Article

Electrophysiological characterization of human KCNT1 channel modulators and the therapeutic potential of hydroquinine and tipepidine in KCNT1 mutation-associated epilepsy mouse model

Qing Guo1,2,3, Jun Gan1,2,3, En-ze Wang1,2,3, Yu-ming Wei1,2,3, Jie Xu1,2,3, Yun Xu1,2,3, Fei-fei Zhang1,2,3, Meng Cui4, Meng-xing Jia5, Ming-jian Kong6, Qiong-yao Tang1,2,3, Zhe Zhang1,2,3
1 Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou 221004, China
2 Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou 221004, China
3 NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
4 Department of Pharmaceutical Sciences, Northeastern University, Boston, MA 02115, USA
5 Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China
6 Department of Anesthesiology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
Correspondence to: Meng-xing Jia: jmx5278@163.com, Ming-jian Kong: mjkong@126.com, Qiong-yao Tang: Qiongyaotang@xzhmu.edu.cn, Zhe Zhang: zhangzhe70@xzhmu.edu.cn,
DOI: 10.1038/s41401-024-01457-8
Received: 16 July 2024
Accepted: 9 December 2024
Advance online: 27 January 2025

Abstract

Patients suffering epilepsy caused by the gain-of-function mutants of the hKCNT1 potassium channels are drug refractory. In this study, we cloned a novel human KCNT1B channel isoform using the brain cDNA library and conducted patch-clamp and molecular docking analyses to characterize the pharmacological properties of the hKCNT1B channel using thirteen drugs. Among cinchona alkaloids, we found that hydroquinine exerted the strongest blocking effect on the hKCNT1B channel, especially the F313L mutant. In addition, we confirmed the antitussive drug tipepidine was also a potent inhibitor of the hKCNT1B channel. Subsequently, we proved that these two drugs produced an excellent therapeutic effect on the epileptic model of KCNT1 Y777H mutant male mice; thus, both could be ready-to-use anti-epileptic drugs. On the other hand, we demonstrated that the activation of the KCNT1 channel by loxapine and clozapine was through interacting with pore domain residues to reverse the run-down of the KCNT1 channel. Taken together, our results provide new insights into the mechanism of the modulators in regulating the KCNT1 channel activity as well as important candidates for clinical tests in the treatment of KCNT1 mutant-associated epilepsy.
Keywords: epilepsy; KCNT1 channel; hydroquinine; tipepidine; patch-clamp; molecular docking

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