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Sensory neuron sodium channels as pain targets; from cocaine to Journavx (VX-548, suzetrigine). 感觉神经元钠通道作为疼痛靶点从可卡因到Journavx (VX-548, suzetriine)。
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-04-28 DOI: 10.1085/jgp.202513778
John N Wood, Nieng Yan, Jian Huang, Jing Zhao, Armen Akopian, James J Cox, C Geoffrey Woods, Mohammed A Nassar

Voltage-gated sodium channels underpin electrical signaling in sensory neurons. Their activity is an essential element in the vast majority of pain conditions, making them significant drug targets. Sensory neuron sodium channels play roles not only in afferent signaling but also in a range of efferent regulatory mechanisms. Side effects through actions on other cell types and efferent signaling are thus important issues to address during analgesic drug development. As an example, the human genetic evidence for NaV1.7 as an ideal pain target contrasts with the side effects of NaV1.7 antagonists. In this review, we describe the history and progress toward the development of useful analgesic drugs and the renewed focus on NaV1.8 as a key target in pain treatment. NaV1.8 antagonists alone or in combination with other analgesics are likely to provide new opportunities for pain relief for the vast number of people (about 33% of the population) impacted by chronic pain, particularly present in aging populations.

电压门控钠通道是感觉神经元电信号的基础。它们的活动是绝大多数疼痛状况的基本要素,使它们成为重要的药物靶点。感觉神经元钠通道不仅参与传入信号,还参与一系列的传出调控机制。因此,通过作用于其他细胞类型和传出信号产生的副作用是镇痛药物开发过程中需要解决的重要问题。例如,人类遗传证据表明,NaV1.7是一个理想的疼痛靶点,与NaV1.7拮抗剂的副作用形成对比。在这篇综述中,我们描述了有用的镇痛药物的历史和进展,并重新关注NaV1.8作为疼痛治疗的关键靶点。NaV1.8拮抗剂单独使用或与其他镇痛药联合使用可能为大量受慢性疼痛影响的人群(约占人口的33%)提供新的疼痛缓解机会,特别是在老年人群中。
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引用次数: 0
Glycerol storage increases passive stiffness of muscle fibers through effects on titin extensibility. 甘油的储存通过影响肌球蛋白的延伸性而增加肌纤维的被动刚度。
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-05-09 DOI: 10.1085/jgp.202413729
Seong-Won Han, Justin Kolb, Gerrie P Farman, Jochen Gohlke, Henk L Granzier

To study the physiological and pathological mechanisms of muscle, it is crucial to store muscle samples in ways that preserve their properties. Glycerol is commonly used for storage, as it stabilizes muscle proteins, slows enzymatic activity, and minimizes degradation. However, previous studies validating glycerol storage have not examined its effects on passive properties. In this study, mouse extensor digitorum longus (EDL) muscles were stored in 50% glycerol in relaxing solution with protease inhibitors for various durations, then rehydrated in physiological solutions to assess mechanical properties. Active properties remained unchanged, but passive stress was sensitive to glycerol storage, showing a 56.5 ± 13.6% increase after 4 days, and this effect was permanent. The increase was most pronounced at sarcomere lengths, where titin's PEVK segment extension dominates. Using gelsolin, we determined whether the passive stress increase requires the thin filament, which is known to interact with titin's PEVK region. Both glycerol-stored fibers with and without thin filament extraction exhibited increased passive stress, suggesting that the underlying mechanism is intrinsic to titin. Finally, fibers treated with methylglyoxal, a reactive carbonyl and glycating agent that forms cross-links on lysine residues, showed a significant increase in passive stress in fibers stored in relaxing solution but not in glycerol. Thus, glycerol storage elevates passive stress in a titin-specific manner, likely involving lysine residues in the PEVK. Therefore, glycerol storage should be avoided when assessing passive stiffness. We further showed that, for long-term preservation, storage of rapidly frozen muscle at -80°C is a viable option.

