Functional characterization of RYR1 variants identified in malignant hyperthermia susceptible individuals

Neuromuscul Disord. 2023 Dec;33(12):951-963. doi: 10.1016/j.nmd.2023.10.019. Epub 2023 Nov 3.


Malignant hyperthermia is a pharmacogenetic disorder triggered by halogenated anesthetic agents in genetically predisposed individuals. Approximately 70 % of these individuals carry mutations in RYR1, the gene encoding the ryanodine receptor calcium channel of skeletal muscle. In this study, we performed functional analysis of 5 RYR1 variants identified in members from 8 families who had been diagnosed by the IVCT. Of the 68 individuals enrolled in the study, 43 were diagnosed as MHS, 23 as MHN, and 2 individuals were not tested. Here we demonstrate that the 5 RyR1 variants cause hypersensitivity to RyR1 agonist-mediated calcium release. According to the EMHG scoring matrix these five genetic variants can be classified as follows: c.8638G>A (p.E2880K) and c.11314C>T (p.R3772W) likely pathogenic, c.11416G>A (p.G3806R), c.14627A>G (p.K4876R) and c.14813T>C (p.I4938T), pathogenic (RefSeq NM_000540.3). We propose that the newly functionally characterized RYR1 variants, be included in the panel of variants to be used for the molecular diagnosis of MHS.

Keywords: Calcium dysregulation; Diagnosis; Malignant hyperthermia; Mutations; Ryanodine receptor.

MeSH terms

  • Calcium / metabolism
  • Genetic Predisposition to Disease / genetics
  • Humans
  • Malignant Hyperthermia* / genetics
  • Muscle, Skeletal
  • Mutation
  • Ryanodine Receptor Calcium Release Channel / genetics


  • Calcium
  • Ryanodine Receptor Calcium Release Channel
  • RYR1 protein, human