title: Skipping of Exon 1 in the KCNQ1 gene causes Jervell and Lange-Nielsen syndrome.
abstract: The Jervell and Lange-Nielsen syndrome (JLNS) is a rare autosomal recessive form of the long QT syndrome linked with a profound hearing loss caused by mutations affecting both alleles of either the KCNQ1 or the KCNE1 gene. We carried out a mutant screening of the KCNQ1 and KCNE1 genes in a clinical diagnosed German family with JLNS. Family members were examined by single strand conformation polymorphism analysis and PCR and amplified products were characterized by DNA sequence analysis. We identified a splice donor mutation of exon 1 in the KCNQ1 gene (G477+1A). Analysis of lymphocyte RNA by RT-PCR revealed that two symptomatic patients, homozygous for the mutant allele, exclusively produce KCNQ1 transcripts lacking exon 1 leading to a frameshift that introduced a premature termination codon at exon 4. Mutant subunits, functionally characterized in Xenpous oocytes, were unable to form homomeric channels but strongly reduced IKs (slowly activating delayed rectifier potassium current) in vitro (mutant isoforms 1 and 2 by 62 and 86%, respectively), a fact supposed to lead to severely affected heterozygous individuals. However, individuals heterozygous for the mutant allele exhibit an asymptomatic cardiac phenotype. Thus, the observed dominant-negative effect of mutant subunits in vitro is absent in vivo leaving heterozygous individuals unaffected. These data suggest mechanisms that prevent production of truncated KCNQ1 channel subunits in cardiomyocytes of individuals heterozygous for the mutant allele.
authors.affiliation: Universitätsklinikum Heidelberg, Innere Medizin III, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Zehelein
authors.forename: Sven
authors.initials: S
authors.lastname: Kathoefer
authors.forename: Markus
authors.initials: M
authors.lastname: Khalil
authors.forename: Markus
authors.initials: M
authors.lastname: Alter
authors.forename: Dierk
authors.initials: D
authors.lastname: Thomas
authors.forename: Konrad
authors.initials: K
authors.lastname: Brockmeier
authors.forename: Herbert E
authors.initials: HE
authors.lastname: Ulmer
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.forename: Michael
authors.initials: M
authors.lastname: Koenen
mesh_terms: D000293:Adolescent; D000818:Animals; D005091:Exons / Q000235:genetics*; D005260:Female; D016368:Frameshift Mutation; D006579:Heterozygote; D006801:Humans; D029593:Jervell-Lange Nielsen Syndrome / Q000235:genetics*; D051657:KCNQ1 Potassium Channel / Q000235:genetics* / Q000378:metabolism; D008297:Male; D009865:Oocytes; D010375:Pedigree; D024642:Potassium Channels, Voltage-Gated / Q000378:metabolism; D021122:Protein Subunits; D022821:RNA Splice Sites / Q000235:genetics; D014981:Xenopus
chemical_list: C489622:KCNE1 protein, human; D051657:KCNQ1 Potassium Channel; C496909:KCNQ1 protein, human; D024642:Potassium Channels, Voltage-Gated; D021122:Protein Subunits; D022821:RNA Splice Sites