为了研究肌肉的生理和病理机制,以保持其特性的方式储存肌肉样品至关重要。甘油通常用于储存,因为它稳定肌肉蛋白质,减缓酶活性,并尽量减少降解。然而,先前验证甘油储存的研究并没有检查其对被动特性的影响。在这项研究中,将小鼠指长伸肌(EDL)在含有蛋白酶抑制剂的50%甘油松弛溶液中储存不同时间,然后在生理溶液中再水合以评估其力学性能。活性性状保持不变,但被动应激对甘油储存敏感,4天后增加56.5±13.6%,且这种影响是永久性的。增加在肌节长度最明显,其中titin的PEVK段延长占主导地位。使用凝胶,我们确定了被动应力增加是否需要细丝,这是已知的与titin的PEVK区域相互作用。在提取和不提取细丝的情况下,甘油储存的纤维都表现出增加的被动应力,这表明潜在的机制是titin固有的。最后,用甲基乙二醛(一种活性羰基和糖基化剂,在赖氨酸残基上形成交联)处理的纤维,在松弛溶液中储存的纤维显示出显著的被动应力增加,而在甘油中没有。因此,甘油储存以titin特异性的方式提高被动应激,可能涉及PEVK中的赖氨酸残基。因此,在评估被动刚度时应避免储存甘油。我们进一步表明,为了长期保存,在-80°C下快速冷冻肌肉是一种可行的选择。
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引用次数: 0
Differential state-dependent Nav1.8 inhibition by suzetrigine, LTGO-33, and A-887826. 苏三嗪、LTGO-33和A-887826对状态依赖性Nav1.8的抑制差异
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-03-26 DOI: 10.1085/jgp.202413719
Sooyeon Jo, Akie Fujita, Tomás Osorno, Robert G Stewart, Patric M Vaelli, Bruce P Bean

Nav1.8 sodium channels are expressed in pain-sensing neurons, and some Nav1.8 inhibitors significantly reduce pain in clinical trials. Several Nav1.8 inhibitors have an unusual state dependence whereby inhibition is relieved by depolarization. We compared the state-dependent action of several Nav1.8 channel inhibitors to test whether inhibition is relieved during action potential (AP) firing under physiological conditions to produce "reverse use dependence." A-887826 inhibition was substantially relieved by AP waveforms applied at 20 Hz at 37°C. In contrast, there was no relief during AP trains with suzetrigine (VX-548) or LTGO-33, even though inhibition could be effectively removed by long, strong depolarizations. These differences were explained by differences in the voltage dependence and kinetics with which the compounds dissociate from depolarized channels and rebind to resting state channels. Suzetrigine required the strongest depolarizations for relief (midpoint +33 mV) and relief was slow (tau >300 ms at +20 mV), so almost no relief occurred during an AP waveform. Relief from A-887826 required weaker depolarizations (midpoint +13 mV) and was much faster, so some relief occurred during each AP waveform and accumulated during 20-Hz trains. LTGO-33 required the weakest depolarizations for relief (midpoint -11 mV) and relief was even faster than for A-887826, but reinhibition between AP waveforms was far faster than for A-887826, so that relief did not accumulate during AP trains at 20 Hz. The results show that, unlike A-887826, there is no use-dependent relief of inhibition by suzetrigine or LTGO-33 with physiological voltage waveforms at physiological temperatures, but each for different reasons.

