1. Loss-of-function of Nav1.8/D1639N linked to human pain can be rescued by lidocaine
- Author
-
Günther Schmalzing, Silvia Detro-Dassen, Jannis E. Meents, Corinna Rösseler, Ralf Hausmann, Martin Hampl, Luisa Kaluza, Petra Hautvast, and Angelika Lampert
- Subjects
0301 basic medicine ,Lidocaine ,Physiology ,Xenopus ,Clinical Biochemistry ,Action Potentials ,Gating ,Pharmacology ,NAV1.8 Voltage-Gated Sodium Channel ,03 medical and health sciences ,0302 clinical medicine ,Loss of Function Mutation ,Cell Line, Tumor ,Physiology (medical) ,medicine ,Animals ,Humans ,Anesthetics, Local ,Receptor ,Loss function ,business.industry ,Sodium channel ,Cell Membrane ,Chronic pain ,medicine.disease ,Protein Transport ,Electrophysiology ,030104 developmental biology ,NAV1 ,Chronic Pain ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Mutations in voltage-gated sodium channels are associated with altered pain perception in humans. Most of these mutations studied to date present with a direct and intuitive link between the altered electrophysiological function of the channel and the phenotype of the patient. In this study, we characterize a variant of Nav1.8, D1639N, which has been previously identified in a patient suffering from the chronic pain syndrome "small fiber neuropathy". Using a heterologous expression system and patch-clamp analysis, we show that Nav1.8/D1639N reduces current density without altering biophysical gating properties of Nav1.8. Therefore, the D1639N variant causes a loss-of-function of the Nav1.8 sodium channel in a patient suffering from chronic pain. Using immunocytochemistry and biochemical approaches, we show that Nav1.8/D1639N impairs trafficking of the channel to the cell membrane. Neither co-expression of β1 or β3 subunit, nor overnight incubation at 27 °C rescued current density of the D1639N variant. On the other hand, overnight incubation with lidocaine fully restored current density of Nav1.8/D1639N most likely by overcoming the trafficking defect, whereas phenytoin failed to do so. Since lidocaine rescues the loss-of-function of Nav1.8/D1639N, it may offer a future therapeutic option for the patient carrying this variant. These results demonstrate that the D1639N variant, identified in a patient suffering from chronic pain, causes loss-of-function of the channel due to impaired cell surface trafficking and that this trafficking defect can be rescued by lidocaine.
- Published
- 2018
- Full Text
- View/download PDF