KCNA1
protein-codingpotassium voltage-gated channel subfamily A member 1, the group of Potassium voltage-gated channels
Gene summary
This gene encodes a voltage-gated delayed potassium channel that is phylogenetically related to the Drosophila Shaker channel. The encoded protein has six putative transmembrane segments (S1-S6), and the loop between S5 and S6 forms the pore and contains the conserved selectivity filter motif (GYGD). The functional channel is a homotetramer. The N-terminus of the channel is associated with beta subunits that can modify the inactivation properties of the channel as well as affect expression levels. The C-terminus of the channel is complexed to a PDZ domain protein that is responsible for channel targeting. Mutations in this gene have been associated with myokymia with periodic ataxia (AEMK). [provided by RefSeq, Jul 2008]
- AEMK
MANE transcript
Inheritance
ClinVar variants
Top phenotype
gnomAD constraint
Max pathogenic AF
Genomic locus
External References & Databases
Transcript & Mutation Effects
hg38 • Region Span ~8.4 kbGenCC Phenotypes & Disease Associations
Curated gene-disease validity assertions and inheritance patterns
Inheritance Pattern: AD
Disease ID:MONDO:0008047
Submitter: Genomics England PanelApp
Inheritance Pattern: AD
Disease ID:MONDO:0008047
Submitter: ClinGen
*KCNA1* was first reported in relation to autosomal dominant episodic ataxia type 1 in 1994 (Browne et al., PMID: 7842011). Episodic ataxia type 1 is characterized by continuous muscle fiber activation or rippling (myokymia) and periodic ataxia, although the phenotype is highly variable. Of note, type 1 episodic ataxia is generally associated with brief periods of ataxia, lasting seconds, whereas other types of episodic ataxia present with longer episodes, usually hours (PMID:17575281). Episodic ataxia 1 may also include hypomagnesemia and renal magnesium wasting, features which may be underdiagnosed in patients with this condition due to lack of testing (PMID:32316562). About 20% of individuals with KCNA1-related episodic ataxia have seizures, and we did not identify any cases with isolated epilepsy (PMID: 32316562, 34566847). Per criteria outlined by the ClinGen Lumping and Splitting Working Group, we found no consistent differences in molecular mechanism, inheritance pattern, or variant location on phenotypic variability, so we are unable to “split” out the patients with seizures. Therefore, we are choosing to curate these cases under episodic ataxia type 1 (MONDO:0008047). Eighteen variants (missense and nonsense) that have been reported in 20 probands in 8 publications (PMIDs: 7842011, 8541859, 11026449, 23349320, 28666963, 28676720, 20660867, 32705822) are included in this curation. Multiple variants have been shown to segregate with disease in families. Of note, we did not identify any cases with isolated epilepsy. More evidence is available in the literature, but the maximum score for genetic evidence (12 pts.) has been reached. The mechanism of pathogenicity is unclear, as pathogenic variants have been found to have various effects in vitro (loss of function, gain of function, and dominant negative in PMIDs: 34778950, 9526001, and 11773313). This gene-disease relationship is also supported by experimental evidence: hippocampal brain slices lacking *KCNA1* showed hyperexcitability and a mouse model expressing p.V408A showed impaired coordination under stress (PMIDs: 9581771, 12612586). In summary, there is a definitive relationship between *KCNA1* and autosomal dominant episodic ataxia type 1. This has been repeatedly demonstrated in both the research and clinical diagnostic settings, and has been upheld over time. This classification was approved by the ClinGen Epilepsy Gene Curation Expert Panel on the meeting date March 7th, 2023 (SOP Version 9). In July 2024, this record underwent administrative changes to reflect additional review by the Tubulopathy GCEP and inclusion of information about hypomagnesemia. The classification remains the same.
Inheritance Pattern: AD
Disease ID:MONDO:0007494
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0008047
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0008047
Submitter: Labcorp Genetics (formerly Invitae)
Inheritance Pattern: AD
Disease ID:MONDO:0008047
Submitter: Ambry Genetics
Inheritance Pattern: AD
Disease ID:MONDO:0016048
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0005027
Submitter: PanelApp Australia
Inheritance Pattern: AR
Disease ID:MONDO:0100062
Submitter: G2P
Inheritance Pattern: AD
Disease ID:MONDO:0100062
Submitter: Orphanet
Inheritance Pattern: AD
Disease ID:MONDO:0100062
Submitter: G2P
Clinical Genomic Database (CGD)
Manifestation: Neurologic; Renal
Intervention: Renal
Rationale: Individuals can have severe hypomagnesemia, which is responsive to magnesium therapy
Comments: For episodic ataxia medical treatment (eg, with phenytoin) may be effective, but the benefit of an early (genetic) diagnosis is unclear
ClinVar Associated Diseases & Phenotypes
Reported disease conditions connected to KCNA1 variants in ClinVar
ClinVar Variants & Pathogenicity by Type
Statistics based on transcript NM_000217.3. Only rare variants are included.