Nav1.8钠通道在痛觉神经元中表达,一些Nav1.8抑制剂在临床试验中可以显著减轻疼痛。几种Nav1.8抑制剂具有不寻常的状态依赖性,从而通过去极化减轻抑制。我们比较了几种Nav1.8通道抑制剂的状态依赖性作用,以测试在生理条件下动作电位(AP)放电时抑制是否会减轻,从而产生“反向使用依赖”。37°C、20 Hz的AP波形显著减轻了A-887826的抑制作用。相比之下,在使用suzetriine (VX-548)或LTGO-33的AP训练中,尽管抑制可以通过长时间的强去极化有效地消除,但没有缓解。这些差异可以用电压依赖性和动力学的差异来解释,这些化合物从去极化通道解离并重新结合到静息状态通道。Suzetrigine需要最强的去极化来缓解(中点+33 mV),并且缓解缓慢(+20 mV时tau >300 ms),因此在AP波形期间几乎没有发生缓解。A-887826的释放需要较弱的去极化(中点+13 mV),并且要快得多,因此在每个AP波形中都有一些释放,并在20 hz的列车中积累。LTGO-33需要最弱的去极化来缓解(中点-11 mV),缓解速度甚至比A-887826更快,但AP波形之间的抑制速度远快于A-887826,因此在20 Hz的AP序列中缓解不会累积。结果表明,与A-887826不同,苏三嗪和LTGO-33在生理温度下的生理电压波形对抑制的缓解没有使用依赖性,但其原因不同。
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引用次数: 0
Prediction and biological significance of small changes in binding of leiomodin to tropomyosin. 扁豆素与原肌球蛋白结合的微小变化的预测及其生物学意义。
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-04-24 DOI: 10.1085/jgp.202413641
Eduardo Sánchez Díaz, Brayan Osegueda, Svetlana Minakhina, Nickolas Starks, Stefanie Novak, Dmitri Tolkatchev, Carol C Gregorio, Alla S Kostyukova, Garry E Smith

In cardiac muscle, regulation of actin polymerization at the thin filament pointed end is controlled by two structurally similar but functionally antagonistic proteins, leiomodin-2 and tropomodulin-1. Both proteins contain tropomyosin-binding site 1, which is essential for their recruitment to the pointed end. Using circular dichroism, we determined changes in melting temperatures (ΔTm) for complexes of tropomyosin and leiomodin-2 fragments containing several hypomorphic mutations, which moderately affect binding to tropomyosin. We ran molecular dynamics simulations for the complexes and calculated standard Gibbs free energies of binding, which we found to strongly correlate with the ΔTm. We found that the E34Q mutation in leiomodin-2 resulted in a decrease in the melting temperature of the complex of tropomyosin and leiomodin-2 fragments, indicating a decrease in the affinity of leiomodin-2 for tropomyosin. Although modest, this change in in vitro affinity made leiomodin-2 a weaker competitor for tropomyosin than tropomodulin-1 in cardiomyocytes. This mutation significantly reduced the ability of leiomodin-2 to displace tropomodulin-1 at thin filament pointed ends and affected the ability of leiomodin-2 to elongate thin filaments. Our results highlight the essential role of the tropomyosin-binding site in the dynamic equilibrium between tropomodulin-1 and leiomodin-2 at the pointed end of thin filaments. Our data also suggest the potential use of the correlation between ΔTm and the modeled standard Gibbs free energies of binding to predict changes in the stability of complexes between tropomyosin and leiomodin or tropomodulin isoforms.

在心肌中,肌动蛋白在细丝尖端聚合的调控是由两种结构相似但功能拮抗的蛋白控制的,即leiomodin-2和tropomodulin-1。这两种蛋白都含有原肌球蛋白结合位点1,这是它们募集到尖端所必需的。利用圆二色性,我们确定了原肌凝蛋白和平滑素-2片段复合物的熔化温度变化(ΔTm),这些复合物含有几种亚形态突变,这些突变适度影响与原肌凝蛋白的结合。我们对配合物进行了分子动力学模拟,并计算了标准吉布斯自由能,我们发现它与ΔTm有很强的相关性。我们发现,leomotin -2的E34Q突变导致原肌凝蛋白和leomotin -2片段复合物的熔融温度降低,表明leomotin -2对原肌凝蛋白的亲和力降低。虽然是适度的,但这种体外亲和力的变化使得心肌细胞中平滑调节素-2对原肌凝蛋白的竞争比原调节素-1弱。该突变显著降低了平滑素-2在细丝尖端取代原调节素-1的能力,并影响了平滑素-2拉长细丝的能力。我们的研究结果强调了原肌球蛋白结合位点在细丝尖端原调蛋白-1和素-2之间的动态平衡中的重要作用。我们的数据还表明,ΔTm与模型标准吉布斯自由结合能之间的相关性可能用于预测原肌球蛋白与素或原调节蛋白异构体之间复合物稳定性的变化。
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引用次数: 0
Trouble in store for muscle fibers. 肌肉纤维有麻烦了。
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-06-18 DOI: 10.1085/jgp.202513836
Ben Short

