␦-Conotoxin EVIA, from Conus ermineus, is a 32-residue polypeptide cross-linked by three disulfide bonds forming a four-loop framework. ␦-Conotoxin EVIA is the first conotoxin known to inhibit sodium channel inactivation in neuronal membranes from amphibians and mammals (subtypes rNa v 1.2a, rNa v 1.3, and rNa v 1.6), without affecting rat skeletal muscle (subtype rNa v 1.4) and human cardiac muscle (subtype hNa v 1.5) sodium channel (Barbier, J., Lamthanh, H., Le Gall, F., Favreau, P., Benoit, E., Chen, H., Gilles, N., Ilan, N., Heinemann, S. F., Gordon, D., Mé nez, A., and Molgó , J. (2004) J. Biol. Chem. 279, 4680 -4685). Its structure was solved by NMR and is characterized by a 1:1 cis/trans isomerism of the Leu 12 -Pro 13 peptide bond in slow exchange on the NMR time scale. The structure of both cis and trans isomers could be calculated separately. The isomerism occurs within a specific long disordered loop 2, including residues 11-19. These contribute to an important hydrophobic patch on the surface of the toxin. The rest of the structure matches the "inhibitor cystine-knot motif" of conotoxins from the "O superfamily" with a high structural order. To probe a possible functional role of the Leu 12 -Pro 13 cis/trans isomerism, a Pro 13 3 Ala ␦-conotoxin EVIA was synthesized and shown to exist only as a trans isomer. P13A ␦-conotoxin EVIA was estimated only two times less active than the wild-type EVIA in binding competition to rat brain synaptosomes and when injected intracerebroventricularly into mice.The new ␦-conotoxin EVIA (␦-EVIA), 1 a 32-amino acid conopeptide isolated from the venom of Conus ermineus, is the first conotoxin demonstrated to inhibit sodium channel inactivation in neuronal membranes from amphibians and mammals (subtypes rNa v 1.2a, rNa v 1.3, and rNa v 1.6) without affecting rat skeletal muscle (subtype rNa v 1.4) and human cardiac muscle (subtype hNa v 1.5) sodium channel subtypes (1). This important recent discovery makes ␦-EVIA a unique tool to study the modulation mechanisms of neuronal Na ϩ channels. As a consequence, ␦-EVIA may also serve as a new lead molecule for the design of new drugs to treat neurological diseases characterized by defective nerve conduction, especially those causing an axonal demyelinization (2, 3). Nerve conduction could be facilitated by specific inhibition of Na ϩ channel inactivation. The knowledge of the detailed three-dimensional structure is therefore the first step necessary to understand the structureactivity relationships of this new lead conotoxin.Despite a low sequence identity with the -, -, and ␦-conotoxins, ␦-EVIA clearly belongs to the four-loop family of conotoxins characterized by a similar cysteine pairing giving a conserved 3-disulfide framework as shown in Fig. 1. Until now, the three-dimensional structure of 10 conotoxins belonging to this family was already determined as follows: the conotoxin -PVIIA (20) targeting potassium channels; conotoxins -MVIIA (21), -MVIIC (22), -MVIID (23), -GVIA (24), -SVIB (25), and -CVID (26) targeting calc...