Neuronal excitability relies on coordinated action of functionally distinction channels. Voltage-gated sodium (Na V ) and potassium (K V ) channels have distinct but complementary roles in firing action potentials: Na V channels provide depolarizing current while K V channels provide hyperpolarizing current. Mutations and dysfunction of multiple Na V and K V channels underlie disorders of excitability, including pain and epilepsy. Modulating ion channel trafficking may offer a potential therapeutic strategy for these diseases. A fundamental question, however, is whether these channels with distinct functional roles are transported independently or packaged together in the same vesicles in sensory axons. We have used Optical Pulse-Chase Axonal Long-distance imaging to investigate trafficking of Na V and K V channels and other axonal proteins from distinct functional classes in live rodent sensory neurons (from male and female rats). We show that, similar to Na V 1.7 channels, Na V 1.8 and K V 7.2 channels are transported in Rab6a-positive vesicles, and that each of the Na V channel isoforms expressed in healthy, mature sensory neurons (Na V 1.6, Na V 1.7, Na V 1.8, and Na V 1.9) is cotransported in the same vesicles. Further, we show that multiple axonal membrane proteins with different physiological functions (Na V 1.7, K V 7.2, and TNFR1) are cotransported in the same vesicles. However, vesicular packaging of axonal membrane proteins is not indiscriminate, since another axonal membrane protein (NCX2) is transported in separate vesicles. These results shed new light on the development and organization of sensory neuron membranes, revealing complex sorting of axonal proteins with diverse physiological functions into specific transport vesicles.

Inflammation causes pain by shifting the balance of ionic currents in nociceptors toward depolarization, leading to hyperexcitability. The ensemble of ion channels within the plasma membrane is regulated by processes including biogenesis, transport, and degradation. Thus, alterations in ion channel trafficking may influence excitability. Sodium channel Na V 1.7 and potassium channel K V 7.2 promote and oppose excitability in nociceptors, respectively. We used live-cell imaging to investigate mechanisms by which inflammatory mediators (IM) modulate the abundance of these channels at axonal surfaces through transcription, vesicular loading, axonal transport, exocytosis, and endocytosis. Inflammatory mediators induced a Na V 1.7-dependent increase in activity in distal axons. Further, inflammation increased the abundance of Na V 1.7, but not of K V 7.2, at axonal surfaces by selectively increasing channel loading into anterograde transport vesicles and insertion at the membrane, without affecting retrograde transport. These results uncover a cell biological mechanism for inflammatory pain and suggest Na V 1.7 trafficking as a potential therapeutic target.