We include only reliable ClinVar variants with their consequences to MANE Select, MANE Plus Clinical transcripts, or transcripts with TSL equal to 1. Click a count to filter the variants table below.
Slight differences between displayed counts and ClinVar may occur due to a different transcript/consequence chosen by our variant effect predictor, or because we classify Benign/Likely benign as Likely benign and Pathogenic/Likely pathogenic as Likely pathogenic.
| Effect | PathogenicP | Likely pathogenicLP | VUS | Likely benignLB | BenignB | Sum |
|---|---|---|---|---|---|---|
| synonymous | 9 | 188 | 1 | 198 | ||
| missense | 23 | 30 | 333 | 7 | 393 | |
| nonsense | 2 | 1 | 12 | 15 | ||
| start loss | 3 | 1 | 4 | |||
| frameshift | 1 | 6 | 7 | |||
| splice donor/acceptor (+/-2bp) | 1 | 1 | ||||
| Total | 25 | 32 | 364 | 195 | 2 | 618 |
Highest pathogenic variant AF is 6.84149e-7
Transcript Catalog
Annotated transcript isoforms across RefSeq and Ensembl databases
| Transcript ID | Source | Protein ID | Coding Exons | MANE Status |
|---|---|---|---|---|
| RefSeq | NP_000208.2 | 1 | MANE Select | |
| Ensembl | ENSP00000371985.3 | 1 | MANE Select | |
| Ensembl | ENSP00000492506.1 | 1 | Standard | |
| Ensembl | ENSP00000492218.1 | 2 | Standard |
Gene Ontology (GO) Annotations & Pathways
Biological processes, molecular functions, cellular components and pathways
Pathways ConsensusPathDB
- Neuronal System
- Voltage gated Potassium channels
- Potassium Channels
Biological Process
- startle response
- potassium ion transport
- regulation of muscle contraction
- chemical synaptic transmission
- neuroblast proliferation
Molecular Function
- voltage-gated potassium channel activity
- delayed rectifier potassium channel activity
- potassium channel activity
- protein binding
- potassium ion transmembrane transporter activity
Cellular Component
- endoplasmic reticulum
- cytosol
- plasma membrane
- integral component of plasma membrane
- voltage-gated potassium channel complex
gnomAD Constraint
Source:
- Gene type
- protein_coding
- Transcript type
- protein_coding
- Transcript
- ENST00000382545
- Coding exons
- 1
- Length
- 21457
- Individuals with no LoFs
- 125741
- Homozygous LoFs
- 0
- Heterozygous LoFs
- 7
- Defined
- 125748
- p
- 0.0000278
| Z-Score | Observed | Expected | Observed/Expected | Mutation Rate | Total Possible | |
|---|---|---|---|---|---|---|
| Missense | 3.33 | 148 | 314 | 0.472 | 0.0000216 | 3296 |
| Missense (PolyPhen) | 37 | 167.35 | 0.22109 | 1777 | ||
| Synonymous | -0.948 | 154 | 140 | 1.10 | 0.0000112 | 985 |
| Loss of Function | 2.23 | 4 | 12.5 | 0.319 | 6.35e-7 | 141 |
Population LoF Frequency
| Population | CAF | p-value | Status |
|---|---|---|---|
| African | 0.000062 | 0.000062 | rare |
| Latino/Admixed American | 0 | 0.0 | absent |
| Ashkenazi Jewish | 0 | 0.0 | absent |
| East Asian | 0.000055 | 0.000054 | rare |
| Finnish | 0 | 0.0 | absent |
| European (Non-Finnish) | 0.000035 | 0.000035 | rare |
| South Asian | 0.000033 | 0.000033 | rare |
| Other | 0 | 0.0 | absent |
dbNSFP Gene Annotations
Source:
- Function
- FUNCTION: Voltage-gated potassium channel that mediates transmembrane potassium transport in excitable membranes, primarily in the brain and the central nervous system, but also in the kidney (PubMed:19903818). Contributes to the regulation of the membrane potential and nerve signaling, and prevents neuronal hyperexcitability (PubMed:17156368). Forms tetrameric potassium- selective channels through which potassium ions pass in accordance with their electrochemical gradient. The channel alternates between opened and closed conformations in response to the voltage difference across the membrane (PubMed:19912772). Can form functional homotetrameric channels and heterotetrameric channels that contain variable proportions of KCNA1, KCNA2, KCNA4, KCNA5, KCNA6, KCNA7, and possibly other family members as well; channel properties depend on the type of alpha subunits that are part of the channel (PubMed:12077175, PubMed:17156368). Channel properties are modulated by cytoplasmic beta subunits that regulate the subcellular location of the alpha subunits and promote rapid inactivation of delayed rectifier potassium channels (PubMed:12077175, PubMed:17156368). In vivo, membranes probably contain a mixture of heteromeric potassium channel complexes, making it difficult to assign currents observed in intact tissues to any particular potassium channel family