In vivo, in vitro and in silico correlations of four de novo SCN1A missense mutations.

Mutations in the SCN1A gene, which encodes for the voltage-gated sodium channel NaV1.1, cause Dravet syndrome, a severe developmental and epileptic encephalopathy. Genetic testing of this gene is recommended early in life. However, predicting the outcome of de novo missense SCN1A mutations is diffic...

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Main Authors: Andreea Nissenkorn, Yael Almog, Inbar Adler, Mary Safrin, Marina Brusel, Milit Marom, Shayel Bercovich, Daniel Yakubovich, Michal Tzadok, Bruria Ben-Zeev, Moran Rubinstein
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0211901
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author Andreea Nissenkorn
Yael Almog
Inbar Adler
Mary Safrin
Marina Brusel
Milit Marom
Shayel Bercovich
Daniel Yakubovich
Michal Tzadok
Bruria Ben-Zeev
Moran Rubinstein
author_facet Andreea Nissenkorn
Yael Almog
Inbar Adler
Mary Safrin
Marina Brusel
Milit Marom
Shayel Bercovich
Daniel Yakubovich
Michal Tzadok
Bruria Ben-Zeev
Moran Rubinstein
author_sort Andreea Nissenkorn
collection DOAJ
description Mutations in the SCN1A gene, which encodes for the voltage-gated sodium channel NaV1.1, cause Dravet syndrome, a severe developmental and epileptic encephalopathy. Genetic testing of this gene is recommended early in life. However, predicting the outcome of de novo missense SCN1A mutations is difficult, since milder epileptic syndromes may also be associated. In this study, we correlated clinical severity with functional in vitro electrophysiological testing of channel activity and bioinformatics prediction of damaging mutational effects. Three patients, bearing the mutations p.Gly177Ala, p.Ser259Arg and p.Glu1923Arg, showed frequent intractable seizures that had started early in life, with cognitive and behavioral deterioration, consistent with classical Dravet phenotypes. These mutations failed to produce measurable sodium currents in a mammalian expression system, indicating complete loss of channel function. A fourth patient, who harbored the mutation p.Met1267Ile, though presenting with seizures early in life, showed lower seizure burden and higher cognitive function, matching borderland Dravet phenotypes. In correlation with this, functional analysis demonstrated the presence of sodium currents, but with partial loss of function. In contrast, six bioinformatics tools for predicting mutational pathogenicity suggested similar impact for all mutations. Likewise, homology modeling of the secondary and tertiary structures failed to reveal misfolding. In conclusion, functional studies using patch clamp are suggested as a prognostic tool, whereby detectable currents imply milder phenotypes and absence of currents indicate an unfavorable prognosis. Future development of automated patch clamp systems will facilitate the inclusion of such functional testing as part of personalized patient diagnostic schemes.
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spelling doaj.art-95b9c06d5e564baf9aa547a6dde9cd1a2022-12-21T22:37:17ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01142e021190110.1371/journal.pone.0211901In vivo, in vitro and in silico correlations of four de novo SCN1A missense mutations.Andreea NissenkornYael AlmogInbar AdlerMary SafrinMarina BruselMilit MaromShayel BercovichDaniel YakubovichMichal TzadokBruria Ben-ZeevMoran RubinsteinMutations in the SCN1A gene, which encodes for the voltage-gated sodium channel NaV1.1, cause Dravet syndrome, a severe developmental and epileptic encephalopathy. Genetic testing of this gene is recommended early in life. However, predicting the outcome of de novo missense SCN1A mutations is difficult, since milder epileptic syndromes may also be associated. In this study, we correlated clinical severity with functional in vitro electrophysiological testing of channel activity and bioinformatics prediction of damaging mutational effects. Three patients, bearing the mutations p.Gly177Ala, p.Ser259Arg and p.Glu1923Arg, showed frequent intractable seizures that had started early in life, with cognitive and behavioral deterioration, consistent with classical Dravet phenotypes. These mutations failed to produce measurable sodium currents in a mammalian expression system, indicating complete loss of channel function. A fourth patient, who harbored the mutation p.Met1267Ile, though presenting with seizures early in life, showed lower seizure burden and higher cognitive function, matching borderland Dravet phenotypes. In correlation with this, functional analysis demonstrated the presence of sodium currents, but with partial loss of function. In contrast, six bioinformatics tools for predicting mutational pathogenicity suggested similar impact for all mutations. Likewise, homology modeling of the secondary and tertiary structures failed to reveal misfolding. In conclusion, functional studies using patch clamp are suggested as a prognostic tool, whereby detectable currents imply milder phenotypes and absence of currents indicate an unfavorable prognosis. Future development of automated patch clamp systems will facilitate the inclusion of such functional testing as part of personalized patient diagnostic schemes.https://doi.org/10.1371/journal.pone.0211901
spellingShingle Andreea Nissenkorn
Yael Almog
Inbar Adler
Mary Safrin
Marina Brusel
Milit Marom
Shayel Bercovich
Daniel Yakubovich
Michal Tzadok
Bruria Ben-Zeev
Moran Rubinstein
In vivo, in vitro and in silico correlations of four de novo SCN1A missense mutations.
PLoS ONE
title In vivo, in vitro and in silico correlations of four de novo SCN1A missense mutations.
title_full In vivo, in vitro and in silico correlations of four de novo SCN1A missense mutations.
title_fullStr In vivo, in vitro and in silico correlations of four de novo SCN1A missense mutations.
title_full_unstemmed In vivo, in vitro and in silico correlations of four de novo SCN1A missense mutations.
title_short In vivo, in vitro and in silico correlations of four de novo SCN1A missense mutations.
title_sort in vivo in vitro and in silico correlations of four de novo scn1a missense mutations
url https://doi.org/10.1371/journal.pone.0211901
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