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Gain-of-function mutations in KCNK3 cause a developmental disorder with sleep apnea.

ABSTRACT: Sleep apnea is a common disorder that represents a global public health burden. KCNK3 encodes TASK-1, a K⁺ channel implicated in the control of breathing, but its link with sleep apnea remains poorly understood. Here we describe a new developmental disorder with associated sleep apnea (developmental delay with sleep apnea, or DDSA) caused by rare de novo gain-of-function mutations in KCNK3. The mutations cluster around the 'X-gate', a gating motif that controls channel opening, and produce overactive channels that no longer respond to inhibition by G-protein-coupled receptor pathways. However, despite their defective X-gating, these mutant channels can still be inhibited by a range of known TASK channel inhibitors. These results not only highlight an important new role for TASK-1 K⁺ channels and their link with sleep apnea but also identify possible therapeutic strategies.

SUBMITTER: Sormann J

PROVIDER: S-EPMC9534757 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Gain-of-function mutations in KCNK3 cause a developmental disorder with sleep apnea.

Sörmann Janina J Schewe Marcus M Proks Peter P Jouen-Tachoire Thibault T Rao Shanlin S Riel Elena B EB Agre Katherine E KE Begtrup Amber A Dean John J Descartes Maria M Fischer Jan J Gardham Alice A Lahner Carrie C Mark Paul R PR Muppidi Srikanth S Pichurin Pavel N PN Porrmann Joseph J Schallner Jens J Smith Kirstin K Straub Volker V Vasudevan Pradeep P Willaert Rebecca R Carpenter Elisabeth P EP Rödström Karin E J KEJ Hahn Michael G MG Müller Thomas T Baukrowitz Thomas T Hurles Matthew E ME Wright Caroline F CF Tucker Stephen J SJ

Nature genetics 20221004 10

Sleep apnea is a common disorder that represents a global public health burden. KCNK3 encodes TASK-1, a K<sup>+</sup> channel implicated in the control of breathing, but its link with sleep apnea remains poorly understood. Here we describe a new developmental disorder with associated sleep apnea (developmental delay with sleep apnea, or DDSA) caused by rare de novo gain-of-function mutations in KCNK3. The mutations cluster around the 'X-gate', a gating motif that controls channel opening, and pr ...[more]

PMID: 36195757

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Project description:T-type calcium channels (Cav3.1 to Cav3.3) regulate low-threshold calcium spikes, burst firing and rhythmic oscillations of neurons and are involved in sensory processing, sleep, and hormone and neurotransmitter release. Here, we examined four heterozygous missense variants in CACNA1I, encoding the Cav3.3 channel, in patients with variable neurodevelopmental phenotypes. The p.(Ile860Met) variant, affecting a residue in the putative channel gate at the cytoplasmic end of the IIS6 segment, was identified in three family members with variable cognitive impairment. The de novo p.(Ile860Asn) variant, changing the same amino acid residue, was detected in a patient with severe developmental delay and seizures. In two additional individuals with global developmental delay, hypotonia, and epilepsy, the variants p.(Ile1306Thr) and p.(Met1425Ile), substituting residues at the cytoplasmic ends of IIIS5 and IIIS6, respectively, were found. Because structure modelling indicated that the amino acid substitutions differentially affect the mobility of the channel gate, we analysed possible effects on Cav3.3 channel function using patch-clamp analysis in HEK293T cells. The mutations resulted in slowed kinetics of current activation, inactivation, and deactivation, and in hyperpolarizing shifts of the voltage-dependence of activation and inactivation, with Cav3.3-I860N showing the strongest and Cav3.3-I860M the weakest effect. Structure modelling suggests that by introducing stabilizing hydrogen bonds the mutations slow the kinetics of the channel gate and cause the gain-of-function effect in Cav3.3 channels. The gating defects left-shifted and increased the window currents, resulting in increased calcium influx during repetitive action potentials and even at resting membrane potentials. Thus, calcium toxicity in neurons expressing the Cav3.3 variants is one likely cause of the neurodevelopmental phenotype. Computer modelling of thalamic reticular nuclei neurons indicated that the altered gating properties of the Cav3.3 disease variants lower the threshold and increase the duration and frequency of action potential firing. Expressing the Cav3.3-I860N/M mutants in mouse chromaffin cells shifted the mode of firing from low-threshold spikes and rebound burst firing with wild-type Cav3.3 to slow oscillations with Cav3.3-I860N and an intermediate firing mode with Cav3.3-I860M, respectively. Such neuronal hyper-excitability could explain seizures in the patient with the p.(Ile860Asn) mutation. Thus, our study implicates CACNA1I gain-of-function mutations in neurodevelopmental disorders, with a phenotypic spectrum ranging from borderline intellectual functioning to a severe neurodevelopmental disorder with epilepsy.

Dataset Information

Gain-of-function mutations in KCNK3 cause a developmental disorder with sleep apnea.

Publications

Gain-of-function mutations in KCNK3 cause a developmental disorder with sleep apnea.

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