Skip to main content

Altered Sodium Channel Gating as Molecular Basis for Pain: Contribution of Activation, Inactivation, and Resurgent Currents

  • Chapter
  • First Online:
Voltage Gated Sodium Channels

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 221))

Abstract

Mutations in voltage-gated sodium channels, especially Nav1.7, can cause the genetic pain syndromes inherited erythromelalgia, small fiber neuropathy, paroxysmal extreme pain disorder, and chronic insensitivity to pain. Functional analysis of these mutations offers the possibility of understanding the potential pathomechanisms of these disease patterns and also may help to explicate the molecular mechanisms underlying pain in normal conditions. The mutations are distributed over the whole channel protein, but nevertheless induce similar changes for each pain syndrome. In this review we focus on their impact on sodium channel gating, which may be conferred via modulation of (1) conformation (affecting all gating characteristics); (2) the amount of voltage-sensing charges (affecting mainly activation); (3) interaction within the protein (e.g., binding of the inactivation linker); and (4) interaction with other proteins (e.g., for generation of resurgent currents). Understanding the molecular basis for each gating mode and its impact on cellular excitability and nociception in each disease type may provide a basis for development of more specific and effective therapeutic tools.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ahn HS, Dib-Hajj SD, Cox JJ, Tyrrell L, Elmslie FV, Clarke AA et al (2010) A new Nav1.7 sodium channel mutation I234T in a child with severe pain. Eur J Pain 14(9):944–950

    Article  PubMed  CAS  Google Scholar 

  • Catterall WA (2000) From ionic currents to molecular mechanisms: the structure and function of voltage-gated sodium channels. Neuron 26(1):13–25

    Article  PubMed  CAS  Google Scholar 

  • Chanda B, Bezanilla F (2002) Tracking voltage-dependent conformational changes in skeletal muscle sodium channel during activation. J Gen Physiol 120(5):629–645

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Chen Y, Yu FH, Surmeier DJ, Scheuer T, Catterall WA (2006) Neuromodulation of Na+ channel slow inactivation via cAMP-dependent protein kinase and protein kinase C. Neuron 49(3):409–420

    Article  PubMed  CAS  Google Scholar 

  • Cheng X, Dib-Hajj S, Tyrrell L, Waxman S (2008) Mutation I136V alters electrophysiological properties of the NaV1.7 channel in a family with onset of erythromelalgia in the second decade. Mol Pain 4(1):1

    Google Scholar 

  • Cheng X, Dib-Hajj SD, Tyrrell L, Wright DA, Fischer TZ, Waxman SG (2010) Mutations at opposite ends of the DIII/S4-S5 linker of sodium channel NaV1.7 produce distinct pain disorders. Mol Pain 6:24

    Google Scholar 

  • Cheng X, Dib-Hajj SD, Tyrrell L, Te Morsche RH, Drenth JP, Waxman SG (2011) Deletion mutation of sodium channel Na(V)1.7 in inherited erythromelalgia: enhanced slow inactivation modulates dorsal root ganglion neuron hyperexcitability. Brain 134(Pt 7):1972–1986

    Article  PubMed  Google Scholar 

  • Choi JS, Dib-Hajj SD, Waxman SG (2006) Inherited erythermalgia: limb pain from an S4 charge-neutral Na channelopathy. Neurology 67(9):1563–1567

    Article  PubMed  Google Scholar 

  • Choi J-S, Zhang L, Dib-Hajj SD, Han C, Tyrrell L, Lin Z et al (2009) Mexiletine-responsive erythromelalgia due to a new Nav1.7 mutation showing use-dependent current fall-off. Exp Neurol 216(2):383

    Article  PubMed  CAS  Google Scholar 

  • Choi J-S, Cheng X, Foster E, Leffler A, Tyrrell L, te Morsche RHM et al (2010) Alternative splicing may contribute to time-dependent manifestation of inherited erythromelalgia. Brain 133(6):1823–1835

    Article  PubMed  Google Scholar 

  • Choi JS, Boralevi F, Brissaud O, Sanchez-Martin J, Te Morsche RH, Dib-Hajj SD et al (2011) Paroxysmal extreme pain disorder: a molecular lesion of peripheral neurons. Nat Rev Neurol 7(1):51–55

    Article  PubMed  CAS  Google Scholar 

  • Clayton GM, Altieri S, Heginbotham L, Unger VM, Morais-Cabral JH (2008) Structure of the transmembrane regions of a bacterial cyclic nucleotide-regulated channel. Proc Natl Acad Sci 105(5):1511–1515

