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In coordination with the New York City Medical Examiner's Office, we received the sequence of a mutated SCN5A gene that was found in a five-week-old girl who died in her sleep. SCN5A codes for the voltage-gated cardiac sodium channel alpha subunit (Nav1.5) and is responsible for the fast depolarization in phase zero of the cardiac action potential. The mutations that were present in the girl's SCN5A gene were a missense mutation, Q1832E, and a truncation mutation, R1944X. In order to gain an understanding of the conditions that led to the patient's death, we carried out a functional analysis on the mutant channels and measured how their properties differed from wild type Nav1.5 properties. For our functional analysis we carried out mutagenesis reactions to produce three experimental constructs in order to examine independent effects of Q1832E or R1944X, and to examine their interaction (mutant Nav1.5 that contains both Q1832E or R1944X; as was found in the genetic screen). These constructs were transfected into HEK 293 cells and studied using the patch clamp analysis using the whole cell configuration. Experiments were carried out to test the Nav1.5 current voltage relationships, the recovery from inactivation properties, and steady state inactivation properties. The data demonstrated that each of the three constructs resulted in a significantly reduced current density when compared to wild type Nav1.5 currents. The gating properties of the mutant channels were similar to those of wild type Nav1.5, though Nav1.5-R1944X did show a statistically significant slower recovery from inactivation than the wild type channel. Though more experimentation is needed to determine the mechanism behind the reduced current in the mutant channels, our data shows that each of the mutations is sufficient to produce a severely dysfunctional channel and this is likely the cause of the patient's death.

Computational methods such as Molecular Dynamics (MD) simulations and Molecular Mechanics generalized Born surface area solvation (MM-GBSA) binding affinity calculations have been utilized to determine the binding modes and final binding affinities of small molecules that are known to interact with the heart sodium channel NaV1.5. Lidocaine, ranolazine, and flecainide are FDA approved arrhythmia drugs that are prescribed to patients in the event of heart disease. Here, we demonstrate the likely binding preferences and modes of action of all molecules with NaV1.5, the stability of the systems, and overall final binding affinities of the small molecules with the protein. To gain insights into the mechanisms of heart disease treatments, the MM-GBSA method was utilized to estimate the binding free energies of each molecule and pose to NaV1.5. The evaluation of the binding of small molecules to NaV1.5 contributes to enhancing our understanding of the underlying processes involved in heart disease treatments. The MM-GBSA approach provides a valuable tool for predicting and analyzing binding affinities, which can aid in the design and optimization of potential therapeutic compounds targeting NaV1.5.

The emergence of pyrethroid resistant Anopheles funestus (a major African vector) in malaria affected parts of KwaZuluNatal, South Africa was correlated with the malaria epidemic of 1996 2000. This finding prompted the necessity of incorporating insecticide resistance management strategies into formal malaria control policy in South Africa. Resistance management strategies often rely on the assumption of reduced fitness associated with insecticide resistance and are based on the principle that resistance genes will tend to drift out of vector populations in the absence of insecticide selection pressure. This study aimed to determine whether a fitness cost is associated with pyrethroid resistance as well as to determine the stability and mode of inheritance of the resistance genes in a pyrethroid resistant (FUMOZR) strain of An. funestus. It also aimed to sequence and analyze a segment of the sodium channel gene for any kdrtype mutation(s) that may be associated with pyrethroid resistance. The final aim was to determine the resistance mechanisms involved in a Ghanaian field population of An. funestus resistant to DDT and pyrethroids. Results obtained suggest that pyrethroid resistance in southern African An. funestus did not incur any loss of fitness. FUMOZR had a reproductive advantage over a pyrethroid susceptible An. funestus strain (FANG) in terms of higher fertility, proportion of females laying eggs and eggtoadult survivorship, and a lower sterility Click to buy NOW! PDFXCHANGE www.docutrack. com Click to buy NOW! PDFXCHANGE www.docutrack. com iv rate. However, FUMOZR had a slower developmental time from egg hatch to adult emergence than FANG. Results of crosses and backcrosses carried out between FUMOZR and FANG were consistent with a monofactorial and autosomal mode of inheritance in which the resistant genes presented as incompletely dominant. The resistant gene was found to be stable over several generations in the absence of insecticide selection pressure. Analysis of the genomic and mRNA sequences of the IIS5 IIS6 segment of the sodium channel gene showed a high sequence identity between FUMOZR and FANG suggesting that the two strains are genetically similar. The kdrtype mutation was absent from this region supporting previous evidence that the resistance mechanism is primarily metabolic. Bioassay data showed that a Ghanaian field population of An. funestus from Obuasi, Ghana, was resistant to DDT and pyrethroids. Molecular analysis of the IIS5 IIS6 segment of the sodium channel gene showed an absence of kdrtype mutations previously associated with insecticide resistance. Biochemical analysis suggests that resistance is metabolically mediated primarily by elevated levels of and esterases with monooxygenases and GSTs playing a lesser role. The presence of an altered acetylcholinesterase conferring carbamate resistance was also evident in the population. These results have implications for the management of resistance in malaria control programmes in Africa.

