NaV1.1 inhibition can reduce visceral hypersensitivity

JCI Insight. 2018 Jun 7;3(11):e121000. doi: 10.1172/jci.insight.121000.

Abstract

Functional bowel disorder patients can suffer from chronic abdominal pain, likely due to visceral hypersensitivity to mechanical stimuli. As there is only a limited understanding of the basis of chronic visceral hypersensitivity (CVH), drug-based management strategies are ill defined, vary considerably, and include NSAIDs, opioids, and even anticonvulsants. We previously reported that the 1.1 subtype of the voltage-gated sodium (NaV; NaV1.1) channel family regulates the excitability of sensory nerve fibers that transmit a mechanical pain message to the spinal cord. Herein, we investigated whether this channel subtype also underlies the abdominal pain that occurs with CVH. We demonstrate that NaV1.1 is functionally upregulated under CVH conditions and that inhibiting channel function reduces mechanical pain in 3 mechanistically distinct mouse models of chronic pain. In particular, we use a small molecule to show that selective NaV1.1 inhibition (a) decreases sodium currents in colon-innervating dorsal root ganglion neurons, (b) reduces colonic nociceptor mechanical responses, and (c) normalizes the enhanced visceromotor response to distension observed in 2 mouse models of irritable bowel syndrome. These results provide support for a relationship between NaV1.1 and chronic abdominal pain associated with functional bowel disorders.

Keywords: Gastroenterology; Ion channels; Neuroscience; Pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Chronic Pain / diagnosis
  • Chronic Pain / drug therapy*
  • Chronic Pain / etiology
  • Chronic Pain / pathology
  • Colon / drug effects*
  • Colon / innervation
  • Colon / pathology
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Drug Evaluation, Preclinical
  • Drug Stability
  • Ganglia, Spinal / cytology
  • Humans
  • Irritable Bowel Syndrome / chemically induced
  • Irritable Bowel Syndrome / complications*
  • Irritable Bowel Syndrome / pathology
  • Male
  • Maximum Tolerated Dose
  • Mice
  • NAV1.1 Voltage-Gated Sodium Channel / metabolism
  • Nociceptors / drug effects
  • Nociceptors / metabolism
  • Pain Measurement
  • Trinitrobenzenesulfonic Acid / administration & dosage
  • Trinitrobenzenesulfonic Acid / toxicity
  • Visceral Pain / diagnosis
  • Visceral Pain / drug therapy*
  • Visceral Pain / etiology
  • Visceral Pain / pathology
  • Voltage-Gated Sodium Channel Blockers / administration & dosage*

Substances

  • NAV1.1 Voltage-Gated Sodium Channel
  • Scn1a protein, mouse
  • Voltage-Gated Sodium Channel Blockers
  • Trinitrobenzenesulfonic Acid