Calsequestrin in Ventricular Arrhythmia and Sudden Death

描述（由申请人提供）：心脏钙螯合蛋白（CASQ 2）及其结合伴侣连接蛋白和三聚体蛋白-1（TRDN）是肌浆网（SR）钙储存和释放的关键调节因子。在人类中，CASQ 2突变导致儿茶酚胺能多态性室性心动过速和心源性猝死综合征。为了确定CASQ 2突变导致电生理不稳定但保留收缩功能的机制，我们产生了Casq 2 null（Casq 2-/-）小鼠。我们的初步研究表明，尽管缺乏Casq 2蛋白，这些小鼠仍保持接近正常的SR Ca 2+储存，这可能是由于SR体积的扩大和Casq 2结合蛋白triadin-1和junctin的急剧减少。Casq 2-/-小鼠通过用儿茶酚胺输注或运动发展多态性室性心动过速来表型复制人类CASQ 2相关的心律失常。Casq 2-/-肌细胞显示过早的自发性SR Ca 2+释放，导致后收缩和触发性搏动。值得注意的是，在体外破坏Ca 2+与CASQ 2结合的常用抗抑郁药物也与心源性猝死的发生率增加有关，这增加了Casq 2相关形式的药物诱导的心律失常的可能性，类似于药物相关的长QT综合征。基于这些人类遗传学、流行病学和小鼠数据，我们假设Casq 2的破坏导致SR Ca 2+释放功能障碍，并导致心律失常易感性和猝死。为了检验我们的中心假设，我们将在Casq 2-/-、Casq 2 +/-、三聚体蛋白-1缺失（Trdn-/-）和选择性杂交的动物中检查单细胞、整个心脏和体内电生理学、收缩功能、Ca 2+稳态、蛋白质表达和SR超微结构。我们的目标是测试Casq 2和三聚体-1对心律失常易感性的个体贡献，并进一步阐明导致室性心律失常的分子和细胞机制，以响应遗传和可能的药物诱导的Casq 2功能障碍。这项研究的结果不仅将促进我们对遗传性心律失常综合征的病理生理学的理解，而且还有助于解开与数百万患者服用的抗抑郁药物相关的猝死机制。

DESCRIPTION (provided by applicant): Cardiac calsequestrin (CASQ2), and its binding partners junctin and triadin-1 (TRDN), are key regulators of sarcoplasmic reticulum (SR) Ca2+ storage and release. In humans, CASQ2 mutations cause a syndrome of catecholaminergic polymorphic ventricular tachycardia and sudden cardiac death. To determine the mechanisms whereby CASQ2 mutations cause electrophysiologic instability but preserve contractile function, we have generated Casq2 null (Casq2-/-) mice. Our preliminary studies demonstrate that despite a lack of Casq2 protein, these mice maintain near normal SR Ca2+ storage, possibly as a result of an expansion of SR volume and drastic reductions in the Casq2 binding proteins triadin-1 and junctin. Casq2-/- mice phenocopy the human CASQ2- linked arrhythmias by developing polymorphic ventricular tachycardia with catecholamine infusion or exercise. Casq2-/- myocytes display premature spontaneous SR Ca2+ releases resulting in after- contractions and triggered beats. Significantly, commonly-used antidepressant drugs, which disrupt Ca2+ binding to CASQ2 in vitro, have also been linked to an increased incidence in sudden cardiac death, raising the possibility of a Casq2-linked form of drug-induced arrhythmias, analogous to the drug-associated long QT syndrome. Based on these human genetic, epidemiological, and mouse data, we hypothesize that disruption of Casq2 causes dysfunctional SR Ca2+ release and contributes to arrhythmia susceptibility and sudden death. To test our central hypothesis, we will examine single cell, whole heart and in vivo electrophysiology, contractile function, Ca2+ homeostasis, protein expression and SR ultrastructure in Casq2-/- , Casq2+/-, triadin-1 null (Trdn-/-) and selectively cross-bred animals. Our goals are to test the individual contribution of Casq2 and triadin-1 to arrhythmia susceptibility and further elucidate the molecular and cellular mechanism(s) that lead to ventricular arrhythmias in response to inherited and possibly drug-induced Casq2 dysfunction. The outcome of this research will not only advance our understanding of the pathophysiology of inherited arrhythmia syndromes, but also help unravel the mechanism(s) responsible for sudden deaths linked to antidepressant medications taken by millions of patients.