The mineralocorticoid hormone, aldosterone, classically acts via the Mineralocorticoid Receptor (MR) to promote sodium transport in aldosterone target tissues, such as the kidney, thereby controlling long-term electrolyte homeostasis and blood pressure (BP). Aldosterone biosynthesis by the adrenal gland is regulated by a negative feedback loop called the Renin Angiotensin Aldosterone System (RAAS). The glucocorticoid cortisol (corticosterone in rodents), which has a very similar structure to aldosterone, shares with aldosterone an equal affinity for the MR. Typically, plasma cortisol levels are approximately 1000-fold higher than plasma aldosterone, and so the ligand specificity for aldosterone must be imposed on MR by other, non-structural, means. This specificity is important in order to retain electrolyte and BP balance within the control of the RAAS. The co-localisation of the enzyme 11β-Hydroxysteroid Dehydrogenase Type 2 (11β-HSD2) with the MR in aldosterone target tissues provides the MR with the aldosterone specificity it inherently lacks. 11β-HSD2 achieves this by converting active cortisol to its inactive 11-keto metabolite, cortisone (dehydrocorticosterone in rodents). In humans with the monogenetic Syndrome of Apparent Mineralocorticoid Excess (SAME), inactivating mutations in the HSD11B2 gene allows cortisol unregulated access to the MR. Resultant symptoms include severe hypertension and life-threatening hypokalemia. Individuals heterozygous for SAME display no overt phenotypes. However, some studies have associated SAME heterozygosity and loss-of-function polymorphisms within the HSD11B2 gene with essential and/or salt-sensitive hypertension in the general population. Targeted disruption of the Hsd11b2 gene in mice (Hsd11b2-/-) faithfully reproduces with all the major phenotypes of SAME patients. Mice heterozygote for the targeted gene (Hsd11b2+/-) have no phenotype and display a normal BP. In the present study, Hsd11b2+/- mice were used to explore the relationship between reduced 11β-HSD2 enzyme activity and salt-sensitive hypertension. On a high salt diet, Hsd11b2+/- mice were found to have increased BP and impaired natriuresis, compared to wild-type controls (Hsd11b2+/+). Further studies used pharmacological blockade of the Epithelial Sodium Channel (ENaC) and MR to ascertain the contributions of these pathways towards the observed phenotypes. These identified a deregulation of ENaC activity pertaining to an inability to regulate sodium appropriately. Investigations into the contributions of the RAAS and the Hypothalamus Pituitary Adrenal (HPA) axis have revealed valuable insights into their roles in this model. There is an implication that the RAAS has increased sensitivity in Hsd11b2+/-, further exacerbated by increased dietary sodium, and that the regulation of corticosteroids may also be altered. Novel observations have suggested that oxidative stress in response to a high salt diet could also be involved, as a study administering an antioxidant drug in conjunction with a high salt diet prevented the manifestation of a phenotype in Hsd11b2+/-. Finally, the generation of a floxed Hsd11b2 targeting construct for tissue-specific deletion of 11β-HSD2 will allow future studies into the contributions of specific 11β-HSD2 expression sites (such as the kidney) towards the phenotypes of both homozygous and heterozygous mice.

