PIP<sub>2</sub> activation of the cardiac I<sub>Ks</sub> potassium channel.

Zhao, Lu; Xu, Xianjin; Cui, Chenxi; Duan, Rui; Kermani, Ali A; Shi, Jingyi; Han, Lu; Sun, Ji et al. · Nat Commun · 2026

basic_science · Level V

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Abstract

The I<sub>Ks</sub> channel, composed of voltage-gated potassium channel KCNQ1 and regulatory subunit KCNE1, controls cardiac action potential durations. KCNQ1 and I<sub>Ks</sub> activation requires PIP<sub>2</sub>, and its depletion abolishes channel opening. KCNQ1 adopts both bent and straight conformations and can bind two PIP<sub>2</sub> molecules: one adjacent to VSD (V-PIP<sub>2</sub>), and the other at the VSD-pore interface (C-PIP<sub>2</sub>). Here we show that the two PIP<sub>2</sub> perform essential yet distinct roles: V-PIP<sub>2</sub> enables the bent-to-straight transition, whereas C-PIP<sub>2</sub> mediates VSD-pore coupling. VSD activation elevates the V-PIP<sub>2</sub> site, permitting the shift from the bent, intermediate open (IO) state associated with KCNQ1 to the straight, I<sub>Ks</sub>-exclusive activated open (AO) state, which is further stabilized by C-PIP<sub>2</sub>. Leveraging this mechanism, we develop a compound CA1, which selectively targets the V-PIP<sub>2</sub> site and modulates I<sub>Ks</sub> channel activity without affecting KCNQ1, offering a promising conceptional path for specific and safe antiarrhythmic therapeutics.