The RYR1 functions as the Ca
2+ release channel in the skeletal muscle SR. The functional RYR1 SR Ca
2+ release channel is a 2.3-megadalton homomeric assembly of four ~565-kD RYR1 subunits. Each RYR1 subunit is composed of a large N-terminal cytosolic “foot” region and six to eight transmembrane sequences located within the C-terminal portion of the protein (
Du et al., 2002,
2004). By analogy with known K
+ channel structures, the selectivity filter of the RYR1 Ca
2+ release channel is determined by a conserved hydrophobic sequence Gly-Ile-Gly (amino acids 4894-4895-4896 in mouse RYR1) (
Zhao et al., 1999;
Gao et al., 2000;
Williams et al., 2001) located between the final two transmembrane domains. Fully assembled tetrameric Ca
2+ release channels are arranged in regular arrays within the terminal cisternae of the SR (
Franzini-Armstrong and Nunzi, 1983;
Block et al., 1988;
Franzini-Armstrong and Kish, 1995;
Protasi et al., 1997). Activation of RYR1 Ca
2+ release channels within these arrays during excitation–contraction (EC) coupling is controlled via a unique conformational interaction with the dihydropyridine receptor (DHPR; L-type Ca
2+ channel), located in the adjacent transverse tubule membrane. DHPR–RYR1 conformational coupling is a bidirectional signaling interaction. Specifically, membrane depolarization triggers DHPRs to rapidly activate RYR1 channels to release SR Ca
2+ (orthograde coupling), while the presence of RYR1 enhances L-type Ca
2+ channel conduction and modifies the gating properties of the DHPR (retrograde coupling) (
Nakai et al., 1996;
Avila and Dirksen, 2000;
Dirksen, 2002). Consistent with the notion that the DHPR and RYR1 Ca
2+ channels are essential for skeletal muscle EC coupling, mutations in the DHPR and RYR1 proteins underlie several clinically distinct skeletal muscle disorders, including autosomal dominant malignant hyperthermia (MH), hypokalemic periodic paralysis, central core disease (CCD), and centronuclear myopathy (
Jungbluth et al., 2007). Autosomal recessive mutations in RYR1 have also been linked to a form of multi-minicore disease (
Jungbluth et al., 2005).
Functional testing of some of the large number of
RYR1 disease mutations identified to date has revealed three mechanistically distinct classes (
Treves et al., 2008). One class of dominantly inherited
RYR1 mutations (termed “leaky” channel mutations) destabilizes the channel closed state and/or stabilizes the open state and, thus, sensitizes the channel to activation by a wide range of RYR1 triggers, including conformational activation by the DHPR and pharmacological activation by caffeine, 4-chloro-
m-cresol (4-CMC), and volatile anesthetics (
Tong et al., 1999;
Avila and Dirksen, 2001). Physiological mechanisms in skeletal muscle exist to suppress inappropriate Ca
2+ release. Loss of suppression can result from an MH mutation in either RYR1 (
Robinson et al., 2006), Ca
V1.1 (
Monnier et al., 1997), or type 1 calsequestrin deficiency (
Dainese et al., 2009) that occurs in combination with an MH-triggering agent. Mechanisms proposed for enhanced RYR1 activity and escape from suppression of release include increased luminal Ca
2+ sensitivity (
Jiang et al., 2008), interdomain unzipping (
Murayama et al., 2007), or altered regulation by cytosolic factors (
Mickelson and Louis, 1996). We proposed that leaky channel mutations increase MH susceptibility and, if the defect is severe enough, can also lead to muscle weakness in CCD as a result of uncompensated RYR1 Ca
2+ leak that results in SR Ca
2+ depletion and a reduction in Ca
2+ release during EC coupling (
Tong et al., 1999;
Dirksen and Avila, 2004). The second class of dominantly inherited
RYR1 mutations is proposed to reduce RYR1 Ca
2+ release during EC coupling in a manner that occurs independently of a change in SR Ca
2+ leak, Ca
2+ store depletion, or RYR1 sensitization (
Avila et al., 2001,
2003;
Zvaritch et al., 2007). These mutations are expected to result in muscle weakness in the absence of MH susceptibility (
Dirksen and Avila, 2002). The third class includes recessively inherited
RYR1 mutations that dramatically reduce RYR1 protein levels and severely lower Ca
2+ release channel density within the junctional SR (
Monnier et al., 2003;
Zhou et al., 2006).
Lynch et al. (1999) identified a CCD mutation in the C-terminal region of RYR1 (I4898T) that is now considered to be one of the most common CCD mutations in humans. The highly conserved Ile4898 residue is located in the center of the selectivity filter of the RYR1 Ca
2+ release channel (
Gao et al., 2000). Based on functional reconstitution studies in myotubes derived from RYR1-null mice, we proposed that this mutation operates via the second class of mechanisms discussed above (reduced SR Ca
2+ release without a change in leak, sensitivity, or store content) (
Avila and Dirksen, 2001;
Avila et al., 2001,
2003). However, other studies conducted after either heterologous expression in HEK293 cells (
Lynch et al., 1999) or endogenous expression in B lymphocytes (
Tilgen et al., 2001) and myotube cultures (
Ducreux et al., 2004) derived from patients heterozygous for the I4898T mutation concluded that the I4898T mutation enhances RYR1 Ca
2+ leak. Discrepancies between these reports most likely reflect differences between the preparations (purified RYRs, native cells, and homozygous/heterozygous expression), experimental approaches (
45Ca
2+ flux, Ca
2+ measurements, and electrophysiology), and expression systems used (HEK293 cells, B lymphocytes, and human or dyspedic myotubes), none of which directly reflect RYR1 Ca
2+ release channel function in fully differentiated adult skeletal muscle fibers.
To overcome these limitations, we compared in vivo muscle strength in adult wild-type (WT) and heterozygous Ryr1I4895T/+ knock-in mice (IT/+) and correlated these findings with measurements of EC coupling, bidirectional DHPR–RYR1 conformational coupling, RYR1-mediated Ca2+ release, and SR Ca2+ content in single skeletal muscle fibers obtained from these animals. Single-channel studies of recombinant homotypic (WT:WT and IT:IT) and heterotypic (WT:IT) channels incorporated into planar lipid bilayers were completed to characterize the effect of the mutation on RYR1 channel Ca2+ conduction/selectivity. Our findings demonstrate that the I4895T mutation causes muscle weakness in IT/+ mice by reducing SR Ca2+ release as a result of a deficit in RYR1 Ca2+ ion permeation.