Structures of the junctophilin/voltage-gated calcium channel interface reveal hot spot for cardiomyopathy mutations

Junctophilins (JPH) are a class of proteins found at junctions between the plasma membrane and the endoplasmic or sarcoplasmic reticulum, allowing for communications between proteins embedded in different membranes. JPHs have been proposed to interact with lipids as well as several ion channels, allowing for specialized communication between them. The JPH3 isoform is the target for repeats that cause Huntington’s disease-like 2, whereas JPH2 is a hot spot for mutations linked to cardiomyopathy. Here we present crystal structures of two JPH isoforms, which resemble a twisted skeleton with ribs formed by membrane occupation recognition nexus repeats, and a backbone built by a long α-helix. We captured the structure of a complex between JPH2 and a C-terminal binding site in the L-type calcium channel (CaV1.1) and show that this interaction is required for clustering of these channels and for robust muscle excitation–contraction coupling. Over 80 sequence variants linked to cardiomyopathy are found in different structurally important regions of JPH2, most of which affect stabilizing interactions. A subset directly affects the interaction with the L-type calcium channel. In parallel, sequence variants in the L-type calcium channel, linked to cardiac arrhythmia, also affect critical interactions.