TMEM65

UniProt ID: Q6PI78
Organism: Homo sapiens
Review Status: COMPLETE
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Gene Description

Small polytopic protein of the mitochondrial inner membrane, imported via a cleaved N-terminal targeting sequence and comprising a matrix-exposed soluble segment followed by three transmembrane helices. TMEM65 is expressed most strongly in heart, skeletal muscle and brain and is essentially absent from liver. It is required for sodium-dependent export of calcium from the mitochondrial matrix: loss of TMEM65 abolishes this efflux and causes matrix calcium overload, primes mitochondria for permeability transition, and produces cardiac and neuromuscular failure in mice, while a homozygous human splice variant causes a severe mitochondrial encephalomyopathy. TMEM65 forms a homodimer and carries conserved acidic and polar residues (Asp132, Asn163, Ser166, Asp167) whose mutation abolishes calcium efflux, and it is a binding target of CGP-37157, the classical inhibitor of mitochondrial sodium/calcium exchange. Whether TMEM65 is itself the transport protein or an obligatory partner of the exchanger NCLX/SLC8B1 is unresolved and actively disputed: purified TMEM65 reconstituted into liposomes reportedly reproduces the hallmarks of mitochondrial sodium/calcium exchange, whereas in fibroblasts the effect of TMEM65 on calcium efflux is abolished by deletion of NCLX. A distinct body of work also localises Tmem65 to the cardiac intercalated disc, where it is reported to stabilise connexin 43 and support ventricular development and cardiac conduction; this pool is not reproduced in the mitochondrial studies and its relationship to the inner-membrane protein is unclear.

