ATP-sensitive potassium (K(ATP)) channels activate under metabolic stress to protect neurons and cardiac myocytes. However, excessive channel activation may cause arrhythmia in the heart and silence neurons in the brain. Here, we report that PKC-mediated downregulation of K(ATP) channel number, via dynamin-dependent channel internalization, can act as a brake mechanism to control K(ATP) activation. A dileucine motif in the pore-lining Kir6.2 subunit of K(ATP), but not the site of PKC phosphorylation for channel activation, is essential for PKC downregulation. Whereas K(ATP) activation results in a rapid shortening of the action potential duration (APD) in metabolically inhibited ventricular myocytes, adenosine receptor stimulation and consequent PKC-mediated K(ATP) channel internalization can act as a brake to lessen this APD shortening. Likewise, in hippocampal CA1 neurons under metabolic stress, PKC-mediated, dynamin-dependent K(ATP) channel internalization can also act as a brake to dampen the rapid decline of excitability due to K(ATP) activation.

Glucose uptake from the bloodstream is the rate-limiting step in whole body glucose utilization, and is regulated by a family of membrane proteins called glucose transporters (GLUTs). Although GLUT4 is the predominant isoform in insulin-sensitive tissues, there is recent evidence that GLUT12 could be a novel second insulin-sensitive GLUT. However, its physiological role in the heart is not elucidated and the regulation of insulin-stimulated myocardial GLUT12 translocation is unknown. In addition, the role of GLUT12 has not been investigated in the diabetic myocardium. Thus, we hypothesized that, as for GLUT4, insulin regulates GLUT12 translocation to the myocardial cell surface, which is impaired during diabetes. Active cell surface GLUT (-4 and -12) content was quantified (before and after insulin stimulation) by a biotinylated photolabeled assay in both intact perfused myocardium and isolated cardiac myocytes of healthy and type 1 diabetic rodents. GLUT localization was confirmed by immunofluorescent confocal microscopy, and total GLUT protein expression was measured by Western blotting. Insulin stimulation increased translocation of GLUT-4, but not -12, in the healthy myocardium. Total GLUT4 content of the heart was decreased during diabetes, while there was no difference in total GLUT12. Active cell surface GLUT12 content was increased in the diabetic myocardium, potentially as a compensatory mechanism for the observed downregulation of GLUT4. Collectively, our data suggest that, in contrast to GLUT4, insulin does not mediate GLUT12 translocation, which may function as a basal GLUT located primarily at the cell surface in the myocardium.

Background Loss-of-function mutations in Nav1.5 cause sodium channelopathies, including Brugada syndrome (BrS), dilated cardiomyopathy (DCM), and sick sinus syndrome (SSS), however, no effective therapy exists. MOG1 increases plasma membrane (PM) expression of Nav1.5 and sodium current (INa) density, thus we hypothesize that MOG1 can serve as a therapeutic target for sodium channelopathies. Methods and Results Knockdown of MOG1 expression using siRNAs reduced Nav1.5 PM expression, decreased INa densities by 2-fold in HEK/Nav1.5 cells and nearly abolished INa in mouse cardiomyocytes. MOG1 did not affect Nav1.5 PM turnover. MOG1 siRNAs caused retention of Nav1.5 in endoplasmic reticulum, disrupted the distribution of Nav1.5 into caveolin3-enriched microdomains, and led to redistribution of Nav1.5 to non-caveolin-rich domains. MOG1 fully rescued the reduced PM expression and INa densities by Nav1.5 trafficking defective mutation D1275N associated with SSS/DCM/atrial arrhythmias. For BrS mutation G1743R, MOG1 restored the impaired PM expression of the mutant protein, and restored INa in a heterozygous state (mixture of wild-type and mutant Nav1.5) to a full level of a homozygous wild-type state. Conclusions Use of MOG1 to enhance Nav1.5 trafficking to PM may be a potential personalized therapeutic approach for some patients with BrS, DCM and SSS in the future.