Background: Pathogenic variants in SCN5A, the gene encoding the cardiac Na channel -subunit Na1.5, result in
life-threatening arrhythmias, e.g., Brugada syndrome, cardiac conduction defects
and long QT syndrome. This variety of phenotypes is underlied by the fact that
each Na1.5 mutation has unique consequences on the channel trafficking and
gating capabilities. Recently, we established that sodium channel
-subunits Na1.5, Na1.1 and Na1.2 could dimerize,
thus, explaining the potency of some Na1.5 pathogenic variants to exert
dominant-negative effect on WT channels, either by trafficking deficiency or
coupled gating. Objective: The present study sought to examine whether
Na1.5 channels can cooperate, or transcomplement each other, to rescue the
Na current (I). Such a mechanism could contribute to explain the
genotype-phenotype discordance often observed in family members carrying
Na-channel pathogenic variants. Methods: Patch-clamp and
immunocytochemistry analysis were used to investigate biophysical properties and
cellular localization in HEK293 cells and rat neonatal cardiomyocytes transfected
respectively with WT and 3 mutant channels chosen for their particular
trafficking and/or gating properties. Results: As previously reported,
the mutant channels G1743R and R878C expressed alone in HEK293 cells both
abolished I, G1743R through a trafficking deficiency and R878C through a
gating deficiency. Here, we showed that coexpression of both G1743R and R878C
nonfunctioning channels resulted in a partial rescue of I, demonstrating a
cooperative trafficking of Na1.5 -subunits. Surprisingly, we also
showed a cooperation mechanism whereby the R878C gating-deficient channel was
able to rescue the slowed inactivation kinetics of the C-terminal truncated
R1860X (Cter) variant, suggesting coupled gating. Conclusions:
Altogether, our results add to the evidence that Na channels are able to
interact and regulate each other’s trafficking and gating, a feature that likely
contributes to explain the genotype-phenotype discordance often observed between
members of a kindred carrying a Na-channel pathogenic variant.