Ion channels are required to generate electrical activity that drives contractility in organs such as the gastrointestinal tract and the heart. In previous grant cycles we have shown that human small intestinal smooth muscle cells (SMC) express a voltage-sensitive Na+ channel, Nav1.5, the a subunit of which is encoded by SCN5A and that Nav1.5 is mechanosensitive. Mechano-regulation of Nav1.5 is highly relevant because of the steep voltage-sensitivity, with small changes in channel kinetics markedly affecting physiology. Nav1.5 is selectively expressed. It generates a Na+ current in the intestinal tract of humans, dogs and rats but not in several other species such as guinea pig and mouse. Mutations in Nav1.5 cause disease. The central hypothesis of this proposal is that mechanosensitivity of the Nav1.5 is due to physical changes in the voltage sensor(s), and that physiologically relevant mechanical stimuli markedly alter Nav1.5 function. We also hypothesize that in a subset of patients with irritable bowel syndrome (IBS), specific mutations in SCN5A result in altered electrophysiology and mechanosensitivity of Nav1.5 and that Nav1.5 regulates membrane potential and Ca2+ dynamics of human SMC. We will test the central hypothesis in 3 specific aims. In SA 1 we will determine the basic mechanisms that underlie ion channel mechanosensitivity. In SA 2 we will determine the physiological relevance of Nav1.5 mutations found in IBS. In SA 3 we will determine the physiological role of Nav1.5.
The specific aims are supported by preliminary data which show that SCN5A mutations are found in approximately 3% of patients with IBS (over 1.35 million), that IBS SCN5A mutations change the electrophysiology of Nav1.5, that mutants and toxins modulate mechanosensitivity, that mechanosensitivity can also be modulated by FDA approved drugs, that knockdown and pharmacological block of Nav1.5 hyperpolarize human intestinal circular SMC membrane potential and change slow wave frequency, that Nav1.5 is clustered on the cell membrane and that Na+ entry through Nav1.5 sets local intracellular Na+ and regulates Ca2+ through Na+/Ca2+ exchanger (NCX). We will use patch clamp techniques, ultrafast pressure delivery, high resolution patch imaging, immunohistochemistry, Western blots, single cell PCR, quantitative PCR, lentivirus RNA knock down techniques, organotypic and single cell cultures, total internal reflection fluorescence (TIRF) imaging of proteins, Ca2+ and Na+ as well as microelectrode recordings to investigate the central hypothesis. Successful completion of the proposed studies has both basic significance and clinical impact. As a result of the work done in the previous grant cycles and the preliminary data presented in this proposal, we are now poised to significantly advance our understanding, at a sub- molecular level, of the fundamental mechanisms that underlie mechanosensitivity, of the role Nav1.5 plays in normal and abnormal human intestinal physiology and to establish a role of ion channelopathies in a subset of patients with IBS.

Public Health Relevance

The human gastrointestinal tract requires ion channels to contract, including a sodium channel called Nav1.5 (SCN5A). In this project we plan to study mutations in SCN5A, found in some patients with irritable bowel syndrome, a syndrome that affects about 15% of the population, to find out what effect they have on gut function. We also plan to study the role and mechanical sensitivity of Nav1.5 to determine how we can modulate mechanical sensitivity to normalize gut function.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK052766-16
Application #
8534756
Study Section
Clinical, Integrative and Molecular Gastroenterology Study Section (CIMG)
Program Officer
Hamilton, Frank A
Project Start
1997-09-01
Project End
2016-08-31
Budget Start
2013-09-01
Budget End
2014-08-31
Support Year
16
Fiscal Year
2013
Total Cost
$333,722
Indirect Cost
$123,834
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
Beyder, Arthur; Mazzone, Amelia; Strege, Peter R et al. (2014) Loss-of-function of the voltage-gated sodium channel NaV1.5 (channelopathies) in patients with irritable bowel syndrome. Gastroenterology 146:1659-68
Farrugia, Gianrico; Szurszewski, Joseph H (2014) Carbon monoxide, hydrogen sulfide, and nitric oxide as signaling molecules in the gastrointestinal tract. Gastroenterology 147:303-13
Farrugia, G; Weinshilboum, R M (2013) Challenges in implementing genomic medicine: the Mayo Clinic Center for Individualized Medicine. Clin Pharmacol Ther 94:204-6
Caio, Giacomo; Volta, Umberto; Cerrato, Enrico et al. (2013) Detection of anticonductive tissue autoantibodies in a patient with chronic intestinal pseudo-obstruction and sick sinus syndrome. Eur J Gastroenterol Hepatol 25:1358-63
Eisenman, S T; Gibbons, S J; Singh, R D et al. (2013) Distribution of TMEM100 in the mouse and human gastrointestinal tract--a novel marker of enteric nerves. Neuroscience 240:117-28
Beyder, Arthur; Farrugia, Gianrico (2012) Targeting ion channels for the treatment of gastrointestinal motility disorders. Therap Adv Gastroenterol 5:5-21
Poh, Yong Cheng; Beyder, Arthur; Strege, Peter R et al. (2012) Quantification of gastrointestinal sodium channelopathy. J Theor Biol 293:41-8
Lees-Green, Rachel; Du, Peng; O'Grady, Gregory et al. (2011) Biophysically based modeling of the interstitial cells of cajal: current status and future perspectives. Front Physiol 2:29
Mazzone, Amelia; Bernard, Cheryl E; Strege, Peter R et al. (2011) Altered expression of Ano1 variants in human diabetic gastroparesis. J Biol Chem 286:13393-403
Gao, Jerry; Du, Peng; Archer, Rosalind et al. (2011) A stochastic multi-scale model of electrical function in normal and depleted ICC networks. IEEE Trans Biomed Eng 58:3451-5

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