Abstract
Voltage-gated potassium (Kv) channels contain voltage-sensing (VSD) and pore-gate (PGD) structural domains. During voltage-dependent gating, conformational changes in the two domains are coupled giving rise to voltage-dependent opening of the channel. In addition to membrane voltage, KCNQ (Kv7) channel opening requires the membrane lipid phosphatidylinositol 4,5-bisphosphate (PIP2). Recent studies suggest that PIP2 serves as a cofactor to mediate VSD-PGD coupling in KCNQ1 channels. In this review, we put these findings in the context of the current understanding of voltage-dependent gating, lipid modulation of Kv channel activation, and PIP2-regulation of KCNQ channels. We suggest that lipid-mediated coupling of functional domains is a common mechanism among KCNQ channels that may be applicable to other Kv channels and membrane proteins.
Introduction
Lipids define the physical and chemical environment of voltage-gated ion channels, yet most of the literature in the ion channel field considers only the channel protein and its proteinacious interacting partners. This protein-centric view is a natural consequence of our powerful genetic tools for manipulating the primary sequence of ion channels and heterologously expressing mutants for functional study. In comparison, we have a limited set of tools for manipulating the lipid environment of ion channels in heterologous or native cells. Despite this limitation, the importance of non-specific (bulk) and specific (cofactor) lipid interactions to ion channel function is a subject of continuing interest. Phosphatidylinositol 4,5-bisphosphate (PIP2) is an anionic lipid found in the inner leaflet of the surface membrane where it makes up a small fraction (<1%) of the total pool of phospholipids (McLaughlin et al., ; Rusten and Stenmark, 2006). PIP2 is known to directly bind to and regulate a diverse set of ion channels (Hilgemann and Ball, ; Hilgemann et al., ; Suh and Hille, 2005, 2008). PIP2 regulation is an excellent model for studying the cofactor-lipid regulation of ion channels, as we have increasingly more tools to manipulate the abundance of PIP2 in heterologous cells (Suh et al., 2006; Suh and Hille, 2007a; Okamura et al., 2009). Additionally, changes in the abundance of PIP2 that are sufficient to alter channel activity are not likely to change the bulk membrane properties.
Voltage-gated ion channels are transmembrane proteins that sense membrane voltage and respond by opening or closing an ion conductive pathway across the membrane. The ionic currents from voltage-gated ion channels generate action potentials in excitable tissues; thereby, they control muscle contraction, neuronal signaling, immune activation, and neurohormonal secretion. Variations in the abundance of membrane PIP2 modulate the function of several families of voltage-gated ion channels, including K+ channels (Kv) (Bian et al., ; Loussouarn et al., ; Zhang et al., 2003; Oliver et al., 2004; Abderemane-Ali et al., ; Rodriguez-Menchaca et al., 2012), Ca2+ channels (Cav) (Wu et al., 2002; Gamper et al., ; Suh et al., 2010), hyperpolarization and cyclic nucleotide activated channels (HCN) (Pian et al., 2006; Zolles et al., 2006), and voltage and Ca2+-activated K+ channels (BK) (Vaithianathan et al., 2008). It should be noted that the physiological relevance of the PIP2-sensitivities of some of these channels remains controversial (Hilgemann, ; Kruse et al., ). Among these voltage- and PIP2-sensitive channels, the KCNQ (herein we use KCNQ to refer gene and protein product—i.e., Kv7) family is unique in that its members absolutely require PIP2 in order to conduct current (as discussed below) making them a relatively straight-forward model to study PIP2 regulation of voltage-dependent gating. The KCNQ family includes five voltage-gated potassium-selective channels (KCNQ1-5) that are known to play important roles in regulating cardiac action potential duration (Barhanin et al., ; Sanguinetti et al., 1996; Wang et al., 1996), modulating neuroexcitability (Wang et al., 1998), and maintaining endolymph K+ homeostasis in the inner ear (Neyroud et al., 1997). The physiological importance of PIP2 regulation of KCNQ channels is well established in neurons where silencing of KCNQ channel activity