense mutation ,Benign familial neonatal seizures ,lcsh:QH301-705.5 ,Spectroscopy ,Genetics ,Mutation ,Brain Diseases ,Coupled charge reversal ,Homology model ,Epileptic encephalopathy ,Retigabine ,Electroencephalography ,General Medicine ,Magnetic Resonance Imaging ,Computer Science Applications ,Transmembrane domain ,Child, Preschool ,Symptom Assessment ,Spasms, Infantile ,Encephalopathy ,Neuroimaging ,Biology ,Catalysis ,Article ,Inorganic Chemistry ,03 medical and health sciences ,Structure-Activity Relationship ,Voltage sensor ,medicine ,Humans ,KCNQ2 Potassium Channel ,Genetic Predisposition to Disease ,Protein Interaction Domains and Motifs ,Physical and Theoretical Chemistry ,Molecular Biology ,Gene ,Loss function ,Genetic Association Studies ,Organic Chemistry ,Infant, Newborn ,Genetic Variation ,Infant ,medicine.disease ,Kv7 channels ,030104 developmental biology ,chemistry ,Amino Acid Substitution ,lcsh:Biology (General) ,lcsh:QD1-999 ,Kv7 channel ,030217 neurology & neurosurgery ,Biomarkers - Abstract
Kv7.2 subunits encoded by the KCNQ2 gene provide a major contribution to the M-current (IKM), a voltage-gated K+ current crucially involved in the regulation of neuronal excitability. Heterozygous missense variants in Kv7.2 are responsible for epileptic diseases characterized by highly heterogeneous genetic transmission and clinical severity, ranging from autosomal-dominant Benign Familial Neonatal Seizures (BFNS) to sporadic cases of severe epileptic and developmental encephalopathy (DEE). Here, we describe a patient with neonatal onset DEE, carrying a previously undescribed heterozygous KCNQ2 c.418G >, C, p.Glu140Gln (E140Q) variant. Patch-clamp recordings in CHO cells expressing the E140Q mutation reveal dramatic loss of function (LoF) effects. Multistate structural modelling suggested that the E140Q substitution impeded an intrasubunit electrostatic interaction occurring between the E140 side chain in S2 and the arginine at position 210 in S4 (R210), this interaction is critically involved in stabilizing the activated configuration of the voltage-sensing domain (VSD) of Kv7.2. Functional results from coupled charge reversal or disulfide trapping experiments supported such a hypothesis. Finally, retigabine restored mutation-induced functional changes, reinforcing the rationale for the clinical use of Kv7 activators as personalized therapy for DEE-affected patients carrying Kv7.2 LoF mutations.
- Published
- 2019