kcne are evolutionarily conserved genes that encode accessory subunits of voltage-gated K ؉ (Kv) channels. Missense mutations in kcne1, kcne2, and kcne3 are linked to congenital and acquired channelopathies in Homo sapiens. Here we show an unique example of conservation of kcne activities at genetic, physiological, functional, and pathophysiological level in Caenorhabditis elegans. Thus, mps-4 is the homologue of kcne1 that operates in human heart and inner ear. Like its KCNE relatives, MPS-4 assembles with a Kv channel, EXP-2, to form a complex that controls pharyngeal muscle contractility. MPS-4 modulates EXP-2 function in a similar fashion as KCNE proteins endow human channels. When defective, MPS-4, can induce abnormal repolarization by mechanisms that resemble the way KCNE proteins are thought to provoke arrhythmia in human heart. Mutation of a conserved aspartate residue associated with human disease (MPS-4-D74N) alters the functional attributes of the C. elegans current. Taken together these data underscore a significant conservation of KCNE activities in different pumps. This implies that C. elegans can develop into a system to study the molecular and genetic basis of KCNE-mediated muscle contractility and disease states.KCNEs are evolutionary conserved ancillary subunits of voltage-gated potassium (Kv) channels (1, 2). They regulate the function, trafficking, modulation by signaling molecules, and pharmacology of their channel partners in multiple mammalian tissues including heart, stomach, skeletal muscle, auditory epithelium, and the central nervous system (2-9). In human left ventricle, KCNE subunits endow the Kv channels that conduct the repolarizing potassium current. Thus, KCNE1 assembles with KCNQ1 to form I Ks, whereas KCNE2 and possibly KCNE1 assemble with HERG to form I Kr (4, 10 -12). Mutations in kcne1 and kcne2 can decrease the repolarizing K ϩ current through impairing I Ks and/or I Kr function, causing congenital and acquired Long QT syndrome (4,(13)(14)(15)(16)(17)(18)(19)(20). This disease predisposes to polymorphic tachyarrhythmias, and life threatening ventricular fibrillation (19). An important feature of kcne genes is that they are conserved across phyla (21-23). There are four kcne-related genes in Caenorhabditis elegans termed mps genes that play a prominent role in the nervous system of the animal. The founding member of the family, MPS-1, assembles with the pore-forming subunit KVS-1 in a subset of sensory neurons to form a complex that contributes to both their maintenance and sensitivity (22). Two other members, MPS-2 and MPS-3, appear to form a ternary complex with KVS-1 that regulates taste sensitivity to sodium (23). In contrast, the role and the partner of the fourth member, MPS-4, which is the homolog of human KCNE1 (Fig. 1A) were not known. In an effort to characterize the physiological role of MPS-4, we found that this gene is expressed in the alimentary system of the worm, the pharynx. Notably, the pharynx is a pump that is considered a prototype of the human heart (24...