by PIP2 hydrolysis downstream of G-protein Gq signaling increases neuroexcitability (Delmas and Brown, ; Brown et al., ). The role of PIP2 modulation of native cardiac KCNQ1 channels is less well established. However, in the heart, α1 adrenergic receptors (α1 AR) activate Gq signaling pathways (Jensen et al., ) which has been shown in heterologous expression systems to modulate IKs channels (formed by KCNQ1 and the auxiliary subunit KCNE1) in through a combination of PIP2 hydrolysis and PKC phosphorylation (Matavel and Lopes, ). Furthermore, KCNQ1 channel mutations associated with cardiac arrythmias in patients have been shown to affect PIP2-dependent activation, suggesting that native IKs channels are sensitive to PIP2 binding (Park et al., 2005; Li et al., ; Zaydman et al., 2013). A detailed understanding of the biophysical and molecular mechanisms by which PIP2 potentiates the function of KCNQ channels is an important step to understanding the physiology and pathophysiology of the cardiac, nervous, and auditory systems, and to developing effective new therapeutics for their diseases. In the following pages, we will review and attempt to synthesize the current body of work studying these mechanisms. Although the gating properties of KCNQ channels can be very different and accessory subunits lead to further variation, we will consider evidence regarding different KCNQ family members as well as KCNQ1 channels associated with KCNE1 accessory subunits. As described below, all these channels are voltage-gated, they all require PIP2 to open, and it appears that they all share a conserved PIP2 binding site at the VSD-PGD interface (see below). Therefore, we believe that considering these studies together may provide additional insights and may lead the reader to consider shared fundamental mechanisms that can tested and validated experimentally.
Voltage-gated ion channel structure and function
Voltage-gated cation channels share a common core structure consisting of four voltage-sensing domains (VSDs) surrounding a central pore-gate domain (PGD). In voltage-gated potassium (Kv) channels, including the members of the KCNQ (Kv7) family, tetrameric assembly of Kv-α subunits yields this channel structure (Figure 1). Each Kv-α subunit contains six transmembrane segments, of which S1-S4 from each Kv-α subunit form a VSD, while the S5-S6s from all four Kv-α subunits form the PGD. In general terms, voltage-dependent gating involves three different processes: VSD activation, PGD opening, and VSD-PGD coupling. In VSD activation, a conformational change is directly driven by transmembrane voltage. The voltage-dependence of this transition arises from forces that the transmembrane electric field exerts on conserved basic residues in S4 (Bezanilla, ). Depolarization yields outward force and promotes displacement of S4 from the resting to the activated state. The PGD forms a gated pathway through the membrane for selected ions to flow down their electrochemical gradient. The PGD opens by a dilation of the pathway at the crossing of the C-terminal portions of the S6 segments (the S6 gate) (Yellen, 1998). Several lines of evidence show that the VSD and the PGD are modular units. First, crystal structures of voltage-dependent cation channels reveal a surprisingly limited protein-protein contact surface at the VSD-PGD interface (Long, ; Payandeh et al., 2011). Second, voltage-independent channels consisting of the PGD alone without a VSD are found in nature, and they likely share a common, PGD-only ancestor with voltage-gated channels (Nayak et al., ). Likewise, voltage-sensor only proteins (VSOP) containing a functioning VSD without a PGD have been identified (Murata et al., ; Ramsey et al., 2006; Sasaki, 2006). Third, channels consisting of an artificially isolated PGD from voltage-gated potassium (Santos et al., 2008, 2012) or sodium (Shaya et al., 2011) channels have been shown to fold and function. Likewise, the artificially isolated VSD from KvAP adopts a similar conformation as in various crystal structures of full-length Kv channels (Butterwick and MacKinnon, ). Finally, functional, voltage-gated ion channels have been engineered by fusing together VSDs and PGDs from different sources (Lu et al., ; Arrigoni et al., ).
