Gain-of-function mutation in Nav1.7 in familial erythromelalgia induces bursting of sensory neurons.

Erythromelalgia is an autosomal dominant disorder characterized by burning pain in response to warm stimuli or moderate exercise. We describe a novel mutation in a family with erythromelalgia in SCN9A, the gene that encodes the Na(v)1.7 sodium channel. Na(v)1.7 produces threshold currents and is selectively expressed within sensory neurons including nociceptors. We demonstrate that this mutation, which produces a hyperpolarizing shift in activation and a depolarizing shift in steady-state inactivation, lowers thresholds for single action potentials and high frequency firing in dorsal root ganglion neurons. Erythromelalgia is the first inherited pain disorder in which it is possible to link a mutation with an abnormality in ion channel function and with altered firing of pain signalling neurons.

Activation of group II metabotropic glutamate receptors results in long-term potentiation following preconditioning stimulation in the dentate gyrus.

The role of group II metabotropic glutamate receptors in the induction/expression of long-term potentiation has been investigated in the medial perforant path of the outer (infrapyramidal) blade of the rat dentate gyrus in vitro. Activation of group II metabotropic glutamate receptors by perfusion of the selective agonist LY354740 did not induce long-term potentiation or long-term depression in control. However, LY354740, applied following the induction of long-term potentiation by high frequency stimulation, resulted in additional long-term potentiation. LY354740 was only found to cause additional long-term potentiation if the pre-existing high frequency stimulation-induced long-term potentiation was sub-maximal. Although activation of metabotropic glutamate receptors was not required for induction of high frequency stimulation-induced long-term potentiation, activation of both group I and group II metabotropic glutamate receptors was required during high frequency stimulation-induced long-term potentiation in order for subsequent application of LY354740 to result in additional long-term potentiation. Thus, the long-term potentiation caused by application of LY354740 following high frequency-induced long-term potentiation was prevented if the high frequency stimulation was given in the presence of (S)-alpha-methyl-4-carboxyphenylglycine or the selective group I or group II metabotropic glutamate receptor antagonists 1-aminoindan-1,5-dicarboxylic acid or (2S)-alpha-ethylglutamic acid respectively. The long-term potentiation caused by LY354740 was also dependent upon activation of N-methyl-D-aspartate receptors during the high frequency stimulation, being blocked if high frequency stimulation was given in the presence of the N-methyl-D-aspartate receptor antagonist, D(-)-2-amino-5-phosphonopentanoic acid. The long-term potentiation resulting from activation of group II metabotropic glutamate receptors could be due either to the enhancement of the expression level of the high frequency stimulation-induced long-term potentiation, or alternatively, to a direct novel induction of long-term potentiation. In either theory, the long-term potentiation resulting from activation of group II metabotropic glutamate receptors is dependent upon prestimulation of group I and group II metabotropic glutamate receptors and N-methyl-D-aspartate receptors during the 'preconditioning high frequency stimulation'.

Presynaptic group II mGluR inhibition of short-term depression in the medial perforant path of the dentate gyrus in vitro.

Inhibition of short-term plasticity by activation of presynaptic group II metabotropic glutamate receptors (group II mGluR) was investigated in the medial perforant path of the dentate gyrus in the hippocampus in vitro. Brief trains of stimulation (10 stimuli at 1--200 Hz) evoked short-term depression of field excitatory postsynaptic potentials (EPSPs). The steady-state level of depression, measured after 10 stimuli, was frequency dependent, increasing between 1 and 200 Hz. Activation of group II mGluR by the selective agonist LY354740 did not alter short-term depression evoked by frequencies up to 10 Hz, but did inhibit short-term depression evoked at higher frequencies in a frequency- and concentration-dependent manner. The time-averaged postsynaptic response (EPSP per unit time) was found to increase linearly with frequency up to approximately 20 Hz. At higher frequencies, the response plateaued, thereby becoming independent of frequency. Frequencies above this were differentiated only during the transient postsynaptic response that accompanies changes in firing rates. Activation of presynaptically located group II mGluR increased the frequency at which the EPSP per unit time plateaued up to 30-50 Hz.

Application of N-methyl-D-aspartate induces long-term potentiation in the medial perforant path and long-term depression in the lateral perforant path of the rat dentate gyrus in vitro.

The effect of application of N-methyl-D-aspartate (NMDA) on synaptic plasticity was studied in the medial and lateral perforant path-granule cell synapse in the outer blade of the dentate gyrus in vitro. Field excitatory post-synaptic potentials were recorded from the middle or outer molecular layer in response to stimulation of the medial or lateral perforant path. Bath perfusion of NMDA (10 microM, 5 min) resulted in induction of long-term potentiation in the medial perforant path, and induction of long-term depression in the lateral perforant path.

