The mechanisms that link the primary increase in SR Ca2+ leak of MH susceptibility and related conditions to their disease phenotypes are not well understood. We found that abnormal Ca2+ homeostasis in MHS individuals induces proteolysis of junctophilin1 (JPh1), an essential structural protein of EC coupling (Perni, in 2017). Guo (in 2018) and Lahiri (in 2020) reported similar fragmentation of JPh2 in stressed hearts. Western blot of patients’ muscle with domain-specific antibodies showed a deficit of full-length JPh1 and excess of a 44-kD C-terminal fragment (JPh44) in MHS subjects. While JPh1 was located in T-SR junctions, JPh44 was found anywhere within the I band, and at high densities within nuclei—a location forbidden for JPh1. Expression and cleavage in mice of a JPh1 plasmid tagged at both ends showed that its N-terminal fragment remained in triads, and the C-terminal fragment, orthologue to JPh44, entered nuclei, which indicates that JPh44 is the C-terminal cleavage product. Endogenous calpain1 appeared in T-SR junctions, colocalized with JPh1. On muscle extracts and primary cultures, Ca2+-activated calpain1 cleaved a 44-kD JPh1 piece, consistent with the C-terminal fragment that starts at Ser241, the highest probability cleavage site found by calpain1 algorithms. Completing the identification of Ser241 as the likely start of JPh44, the tagged deletion plasmid GFP-JPh1_Δ1-240, expressed in mice, copied the location and migration of JPh44. Expression of GFP-JPh1_Δ1-240 in C2C12 myoblasts reduced by more than twofold the transcription of PI3K-Akt genes that inhibit muscle uptake and storage of glucose, including GSK3β, an inhibitor of glycogen synthase that is activated in MHS patients. In agreement with the genetic profile, GSK3β protein content decreased upon expression of GFP-JPh1_Δ1-240. In sum, the identified gene control roles of JPh44 oppose the deleterious effects of chronically elevated cytosolic [Ca2+], including late-onset hyperglycemia and type-2 diabetes (Tammineni, in 2020).

This work was supported by funding from the National Institutes of Health-National Institute of Arthritis and Musculoskeletal and Skin Diseases (grants R01AR071381 and R01AR072602).

This article is available under a Creative Commons License (Attribution–Noncommercial–Share Alike 4.0 International license, as described at