Background:
Co-assembly of cardiac Na
+
channels (Na
v
1.5) with β subunits modifies channel gating, expression, and post-translational modification. β subunit mutations have been linked to the Brugada and Long QT Syndromes, and atrial fibrillation (AF).
Hypothesis:
We tested whether β
3
subunits regulate Nav.1.5 ionic current and drug response by modulating the voltage sensing domains (VSDs).
Methods:
The Na
V
1.5 α subunit contains four domains (DI-DIV), each with its own voltage sensing domain (VSD). We previously created four DNA constructs that carried a cysteine within a single VSD. Channels expressed in
Xenopus
oocytes and these cysteines were labeled with TAMRA-MTS fluorophores. Ionic current and fluorescence emission that tracked VSD conformation were simultaneously recorded using the cut-open configuration with and without β
3
.
Results:
Steady state inactivation is significantly right shifted by β
3
(V
1/2
= -88.9 ± 1.1 SEM (with, +β
3
) and -97.8 ± 1.5 (without, -β
3
), p=0.002, n=4). β
3
also
right shifts DIII-VSD activation (V
1/2
= -93.0±2.3 +β
3
, V
1/2
= --114.8±0.8 -β
3
, p=0.001, n=4), while modestly left-shifting channel activation, suggesting enhanced DIII-VSD to pore coupling (V
1/2GV
-V
1/2FV
=55.0 ± 4.0 +β
3
, V
1/2GV
-V
1/2FV
=73.6 ± 2.4 -β
3
, n=4). DI and DII were not affected, while DIV was modestly shifted, consistent with DIII/DIV cooperativity. Extracellular domain AF-linked β
3
mutations, R6K and L10P, further enhance DIII-VSD to pore coupling (V
1/2GV
-V
1/2FV
=34.1 ± 5.8, (R6K), V
1/2GV
-V
1/2FV
=41.5 ± 4.7 (L10P), n=4). β
3
nearly abolishes stabilization of the DIII-VSD by lidocaine (DIII FV shift by lidocaine: ΔV
1/2
lido=-27.71 ± 12.23 (+β
3
), ΔV
1/2
lido=-65.44 ± 3.83 (-β
3
), n=3). The conservative R6K mutation exacerbates this effect, suggesting a cation-pi interaction with Na
V
1.5. W1684 is co-localized with the DIII-VSD, and W1684A disrupted β
3
modification of channel gating and the DIII lidocaine interaction.
Conclusions:
β
3
modifies Nav1.5 gating by increasing DIII-VSD coupling to the pore via interaction with W1684. AF β
3
mutants further enhance DIII-VSD to pore coupling. The differential lidocaine response caused by WT and AF β
3
mutants suggests a molecular mechanism whereby the lidocaine response is patient and heart-chamber specific.