| 2000 |
SCN5A encodes the pore-forming α-subunit of the cardiac sodium channel responsible for action potential initiation and propagation; gain-of-function mutations cause persistent (late) sodium current leading to LQT3, while distinct mutations cause loss-of-function associated with Brugada syndrome. |
Mutational analysis and patch-clamp electrophysiology in heterologous expression systems |
Circulation |
High |
10973849 19027780 29798782
|
| 2002 |
The Brugada syndrome double mutant R1232W/T1620M abolishes Nav1.5 functional expression because the channel is retained in the endoplasmic reticulum rather than trafficking to the cell surface; a positively charged residue at position 1232 (R or K) is required for proper channel transport. |
Whole-cell patch-clamp, immunofluorescence, confocal microscopy with FLAG-tagged constructs, calnexin co-localization in tsA201 cells |
Circulation research |
High |
11786529
|
| 2003 |
The LQT3 mutation L619F in the domain I-II linker of Nav1.5 increases maintained (persistent) Na+ current and causes a +5.8 mV shift in steady-state inactivation, implicating the I-II linker in inactivation gating. |
Whole-cell patch-clamp in transiently expressed HEK293 cells |
Human mutation |
Medium |
12673799
|
| 2003 |
The LQT3 mutation I1768V in domain IVS6 causes faster recovery from inactivation and less slow inactivation without increasing persistent Na+ current, implicating domain IVS6 in inactivation kinetics. |
Two-electrode voltage clamp in Xenopus oocytes |
Cardiovascular research |
Medium |
12650885
|
| 2004 |
Transgenic mice with cardiac-specific expression of the LQT3 mutation N1325S in SCN5A display QT prolongation, spontaneous polymorphic VT/VF, and slow recovery from inactivation of INa; mexiletine (a late Na+ current blocker) suppresses arrhythmias and restores inactivation recovery, establishing that the N1325S-induced persistent Na+ current causes arrhythmogenesis in vivo. |
Transgenic mouse model, ECG, action potential recording, voltage-clamp in isolated myocytes, mexiletine pharmacology |
Cardiovascular research |
High |
14736542
|
| 2005 |
The LQT3 mutant L1825P fails to traffic to the cell surface (only ~9% of wild-type surface expression) and therefore does not prolong QT interval; cisapride rescues misprocessing to ~30% of wild-type surface expression and simultaneously increases late Na+ current, revealing that cell surface trafficking determines LQT3 phenotype expressivity. |
Patch-clamp, confocal imaging and cell-counting with epitope-tagged constructs in CHO cells |
Circulation |
High |
16301357
|
| 2005 |
Two Brugada syndrome mutations (L325R and R535X) cause severe Nav1.5 loss-of-function; the L325R mutant is likely misfolded (rescued partially by mexiletine or curcumin) and exerts a dominant-negative effect on wild-type channels when co-expressed. Fever accelerates Nav1.5 activation and fast inactivation kinetics, providing the mechanism by which reduced INa patients are vulnerable to fever-exacerbated Brugada syndrome. |
Whole-cell patch-clamp at various temperatures, Western blot protein expression, co-expression dominant-negative experiments, action potential modelling in HEK293 cells |
Cardiovascular research |
High |
15890323
|
| 2008 |
Telethonin (encoded by TCAP) is a Nav1.5-interacting protein: it co-localizes with Nav1.5 in gastrointestinal smooth muscle, co-immunoprecipitates with sodium channels, and a disease-associated telethonin mutation doubles the window current of Nav1.5 when co-expressed in HEK293 cells by altering steady-state activation kinetics. |
Co-immunoprecipitation, immunofluorescence co-localization, whole-cell patch-clamp in HEK293 cells |
The Journal of biological chemistry |
Medium |
18408010
|
| 2010 |
