Potassium (K+) channels influence neurotransmitter release, burst firing ra
te activity, pacing, and critical dampening of neuronal circuits. Internal
and external factors that further modify K+ channel function permit fine-tu
ning of neuronal circuits. Human ether-a-go-go-related gene (HERG) K+ chann
els are unusually sensitive to external calcium concentration ([Ca2+](o)).
Small changes in [Ca2+](o) shift the voltage dependence of channel activati
on to more positive membrane potentials, an effect that cannot be explained
by nonspecific surface charge screening or channel pore block. The HERG-ca
lcium concentration-response relationship spans the physiological range for
[Ca2+](o). The modulatory actions of calcium are attributable to differenc
es in the Ca2+ affinity between rested and activated channels. Adjacent ext
racellular, negatively charged amino acids (E518 and E519) near the S4 volt
age sensor influence both channel gating and Ca2+ dependence. Neutralizatio
n of these charges had distinct effects on channel gating and calcium sensi
tivity. A change in the degree of energetic coupling between these amino ac
ids on transition from closed to activated channel states reveals movement
in this region during channel gating and defines a molecular mechanism for
protein state-dependent ligand interactions. The results suggest a novel ex
tracellular [Ca2+](o) sensing mechanism coupled to allosteric changes in ch
annel gating and a mechanism for fine-tuning cell repolarization.