M-channel activation contributes to the anticonvulsant action of the ketone body β-Hydroxybutyrate

Ryan Manville, Maria Papanikolaou, Geoffrey W. Abbott*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Ketogenic diets are effective therapies for refractory epilepsy, yet the underlying mechanisms are incompletely understood. The anticonvulsant efficacy of ketogenic diets correlates positively to the serum concentration of β-hydroxybutyrate (BHB), the primary ketone body generated by ketosis. Voltage-gated potassium channels generated by KCNQ2-5 subunits, especially KCNQ2/3 heteromers, generate the M-current, a therapeutic target for synthetic anticonvulsants. Here, we report that BHB directly activates KCNQ2/3 channels (EC50 = 0.7 µM), via a highly conserved S5 tryptophan (W265) on KCNQ3. BHB was also acutely effective as an anticonvulsant in the pentylene tetrazole (PTZ) seizure assay in mice. Strikingly, coadministration of γ-amino-β-hydroxybutyric acid, a high-affinity KCNQ2/3 partial agonist that also acts via KCNQ3-W265, similarly reduced the efficacy of BHB in KCNQ2/3 channel activation in vitro and in the PTZ seizure assay in vivo. Our results uncover a novel, unexpected molecular basis for anticonvulsant effects of the major ketone body induced by ketosis.
Original languageEnglish
Pages (from-to)148–156
JournalJournal of Pharmacology and Experimental Therapeutics
Volume372
Issue number2
DOIs
Publication statusPublished - 1 Feb 2020
Externally publishedYes

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