SUMOylation determines the voltage required to activate cardiac IKs channels [Physiology]

I_Ks channels open in response to depolarization of the membrane voltage during the cardiac action potential, passing potassium ions outward to repolarize ventricular myocytes and end each beat. Here, we show that the voltage required to activate I_Ks channels depends on their covalent modification by small ubiquitin-like modifier (SUMO) proteins. I_Ks channels are comprised of four KCNQ1 pore-forming subunits, two KCNE1 accessory subunits, and up to four SUMOs, one on Lys₄₂₄ of each KCNQ1 subunit. Each SUMO shifts the half-maximal activation voltage (V_1/2) of I_Ks ∼ +8 mV, producing a maximal +34-mV shift in neonatal mouse cardiac myocytes or Chinese hamster ovary (CHO) cells expressing the mouse or human subunits. Unexpectedly, channels formed without KCNE1 carry at most two SUMOs despite having four available KCNQ1-Lys₄₂₄ sites. SUMOylation of KCNQ1 is KCNE1 dependent and determines the native attributes of cardiac I_Ks in vivo.