Voltage-gated sodium channels (VGSCs), composed of a pore-forming α subunit and up to two associated β subunits, are critical for the initiation of the action potential in excitable tissues. Building upon the monumental discovery and description of sodium current in 1952, intrepid researchers described the voltage-dependent gating mechanism, selectivity of the channel, and general structure of the VGSC channel. Recently, crystal structures of bacterial VGSC α subunits have confirmed many of these studies and provided new insights into VGSC function. VGSC β subunits, first cloned in 1992, modulate sodium current but also have non-conducting roles as cell adhesion molecules and function in neurite outgrowth and neuronal pathfinding. Mutations in VGSC α and β genes are associated with diseases caused by dysfunction of excitable tissues such as epilepsy. Due to the multigenic and drug-resistant nature of some of these diseases, induced pluripotent stem cells and other novel approaches are being used to screen for new drugs and further understand how mutations in VGSC genes contribute to pathophysiology.
Voltage-gated sodium channels (VGSCs) conduct inward current that depolarizes the plasma membrane and initiates the action potential (AP) in excitable cells, including neurons, cardiomyocytes, and skeletal muscle cells. Because of the intrinsic link between VGSCs and cellular excitability, it is not surprising that mutations in VGSC genes are linked with epilepsy, cardiac arrhythmia, neuropathic pain, migraine, and neuromuscular disorders (Table 1). The goal of this review is to provide an overview of critical discoveries in VGSC physiology and discuss the challenges of studying VGSCs in disease, including some of the exciting techniques to address these challenges.