Epilepsy Mutations in Different Regions of the Nav1.2 Channel Cause
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EPILEPSY MUTATIONS IN DIFFERENT REGIONS OF THE NAV1.2 CHANNEL CAUSE DISTINCT BIOPHYSICAL EFFECTS Emily R. Mason Submitted to the faculty of the University Graduate School in partial fulfillment of the requirements for the degree Doctor of Philosophy in the Department of Pharmacology and Toxicology, Indiana University June 2020 Accepted by the Graduate Faculty of Indiana University, in partial fulfillment of the requirements for the degree of Doctor of Philosophy. Doctoral Committee ______________________________________ Theodore Cummins, Ph.D., Chair ______________________________________ William Sullivan, Ph.D. March 11, 2020 ______________________________________ Nickolay Brustovetsky, Ph.D. ______________________________________ Patrick Sheets, Ph.D. ______________________________________ Eri Hashino, Ph.D. ii DEDICATION This work is dedicated to patients and their families who struggle with genetically-driven epilepsies. iii ACKNOWLEDGEMENTS I would like to express my deepest gratitude to everyone whose help and support saw me through my graduate work and made this dissertation possible. You are all amazing! First, I want to thank God for His endless love and guidance, as well as for putting so many wholesome and supportive people in my life. Secondly, I would like to thank my family for their love, encouragement, and guidance. My mother, Debra, has been especially important in my entire career path so far. She guided me into the world of biomedical research, recognized that it was a good fit for me, saw that I enjoyed it, encouraged me to stay on this career path, and has helped me navigate every step along the path. My maternal grandmother, Revenna, deserves credit for her work ethic and love of learning, which she has passed down to my mother and me. My dad, Barry, and my sister, Hannah, have been very empathetic and supportive of my research endeavors. Additionally, the love, acceptance, and support that I have always received from all my grandparents and other extended family members has helped to motivate me to always keep moving forward. I would also like to thank all my wonderful friends for their loyalty, support, and encouragement. I would like to acknowledge and thank my mentor, Dr. Cummins, for all of his guidance and support. Thank you for taking time out of your busy schedule to answer my questions and offer thoughtful and very helpful advice. Thank you, also, for giving me opportunities to attend conferences, present posters, present in lab meetings, and iv mentor other students; these things helped me to develop my knowledge base, networking skills, and self-confidence. I would also like to thank my other committee members, Dr. Bill Sullivan, Dr. Nick Brustovetsky, Dr. Patrick Sheets, and Dr. Eri Hashino. Thank you for your support and encouragement, which were much needed and greatly appreciated. Thank you for taking the time to lead me through the planning and completion of my research, papers, and presentations. I would like to thank our collaborators at the University of California Los Angeles, David Geffen School of Medicine: Dr. Stephen Cannon and Dr. FenFen Wu. Thank you for providing valuable content for my first publication and for this dissertation by performing the oocyte electrophysiology experiments and helping me to analyze the resulting data. Thanks to the past and present members of the Cummins lab, Reesha Patel, Cindy Barbosa, Zifan Pei, Yucheng Xiao, James Jackson, Adrienne Jackson, Claudia Pan, Agnes (Zybura) Wardrop, Ashley Frazee, and Patrick Milder for your mentorship, comraderie and encouragement. Thank you for making the lab environment warm and pleasant. I’ve enjoyed working with you! I would like to thank the Pharmacology and Toxicology department for their support. Thanks to the administrative staff, including Lisa King, Amy Lawson, Joanna Plew, and Susan Gunter, for helping me navigate the processes and paperwork involved in my graduate studies and grant submissions. Thanks to all the students, post-docs, v and faculty from the department for your guidance, comraderie, and unique perspectives on both research and life in general. Thanks to the IUSM Graduate Department, especially Tara Hobson and Brandy Woods. Thank you for working hard to ensure that other students and I were well- informed and had smooth and positive experiences throughout our IBMG experience and graduate work. Thank you also for your enthusiasm, encouragement, and for your invaluable assistance in preparing myself for the next steps in my career. I would also like to thank the organizations that funded my dissertation work, including SCN2A Research Foundation, Dravet Syndrome Foundation, Rogcon Biosciences, and the National Institute of Health. *The content of much of this manuscript was adapted from papers published in eNeuro (Mason et al., 2019) and in the International Journal of Molecular Sciences (Mason and Cummins, 2020), both published under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/).* vi Emily R. Mason EPILEPSY MUTATIONS IN DIFFERENT REGIONS OF THE NAV1.2 CHANNEL CAUSE DISTINCT BIOPHYSICAL EFFECTS While most cases of epilepsy respond well to common antiepileptic drugs, many genetically-driven epilepsies are refractory to conventional antiepileptic drugs. Over 250 mutations in the Nav1.2 gene (SCN2A) have been implicated in otherwise idiopathic cases of epilepsy, many of which are refractory to traditional antiepileptic drugs. Few of these mutations have been studied in vitro to determine their biophysical effects on the channels, which could reveal why the effects of some are refractory to traditional antiepileptic drugs. The goal of this dissertation was to characterize multiple epilepsy mutations in the SCN2A gene, which I hypothesized would have distinct biophysical effects on the channel’s function. I used patch-clamp electrophysiology to determine the biophysical effects of three SCN2A epilepsy mutations (R1882Q, R853Q, and L835F). Wild-type (WT) or mutant human SCN2A cDNAs were expressed in human embryonic kidney (HEK) cells and subjected to a panel of electrophysiological assays. I predicted that the net effect of each of these mutations was enhancement of channel function; my results regarding the L835F and R1882Q mutations supported this hypothesis. Both mutations enhance persistent current, and R1882Q also impairs fast inactivation. However, examination of the same parameters for the R853Q mutation suggested a decrease of channel function. I hypothesized that the R853Q mutation creates a gating pore in the channel structure through which sodium leaks into the cell when the channel is in its resting conformation. This hypothesis was supported by vii electrophysiological data from Xenopus oocytes, which showed a significant voltage- dependent leak current at negative potentials when they expressed the R853Q mutant channels. This was absent in oocytes expressing WT channels. Overall, these results suggest that individual mutations in the SCN2A gene generate epilepsy via distinct biophysical effects that may require novel and/or tailored pharmacotherapies for effective management. Theodore Cummins, Ph.D., Chair viii TABLE OF CONTENTS LIST OF TABLES .................................................................................................................... xi LIST OF FIGURES ................................................................................................................. xii LIST OF ABBREVIATIONS ................................................................................................... xiii I. INTRODUCTION .................................................................................................................1 Overview ........................................................................................................................1 Voltage-Gated Sodium (Nav) Channel Overview ...........................................................2 Nav Channels of the Brain..............................................................................................7 Epilepsy ..........................................................................................................................9 Nav1.2 and Molecular Mechanisms of Epilepsy ......................................................... 11 Antiepileptic Drug Strategies ...................................................................................... 24 Hypothesis and Experimental Approach/Strategy ..................................................... 30 II. MATERIALS AND METHODS .......................................................................................... 35 DNA Constructs .......................................................................................................... 35 HEK293 Cell Culture .................................................................................................... 35 Transient Transfections .............................................................................................. 35 Generation of Cell Lines Stably Expressing hNav1.2................................................... 36 HEK Electrophysiology ................................................................................................ 36 HEK Voltage Protocols ................................................................................................ 38 Subcloning and Expression in Oocytes ....................................................................... 40 Oocyte Maintenance..................................................................................................