C2A in otoferlin's longer form, with six C2 domains, is structurally similar to dysferlin C2A. However, loop 1 in the calcium (Ca2+) binding site of otoferlin C2A is significantly shorter than the homologous loop in dysferlin and myoferlin C2A domains. Therefore, it is unable to bind to calcium. Otoferlin C2A is also unable to bind to phospholipids and hence it is structurally and functionally distinct from other C2 domains. Nonetheless, the homology suggests that this protein may be involved in vesicle membrane fusion.
Similar to dysferlin and myoferlin, otoferlin has a FerA domain and its FerA domain has been shown to interact with zwitterionic lipids in a calcium-dependent manner and with negatively charged lipids in a calcium-independent manner. The estimated charge of the FerA domain among ferlin proteins varies significantly. At pH 7, the estimated charge of dysferlin is -8.4 while otoferlin FerA is +8.5. Several transcript variants encoding multiple isoforms have been found for this gene.
Gene therapies for restoring the defective Otoferlin using an adeno-associated virus (AAVs) have been under development for some time, including AAVAnc80-hOTOF used in experimental gene therapy in humans. A successful application of the therapy in Britain was announced in May 2024. Lunsotogene parvec-cwha is a therapy approved for use in the United States.
↑"Human PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
↑"Mouse PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
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