JGP study (Han et al. https://doi.org/10.1085/jgp.202413729) reveals that glycerol storage increases the titin-based stiffness of muscle fibers, suggesting that this commonly used method should be avoided by researchers interested in the passive properties of muscle.

JGP研究(Han等人https://doi.org/10.1085/jgp.202413729)表明甘油储存增加了肌纤维的titin基刚度,这表明对肌肉被动特性感兴趣的研究人员应该避免使用这种常用的方法。
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引用次数: 0
Disruption of a side portal pathway permits closed-state inactivation by BK β subunit N termini. 侧门静脉通路的破坏允许BK β亚基N末端的闭合状态失活。
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-05-30 DOI: 10.1085/jgp.202513790
Yu Zhou, Xiao-Ming Xia, Christopher J Lingle

Cytosolic N termini of several BK channel β regulatory subunits mediate rapid inactivation. However, in contrast to Kv channels, inactivation does not occur via a simple, open-channel block mechanism, but involves two steps, an association step in which ion permeation is maintained (O*), then followed by inactivation (I). To produce inactivation, BK β subunit N termini enter the central cavity through a lateral entry pathway ("side portal") separating the transmembrane pore-gate domain and cytosolic gating ring. Comparison of BK conformations reveals an aqueous pathway into the central cavity in the open structure, while in the closed structure, three sequential basic residues (R329K330K331) in the C-linker just following S6 occlude central cavity access. We probed the impact of mutations of the RKK motif (RKK3Q, RKK3E, and RKK3V) on inactivation mediated by the β3a N terminus. All three RKK-mutated constructs differentially reduce depolarization-activated outward current, prolong β3a-mediated tail current upon repolarization, and produce a persistent inward current at potentials down to -240 mV. With depolarization, channels are driven into O*-I inactivated states, and upon repolarization, slow tails and persistent inward currents reflect slow changes in O*-I occupancy. However, evaluation of closed-state occupancy prior to depolarization and at the end of slow tails reveals that some fraction of closed states at negative potentials correspond to resting closed states in voltage-independent equilibrium with N-terminal-occluded closed states. Thus, disruption of the RKK triplet both stabilizes the β3a N terminus in its position of inactivation and permits access of that N terminus to its blocking position in closed states.

几个BK通道β调控亚基的胞浆N端介导快速失活。然而,与Kv通道相反,失活不是通过简单的开放通道阻滞机制发生的,而是涉及两个步骤,一个是维持离子渗透的结合步骤(O*),然后是失活(I)。为了产生失活,BK β亚基N末端通过分离跨膜孔门结构域和细胞质门环的侧向进入途径(“侧门”)进入中央腔。通过对比BK构象发现,在开放结构中存在一条进入中心腔的水通道,而在封闭结构中,c -连接体中紧跟S6的三个顺序的碱基(R329K330K331)阻断了中心腔的通道。我们探讨了RKK基序(RKK3Q、RKK3E和RKK3V)突变对β3a N端介导的失活的影响。所有三种rkk突变构建体都不同程度地减少了去极化激活的外向电流,延长了β3a介导的复极化尾电流,并在低至-240 mV的电位下产生持续的内向电流。在去极化过程中,通道被驱动到O*-I失活状态,在再极化时,慢尾和持续的内向电流反映了O*-I占用的缓慢变化。然而,在去极化之前和慢尾末端对闭合状态占用的评估表明,负电位下的一部分闭合状态对应于与n端闭合状态无关的电压平衡中的静息闭合状态。因此,RKK三重态的破坏既稳定了β3a N末端的失活位置,又允许该N末端在关闭状态下进入其阻断位置。
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引用次数: 0
Molecular dynamics simulation of GJC2 mutants reveal pathogenic mechanisms of PMLD1 and SPG44. GJC2突变体分子动力学模拟揭示PMLD1和SPG44致病机制。
IF 2.9 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-06-10 DOI: 10.1085/jgp.202413617
David Gong, Jennifer L Orthmann-Murphy, Deepak Kumar, Gabriel D Dungan, Ayman W El-Hattab, Nicoline Schiess, Yun L Luo, Mona M Freidin, Charles K Abrams