Hyperkalemic periodic paralysis, HyperKPP, is an inherited progressive disorder of the muscles caused by mutations in the voltage gated sodium channel (NaV1.4). The objectives of this thesis were to develop a technique for measurement symptoms in vivo using electromyography (EMG) and to determine the mechanism by which Ca2+ alleviates HyperKPP symptoms, since this is unknown. Increasing extracellular [Ca2+] ([Ca2+]e) from 1.3 to 4 mM did not result in any increases in45Ca2+ influx suggesting no increase in intracellular [Ca2+] ([Ca2+]i) acting on an intracellular signaling pathway or on an ion channel such as the Ca2+sensitive K+ channels. HyperKPP muscles have larger TTX-sensitive22Na+ influx than wild type muscles because of the defective NaV1.4 channels. When [Ca2+] was increased from 1.3 to 4 mM, the abnormal 22Na+ influx was completely abolished. Thus, one mechanism by which Ca2+alleviates HyperKPP symptoms is by reducing the abnormal Na+ influx caused by the mutation in the NaV1.4 channel.

Calmodulin (CaM) is an essential protein found in all eukaryotes ranging from vertebrates to unicellular organisms such as Paramecia. CaM is a calcium sensor protein composed of two domains (N and C) responsible for the regulation of numerous calcium-mediated signaling pathways. Four calcium ions bind to CaM, changing its conformation and determining how it recognizes and regulates its cellular targets. Since the discovery of CaM, most studies have focused on the role of its calcium-saturated form. However, an increasing number of target proteins have been discovered that preferentially bind apo (calcium-depleted) CaM. My study focused on understanding how apo CaM recognizes drugs and protein sequences, and how those interactions differ from those of calcium-saturated CaM. I have used spectroscopic methods to explore CaM binding the drug Trifluoperazine (TFP) and the IQ-motif of the type 2 Voltage-Dependent Sodium Channel (Nav1.2IQp). These studies have shown that both TFP and Nav1.2IQp preferentially bind to the "semi-open" conformation of apo CaM. TFP was shown to be an unusual allosteric effector of calcium binding to CaM. Using 15N-HSQC NMR spectroscopy, I determined the stoichiometry of TFP binding to apo Cam to be 2:1 and to (Ca2+)4-CaM to be 4:1 TFP:CaM. That difference in stoichiometry determined whether TFP decreased or increased the affinity of CaM for calcium. Analysis of residue-specific chemical shift differences indicated that TFP binding to apo and (Ca2+)4-CaM perturbed the C-domain more than the N-domain, prompting high-resolution structural studies of the isolated C-domain of CaM. Crystallographic studies of TFP bound to a calcium-saturated C-domain fragment of CaM (CaM76-148) revealed that CaM adopted an "open" tertiary conformation. The unit cell contained two protein and 4 drug molecules. The orientation of TFP revealed that its trifluoromethyl group was found in two alternative positions (one in each protein in the unit cell), and that Met 144 acted as a gatekeeper to select the orientation of TFP. In contrast to TFP binding to the "open" conformation of calcium-saturated CaM76-148, my NMR studies showed that TFP bound the "semi-open" conformation of apo CaM76-148. TFP interacted with CaM residues near the perimeter of the hydrophobic pocket, but did not contact residues that are solvent-accessible only in the "open" form. Allosteric effects due to TFP binding were observed in the calcium-binding loops of apo CaM76-148. These properties suggest that TFP may antagonize interactions between apo CaM and target proteins such as ion channels that preferentially bind apo CaM. Nav1.2, is responsible for the passage of Na+ ion across cellular membranes. Apo binding of CaM to Nav1.2 poises it for action upon calcium release in the cell. My NMR studies of CaM binding to the Nav1.2 IQ-motif sequence (Nav1.2IQp) showed that the C-domain of apo CaM was necessary and sufficient for binding. My high-resolution structure of the isolated C-domain of CaM bound to Nav1.2IQp revealed that the domain adopted a "semi-open" conformation. At the interface between the IQ-motif and CaM, the highly conserved I and two Y residues of Nav1.2IQp interacted with hydrophobic residues of CaM, while the invariant Q residue interacted with residues in the loop between helices F and G of CaM. This is the first CaM-IQ complex to be determined by NMR; the only other available structure of apo CaM bound to an IQ-motif was determined crystallographically. To accomplish its regulatory roles in response to cellular Ca2+ fluxes, CaM has evolved multiple binding interfaces that are allosterically linked to its Ca2+-ligation state. My studies of CaM binding to TFP and NaV1.2 demonstrate the versatility of CaM functioning as a regulatory protein comprised of domains having separable functions.