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Cruz JS, Silva DF, Ribeiro LA, Araujo IG, Magalhaes N, Medeiros A et al (2011) Resurgent Na+ current: a new avenue to neuronal excitability control. Life Sci 89(15–16):564–569

    Google Scholar 

  • Cummins TR, Dib-Hajj SD, Waxman SG (2004) Electrophysiological properties of mutant Nav1.7 sodium channels in a painful inherited neuropathy. J Neurosci 24(38):8232–8236

    Article  PubMed  CAS  Google Scholar 

  • Cummins TR, Dib-Hajj SD, Herzog RI, Waxman SG (2005) Nav1.6 channels generate resurgent sodium currents in spinal sensory neurons. FEBS Lett 579(10):2166

    Article  PubMed  CAS  Google Scholar 

  • Dib-Hajj SD, Rush AM, Cummins TR, Hisama FM, Novella S, Tyrrell L et al (2005) Gain-of-function mutation in Nav1.7 in familial erythromelalgia induces bursting of sensory neurons. Brain 128(Pt 8):1847–1854

    Article  PubMed  CAS  Google Scholar 

  • Dib-Hajj S, Estacion M, Jarecki B, Tyrrell L, Fischer T, Lawden M et al (2008) Paroxysmal extreme pain disorder M1627K mutation in human Nav1.7 renders DRG neurons hyperexcitable. Mol Pain 4(1):37

    Article  PubMed Central  PubMed  Google Scholar 

  • Doyle DA, Morais Cabral J, Pfuetzner RA, Kuo A, Gulbis JM, Cohen SL et al (1998) The structure of the potassium channel: molecular basis of K+ conduction and selectivity. Science 280(5360):69–77

    Google Scholar 

  • Drenth JP, te Morsche RH, Guillet G, Taieb A, Kirby RL, Jansen JB (2005) SCN9A mutations define primary erythermalgia as a neuropathic disorder of voltage gated sodium channels. J Invest Dermatol 124(6):1333–1338

    Article  PubMed  CAS  Google Scholar 

  • Estacion M, Dib-Hajj SD, Benke PJ, te Morsche RHM, Eastman EM, Macala LJ et al (2008) NaV1.7 gain-of-function mutations as a continuum: A1632E displays physiological changes associated with erythromelalgia and paroxysmal extreme pain disorder mutations and produces symptoms of both disorders. J Neurosci 28(43):11079–11088

    Article  PubMed  CAS  Google Scholar 

  • Estacion M, Choi JS, Eastman EM, Lin Z, Li Y, Tyrrell L et al (2010) Can robots patch-clamp as well as humans? Characterization of a novel sodium channel mutation. J Physiol 588(Pt 11):1915–1927

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Estacion M, Han C, Choi JS, Hoeijmakers JG, Lauria G, Drenth JP et al (2011) Intra- and interfamily phenotypic diversity in pain syndromes associated with a gain-of-function variant of NaV1.7 Mol Pain 7:92

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Estacion M, Yang Y, Dib-Hajj SD, Tyrrell L, Lin Z, Yang Y et al (2013) A new Nav1.7 mutation in an erythromelalgia patient. Biochem Biophys Res Commun 432(1):99–104

    Article  PubMed  CAS  Google Scholar 

  • Faber CG, Hoeijmakers JG, Ahn HS, Cheng X, Han C, Choi JS et al (2012) Gain of function NaV1.7 mutations in idiopathic small fiber neuropathy. Ann Neurol 71(1):26–39

    Google Scholar 

  • Fang X, Djouhri L, McMullan S, Berry C, Waxman SG, Okuse K et al (2006) Intense isolectin-B4 binding in rat dorsal root ganglion neurons distinguishes c-fiber nociceptors with broad action potentials and high Nav1.9 expression. J Neurosci 26(27):7281–7292

    Article  PubMed  CAS  Google Scholar 

  • Felts PA, Yokoyama S, Dib-Hajj S, Black JA, Waxman SG (1997) Sodium channel alpha-subunit mRNAs I, II, III, NaG, Na6 and hNE (PN1): different expression patterns in developing rat nervous system. Brain Res Mol Brain Res 45(1):71–82

    Article  PubMed  CAS  Google Scholar 

  • Fertleman CR, Baker MD, Parker KA, Moffatt S, Elmslie FV, Abrahamsen B et al (2006) SCN9A mutations in paroxysmal extreme pain disorder: allelic variants underlie distinct channel defects and phenotypes. Neuron 52:767–774