GJC2 encodes connexin 47 (Cx47), a gap junction protein expressed by oligodendrocytes that forms gap junction channels (GJCs) between adjacent oligodendrocytes (or astrocytes, via heterotypic Cx47-Cx43 GJCs). Autosomal recessive mutations of GJC2 lead to at least three central nervous system phenotypes: Pelizaeus-Merzbacher-like disease 1 (PMLD1), spastic paraparesis 44 (SPG44), and a minimal leukodystrophy. Here, we describe the clinical, functional, and molecular effects of two mutations in GJC2, p.G40S, and p.R244P, identified in two different families with GJC2-related disorders. Expressed exogenously, p.G40S forms GJC plaques like WT but does not functionally couple with WT nor with Cx43. p.R244P also fails to demonstrate functional coupling. Moreover, plaque formation is absent, concomitant with intracellular connexin accumulation. When the two mutants are co-expressed in a compound heterozygous state, plaques form, but no GJC coupling is detected in any configuration. MD simulations demonstrate that p.G40S modifies secondary structure of the pore-lining α-helix, disrupting supersecondary interactions with the N-terminal helix and predicting channel closure. p.R244P simulations are characterized by partial loss of the extracellular β-sheet domains and a marked reduction of electrostatic interactions between the connexin and lipid headgroups of the plasma membrane, suggesting pathways by which p.R244P mutation impairs GJC formation. This combination of in vitro assays and molecular simulations provides mechanistic insight into the pathogenesis of GJC2-related disease.

GJC2编码连接蛋白47 (Cx47),这是一种由少突胶质细胞表达的间隙连接蛋白,通过异型Cx47- cx43 GJCs在相邻少突胶质细胞(或星形胶质细胞)之间形成间隙连接通道(GJCs)。GJC2的常染色体隐性突变导致至少三种中枢神经系统表型:pelizaeus - merzbacher样疾病1 (PMLD1)、痉挛性麻痹44 (SPG44)和轻度脑白质营养不良。在这里,我们描述了GJC2, p.G40S和p.R244P两种突变的临床、功能和分子效应,这两种突变在两个不同的GJC2相关疾病家族中被鉴定出来。外源性表达,p.G40S像WT一样形成GJC斑块,但不与WT或Cx43功能偶联。p.R244P也不能证明功能耦合。此外,没有斑块形成,伴随细胞内连接蛋白积累。当两个突变体以复合杂合状态共表达时,会形成斑块,但在任何构型中均未检测到GJC偶联。MD模拟表明,p.G40S改变了孔衬α-螺旋的二级结构,破坏了与n端螺旋的超二级相互作用,并预测了通道关闭。p.R244P模拟的特点是细胞外β-sheet结构域的部分缺失,以及质膜连接蛋白和脂质头群之间的静电相互作用的显著减少,这表明p.R244P突变可能会损害GJC的形成。这种体外实验和分子模拟的结合为gj_2相关疾病的发病机制提供了深入的了解。
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引用次数: 0
Loss of intracellular FGF14 (iFGF14) increases excitability of mature hippocampal pyramidal neurons. 细胞内FGF14 (iFGF14)的缺失增加了成熟海马锥体神经元的兴奋性。
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-05-05 DOI: 10.1085/jgp.202413597
Joseph L Ransdell, Yarimar Carrasquillo, Marie K Bosch, Rebecca L Mellor, David M Ornitz, Jeanne M Nerbonne

