All eight missense mutations of NaV1.4 associated with hypokalemic periodic paralysis (HypoPP) occur at arginine residues in S4 voltage sensors. These R/X mutations create an anomalous ion conduction pathway, detected as a gating pore current (Igp) in the oocyte. A critical question is how large is the gating pore conductance in HypoPP muscle, since this will determine susceptibility to depolarization-induced weakness. Large discrepancies for estimates of Igp relative to peak INa have been reported; Igp / INa = ∼ 1:100 when currents are measured with TTX (Igp) and without (INa) in the same egg, whereas the conductance ratio γgp / γNa = ∼ 1:1000 based on measurement of Igp and maximal “on” gating charge displacement, Qon.To resolve this issue, we measured Qon, INa, and Igp in oocytes expressing WT or R672G channels. Robust gating pore currents were observed for R672G channels, with Igp/Qon = 65.2 nA/nC at −140 mV. The ratio of INa(-10 mv) to Qon was decreased 2.3-fold for R672G channels compared to WT. This decoupling may also account for the 2x reduction of INa in muscle fibers from R669H knock-in HypoPP mouse for which mRNA levels were not reduced. For R672G, the measured currents had a ratio of Igp(-140) / INa(-10) = 0.025 or 1:40. This current ratio can be converted to an equivalent conductance ratio by accounting for (i) decoupling 2.3, (ii) Popen_max = 0.25, (iii) driving force of 140 mV for Igp and 50 mV for INa. All together, these factors are ∼25 and yield an equivalent conductance ratio of 1: 40 x 25 = 1 : 1000; thereby resolving the discrepancy in the literature.Supported by NIAMS and MDA.
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