    Article  PubMed  CAS  Google Scholar 

  • Fertleman CR, Ferrie CD, Aicardi J, Bednarek NA, Eeg-Olofsson O, Elmslie FV et al (2007) Paroxysmal extreme pain disorder (previously familial rectal pain syndrome). Neurology 69(6):586–595

    Article  PubMed  CAS  Google Scholar 

  • Fischer TZ, Gilmore ES, Estacion M, Eastman E, Taylor S, Melanson M et al (2009) A novel Nav1.7 mutation producing carbamazepine-responsive erythromelalgia. Ann Neurol 65(6):733–741

    Article  PubMed  Google Scholar 

  • Grieco TM, Raman IM (2004) Production of resurgent current in NaV1.6-null Purkinje neurons by slowing sodium channel inactivation with β-pompilidotoxin. J Neurosci 24(1):35–42

    Article  PubMed  CAS  Google Scholar 

  • Grieco TM, Malhotra JD, Chen C, Isom LL, Raman IM (2005) Open-channel block by the cytoplasmic tail of sodium channel [β]4 as a mechanism for resurgent sodium current. Neuron 45(2):233–244

    Article  PubMed  CAS  Google Scholar 

  • Han C, Rush AM, Dib-Hajj SD, Li S, Xu Z, Wang Y et al (2006) Sporadic onset of erythermalgia: a gain-of-function mutation in Nav1.7. Ann Neurol 59(3):553–558

    Article  PubMed  CAS  Google Scholar 

  • Han C, Dib-Hajj SD, Lin Z, Li Y, Eastman EM, Tyrrell L et al (2009) Early- and late-onset inherited erythromelalgia: genotype-phenotype correlation. Brain 132:awp078

    Article  Google Scholar 

  • Han C, Hoeijmakers JGJ, Ahn H-S, Zhao P, Shah P, Lauria G et al (2012) Nav1.7-related small fiber neuropathy. Neurology 78:1635–43

    Article  PubMed  CAS  Google Scholar 

  • Harper AA, Lawson SN (1985) Conduction velocity is related to morphological cell type in rat dorsal root ganglion neurones. J Physiol 359:31–46

    PubMed Central  PubMed  CAS  Google Scholar 

  • Harty TP, Dib-Hajj SD, Tyrrell L, Blackman R, Hisama FM, Rose JB et al (2006) Na(V)1.7 mutant A863P in erythromelalgia: effects of altered activation and steady-state inactivation on excitability of nociceptive dorsal root ganglion neurons. J Neurosci 26(48):12566–12575

    Article  PubMed  CAS  Google Scholar 

  • Ho C, O‘Leary ME (2011) Single-cell analysis of sodium channel expression in dorsal root ganglion neurons. Mol Cell Neurosci 46(1):159–166

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Hoeijmakers JG, Han C, Merkies IS, Macala LJ, Lauria G, Gerrits MM et al (2012) Small nerve fibres, small hands and small feet: a new syndrome of pain, dysautonomia and acromesomelia in a kindred with a novel NaV1.7 mutation. Brain 135(Pt 2):345–358

    Article  PubMed  Google Scholar 

  • Huth T, Rittger A, Saftig P, Alzheimer C (2011) Beta-site APP-cleaving enzyme 1 (BACE1) cleaves cerebellar Na+ channel beta4-subunit and promotes Purkinje cell firing by slowing the decay of resurgent Na+ current. Pflugers Arch 461:355–371

    Article  PubMed  CAS  Google Scholar 

  • Jarecki BW, Sheets PL, Jackson IIJO, Cummins TR (2008) Paroxysmal extreme pain disorder mutations within the D3/S4-S5 linker of Nav1.7 cause moderate destabilization of fast-inactivation. J Physiol 586:4137–53

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Jarecki BW, Piekarz AD, Jackson JO 2nd, Cummins TR (2010) Human voltage-gated sodium channel mutations that cause inherited neuronal and muscle channelopathies increase resurgent sodium currents. J Clin Invest 120(1):369–378

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Klinger AB, Eberhardt M, Link AS, Namer B, Schuy ET, Sittl R et al (2012) Sea-anemone toxin ATX-II elicits A-fiber-dependent pain and enhances resurgent and persistent sodium currents in large sensory neurons. Mol Pain 8(1):69

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Kremeyer B, Lopera F, Cox JJ, Momin A, Rugiero F, Marsh S et al (2010) A gain-of-function mutation in TRPA1 causes familial episodic pain syndrome. Neuron 66(5):671–680