Existing Annotations Review

GO Term Evidence Action Reason
GO:0005739 mitochondrion
IBA
GO_REF:0000033
ACCEPT
Summary: Phylogenetic assignment of TMEM65 to the mitochondrion, matching all focused experimental studies of the protein.
Reason: Correct, though the mitochondrial inner membrane (GO:0005743) annotations this gene also carries are more informative about where the protein sits.
GO:0003231 cardiac ventricle development
IBA
GO_REF:0000033
KEEP AS NON CORE
Summary: Phylogenetic propagation of a cardiac developmental phenotype seen on Tmem65 knockdown in mouse and zebrafish.
Reason: A real organismal phenotype, but distal to the molecular function. It arises from the intercalated-disc/connexin-43 work in zebrafish and mouse, and it would equally be an indirect consequence of impaired mitochondrial calcium handling in cardiomyocytes. Retained as a non-core, downstream process.
GO:1903779 regulation of cardiac conduction
IBA
GO_REF:0000033
KEEP AS NON CORE
Summary: Phylogenetic propagation of the conduction phenotype associated with Tmem65 loss.
Reason: Downstream organismal process rather than the molecular function. Derived from the connexin-43 mislocalisation phenotype, and confounded by the separate requirement for TMEM65 in mitochondrial calcium efflux in excitable tissue.
GO:0005743 mitochondrial inner membrane
IEA
GO_REF:0000044
ACCEPT
Summary: UniProt subcellular-location mapping to the mitochondrial inner membrane.
Reason: Matches the direct experimental evidence; this is the established primary location.
GO:0005886 plasma membrane
IEA
GO_REF:0000120
KEEP AS NON CORE
Summary: Electronic propagation of a plasma-membrane location from mouse Tmem65.
Reason: The plasma-membrane/intercalated-disc pool traces to one cardiac membrane-proteomics study and is not reproduced by any of the mitochondrial studies, which find a cleaved targeting sequence and inner-membrane integration. The two localisations are not formally exclusive, so this is retained rather than removed, but it is not where the characterised function occurs.
GO:0035725 sodium ion transmembrane transport
IEA
GO_REF:0000108
UNDECIDED
Summary: Automatically inferred from the contested GO:0005432 calcium:sodium antiporter activity annotation by inter-ontology logical inference.
Reason: This annotation is only as sound as the molecular function it is derived from, and that function is the subject of an unresolved dispute that GOA itself records with opposite qualifiers (see the two GO:0005432 entries). If TMEM65 is an obligatory partner of NCLX rather than the transporter, TMEM65 does not itself translocate sodium and this term does not apply. No direct measurement of TMEM65-mediated sodium flux exists.
GO:0005515 protein binding
IPI
PMID:32296183
A reference map of the human binary protein interactome.
REMOVE
Summary: Bare protein binding from the HuRI binary interactome screen, covering 37 separate partners.
Reason: Uninformative as a molecular function; none of the listed partners corresponds to a characterised TMEM65 complex. No more informative molecular function is supportable from this evidence, so the row is removed rather than rewritten. Removal does not imply the reported interaction is false.
GO:0003231 cardiac ventricle development
IEA
GO_REF:0000107
KEEP AS NON CORE
Summary: Ensembl Compara projection of the mouse Tmem65 cardiac developmental phenotype.
Reason: A real organismal phenotype, but distal to the molecular function. It arises from the intercalated-disc/connexin-43 work in zebrafish and mouse, and it would equally be an indirect consequence of impaired mitochondrial calcium handling in cardiomyocytes. Retained as a non-core, downstream process.
GO:0014704 intercalated disc
IEA
GO_REF:0000107
KEEP AS NON CORE
Summary: Ensembl Compara projection of the mouse intercalated-disc localisation.
Reason: Traces to a single cardiac membrane-proteomics and immunofluorescence study; unreconciled with the inner-membrane localisation established by the mitochondrial literature. Kept because the underlying evidence is experimental and the two pools are not formally exclusive.
GO:0061337 cardiac conduction
IEA
GO_REF:0000107
KEEP AS NON CORE
Summary: Ensembl Compara projection of the cardiac conduction phenotype.
Reason: Organismal process downstream of whichever molecular role is correct; not the gene's core function.
GO:0099093 calcium export from the mitochondrion
IEA
GO_REF:0000107
ACCEPT
Summary: Ensembl Compara projection of mouse Tmem65 involvement in mitochondrial calcium export.
Reason: This is the one thing all parties to the TMEM65 dispute agree on - loss of TMEM65 abolishes sodium-dependent export of matrix calcium. Core biological process.
GO:1903779 regulation of cardiac conduction
IEA
GO_REF:0000107
KEEP AS NON CORE
Summary: Ensembl Compara projection of the conduction-regulation phenotype.
Reason: Downstream organismal process rather than the molecular function. Derived from the connexin-43 mislocalisation phenotype, and confounded by the separate requirement for TMEM65 in mitochondrial calcium efflux in excitable tissue.
GO:0005886 plasma membrane
IDA
GO_REF:0000052
KEEP AS NON CORE
Summary: Human Protein Atlas immunofluorescence assignment to the plasma membrane.