Mutations in FGF14, which encodes intracellular fibroblast growth factor 14 (iFGF14), have been linked to spinocerebellar ataxia type 27 (SCA27), a multisystem disorder associated with deficits in motor coordination and cognitive function. Mice lacking iFGF14 (Fgf14-/-) display similar phenotypes, and we have previously shown that the deficits in motor coordination reflect reduced excitability of cerebellar Purkinje neurons, owing to a hyperpolarizing shift in the voltage-dependence of voltage-gated Na+ (Nav) current steady-state inactivation. Here, we present the results of experiments designed to test the hypothesis that loss of iFGF14 also attenuates the intrinsic excitability of mature hippocampal pyramidal neurons. Current-clamp recordings from CA1 pyramidal neurons in acute in vitro slices, however, revealed that evoked repetitive firing rates were higher in Fgf14-/- than in wild type (WT) cells. Also, in contrast with Purkinje neurons, voltage-clamp recordings demonstrated that the loss of iFGF14 did not affect the voltage dependence of steady-state inactivation of the Nav currents in CA1 pyramidal neurons. In addition, in contrast with results reported for neonatal (rat) hippocampal pyramidal neurons in dissociated cell culture, immunohistochemical experiments revealed that loss of iFGF14 does not disrupt the localization or alter the normalized distribution of α-Nav1.6 or α-ankyrin G labeling along the axon initial segments (AIS) of mature hippocampal CA1 neurons in situ. However, the integrated intensities of α-Nav1.6 labeling were significantly higher along the AIS of Fgf14-/-, compared with WT, adult hippocampal CA1 pyramidal neurons, consistent with the marked increase in the excitability of CA1 neurons with the loss of iFGF14.

编码细胞内成纤维细胞生长因子14 (iFGF14)的FGF14突变与脊髓小脑性共济失调27型(SCA27)有关,脊髓小脑性共济失调是一种与运动协调和认知功能缺陷相关的多系统疾病。缺乏iFGF14 (Fgf14-/-)的小鼠表现出类似的表型,我们之前已经表明,运动协调缺陷反映了小脑浦肯野神经元的兴奋性降低,这是由于电压门控Na+ (Nav)电流稳态失活的电压依赖性的超极化转移。在这里,我们提出了旨在验证iFGF14缺失也会减弱成熟海马锥体神经元固有兴奋性的假设的实验结果。然而,体外急性CA1锥体神经元切片的电流钳记录显示,Fgf14-/-细胞的诱发重复放电率高于野生型(WT)细胞。此外,与浦肯野神经元相比,电压钳记录显示iFGF14的丢失并不影响CA1锥体神经元中Nav电流稳态失活的电压依赖性。此外,与分离细胞培养新生(大鼠)海马锥体神经元的结果相反,免疫组织化学实验显示,iFGF14的缺失不会破坏成熟海马CA1神经元轴突初始段(AIS) α-Nav1.6或α-锚蛋白G标记的原位定位或改变其标准化分布。然而,与WT相比,成年海马CA1锥体神经元沿Fgf14-/-的AIS区α-Nav1.6标记的综合强度显著升高,这与CA1神经元的兴奋性随着iFGF14的缺失而显著增加是一致的。
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引用次数: 0
Using metaphorical considerations to benefit research on the sodium channel fast inactivation mechanism. 用隐喻的方法研究钠离子通道的快速失活机制。
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-07-07 Epub Date: 2025-06-03 DOI: 10.1085/jgp.202413683
Peter Hull, Angelika Lampert

Metaphorical language is ubiquitous throughout the life sciences, with, for example, molecules forming chains which define genetic blueprints for the development of cells and ultimately the gates in the channels forming the subject of this special issue. Indeed, metaphor is a fundamental component of scientific discourse and influences how science is both communicated and understood across all levels of expertise. This article, written for readers without a background in linguistics, first provides a brief introduction to the mechanisms of scientific metaphor and then illustrates its productive application to the sodium channel fast inactivation mechanism.