Nav1.5 is mechanosensitive: applying negative patch pressure produces dose-dependent hyperpolarizing shifts in voltage dependence of activation and inactivation (~0.7 mV/mmHg), accelerates voltage-sensor movement but not gate-opening or fast inactivation rate constants, and increases peak current by recruiting more active channels, without changing unitary conductance or maximum open probability. |
Cell-attached patch-clamp with controlled pressure in HEK293 cells expressing Nav1.5 |
The Journal of physiology |
High |
21041530
|
| 2011 |
Nav1.5-dependent persistent Na+ influx (late INa) activates CaMKII in cardiomyocytes; Nav1.5 knockdown (but not Nav1.1 or Nav1.2) prevents ATX-II-induced CaMKII phosphorylation, and CaMKII co-immunoprecipitates with Nav1.5 after late INa activation, establishing a feed-forward loop where Nav1.5 late current → CaMKII activation → CaMKII phosphorylation of Nav1.5 → further late current. |
siRNA knockdown, CaMKII autophosphorylation assays, co-immunoprecipitation, patch-clamp, transgenic N1325S mouse model, pharmacological inhibition (ranolazine, KN93) in neonatal rat ventricular myocytes |
American journal of physiology. Cell physiology |
High |
21677263
|
| 2012 |
TBX5 directly drives Scn5a expression in the ventricular conduction system through a TBX5-responsive enhancer downstream of Scn5a that requires canonical T-box binding sites; conditional deletion of Tbx5 from the ventricular conduction system reduces Nav1.5 protein expression and causes severe conduction dysfunction. |
Conditional mouse knockout, in vivo enhancer assay, T-box site mutagenesis, immunostaining, optical mapping, ECG |
The Journal of clinical investigation |
High |
22728936
|
| 2012 |
αB-crystallin physically interacts with Nav1.5 (validated by yeast two-hybrid, GST pulldown, Co-IP, and immunostaining); overexpression increases peak INa by reducing Nav1.5 internalization and ubiquitination via interaction with Nedd4-2; knockout of αB-crystallin decreases Nav1.5 cell surface expression. |
Yeast two-hybrid, GST pulldown, co-immunoprecipitation, immunostaining, whole-cell patch-clamp, mutagenesis of Nav1.5 Nedd4-2 binding site in HEK293 cells |
The Journal of biological chemistry |
High |
26961874
|
| 2012 |
The PDZ domain-binding SIV motif (last 3 residues of Nav1.5) is required for Nav1.5 expression and INa specifically at the lateral cardiomyocyte membrane but not at intercalated disks; deletion of the SIV motif in knock-in mice reduces lateral-membrane INa and decreases transverse conduction velocity, increasing anisotropy. The SIV motif regulates Nav1.5 degradation via the proteasome. |
Knock-in mouse (ΔSIV), optical mapping, whole-cell patch-clamp, proteasome inhibitor rescue (MG132), HEK293 internalization assay, patient mutation screening |
Circulation |
High |
24895455
|
| 2012 |
Foxo1 transcription factor negatively regulates Nav1.5 expression by directly binding to insulin-responsive elements (IRE) in the SCN5A promoter; reactive oxygen species (H2O2) promote Foxo1 nuclear localization and thereby suppress Nav1.5 expression and Na+ current. |
Chromatin immunoprecipitation, constitutively nuclear Foxo1 mutant expression, RNAi knockdown, whole-cell voltage-clamp in HL-1 cardiomyocytes |
PloS one |
High |
22400069
|
| 2014 |
Nav1.5 promotes breast cancer cell invasiveness through activity-dependent mechanisms; shRNA-mediated stable knockdown of Nav1.5 reduces tumor growth, local invasion, and metastasis to liver, lungs and spleen in an orthotopic model, and in vitro Nav1.5 down-regulation reduces CD44 expression, suggesting regulation of invasion via the CD44-src-cortactin axis. |
Stable shRNA knockdown, orthotopic mouse xenograft model, in vitro invasion assay, immunohistochemistry, flow cytometry |
Oncotarget |
Medium |
26452220
|
