Department of Pharmacology and Toxicology, Stark Neurosciences Research Institute, Indiana University School of Medicine, 950 Walnut Street, Indianapolis, Indiana 46202, USA.
J Clin Invest. 2010 Jan;120(1):369-78. doi: 10.1172/JCI40801. Epub 2009 Dec 28.
Inherited mutations in voltage-gated sodium channels (VGSCs; or Nav) cause many disorders of excitability, including epilepsy, chronic pain, myotonia, and cardiac arrhythmias. Understanding the functional consequences of the disease-causing mutations is likely to provide invaluable insight into the roles that VGSCs play in normal and abnormal excitability. Here, we sought to test the hypothesis that disease-causing mutations lead to increased resurgent currents, unusual sodium currents that have not previously been implicated in disorders of excitability. We demonstrated that a paroxysmal extreme pain disorder (PEPD) mutation in the human peripheral neuronal sodium channel Nav1.7, a paramyotonia congenita (PMC) mutation in the human skeletal muscle sodium channel Nav1.4, and a long-QT3/SIDS mutation in the human cardiac sodium channel Nav1.5 all substantially increased the amplitude of resurgent sodium currents in an optimized adult rat-derived dorsal root ganglion neuronal expression system. Computer simulations indicated that resurgent currents associated with the Nav1.7 mutation could induce high-frequency action potential firing in nociceptive neurons and that resurgent currents associated with the Nav1.5 mutation could broaden the action potential in cardiac myocytes. These effects are consistent with the pathophysiology associated with the respective channelopathies. Our results indicate that resurgent currents are associated with multiple channelopathies and are likely to be important contributors to neuronal and muscle disorders of excitability.
电压门控钠离子通道(VGSCs;或 Nav)中的遗传突变可导致多种兴奋性疾病,包括癫痫、慢性疼痛、肌强直和心律失常。了解致病突变的功能后果可能为理解 VGSCs 在正常和异常兴奋性中的作用提供宝贵的见解。在这里,我们试图验证这样一个假设,即致病突变导致复发性电流增加,这是一种以前未被牵涉到兴奋性疾病的异常钠离子电流。我们证明了人类周围神经元钠离子通道 Nav1.7 中的阵发性极度疼痛障碍(PEPD)突变、人类骨骼肌钠离子通道 Nav1.4 中的先天性肌强直(PMC)突变以及人类心脏钠离子通道 Nav1.5 中的长 QT3/SIDS 突变均显著增加了复发性钠离子电流在优化的成年大鼠源性背根神经节神经元表达系统中的幅度。计算机模拟表明,与 Nav1.7 突变相关的复发性电流可在伤害感受神经元中诱导高频动作电位放电,而与 Nav1.5 突变相关的复发性电流可使心肌细胞中的动作电位变宽。这些效应与各自的通道病相关的病理生理学一致。我们的结果表明,复发性电流与多种通道病有关,并且可能是神经元和肌肉兴奋性疾病的重要贡献者。
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