Reason: The plasma-membrane/intercalated-disc pool traces to one cardiac membrane-proteomics study and is not reproduced by any of the mitochondrial studies, which find a cleaved targeting sequence and inner-membrane integration. The two localisations are not formally exclusive, so this is retained rather than removed, but it is not where the characterised function occurs.
GO:0005432 calcium:sodium antiporter activity
IDA NOT
PMID:40200126
TMEM65 regulates and is required for NCLX-dependent mitochon...
UNDECIDED
Summary: A NOT annotation: Garbincius et al. conclude that TMEM65 is an NCLX binding partner required for sodium-dependent mitochondrial calcium efflux, but is not itself the exchanger, because the TMEM65 effect is abolished by deletion or pharmacological inhibition of NCLX.
Reason: GOA carries this GO term on TMEM65 twice with opposite polarity - NOT|enables IDA from PMID:40200126 and enables IDA from PMID:40691517, both curated by UniProt on the same date. GO has annotated both sides of a live dispute rather than choosing between them, and there is no basis in the published evidence for choosing either. Position B (this annotation) rests on a clean epistatic result: TMEM65 overexpression accelerates matrix calcium efflux in control fibroblasts but has no effect in Nclx-null fibroblasts. Position A rests on reconstitution of purified TMEM65 into liposomes, which a Cell Metab commentary argues cannot distinguish calcium binding from calcium translocation, and on TMEM65-induced exchange in Sf9 mitochondria that lack native activity. No electrophysiological recording of purified TMEM65 exists. UNDECIDED rather than ACCEPT or REMOVE, for both entries; accepting either would assert a resolution the evidence does not support.
Supporting Evidence:
PMID:40200126
we identify the mitochondrial inner membrane protein TMEM65 as an NCLX binding partner that enhances sodium (Na+)-dependent mCa2+ efflux. Mechanistically, acute pharmacological NCLX inhibition or genetic deletion of NCLX ablates the TMEM65-dependent increase in mCa2+ efflux, and loss-of-function studies show that TMEM65 is required for Na+-dependent mCa2+ efflux.
PMID:40200126
These findings suggest that TMEM65 limits net matrix Ca2+ accumulation upon increased cytosolic Ca2+, but that this effect requires NCLX.
PMID:41061666
Unfortunately, this experiment cannot distinguish simple binding of Ca2+ to TMEM65 protein embedded in the proteoliposome membrane from actual transport of Ca2+ across the membrane.
GO:0005432 calcium:sodium antiporter activity
IDA
PMID:40691517
TMEM65 functions as the mitochondrial Na(+)/Ca(2+) exchanger...
UNDECIDED
Summary: Zhang et al. conclude that TMEM65 is itself the mitochondrial Na+/Ca2+ exchanger, on the basis of exchange activity induced in Sf9 mitochondria that lack native mito-NCX and of purified TMEM65 reconstituted into liposomes.
Reason: GOA carries this GO term on TMEM65 twice with opposite polarity - NOT|enables IDA from PMID:40200126 and enables IDA from PMID:40691517, both curated by UniProt on the same date. GO has annotated both sides of a live dispute rather than choosing between them, and there is no basis in the published evidence for choosing either. Position A (this annotation) has the stronger reductionist design - heterologous reconstitution with NCLX verified absent from the preparation, plus a tissue distribution that tracks mito-NCX activity where NCLX's does not - but its liposome assay measures 45Ca2+ accumulation, which a Cell Metab commentary argues cannot distinguish binding from transport, and no electrophysiology on purified TMEM65 exists. Position B's epistatic result (no TMEM65 effect in Nclx-null cells) is unexplained under Position A. UNDECIDED rather than ACCEPT, for both entries; accepting this one while a NOT annotation of the same term stands would assert a resolution the evidence does not support.
Supporting Evidence:
PMID:40691517
Heterologous expression of TMEM65 induces Na+/Ca2+ exchange in cells lacking native mito-NCX activity. Moreover, purified, liposome-reconstituted TMEM65 exhibits key mito-NCX features.
PMID:40691517
Lastly, we verified that no NCLX was co-purified or co-reconstituted with TMEM65 (Extended Data Fig. 9b–c), ensuring that the observed activity is unrelated to NCLX.
PMID:40691517
TMEM65 is highly expressed in the heart and brain but absent in the liver, correlating with mito-NCX activity in these tissues.
PMID:41061666
In a recent study published in Nature Cell Biology, Zhang et al. challenge the prevailing view that NCLX is the main mediator of mitochondrial sodium (Na+)/Ca2+ exchange (mito-NCX) by proposing that transmembrane protein 65 (TMEM65) is responsible for this phenomenon.
GO:0005743 mitochondrial inner membrane
IDA
PMID:40200126
TMEM65 regulates and is required for NCLX-dependent mitochon...
ACCEPT
Summary: TMEM65 acts at the mitochondrial inner membrane.
Reason: Well-established core location, agreed by every study of the protein including both sides of the transport dispute.
Supporting Evidence:
PMID:40200126
Here we report the identification of TMEM65, an inner mitochondrial membrane protein, as a genetically confirmed regulator of NCLX-dependent mCa2+ efflux and demonstrate its critical role in preventing pathogenic mCa2+ overload in excitable tissues.
GO:0005743 mitochondrial inner membrane
IDA
PMID:40691517
TMEM65 functions as the mitochondrial Na(+)/Ca(2+) exchanger...
ACCEPT
Summary: TMEM65 acts at the mitochondrial inner membrane.