| 2015 |
Nav1.5 channels reach the plasma membrane through two distinct N-glycosylation states; only the fully-glycosylated form generates sodium current, while core-glycosylated channels can reach the membrane via an unconventional Golgi-independent route but are non-functional. Brugada syndrome mutants exert dominant-negative effects by trapping the fully-glycosylated form. |
Patch-clamp, surface biotinylation assays, enzymatic deglycosylation, brefeldin A treatment, HEK293T cells |
Biochimica et biophysica acta |
Medium |
25721215
|
| 2016 |
GATA4 and GATA5 transcription factors directly co-occupy SCN5A promoter and intron 1 regions in human cardiac tissue and synergistically activate SCN5A transcription through predicted GATA binding sites; GATA4 mRNA levels are strongly correlated with SCN5A transcript levels in human heart. |
Chromatin immunoprecipitation (ChIP) and Re-ChIP in human left ventricle, luciferase reporter with site mutagenesis, ddPCR quantification |
Journal of molecular and cellular cardiology |
High |
27894866
|
| 2016 |
Wnt/β-catenin signaling transcriptionally suppresses Nav1.5 expression: H2O2 activates β-catenin nuclear localization, β-catenin interacts with TCF4, and the β-catenin/TCF4 complex is recruited to the SCN5A promoter to repress its activity in a dose-dependent manner. |
Immunofluorescence, immunoprecipitation, ChIP, luciferase reporter, siRNA knockdown, whole-cell recording in HL-1 cardiomyocytes |
Free radical biology & medicine |
High |
27068063
|
| 2017 |
Kir2.1 and Nav1.5 channels form complexes in ventricular cardiomyocyte membranes (within <40 nm by proximity ligation assay); CaMKII inhibition decreases INa and IK1 only when channels are co-expressed but not Kir2.1 alone, and Nedd4-2 ubiquitin-ligase promotes Nav1.5 (and Kir2.1-Nav1.5 complex) degradation via the proteasome. The dynein/dynactin motor governs forward trafficking of Nav1.5 and of Kir2.1-Nav1.5 complexes. |
Proximity ligation assay, patch-clamp with intracellular antibody dialysis, pharmacological inhibition of CaMKII/14-3-3/dynamin/dynein in heterologous and cardiomyocyte systems |
Frontiers in physiology |
Medium |
29184507
|
| 2018 |
Brugada syndrome-associated endoplasmic reticulum (ER) trafficking-defective Nav1.5 mutants fail to positively modulate Kir2.1/2.2 channels, thereby reducing IK1 in addition to INa. Golgi trafficking-defective Nav1.5 mutants additionally exert a dominant-negative effect, further reducing IK1. ER-trapped Nav1.5 can be partially rescued by Kir2.1/2.2 through an unconventional secretory route involving GRASPs. |
SCN5A haploinsufficiency mouse model, heterologous expression, rat ventricular cardiomyocytes, hiPSC-CMs, patch-clamp |
JCI insight |
High |
30232268
|
| 2018 |
The RNA-binding protein HuR stabilizes SCN5A mRNA in cardiomyocytes; HuR expression is downregulated in failing hearts. AAV9-mediated overexpression of HuR in a mouse MI model increases SCN5A expression, improves action potential upstroke and conduction velocity in the infarct border zone, and reduces reentrant arrhythmia risk. |
Ribonucleoprotein immunoprecipitation, AAV9 overexpression in mice, optical mapping of intact heart, quantitative RT-PCR |
Heart rhythm |
High |
29454929
|
| 2018 |
HuR protects MEF2C mRNA from degradation, thereby maintaining MEF2C protein levels, which in turn binds the SCN5A promoter to enhance its transcription; HuR overexpression increases SCN5A mRNA and this effect is abolished by MEF2C siRNA, placing HuR upstream of MEF2C in an SCN5A regulatory network. |
Ribonucleoprotein immunoprecipitation, ChIP-qPCR, EMSA, siRNA knockdown, RT-PCR in cardiomyocytes |
Journal of the American Heart Association |
Medium |
29678826
|
| 2018 |