Electrophysiological properties of sodium current subtypes in small cells from adult rat dorsal root ganglia.

1. Whole-cell and single-channel Na+ currents were recorded from small (ca. 20 micron diameter) cells isolated from adult rat dorsal root ganglia (DRG). Currents were classified by their sensitivity to 0.3 microM tetrodotoxin (TTX), electrophysiological properties and single-channel amplitude. Cells were classified according to the types of current recorded from them. 2. Type A cells expressed essentially pure TTX-sensitive (TTX-S) currents. Availability experiments with prepulse durations between 50 ms and 1 s gave a half-available voltage (Vh) of around -65 mV but the availability curves often had a complex shape, consistent with multiple inactivation processes. Measured inactivation time constants ranged from less than 1 ms to over 100 s, depending on the protocol used. 3. Cell types B and C each had, in addition to TTX-S currents, substantial and different TTX-resistant (TTX-R) currents that we have designated TTX-R1 and TTX-R2, respectively. TTX-R1 currents had a 1 s Vh of -29 mV, showed little 1 Hz use dependence at -67 mV and recovered from the inactivation induced by a 60 ms depolarizing pulse with time constants of 1.6 ms (91 %) and 908 ms. They also exhibited slow inactivation processes with component time constants around 10 and 100 s. TTX-R2 currents activated and inactivated at more negative potentials (1 s Vh = -46 mV), showed substantial 1 Hz use dependence and had inactivation (60 ms pulse) recovery time constants at -67 mV of 3.3 ms (58 %) and 902 ms. 4. Type D cells had little or no current in 0.3 microM TTX at a holding potential of -67 mV. Current amplitude increased on changing the holding potential to -107 mV. Type D cell currents had more hyperpolarized availability and I-V curves than even TTX-R2 currents and suggest the existence of TTX-R3 channels. 5. In outside-out patches with 250 mM external NaCl, the single-channel conductance (gamma) of TTX-S channels was 19.5 pS and the potential for half-maximal activation (Va) was -45 mV. One population of TTX-R channels had a gamma of 9.2 pS and a Va of -27 mV. A second population had a gamma of 16.5 pS and a more negative Va of -42 mV. The latter population may underlie the type D cell current. 6. Small DRG cells express multiple Na+ currents with varied time constants and voltage dependences of activation and inactivation. Nociceptive cells still fire when chronically depolarized by an increased external K+ concentration. TTX-R1 and TTX-R2 Na+ channels may support that firing, while the range of inactivation time constants described here would increase the repertoire of DRG cell burst firing behaviour generally.

Phenytoin and carbamazepine: differential inhibition of sodium currents in small cells from adult rat dorsal root ganglia.

We determined the effects of carbamazepine and phenytoin, anticonvulsant drugs used to treat neuropathic pain, on the heterogeneous population of Na+ channels in patch-clamped small cells from adult rat dorsal root ganglia. Both fast tetrodotoxin-sensitive (TTX-S) and slow TTX-resistant (TTX-R) currents were inhibited by 10-100 microM drug. TTX-R currents were divided into two classes. Control type I currents had a very depolarized voltage for 50% availability (Vh) of ca. -29 mV and 17% reduction in current by the 20th pulse at 1 Hz. Control type II currents had a Vh closer to -46 mV and 49% reduction in current at 1 Hz. At 0.1 Hz, which gave relatively little loss of control current, 100 microM drug caused 53 +/- 4% (n = 5) block of type I current and 88 +/- 2% inhibition of type II current (n = 4). Strong 1 s hyperpolarizing prepulses relieved most of the fast channel block but had much less effect on blocked TTX-R channels.

Surveillance of HIV infection by voluntary testing in England.

Eighteen laboratories, which together provide primary HIV antibody testing for 43% of the population in England, collaborated in a study to record epidemiological information for all individuals voluntarily tested by them over a five year period. From the 184,113 individuals who had a first test during the study period, it is estimated that 1 in 12 adults in London, and 1 in 50 outside London have been voluntarily tested for HIV since testing became widely available in 1985. The majority of those tested were individuals whose perceived risk was heterosexual exposure. Infection in this group was concentrated in individuals whose partner had an identified risk and in those who had lived in or visited Africa. The rise in antibody prevalence observed in the latter group during 1990/91 may have been partly due to infection recently acquired in the UK. Antibody prevalence in heterosexuals without a high risk partner or a history of exposure abroad also rose during the study period, suggesting a recent increase in transmission through casual heterosexual exposure in the UK. The study also provided strong evidence of continuing high risk behaviour among homosexual men, particularly in the younger age groups. Homosexuals aged under 30 years and living in London had the greatest risk of acquiring HIV infection since 1988.