Reason: Well-established core location, agreed by every study of the protein including both sides of the transport dispute.
GO:0099093 calcium export from the mitochondrion
IDA
PMID:40200126
TMEM65 regulates and is required for NCLX-dependent mitochon...
ACCEPT
Summary: Loss of TMEM65 abolishes sodium-dependent export of calcium from the mitochondrial matrix.
Reason: This is the one thing all parties to the TMEM65 dispute agree on - the annotation is supported by IDA from both PMID:40200126 and PMID:40691517, which disagree about the mechanism but not about the requirement. Core biological process.
Supporting Evidence:
PMID:40200126
loss-of-function studies show that TMEM65 is required for Na+-dependent mCa2+ efflux
GO:0099093 calcium export from the mitochondrion
IDA
PMID:40691517
TMEM65 functions as the mitochondrial Na(+)/Ca(2+) exchanger...
ACCEPT
Summary: TMEM65 depletion severely impairs mitochondrial sodium/calcium exchange and elevates matrix calcium.
Reason: This is the one thing all parties to the TMEM65 dispute agree on - the annotation is supported by IDA from both PMID:40200126 and PMID:40691517, which disagree about the mechanism but not about the requirement. Core biological process.
Supporting Evidence:
PMID:41061666
Zhang et al. provide compelling evidence supporting a critical role for TMEM65 in mCa2+ extrusion.
GO:0005739 mitochondrion
HTP
PMID:34800366
Quantitative high-confidence human mitochondrial proteome an...
ACCEPT
Summary: High-throughput mitochondrial proteomics places TMEM65 in the mitochondrion.
Reason: Correct, though the mitochondrial inner membrane (GO:0005743) annotations this gene also carries are more informative about where the protein sits.
GO:0061337 cardiac conduction
ISS
GO_REF:0000024
KEEP AS NON CORE
Summary: Curator-judged orthology transfer of the cardiac conduction phenotype from mouse Tmem65.
Reason: Organismal process downstream of whichever molecular role is correct; not the gene's core function.
GO:0005743 mitochondrial inner membrane
IDA
PMID:24765583
TMEM65 is a mitochondrial inner-membrane protein.
ACCEPT
Summary: Alkali and digitonin extraction of isolated mitochondria identify TMEM65 as an integral protein of the inner membrane, imported via a cleaved N-terminal targeting sequence.
Reason: Founding localisation study; well-supported core location.
Supporting Evidence:
PMID:24765583
Alkali extraction analysis and digitonin extraction test using isolated mitochondria revealed that TMEM65 is an integral membrane protein that localizes to the inner-membrane of mitochondria.
GO:0005743 mitochondrial inner membrane
IDA
PMID:28295037
A mutation in the TMEM65 gene results in mitochondrial myopa...
ACCEPT
Summary: Subcellular fractionation of patient and control fibroblasts confirms inner-membrane residence.
Reason: Independent confirmation of the core location, in a study that also links TMEM65 loss to severe mitochondrial disease.
Supporting Evidence:
PMID:28295037
Subcellular fractionation confirmed that the TMEM65 protein was present in the inner mitochondrial membrane.
GO:0003231 cardiac ventricle development
ISS
GO_REF:0000024
KEEP AS NON CORE
Summary: Curator-judged orthology transfer of the cardiac developmental phenotype.
Reason: A real organismal phenotype, but distal to the molecular function. It arises from the intercalated-disc/connexin-43 work in zebrafish and mouse, and it would equally be an indirect consequence of impaired mitochondrial calcium handling in cardiomyocytes. Retained as a non-core, downstream process.
GO:0005886 plasma membrane
IDA
PMID:26403541
Evolutionarily conserved intercalated disc protein Tmem65 re...
KEEP AS NON CORE
Summary: Cationic silica-bead plasma-membrane enrichment and immunofluorescence identify Tmem65 at the cardiomyocyte surface.
Reason: The plasma-membrane/intercalated-disc pool traces to one cardiac membrane-proteomics study and is not reproduced by any of the mitochondrial studies, which find a cleaved targeting sequence and inner-membrane integration. The two localisations are not formally exclusive, so this is retained rather than removed, but it is not where the characterised function occurs.
Supporting Evidence:
PMID:26403541
We identify Tmem65 as a cardiac-enriched, intercalated disc protein that increases during development in both mouse and human hearts.
GO:0014704 intercalated disc
IDA
PMID:26403541
Evolutionarily conserved intercalated disc protein Tmem65 re...
KEEP AS NON CORE
Summary: Tmem65 is reported at the cardiac intercalated disc, where it is required for correct localisation of connexin 43.
Reason: Traces to a single cardiac membrane-proteomics and immunofluorescence study; unreconciled with the inner-membrane localisation established by the mitochondrial literature. Kept because the underlying evidence is experimental and the two pools are not formally exclusive.
Supporting Evidence:
PMID:26403541
We identify Tmem65 as a cardiac-enriched, intercalated disc protein that increases during development in both mouse and human hearts.
GO:1903779 regulation of cardiac conduction
ISS
GO_REF:0000024
KEEP AS NON CORE
Summary: Curator-judged orthology transfer of the conduction-regulation phenotype.
Reason: Downstream organismal process rather than the molecular function. Derived from the connexin-43 mislocalisation phenotype, and confounded by the separate requirement for TMEM65 in mitochondrial calcium efflux in excitable tissue.

