RT Journal Article
T1 Molecular stratification of arrhythmogenic mechanisms in the Andersen Tawil Syndrome.
A1 Manuel, Ana Isabel Moreno
A1 Gutiérrez, Lilian K
A1 Pedrosa, María Linarejos Vera
A1 Uréndez, Francisco Miguel Cruz
A1 Jiménez, Francisco José Bermúdez
A1 Carrascoso, Isabel Martínez
A1 Pérez, Patricia Sánchez
A1 Macías, Álvaro
A1 Jalife, José
K1 KCNJ2 mutations
K1 Kir2.1 mutations classification
K1 Kir2.1-NaV1.5 channelosome
K1 channelopathies
K1 sarcoplasmic reticulum Kir2.1 channels
K1 sudden cardiac death
AB Andersen Tawil Syndrome (ATS) is a rare inheritable disease associated with loss-of-function mutations in KCNJ2, the gene coding the strong inward rectifier potassium channel Kir2.1, which forms an essential membrane protein controlling cardiac excitability. ATS is usually marked by a triad of periodic paralysis, life-threatening cardiac arrhythmias and dysmorphic features, but its expression is variable and not all patients with a phenotype linked to ATS have a known genetic alteration. The mechanisms underlying this arrhythmogenic syndrome are poorly understood. Knowing such mechanisms would be essential to distinguish ATS from other channelopathies with overlapping phenotypes and to develop individualized therapies. For example, the recently suggested role of Kir2.1 as a countercurrent to sarcoplasmic calcium reuptake might explain the arrhythmogenic mechanisms of ATS and its overlap with catecholaminergic polymorphic ventricular tachycardia (CPVT). Here we summarize current knowledge on the mechanisms of arrhythmias leading to sudden cardiac death in ATS. We first provide an overview of the syndrome and its pathophysiology, from the patient´s bedside to the protein, and discuss the role of essential regulators and interactors that could play a role in cases of ATS. The review highlights novel ideas related to some post-translational channel interactions with partner proteins that might help define the molecular bases of the arrhythmia phenotype. We then propose a new all-embracing classification of the currently known ATS loss-of-function mutations according to their position in the Kir2.1 channel structure and their functional implications. We also discuss specific ATS pathogenic variants, their clinical manifestations and treatment stratification. The goal is to provide a deeper mechanistic understanding of the syndrome toward the development of novel targets and personalized treatment strategies.
YR 2022
FD 2022-07-27
LK http://hdl.handle.net/10668/19756
UL http://hdl.handle.net/10668/19756
LA en
DS RISalud
RD Apr 10, 2025