Background and Purpose Transmembrane Cav2.2 (N-type) voltage-gated
calcium channels are genetically and pharmacologically validated pain
targets. Clinical block of Cav2.2 (e.g., with Prialt) or indirect
modulation (e.g., with gabapentinoids) mitigates chronic pain but is
constrained by side effects. The cytosolic auxiliary subunit collapsin
response mediator protein 2 (CRMP2) targets Cav2.2 to the sensory neuron
membrane and regulates their function. A CRMP2-derived peptide (CBD3)
uncouples the Cav2.2-CRMP2 interaction to inhibit calcium influx,
transmitter release and pain. Homology-guided mutagenesis of CBD3
revealed an antinociceptive core at A1RSR4. Here, the A1R2 CBD3
dipeptide was identified as critical for Cav2.2 molecular recognition
and served as a scaffold for identification of small molecule
peptidomimetic allosteric regulators of Cav2.2. Experimental Approach We
developed and applied a novel molecular dynamics approach to identify
the Cav2.2 recognition motif of the core CBD3 peptide as the A1R2
dipeptide and used its presenting motif to design pharmacophore models
to screen 27 million compounds in the open access server ZincPharmer. Of
200 curated hits, 77 compounds were assessed using depolarization‐evoked
calcium influx in rat dorsal root ganglion (DRG) neurons. Nine compounds
were tested using electrophysiology and one compound (CBD3063) was
evaluated biochemically, electrophysiologically, and behaviorally
effects in a model of experimental pain: Key Results CBD3063 reduced
membrane Cav2.2 expression and currents, inhibited neuronal
excitability, uncoupled the Cav2.2-CRMP2 interaction, and reversed
mechanical allodynia in rats with spared nerve injury. Conclusions and
Implications These results identify CBD3063, as a selective,
first-in-class, CRMP2-based peptidomimetic, which allosterically
regulates Cav2.2 to achieve analgesia.