    Article  PubMed  CAS  Google Scholar 

  • Kuo A, Gulbis JM, Antcliff JF, Rahman T, Lowe ED, Zimmer J et al (2003) Crystal structure of the potassium channel KirBac1.1 in the closed state. Science 300(5627):1922–1926

    Article  PubMed  CAS  Google Scholar 

  • Lampert A, Dib-Hajj SD, Tyrrell L, Waxman SG (2006) Size matters: erythromelalgia mutation S241T in Nav1.7 alters channel gating. J Biol Chem 281(47):36029–36035

    Article  PubMed  CAS  Google Scholar 

  • Lampert A, O‘Reilly AO, Dib-Hajj SD, Tyrrell L, Wallace BA, Waxman SG (2008) A pore-blocking hydrophobic motif at the cytoplasmic aperture of the closed-state Nav1.7 channel is disrupted by the erythromelalgia-associated F1449V mutation. J Biol Chem 283(35):24118–24127

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Lampert A, Dib-Hajj S, Eastman E, Tyrrell L, Lin Z, Yang Y et al (2009) Erythromelalgia mutation L823R shifts activation and inactivation of threshold sodium channel Nav1.7 to hyperpolarized potentials. Biochem Biophys Res Commun 390(2):319–324

    Article  PubMed  CAS  Google Scholar 

  • Lee MJ, Yu HS, Hsieh ST, Stephenson DA, Lu CJ, Yang CC (2007) Characterization of a familial case with primary erythromelalgia from Taiwan. J Neurol 254:210–214

    Article  PubMed  Google Scholar 

  • Lewis AH, Raman IM (2011) Cross-species conservation of open-channel block by Na channel β4 peptides reveals structural features required for resurgent Na current. J Neurosci 31(32):11527–11536

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Michiels JJ, te Morsche RH, Jansen JB, Drenth JP (2005) Autosomal dominant erythermalgia associated with a novel mutation in the voltage-gated sodium channel alpha subunit Nav1.7. Arch Neurol 62(10):1587–1590

    Article  PubMed  Google Scholar 

  • Nau C, Wang GK (2004) Interactions of local anesthetics with voltage-gated Na + channels. J Membr Biol 201(1):1–8

    Article  PubMed  CAS  Google Scholar 

  • Oliveira JS, Redaelli E, Zaharenko AJ, Cassulini RR, Konno K, Pimenta DC et al (2004) Binding specificity of sea anemone toxins to Nav 1.1-1.6 sodium channels: unexpected contributions from differences in the IV/S3-S4 outer loop. J Biol Chem 279(32):33323–33335

    Article  PubMed  CAS  Google Scholar 

  • O‘Reilly JP, Wang S-Y, Wang GK (2001) Residue-specific effects on slow inactivation at V787 in D2-S6 of Nav1.4 sodium channels. J Biophys 81(4):2100–2111

    Article  Google Scholar 

  • Payandeh J, Scheuer T, Zheng N, Catterall WA (2011) The crystal structure of a voltage-gated sodium channel. Nature 475(7356):353–358

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Raman IM, Bean BP (1997) Resurgent sodium current and action potential formation in dissociated cerebellar Purkinje neurons. J Neurosci 17(12):4517–4526

    PubMed  CAS  Google Scholar 

  • Raman IM, Bean BP (2001) Inactivation and recovery of sodium currents in cerebellar purkinje neurons: evidence for two mechanisms. Biophys J 80(2):729–737

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Raman IM, Sprunger LK, Meisler MH, Bean BP (1997) Altered subthreshold sodium currents and disrupted firing patterns in Purkinje neurons of Scn8a mutant mice. Neuron 19(4):881–891

    Article  PubMed  CAS  Google Scholar 

  • Rathmayer W (1979) Anemone toxin discriminates between ionic channels for receptor potential and for action potential production in a sensory neuron. Neurosci Lett 13(3):313–318

    Article  PubMed  CAS  Google Scholar 

  • Schiavon E, Sacco T, Cassulini RR, Gurrola G, Tempia F, Possani LD et al (2006) Resurgent current and voltage sensor trapping enhanced activation by a β-scorpion toxin solely in Nav1.6 channel: significance in mice purkinje neurons. J Biol Chem 281(29):20326–20337

    Article  PubMed  CAS  Google Scholar 

  • Schmalhofer W, Calhoun J, Burrows R, Bailey T, Kohler MG, Weinglass AB, et al. (2008). ProTx-II, a selective inhibitor of NaV1.7 sodium channels, blocks action potential propagation in nociceptors. Mol Pharmacol : mol.108.047670.