member. Homotetrameric KCNA1 forms a delayed-rectifier potassium channel that opens in response to membrane depolarization, followed by slow spontaneous channel closure (PubMed:19912772, PubMed:19968958, PubMed:19307729, PubMed:19903818). In contrast, a heterotetrameric channel formed by KCNA1 and KCNA4 shows rapid inactivation (PubMed:17156368). Regulates neuronal excitability in hippocampus, especially in mossy fibers and medial perforant path axons, preventing neuronal hyperexcitability. Response to toxins that are selective for KCNA1, respectively for KCNA2, suggests that heteromeric potassium channels composed of both KCNA1 and KCNA2 play a role in pacemaking and regulate the output of deep cerebellar nuclear neurons (By similarity). May function as down- stream effector for G protein-coupled receptors and inhibit GABAergic inputs to basolateral amygdala neurons (By similarity). May contribute to the regulation of neurotransmitter release, such as gamma-aminobutyric acid (GABA) release (By similarity). Plays a role in regulating the generation of action potentials and preventing hyperexcitability in myelinated axons of the vagus nerve, and thereby contributes to the regulation of heart contraction (By similarity). Required for normal neuromuscular responses (PubMed:11026449, PubMed:17136396). Regulates the frequency of neuronal action potential firing in response to mechanical stimuli, and plays a role in the perception of pain caused by mechanical stimuli, but does not play a role in the perception of pain due to heat stimuli (By similarity). Required for normal responses to auditory stimuli and precise location of sound sources, but not for sound perception (By similarity). The use of toxins that block specific channels suggest that it contributes to the regulation of the axonal release of the neurotransmitter dopamine (By similarity). Required for normal postnatal brain development and normal proliferation of neuronal precursor cells in the brain (By similarity). Plays a role in the reabsorption of Mg(2+) in the distal convoluted tubules in the kidney and in magnesium ion homeostasis, probably via its effect on the membrane potential (PubMed:23903368, PubMed:19307729). {ECO:0000250|UniProtKB:P10499, ECO:0000269|PubMed:11026449, ECO:0000269|PubMed:12077175, ECO:0000269|PubMed:15837928, ECO:0000269|PubMed:17136396, ECO:0000269|PubMed:17156368, ECO:0000269|PubMed:19307729, ECO:0000269|PubMed:19903818, ECO:0000269|PubMed:19912772, ECO:0000269|PubMed:19968958, ECO:0000269|PubMed:21106501, ECO:0000269|PubMed:23903368}.;
- Disease
- DISEASE: Episodic ataxia 1 (EA1) [MIM:160120]: An autosomal dominant disorder characterized by brief episodes of ataxia and dysarthria. Neurological examination during and between the attacks demonstrates spontaneous, repetitive discharges in the distal musculature (myokymia) that arise from peripheral nerve. Nystagmus is absent. {ECO:0000269|PubMed:10355668, ECO:0000269|PubMed:11013453, ECO:0000269|PubMed:11026449, ECO:0000269|PubMed:12077175, ECO:0000269|PubMed:15532032, ECO:0000269|PubMed:17156368, ECO:0000269|PubMed:7842011, ECO:0000269|PubMed:8541859, ECO:0000269|PubMed:8845167, ECO:0000269|PubMed:8871592, ECO:0000269|PubMed:9600245}. Note=The disease is caused by mutations affecting the gene represented in this entry.; DISEASE: Myokymia isolated 1 (MK1) [MIM:160120]: A condition characterized by spontaneous involuntary contraction of muscle fiber groups that can be observed as vermiform movement of the overlying skin. Electromyography typically shows continuous motor unit activity with spontaneous oligo- and multiplet-discharges of high intraburst frequency (myokymic discharges). Isolated spontaneous muscle twitches occur in many persons and have no grave significance. {ECO:0000269|PubMed:11026449, ECO:0000269|PubMed:17136396, ECO:0000269|PubMed:19307729, ECO:0000269|PubMed:19903818}. Note=The disease is caused by mutations affecting the gene represented in this entry.;
Recessive Scores
- pRec
- 0.299
Intolerance Scores
- LoFtool
- 0.0791
- RVIS EVS
- -0.56
- RVIS percentile EVS
- 19.54
Essentials
- Essential (CRISPR)
- N
- Essential (CRISPR2)
- N
- Essential (gene trap)
- N
- Indispensability pred.
- E
- Indispensability score
- 0.803
Gene Damage Prediction
| All | Recessive | Dominant | |
|---|---|---|---|
| Mendelian | Medium | Medium | Medium |
| Primary Immunodeficiency | Medium | Medium | Medium |
| Cancer | Medium | Medium | Medium |