隐喻语言在整个生命科学中无处不在,例如,分子形成的链定义了细胞发育的遗传蓝图,最终形成了通道中的门,形成了本期特刊的主题。事实上,隐喻是科学话语的基本组成部分,影响着科学在各个专业水平上的交流和理解。这篇文章是写给没有语言学背景的读者的,首先简要介绍了科学隐喻的机制,然后说明了它在钠通道快速失活机制中的有效应用。
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引用次数: 0
Mechanisms underlying the distinct K+ dependencies of periodic paralysis. 周期性麻痹的不同 K+ 依赖性的内在机制。
IF 3.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2025-05-05 Epub Date: 2025-02-04 DOI: 10.1085/jgp.202413610
Brent D Foy, Chris Dupont, Phillip V Walker, Kirsten Denman, Kathrin L Engisch, Mark M Rich

Patients with periodic paralysis have attacks of weakness precipitated by depolarization of muscle. Each form of periodic paralysis is associated with unique changes in serum K+ during attacks of weakness. In hypokalemic periodic paralysis (hypoKPP), the mutation-induced gating pore current causes weakness associated with low serum K+. In hyperkalemic periodic paralysis (hyperKPP), mutations increase a non-inactivating Na+ current (Na persistent or NaP), which causes weakness associated with elevation of extracellular K+. In Andersen-Tawil syndrome, mutations causing loss of Kir channel function cause weakness associated with either low or high K+. We developed a computer model to address two questions: (1) What mechanisms are responsible for the distinct K+ dependencies of muscle depolarization-induced weakness in the three forms of periodic paralysis? (2) Why does extracellular K+ become elevated during attacks of weakness in hyperKPP, reduced in hypoKPP, and both elevated and reduced in Andersen-Tawil syndrome? We experimentally tested the model assumptions about resting potential in normal K+ solution in hyperKPP and hypoKPP. Recreating the distinct K+ dependence of all three forms of periodic paralysis required including the K+ and voltage dependence of current through Kir channels, the extracellular K+ and intracellular Na+ dependence of the Na/K ATPase activity, and the distinct voltage dependencies of the gating pore current and NaP. A key factor determining whether muscle would depolarize was the direction of small net K+ and net Na+ fluxes, which altered ion concentrations over hours. Our findings may aid in development of novel therapy for diseases with dysregulation of muscle excitability.

周期性麻痹患者会因肌肉去极化而发作无力。每种形式的周期性麻痹都与无力发作时血清 K+ 的独特变化有关。在低血钾性周期性麻痹(hypoKPP)中,突变诱导的门孔电流会导致与低血清 K+ 有关的虚弱。在高钾血症性周期性麻痹(hyperKPP)中,突变会增加非失活的 Na+ 电流(Na 持久性或 NaP),从而导致与细胞外 K+ 升高有关的虚弱。在安德森-塔维尔综合征(Andersen-Tawil Syndrome)中,导致 Kir 通道功能缺失的突变会引起与低或高 K+ 相关的虚弱。我们开发了一个计算机模型来解决两个问题:(1) 在三种形式的周期性麻痹中,肌肉去极化诱导的无力对 K+ 的依赖性有何不同?(2)为什么在高周期性瘫痪的肌无力发作期间细胞外 K+ 会升高,在低周期性瘫痪的肌无力发作期间细胞外 K+ 会降低,而在安德森-塔维尔综合征的肌无力发作期间细胞外 K+ 既升高又降低?我们通过实验测试了模型对高KPP和低KPP正常K+溶液中静息电位的假设。要重现所有三种形式周期性麻痹的不同 K+ 依赖性,需要包括通过 Kir 通道的电流的 K+ 和电压依赖性、Na/K ATPase 活性的细胞外 K+ 和细胞内 Na+ 依赖性以及门孔电流和 NaP 的不同电压依赖性。决定肌肉是否去极化的一个关键因素是小的净 K+ 和净 Na+ 通量的方向,它们会在数小时内改变离子浓度。我们的发现可能有助于开发治疗肌肉兴奋性失调疾病的新疗法。
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Journal of General Physiology
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