    Google Scholar 

  • Sheets MF, Hanck DA (2003) Molecular action of lidocaine on the voltage sensors of sodium channels. J Gen Physiol 121(2):163–175

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Sheets PL, Jackson JO 2nd, Waxman SG, Dib-Hajj SD, Cummins TR (2007) A Nav1.7 channel mutation associated with hereditary erythromelalgia contributes to neuronal hyperexcitability and displays reduced lidocaine sensitivity. J Physiol 581(Pt 3):1019–1031

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Sittl R, Lampert A, Huth T, Schuy ET, Link AS, Fleckenstein J et al (2012) Anticancer drug oxaliplatin induces acute cooling-aggravated neuropathy via sodium channel subtype NaV1.6-resurgent and persistent current. Proc Natl Acad Sci 109(17):6704–6709

    Google Scholar 

  • Skeik N, Rooke TW, Davis MD, Davis DM, Kalsi H, Kurth I et al (2012) Severe case and literature review of primary erythromelalgia: novel SCN9A gene mutation. Vascular Med 17(1):44–49

    Article  Google Scholar 

  • Smith MR, Smith RD, Plummer NW, Meisler MH, Goldin AL (1998) Functional analysis of the mouse Scn8a sodium channel. J Neurosci 18(16):6093

    PubMed  CAS  Google Scholar 

  • Takahashi K, Saitoh M, Hoshino H, Mimaki M, Yokoyama Y, Takamizawa M et al (2007) A case of primary erythermalgia, wintry hypothermia and encephalopathy. Neuropediatrics 38(03):157

    Article  PubMed  CAS  Google Scholar 

  • Theile JW, Cummins TR (2011) Inhibition of Nav{β}4 peptide-mediated resurgent sodium currents in Nav1.7 channels by carbamazepine, riluzole and anandamide. Mol Pharmacol 80(4):724–34

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Theile JW, Jarecki BW, Piekarz AD, Cummins TR (2011) Nav1.7 mutations associated with paroxysmal extreme pain disorder, but not erythromelalgia, enhance Navβ4 peptide-mediated resurgent sodium currents. J Physiol 589(Pt 3):597–608

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Wang GK, Strichartz GR (2012) State-dependent inhibition of sodium channels by local anesthetics: a 40-year evolution. Biochem (Mosc) Suppl Ser A Membr Cell Biol 6(2):120–127

    Article  Google Scholar 

  • Wang GK, Edrich T, Wang SY (2006) Time-dependent block and resurgent tail currents induced by mouse β4(154–167) peptide in cardiac Na+ channels. J Gen Physiol 127(3):277–289

    Google Scholar 

  • Wu MT, Huang PY, Yen CT, Chen CC, Lee MJ (2013) A novel SCN9A mutation responsible for primary erythromelalgia and is resistant to the treatment of sodium channel blockers. PLoS One 8(1):e55212

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Yang Y, Wang Y, Li S, Xu Z, Li H, Ma L et al (2004) Mutations in SCN9A, encoding a sodium channel alpha subunit, in patients with primary erythermalgia. J Med Genet 41(3):171–174

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Yang Y, Dib-Hajj SD, Zhang J, Zhang Y, Tyrrell L, Estacion M et al (2012) Structural modelling and mutant cycle analysis predict pharmacoresponsiveness of a Na(v)1.7 mutant channel. Nat Commun 3:1186

    Article  PubMed Central  PubMed  Google Scholar 

  • Yang Y, Estacion M, Dib-Hajj SD, Waxman SG (2013) Molecular architecture of a sodium channel S6 helix: radial tuning of the voltage-gated sodium channel 1.7 activation gate. J Biol Chem 288(19):13741–13747

    Article  PubMed  CAS  Google Scholar 

  • Yu FH, Westenbroek RE, Silos-Santiago I, McCormick KA, Lawson D, Ge P et al (2003) Sodium channel β4, a new disulfide-linked auxiliary subunit with similarity to β2. J Neurosci 23(20):7577

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Angelika Lampert .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Lampert, A., Eberhardt, M., Waxman, S.G. (2014). Altered Sodium Channel Gating as Molecular Basis for Pain: Contribution of Activation, Inactivation, and Resurgent Currents. In: Ruben, P. (eds) Voltage Gated Sodium Channels. Handbook of Experimental Pharmacology, vol 221. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-41588-3_5

Download citation

Publish with us

Policies and ethics