Mutations in the cardiac potassium ion channel gene KCNQ1 (voltage-gated K channel subtype KvLQT1) cause LQT1, the most common type of hereditary lon
g Q-T syndrome. KvLQT1 mutations prolong Q-T by reducing the repolarizing c
ardiac current [slow delayed rectifier K+ current (I-Ks)], but, for reasons
that are not well understood, the clinical phenotypes may vary considerabl
y even for carriers of the same mutation, perhaps explaining the mode of in
heritance. At present, only currents expressed by LQT1 mutants have been st
udied, and it is unknown whether abnormal subunits are transported to the c
ell surface. Here, we have examined for the first time trafficking of KvLQT
1 mutations and correlated the results with the I-Ks currents that were exp
ressed. Two missense mutations, S225L and A300T, produced abnormal currents
, and two others, Y281C and Y315C, produced no currents. However, all four
KvLQT1 mutations were detected at the cell surface. S225L, Y281C, and Y315C
produced dominant negative effects on wild-type I-Ks current, whereas the
mutant with the mildest dysfunction, A300T, did not. We examined traffickin
g of a severe insertion deletion mutant Delta 544 and detected this protein
at the cell surface as well. We compared the cellular and clinical phenoty
pes and found a poor correlation for the severely dysfunctional mutations.