On the role of Nav1.7 sodium channels in chronic pain: an experimental and computational study

Abstract

Chronic pain is a global healthcare problem with a huge societal impact. Its management remains generally unsatisfactory, with no single treatment clinically approved in most cases. In this study we use an in vitro model of erythromelalgia consisting of dorsal root ganglion neurons derived from human induced pluripotent stem cells obtained from a patient (carrying the mutation F1449V) and a control subject. We combine neurophysiology and computational modelling to focus on the Nav1.7 voltage gated sodium channel, which acts as an amplifier of the receptor potential in nociceptive neurons and plays a critical role in erythromelalgia due to gain of function mutations causing the channel to open with smaller depolarisations.Using extracellular recordings, we found that the scorpion toxin OD1 (a Nav1.7 channel opener) increases dorsal root ganglion cell excitability in cultures obtained from the control donor, evidenced by an increase in spontaneous discharges, firing rate and spike amplitude. In addition, we confirmed previous reports of voltage clamp experiments concerning an increase in spontaneous discharge in the patient cell cultures and the analgesic effects of the Nav1.7 blocker PF-05089771. Our findings are explained with a conductance-based model of the dorsal root ganglion neuron, exploring its behaviour for different values of half activation voltage and inactivation removal rate of the Nav1.7 current. Erythromelalgia was simulated through a decrease of the Nav1.7 half activation voltage, turning previously subthreshold stimuli to pain-inducing, and successfully counteracted with the channel blocker. The painful effects of OD1 were simulated through a quicker removal of Nav1.7 inactivation that reproduced the effects of the toxin not only on the spike frequency but also on its amplitude.New & NoteworthyWe investigate Nav1.7 channel gating mechanisms in human iPSC-derived dorsal root ganglion cell cultures using multielectrode array recordings. The scorpion toxin OD1 increases firing frequency and spike amplitudes whilst the analgesic PF-05089771 decreases or even abolishes spontaneous activity. The antagonistic effect of these compounds is explained with a computational model to reach deeper understanding of changes in channel kinetics in erythromelalgia, a chronic pain disorder.