Anti-Nav1.5 autoantibodies are detectable in 90% of Brugada syndrome patients vs. 6% of controls; these autoantibodies reduce sodium current density in cellular models and injection of BrS patient plasma into wild-type mice induces Brugada-like ECG abnormalities, demonstrating a pathogenic immunological mechanism. |
Western blot, immunoprecipitation, immunofluorescence screening with HEK293A cells expressing Nav1.5; patch-clamp for current density; plasma injection in vivo mouse ECG |
European heart journal |
High |
39078224
|
| 2019 |
K219T mutation in LMNA causes increased binding of Lamin A/C to the SCN5A promoter and enhanced recruitment of PRC2 protein SUZ12 and deposition of repressive histone mark H3K27me3 at SCN5A, resulting in downregulated Nav1.5 expression, reduced peak sodium current density, and slower conduction velocity in iPSC-derived cardiomyocytes. CRISPR/Cas9 correction of the mutation restores sodium current density and SCN5A expression. |
iPSC-derived cardiomyocytes from patient cells, ChIP for Lamin A/C and H3K27me3 at SCN5A promoter, patch-clamp, conduction velocity measurement, CRISPR/Cas9 correction |
Nature communications |
High |
31118417
|
| 2019 |
An evolutionarily conserved enhancer cluster downstream of SCN5A with super-enhancer characteristics drives cardiac-specific Scn5a expression; genome editing to delete individual enhancer elements or the entire cluster in mice reduces Scn5a expression, impairs cardiac conduction, and affects embryonic development. This cluster also controls chromatin conformation across a >0.5 Mb genomic region. |
Genome editing (deletion series) in mice, gene expression analysis, cardiac conduction measurements, chromatin conformation capture (3C/Hi-C) |
Nature communications |
High |
31666509
|
| 2020 |
UBE1 and UBA6 are E1 ubiquitin-activating enzymes that ubiquitinate Nav1.5 at lysine residues K590 and K591; overexpression reduces Nav1.5 expression and sodium current density, knockdown increases them, and the effects require the UBC9 E2 enzyme. Mutation of K590A/K591A abolishes the effects. |
Western blot ubiquitination assay, patch-clamp, siRNA knockdown, overexpression, site-directed mutagenesis in HEK293/Nav1.5 cells and neonatal cardiomyocytes |
The Biochemical journal |
High |
32315024
|
| 2021 |
FAT10 stabilizes Nav1.5 by binding to lysine residues in the C-terminal fragments of Nav1.5 and competing with Nedd4-2 ubiquitin E3 ligase binding, thereby preventing ubiquitination and proteasomal degradation of Nav1.5. Cardiac-specific Fat10 deletion reduces peak Na+ current and membrane Nav1.5 expression, increases late Na+ current, and increases arrhythmia after MI. |
Cardiac-specific conditional knockout mouse (Myh6-Cre × Fat10F/F), patch-clamp, co-immunoprecipitation, immunoblot/immunofluorescence |
Cell death & disease |
High |
33414395
|
| 2021 |
Zfhx3 transcription factor directly represses the SCN5A promoter and also suppresses TBX5 expression and increases Nedd4-2 expression, thereby reducing peak INa density in cardiomyocytes through transcriptional and post-translational (proteasomal) mechanisms. |
Transcriptional reporter assay, siRNA knockdown, overexpression, patch-clamp in HL-1 cardiomyocytes |
International journal of molecular sciences |
Medium |
34884836
|
| 2022 |
TBX5 variant p.F206L fails to transactivate the SCN5A promoter, markedly decreasing peak INa and causing QRS widening in mice; variant p.D111Y increases SCN5A expression but fails to repress CAMK2D and SPTBN4, resulting in increased late INa (INaL) and QT prolongation. This establishes that TBX5 controls both peak INa and INaL in human cardiomyocytes by regulating SCN5A, CaMKIIδ, and βIV-spectrin expression. |
hiPSC-CM electrophysiology, HL-1 cell patch-clamp, in vivo ECG of transgenic mice, molecular transcriptional assays |
Cardiovascular research |
