title: HCN1 channels as targets for anesthetic and nonanesthetic propofol analogs in the amelioration of mechanical and thermal hyperalgesia in a mouse model of neuropathic pain.
abstract: Chronic pain after peripheral nerve injury is associated with afferent hyperexcitability and upregulation of hyperpolarization-activated, cyclic nucleotide-regulated (HCN)-mediated IH pacemaker currents in sensory neurons. HCN channels thus constitute an attractive target for treating chronic pain. HCN channels are ubiquitously expressed; analgesics targeting HCN1-rich cells in the peripheral nervous system must spare the cardiac pacemaker current (carried mostly by HCN2 and HCN4) and the central nervous system (where all four isoforms are expressed). The alkylphenol general anesthetic propofol (2,6-di-iso-propylphenol) selectively inhibits HCN1 channels versus HCN2-HCN4 and exhibits a modest pharmacokinetic preference for the periphery. Consequently, we hypothesized that propofol, and congeners, should be antihyperalgesic. Alkyl-substituted propofol analogs have different rank-order potencies with respect to HCN1 inhibition, GABA(A) receptor (GABA(A)-R) potentiation, and general anesthesia. Thus, 2,6- and 2,4-di-tertbutylphenol (2,6- and 2,4-DTBP, respectively) are more potent HCN1 antagonists than propofol, whereas 2,6- and 2,4-di-sec-butylphenol (2,6- and 2,4-DSBP, respectively) are less potent. In contrast, DSBPs, but not DTBPs, enhance GABA(A)-R function and are general anesthetics. 2,6-DTBP retained propofol's selectivity for HCN1 over HCN2-HCN4. In a peripheral nerve ligation model of neuropathic pain, 2,6-DTBP and subhypnotic propofol are antihyperalgesic. The findings are consistent with these alkylphenols exerting analgesia via non-GABA(A)-R targets and suggest that antagonism of central HCN1 channels may be of limited importance to general anesthesia. Alkylphenols are hydrophobic, and thus potential modifiers of lipid bilayers, but their effects on HCN channels are due to direct drug-channel interactions because they have little bilayer-modifying effect at therapeutic concentrations. The alkylphenol antihyperalgesic target may be HCN1 channels in the damaged peripheral nervous system.
authors.affiliation: Department of Anesthesiology, College of Physicians & Surgeons, Columbia University, New York, New York, USA.
authors.forename: Gareth R
authors.initials: GR
authors.lastname: Tibbs
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Rowley
authors.forename: R Lea
authors.initials: RL
authors.lastname: Sanford
authors.forename: Karl F
authors.initials: KF
authors.lastname: Herold
authors.forename: Alex
authors.initials: A
authors.lastname: Proekt
authors.forename: Hugh C
authors.initials: HC
authors.lastname: Hemmings
authors.forename: Olaf S
authors.initials: OS
authors.lastname: Andersen
authors.forename: Peter A
authors.initials: PA
authors.lastname: Goldstein
authors.forename: Pamela D
authors.initials: PD
authors.lastname: Flood
mesh_terms: D000465:Algorithms; D000777:Anesthetics / Q000494:pharmacology* / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D001522:Behavior, Animal / Q000187:drug effects; D001682:Biological Availability; D054815:Cyclic Nucleotide-Gated Cation Channels / Q000187:drug effects*; D018076:DNA, Complementary / Q000096:biosynthesis / Q000235:genetics; D055724:Electrophysiological Phenomena / Q000187:drug effects; D005260:Female; D006358:Hot Temperature; D006801:Humans; D006930:Hyperalgesia / Q000188:drug therapy*; D064428:Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels; D007202:Indicators and Reagents; D008051:Lipid Bilayers; D051379:Mice; D008810:Mice, Inbred C57BL; D009437:Neuralgia / Q000188:drug therapy*; D009865:Oocytes / Q000187:drug effects; D018408:Patch-Clamp Techniques; D015221:Potassium Channels / Q000187:drug effects*; D015742:Propofol / Q000031:analogs & derivatives* / Q000494:pharmacology* / Q000627:therapeutic use; D014981:Xenopus
chemical_list: D000777:Anesthetics; D018686:Anesthetics, Intravenous; D054815:Cyclic Nucleotide-Gated Cation Channels; D018076:DNA, Complementary; C578665:HCN1 protein, human; C578666:Hcn1 protein, mouse; D064428:Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels; D007202:Indicators and Reagents; D008051:Lipid Bilayers; D015221:Potassium Channels; D015742:Propofol
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