Figure 1
In VSD-PGD coupling, the conformations of the two modules are linked so that VSD activation promotes PGD opening, yielding a voltage-dependent conductance. Previous studies have identified several sites at the VSD-PGD interface that are important for the coupling, including the interactions between the S4-S5 linker and S6 (Lu et al.,
Models of voltage-dependent gating and the description of VSD-PGD coupling
Given that distinct VSD and PGD domains form Kv channels and that coupling is essential to voltage-dependent gating (Figure 2A), any model describing voltage-dependent gating should explicitly define coupling. Two mathematical models of voltage-dependent gating have found widespread application. A linear activation scheme (see Figure 2B for a simplified version) was first used to describe the gating of Shaker potassium channels (Schoppa et al., 1992; Zagotta et al., 1994). In this model, PGD opening occurs only after the independent activation of the four VSDs. In contrast, an allosteric scheme (see Figure 2C for a simplified version) was devised to describe the voltage-dependent gating (in the absence of calcium) of calcium-activated, large conductance potassium (BK) channels (Horrigan et al.,
Figure 2

Models of voltage-dependent gating. (A) The VSD and PGD are independent structural and functional domains; each domain on its own may undergo conformational transitions that can be described by independent energy landscapes. These hypothetical reaction coordinates illustrate the free energy associated with the different states of the domains and the transitions among them. In the voltage-gated ion channel, the conformational changes of these domains are coupled, and such coupling has been modeled in two different ways (B,C). Here, for simplicity, all models are shown considering only one VSD, and both VSD activation and PGD opening are modeled as two-state processes, for full models see references (Zagotta et al., 1994; Horrigan and Aldrich,
Several lines of experimental evidence strongly support allosteric coupling of KCNQ channels. First, even at low voltages, wt KCNQ1 channels display a small, but measurable, conductance (~5% of maximal conductance), which is sensitive to mutations of KCNQ1 and a KCNQ channel blocker, indicating that it is indeed a KCNQ1 conductance (Ma et al.,
Regulation of voltage-dependent gating by cofactor lipids
How might specific lipid interactions affect voltage-dependent gating? Three possible mechanisms are suggested above: by affecting VSD activation, PGD opening, and/or VSD-PGD coupling. Foundational work establishing roles for lipids as cofactors in voltage-dependent gating came through the study of Kv channel interactions with phospholipids other than PIP2. These findings are presented here, briefly.
MacKinnon and colleagues showed that, to open in response to depolarization, KvAP channels reconstituted into a planar bilayer require phospholipids in the membrane. They further found that, in sustaining current, the lipid phosphate group is key, not the net headgroup charge, the acyl chain length, or the effects of the lipids on membrane curvature (Schmidt et al., 2006). These findings suggest that specific interactions between the lipid phosphodiesters and the channel protein are important for voltage-dependent gating. Along these lines, crystal structures and molecular dynamics simulations of Kv channels reveal probable interactions between the S4 arginines and the lipid phosphate groups, which may help to stabilize the activated-state of the VSD (Freites,
Another line of evidence for lipid modification of voltage-dependent gating comes from enzymatic modification of the headgroup of sphingomyelin, a zwitterionic lipid found primarily in the external leaflet of the cell membrane. Shingomyelinase D (Smase D) cleaves choline from the headgroup, leaving behind negatively charged ceramide-1-phosphate. Smase D treatment of oocytes expressing Kv channels was shown to left-shift the voltage dependence of PGD opening and VSD activation (Ramu et al., 2006). Again, these results alone do not provide exclusive evidence for a direct effect on VSD activation, as the voltage-dependence of VSD movement could be indirectly affected by alteration in the coupling or PGD opening (Colquhoun,
Additional evidence for lipid interaction with the PGD comes from the presence of a lipid, phosphatidylglycerol (PG), in the crystal structure of the voltage-independent KCSA channel (Valiyaveetil et al., 2002), which is required for channel opening (Heginbotham,