Cell surfaces are replete with complex, biologically important glycans responsible for multiple cellular functions including cell adhesion and cellular communication. Proper protein glycosylation is essential for normal development and often pathologies are marked by altered glycosylation. Here, data showed that the auxillary subunit, ß1, modified voltage-gated Na+ channel (Nav) gating in an isoform-specific, sialic acid dependent, and saturating manner. The regulated activity of the hundreds of glycogenes (glycosylation-associated genes) is responsible for protein glycosylation; this could result in a glycome of thousands of glycan structures. Microarray analyses indicated that glycogene expression was highly regulated throughout the heart during development. Specifically, >59% of glycogenes were significantly differentially expressed among neonatal and adult atrial and ventricular myocytes. Quantitative-PCR of individual genes confirmed the microarray analyses. Such substantial regulation of glycogene expression likely results in changes in glycan structures attached to cell surface proteins. To confirm this, myocyte glycan profiles were determined and compared among neonatal and adult atria and ventricles using mass spectrometry. The data predicted marked differences in glycan structures among myocyte types, indicating that the glycome is remodeled throughout the heart during development. To address the question of whether the remodeled glycome can impact cardiac function, action potentials and Na[subscript]v activity were measured and compared under conditions in which glycogene expression was regulated. That is, atrial and ventricular myocytes were isolated from control mice and from mice in which the polysialyltransferase, STX, was knocked out. STX is expressed in the neonatal atria, and is essentially absent in neonatal ventricle. Action potential waveforms and Nav activity measured in atrial myocytes were impacted by STX expression. No changes in ventricular action potential waveform or in Na[subscript]v activity were observed; as expected since STX is not expressed in the ventricle. The magnitude of the atrial action potential and the rate of depolarization were decreased in the absence of STX. Further, Na[subscript]v gating was shifted consistently in the depolarized direction in STX knockout atrial myocytes. Together, these data indicate that the glycome is tightly controlled and regulated in the heart, and proper glycosylation is essential for normal myocyte function.

Lithium has been used for more than 50 years as a primary therapy for bipolar affective disorder (BPD) and has proven highly effective for both acute and long-term phases of the disease. Unfortunately, the molecular and cellular mechanisms underlying the mood-stabilizing action of lithium for the treatment of BPD remains largely unknown. In an effort towards understanding the complexities of lithium's action in the nervous system, I have utilized the Drosophila neurological mutant Shudderer (Shu). Previous findings have suggested that the adult Shu phenotypes may be improved by providing a diet containing millimolar concentrations of lithium. Using well-established genetic techniques and behavioral paradigms I thoroughly characterized the Shu mutant phenotypes. I found that the mutant displays morphological and behavioral abnormalities indicative of dysregulated neuronal excitability that include: down-turning wings and indented dorsal thorax, defects in negative geotaxis, deficits in locomotion, abnormal sleep architecture and unusual patterns of leg-shaking behaviors upon recovery of ether anesthetics. Furthermore, I confirmed that lithium was able to significantly improve many aspects of Shu behaviors. Recombination-based mutation mapping in Shu revealed that the genetic lesion lies somewhere within the gene CG9907, which encodes the voltage-gated sodium channel á-subunit paralytic (para). Subsequent genetic experiments using para hypomorphic mutant alleles as well as a UAS-RNAi/GAL4 system showed that a reduction in sodium channel levels resulted in a drastic improvement of the mutant defects. Together, these data suggest that the lithium-responsive Shu mutant is likely a gain-of-function allele of para. Sequencing of the entire para coding region identified a missense mutation in a highly conserved region of the para coding sequence, in transmembrane segment S2 of homology domain III ((M1350I). To date, this is the first known discovery of a sodium channel mutant allele in Drosophila which causes hyperactivity. These data suggest that the Shu phenotypes are somehow caused by an increase in sodium channel activation. Lastly, I identified a number of genes likely to functionally interact with the Shu mutation. Of note, the Ca2+/calmodulin-activated Ser/Thr protein phosphatase alpha subunit gene CanA-14F is up-regulated in Shu and reduction of its activity suppresses the mutant phenotypes. Furthermore, a large percentage of genes encoding anti-microbial peptides (AMP) were also significantly up-regulated in Shu, possibly acting downstream of CanA-14F. A genetic deficiency screen looking for genes that alter the Shu phenotypes has identified that the gene Glutathione S-transferase S1 (Gsts1) suppresses the morphological and behavioral defects in the lithium-responsive mutant. Overall, these genes will help decipher how the gain-of-function sodium channel Shu mutation alters nervous system function. In addition, they will shed light on those mechanisms responsible for lithium's mood-stabilizing effects in the brain.