Core Functions

TMEM65 is an obligatory component of the machinery that exports calcium from the mitochondrial matrix in exchange for sodium, acting from the mitochondrial inner membrane. Its requirement is established by three independent groups - depletion abolishes sodium-dependent matrix calcium efflux, raises matrix calcium and primes mitochondria for permeability transition, and in mice produces cardiac and neuromuscular failure. TMEM65 forms a homodimer and carries conserved acidic and polar residues whose substitution abolishes efflux, and it binds CGP-37157, the classical mito-NCX inhibitor. No molecular function term is asserted here, because whether TMEM65 is the ion-translocating protein (GO:0005432 calcium:sodium antiporter activity) or an obligatory partner of NCLX/SLC8B1 is unresolved; GOA records both readings as opposing IDA annotations of the same term, and the reconstitution experiment that would distinguish them has not been done in a form that separates calcium binding from calcium translocation.

Supporting Evidence:
  • PMID:40200126
    loss-of-function studies show that TMEM65 is required for Na+-dependent mCa2+ efflux
  • PMID:40691517
    TMEM65 is highly expressed in the heart and brain but absent in the liver, correlating with mito-NCX activity in these tissues.
  • PMID:41061666
    Zhang et al. provide compelling evidence supporting a critical role for TMEM65 in mCa2+ extrusion.

References

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Suggested Questions for Experts

Q: Does purified TMEM65 translocate ions across a membrane, or does it only bind calcium? The 45Ca2+ proteoliposome accumulation assay in PMID:40691517 cannot distinguish the two; electrophysiological recording of reconstituted TMEM65, or simultaneous bilayer Ca2+ and Na+ reporters, would decide between Position A (TMEM65 is the exchanger) and Position B (TMEM65 is a required partner of NCLX).

Q: Why does the TMEM65 effect on matrix calcium efflux require NCLX in mouse embryonic fibroblasts (PMID:40200126) while TMEM65 alone suffices to generate exchange in Sf9 mitochondria and in liposomes (PMID:40691517)? Is there a cell-type-dependent requirement, or does one system report something other than exchange?

Q: Is CGP-37157 a direct inhibitor of TMEM65, of NCLX, or of both? The inhibitor-binding residues reported for TMEM65 were mapped in cells with intact endogenous NCLX.

Q: What is the physical stoichiometry of a TMEM65-NCLX assembly, and does TMEM65 loss alter NCLX oligomeric state or stability rather than its intrinsic activity?

Q: Is the cardiac intercalated-disc pool of Tmem65 a genuine second localisation, and if so how does a protein with a cleaved mitochondrial targeting sequence reach the sarcolemma?

Suggested Experiments

Experiment: Reconstitute purified TMEM65 into planar lipid bilayers and record currents under imposed Na+ and Ca2+ gradients, testing for the electrogenic, CGP-37157-sensitive exchange predicted by Position A and for loss of current in the D132/N163/S166/D167 mutants.

Experiment: Repeat the Sf9 heterologous-expression experiment in a system verified to lack any NCLX orthologue by genome search and proteomics, and in parallel test whether TMEM65 can generate exchange in NCLX-knockout mammalian mitochondria.

Experiment: Determine a cryo-EM structure of the TMEM65 homodimer, with and without NCLX, to establish whether TMEM65 has a continuous ion pathway and whether the two proteins form a stoichiometric complex.

Experiment: Measure matrix Na+ (not only Ca2+) directly in TMEM65-null and NCLX-null cells with a targeted Na+ sensor, to test whether TMEM65 loss abolishes Na+ entry into the matrix as a true exchanger model requires.

πŸ“š Additional Documentation

Notes

(TMEM65-notes.md)

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