These studies have greatly enriched our understanding of the lipid regulation of voltage-dependent gating, but many questions remain unresolved. Particularly the role of lipids in VSD-PGD coupling was not explored. Previously, this coupling has been largely attributed to protein-protein interactions at the VSD-PGD interface. However, the presence of an anionic phospholipid bound at this interface in the Kv1.2/2.1 chimera channel crystal structure suggested that lipids may play a role as well (Long et al.,
PIP2 is a KCNQ gating modulator
All five members of the KCNQ family require PIP2 to conduct measurable current (Zhang et al., 2003). KCNQ currents are inhibited by various treatments that decrease the abundance of PIP2 in the membrane, including stimulating PIP2 hydrolysis through receptor-mediated activation of phospholipase C (Suh and Hille, 2002; Zhang et al., 2003), elevating the rate of PIP2 dephopsphorylation through activation of lipid phosphatases (Suh et al., 2006; Murata and Okamura,
KCNQ channels are generally known to be voltage-gated, but the effects of PIP2 on their voltage-dependency may appear different among KCNQ channels. Following muscarinic stimulation to partially deplete PIP2, Shapiro et al. found that conductance-voltage (GV) relationship of KCNQ2+KCNQ3 channels was unaffected (Shapiro et al., 2000). Subsequently, Nakajo and Kubo observed a rightward shift in the GV curve following activation of muscarinic receptors for KCNQ2, KCNQ2+KCNQ3 or KCNQ4 channels. However, this shift was fully accounted for by the downstream activation of PKC, and application of Wortmannin, a relatively unspecific kinase inhibitor that is known to block the PI 4- kinase (Nakanishi et al.,
Biophysical models for PIP2 regulation of voltage-dependent gating in KCNQ
As described above, voltage-dependent gating involves three fundamental processes: VSD activation, VSD-PGD coupling, and PGD opening. Recently, we have investigated which step(s) requires PIP2 in KCNQ1 channels. To test if PIP2 affects VSD activation in KCNQ1 channels, VSD activation was detected by using voltage clamp fluorometry (VCF) (Mannuzzu et al.,
We then tested if PIP2 is required for coupling by measuring the impact of PGD opening on VSD activation both in the presence of endogenous PIP2 and after PIP2 depletion by CiVSP. In the presence of PIP2, VSD-PGD coupling caused a leftward shift in the FV relationship when the PGD was locked open by the mutation L353K. After depletion of PIP2, L353K KCNQ1 channels remained open, but the shift was eliminated and the FV relationships of L353K and wt could be superimposed (Zaydman et al., 2013). This result demonstrates that PIP2 is required for PGD opening to promote VSD activation, in addition to being required for VSD activation to promote PGD opening. These bidirectional effects are consistent with a model in which PIP2 is required for allosteric coupling between the activated-state of the VSD and the open-state of the PGD. A simple version of such a model globally fits the steady-state voltage- and PIP2-dependencies of PGD opening and VSD activation in KCNQ1 (Zaydman et al., 2013). This model demonstrates that the effect of PIP2 on coupling is sufficient to quantitatively model the gating behavior of KCNQ1 without any direct effects on PGD opening; however, these results do not rule out the possibility that PIP2 affects PGD opening as well.
Loussouarn et al. proposed a model for PIP2 regulation of KCNQ1+KCNE1 channels in which the role of PIP2 is to stabilize the PGD open-state (Loussouarn et al.,
Molecular models of KCNQ-PIP2 interaction
Identification of the binding site is critical to mechanistically understanding how PIP2 regulates KCNQ channels, and may hold the key to developing new therapeutics targeting PIP2-dependent activation. The search for putative PIP2 interacting partners has focused on basic residues that are exposed to the cytosol based on the rationale that PIP2 is restricted to the intracellular leaflet of the membrane and that crystalographically verified PIP2 binding sites in other proteins contain multiple basic residues for coordination of the negatively charged headgroup phosphates (McLaughlin et al.,
Figure 3

Location of three proposed PIP2 interacting sites on KCNQ. The VSD-PGD interface site includes contributions from the S2-S3 linker, S4-S5 linker, S6 and proximal C-terminus. Other sites have been proposed at the helix A-B linker or the distal C-terminus. Blue residues indicate residues for which mutations have been reported to affect PIP2 dependent activation. Black residues highlight the conservation of such residues among other members of the KCNQ family. Numbering indicates the positions of highlighted residues in the human KCNQ1 channel sequence.