High |
33576403
|
| 2022 |
Most SCN5A missense loss-of-function variants exert dominant-negative effects on wild-type Nav1.5 when co-expressed in heterozygous conditions; 32 of 35 complete LoF variants reduced peak current to <75% of wild-type alone. Individuals with dominant-negative variants have 2.7-fold higher Brugada syndrome burden than those with haploinsufficient variants. |
Automated patch-clamp in HEK293T cells with heterozygous WT + mutant co-expression for 50 variants; clinical cohort comparison with gnomAD |
Genetics in medicine |
High |
35305865
|
| 2008 |
SCN5A gain-of-function mutation M1875T causes a +16.4 mV depolarized shift in the voltage-dependence of steady-state inactivation without generating persistent Na+ current, increasing atrial excitability and predisposing to familial atrial fibrillation through a mechanism distinct from LQT3. |
Whole-cell patch-clamp in heterologous expression system with M1875T mutant |
Journal of the American College of Cardiology |
Medium |
18929244
|
| 2016 |
Nav1.5 protein is localized to late endosomes and phagolysosomes (Rab7+, LAMP-1+) rather than early endosomes in macrophages within active MS lesions, consistent with a role in endosomal acidification for myelin degradation. |
Immunohistochemistry with triple immunolabeling for Nav1.5, endosomal markers, and myelin protein in human MS lesion tissue |
Multiple sclerosis |
Medium |
22951351
|
| 2014 |
In macrophages, an intracellular SCN5A variant initiates innate immune signaling through ADCY8 and ATF2 transcription factor; cytoplasmic poly(I:C) (viral dsRNA mimic) activates this pathway and markedly augments an inward voltage-sensitive sodium current mediated by the channel, linking pathogen recognition to Nav1.5 channel activation and downstream transcriptional regulation of interferon β. |
Electrophysiology (patch-clamp), pharmacological channel stimulation, poly(I:C) treatment, signaling pathway pharmacology in macrophages |
The Journal of biological chemistry |
Medium |
25368329
|
| 2010 |
The common H558R polymorphism has mutation-specific effects on SCN5A-related sick sinus syndrome: it rescues the loss-of-function D1275N mutant by enhancing cell surface targeting and improving steady-state activation, but aggravates defects of E161K, P1298L, and R1632H mutants by reducing steady-state availability. |
Whole-cell patch-clamp, cell surface biotinylation in HEK293 cells with all 13 known SSS-related hNav1.5 mutants on H558 vs R558 backgrounds |
Journal of cardiovascular electrophysiology |
Medium |
20384651
|
| 2016 |
Pan-HDAC inhibitors (TSA, vorinostat, romidepsin) reduce peak INa density and increase Nav1.5 acetylation in cardiomyocytes; Nav1.5 protein levels are significantly reduced after HDAC inhibition without changes in Scn5a mRNA, and co-immunoprecipitation with anti-acetyl-lysine antibody confirms Nav1.5 acetylation is increased in vivo after HDAC inhibition. |
Whole-cell patch-clamp, Western blot, immunoprecipitation with anti-acetyl-lysine antibody in neonatal mouse ventricular cardiomyocytes and hiPSC-CMs |
American journal of physiology. Heart and circulatory physiology |
Medium |
27638876
|
| 2018 |
A synonymous SNP (rs1805126) in the SCN5A coding sequence adjacent to a miR-24 binding site modulates miR-24-mediated suppression of SCN5A expression; miR-24 potently suppresses SCN5A expression and the minor allele of rs1805126 is associated with decreased cardiac SCN5A expression. In mice, decreased Scn5a expression leads to accumulation of myocardial reactive oxygen species. |
miRNA binding site mapping, luciferase reporter assays, human heart tissue expression correlation, mouse Scn5a reduction model with ROS measurement |
The Journal of clinical investigation |
Medium |
29457789
|