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Caractérisation fonctionnelle de formes mutées du récepteur des dihydropyridines responsables de Paralysie Périodique Hypokaliémique de type 1

Abstract : The type 1 Hypokalemic Periodic Paralysis (HypoPP1) is a muscle autosomal dominant genetic disease characterized by episodic attacks of paralysis lasting between a few hours and several days. These attacks are associated with hypokalemia which is responsible of cardiac arrhythmias leading to death in worst cases. Attacks are triggered by stress, high carbohydrate diet or during rest following exercise. HypoPP1 is caused by missense mutations in the gene CACNA1S encoding the main subunit of the voltage-gated calcium channel (Cav1.1) of skeletal muscle. In all but one, HypoPP1 mutations lead to the replacement of an outermost arginine in one of the voltage sensor segment, called S4, with a neutral amino-acid. Experiments realized with the closely structurally related voltage-gated K+ and Na+ channels showed that comparable mutations generate an accessory pathtoway called gating pore through which a depolarizing current flows at rest. If such an accessory pathway also exists in the skeletal muscle Cav1.1, it could initiate depolarization of skeletal muscle to the point of inexcitability and lead to paralysis. My work aimed at investigating the properties of HypoPP1-associated mutant Cav1.1s R1239H and V876E in order to determine if such an accessory pathway could be present in mutated Cav1.1. The R1239H mutation corresponds to the replacement of the second arginine in the S4 segment of domain IV by a histidine and the V876E mutation has the particularity to not affect a S4 segment but the S3 segment in domain III. In this work, we used in vivo gene expression of the wild type (WT) or mutated forms of the human Cav1.1in the hind limb muscle of mice and analyzed ions fluxes by combining voltage-clamp and measurements of intracellular H+ or Na+ by fluorescence. The R1239H mutation was shown to induce a significant larger H+ influx giving rise to a larger inward H+ current at rest as compared to WT. The V876E mutation, which had never been investigated so far, was found to induce an elevated inward current at rest but in this case carried by Na+ ions. These results have relevance because they suggest that the presence of an accessory pathway could be a physiopathological mechanism shared by different HypoPPs, even when the mutation does not directly affect a S4 segment
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Clarisse Fuster. Caractérisation fonctionnelle de formes mutées du récepteur des dihydropyridines responsables de Paralysie Périodique Hypokaliémique de type 1. Physiologie [q-bio.TO]. Université de Lyon, 2017. Français. ⟨NNT : 2017LYSE1268⟩. ⟨tel-01717926⟩

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