The VSD-PGD interface site includes contributions from the S2-S3 linker, S4-S5 linker and the proximal C-terminus (Figure 3). Logothetis and colleagues identified a mutation, H328C, in the proximal C-terminus of KCNQ2, that significantly decreased the apparent affinity of KCNQ2+KCNQ3 channels to exogenous PIP2 (Zhang et al., 2003). Subsequently, Loussouarn and colleagues demonstrated that the disease-associated mutation R243 in the S4-S5 linker decreases the apparent affinity of KCNQ1+KCNE1 channels for exogenous PIP2 (Park et al., 2005). Recently, Li and colleagues reported that K222A, in the S4-S5 linker, lowered the apparent PIP2 affinity of KCNQ3 channels (Zhou et al., 2013). In 2011, Tinker and colleagues found a cluster of basic residues (K354, K358, R360, K362) in the KCNQ1 proximal C-terminus is important for the binding of C-terminal fragments of KCNQ1 to immobilized phosphoinositides (Thomas et al., 2011). One concern with such an approach is that binding of a protein fragment may represent a non-specific electrostatic interaction that is not representative of PIP2 binding in the channel protein. Accordingly, these authors found that the identified mutations decreased the whole cell currents of full-length KCNQ1+KCNE1 channels, and a double mutation (K358A/R360A) had a blunted response to dialysis of 25 μ M diC8 PIP2. Studying the homologous residues in KCNQ2, Brown and colleagues found that the mutation R325A decreased the on-cell, single-channel open probability and the apparent affinity for diC8 PIP2 in excised patches; in contrast, the mutation K327A did not affect the dose response of KCNQ2 (Telezhkin et al., 2013). Lopes and colleagues found that the long QT syndrome-associated mutation R366Q increased the sensitivity of KCNQ1+KCNE1 channels to PIP2 hydrolysis (Matavel et al.,
Figure 4

The VSD-PGD interface site. Side view (left) and bottom view (right) of a single KCNQ1 subunit from a homology model (Smith et al., 2007), which was built of the template of the Kv1.2 crystal structure (Long et al.,
Shapiro and colleagues identified a possible interaction between the helix A-B linker of the C-terminus and PIP2 (Hernandez et al.,
The residues in the distal C-terminus site (R539 and R555 in KCNQ1) were found by the Loussouarn group (Park et al., 2005). They studied the long QT syndrome-associated mutations R539W and R555C, located within helix C of the C-terminus, and found that these mutations decrease the apparent affinity KCNQ1+KCNE1 channels to exogenous PIP2. The distal position of R539 and R555 in the protein sequence makes it difficult to locate these residues with respect to the membrane because the structure of the large KCNQ C-terminus is unknown. There are several possible explanations for how these residues affect PIP2 dependent activation. First they could form an independent PIP2 binding site that affects channel gating. Second, the structure of the C-terminus could position these residues close to the VSD-PGD interface site to form a single PIP2 binding site. Third, the distal C-terminus site could be allosterically linked to a distant PIP2 binding site instead of directly coordinating PIP2. Further studies are required to address these possibilities.
Coupling as a conserved mechanism for lipid modulation of transmembrane proteins
The remarkable similarity in the location of the putative PIP2 binding site in KCNQ1 and the PIP2 binding site in the Kir crystal structure (Zaydman et al., 2013) suggests a conserved mechanism for PIP2 regulation of voltage-dependent and voltage independent K+ channels. Consistently, recent structural studies suggest that PIP2 is required to couple the Kir cytosolic domain, a sensor of intracellular factors, to the PGD. The Kir2.2 structures reveal that PIP2 binding pulls the cystosolic domain toward the PGD by roughly six angstroms and causes them to engage in a set of interactions that moves the PGD toward an open conformation (Hansen et al.,
Figure 5

Coupling of modular sensor and effector domains as a general mechanism for the regulation of transmembrane proteins by PIP2 or other anionic phospholipids.
PIP2 mediated coupling as a new therapeutic target
Voltage-gated ion channels are an appealing drug target (Kaczorowski et al.,
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Statements
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Summary
Keywords
PIP2, voltage-gating, lipid modulations, ion channel, KCNQ
Citation
Zaydman MA and Cui J (2014) PIP2 regulation of KCNQ channels: biophysical and molecular mechanisms for lipid modulation of voltage-dependent gating. Front. Physiol. 5:195. doi: 10.3389/fphys.2014.00195
Received
15 February 2014
Accepted
08 May 2014
Published
27 May 2014
Volume
5 - 2014
Edited by
Harley Takatsuna Kurata, University of British Columbia, Canada
Reviewed by
Álvaro Villarroel, Euskal Herriko Unibertsitatea, Spain; Koichi Nakajo, National Institute for Physiological Sciences, Japan; Naoto Hoshi, University of California Irvine, USA
Copyright
© 2014 Zaydman and Cui.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Jianmin Cui, Department of Biomedical Engineering, Washington University in St. Louis, Whitaker Rm 290C, One Brookings Drive, St. Louis, MO 63130, USA e-mail: jcui@wustl.edu
This article was submitted to Membrane Physiology and Membrane Biophysics, a section of the journal Frontiers in Physiology.
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