HCN pacemaker channels and pain: a drug discovery perspective.

This article reviews evidence that hyperpolarization-activated, cation nonselective (HCN) channels, the molecular basis of the Ih current, potentially represent valid targets for novel analgesic agents. Ih is a prominent current in many peripheral sensory nerves, with highest current density typically found in large diameter neurons. Recent data suggest that Ih may represent a valid target for the treatment of spontaneous pain and allodynia associated with nerve injury. The majority of available electrophysiological and molecular evidence suggests that fast activating, weakly cyclic adenosine monophosphate (cAMP) sensitive HCN1-based channels may make a significant contribution to Ih, especially in large diameter, mechanosensitive fibers, where the Ih current appears to support abnormal spontaneous firing after nerve injury. In contrast, HCN4 channels seem to play the predominant role in cardiac pacemaker tissue. These observations raise the possibility that HCN1 selective blockers may inhibit pain associated with nerve injury without dramatic effects on heart rate. Development of novel HCN blocking analgesics presents a number of significant technical challenges. Although a number of HCN blockers are available, such as ZD-7288, ivabradine, and others, these drugs inhibit all HCN isoforms with the same potency. As a result, these compounds have powerful effects on heart rate, severely limiting their utility for non-cardiac indications such as pain. Selectivity challenges, mechanisms of compound interaction with the channel, and assay methods are described in detail.

Experiments with incentives in telephone surveys.

In an effort to counter the problem of noncooperation, survey organizations are offering incentives to respondents with increasing frequency, some at the outset of the survey, as has traditionally been done in mail surveys, and some only after the person has refused, in an attempt to convert the refusal. This article reports on a series of experiments carried out over a period of about 2 years with a monthly telephone survey, the Survey of Consumer Attitudes, in an effort to increase response rates or reduce interviewer effort. We report on experiments with prepaid versus promised incentives; advance letters; and advance letters with prepaid incentives; and we also report on the effects of incentives on response quality, sample composition, response bias, interviewer and respondent expectations, and costs.

Microstructures for studies of cultured neural networks.

A description is given of a functional silicon micromachined device that permits non-invasive, bidirectional, highly specific communication with cultured mammalian neurons. The heart of the system is a well structure that holds the cell in close proximity to a metal extracellular electrode while permitting normal outgrowth of axons and dendrites. An iterative approach is used to create a design that allows normal growth of the neurons while preventing their escape. An array of 16 such neurowells makes it possible to perform studies of biological neural network development and function with unprecedented detail.

The neurochip: a new multielectrode device for stimulating and recording from cultured neurons.

The neurochip is a silicon micromachined device upon which cultured mammalian neurons can be continuously and individually monitored and stimulated. The neurochip is based upon a 4 x 4 array of metal electrodes, each of which has a caged well structure designed to hold a single mature cell body while permitting normal outgrowth of neural processes. We demonstrate that this device is capable of maintaining cell survival, and that the electrodes can both record and stimulate electrical activity in individual cells with no crosstalk between channels.

Use of a new bioassay to study pentamidine pharmacokinetics.

We developed a sensitive and specific agar-diffusion bioassay for pentamidine by using an amphotericin B-resistant isolate, Candida tropicalis ATCC 28707, as the test organism. We determined levels of pentamidine in serum of rats given intramuscular or intravenous injections and levels in serum, urine, and tissues of humans who had received the drug by slow intravenous infusion. Rats given intravenous pentamidine at a dose of 2 mg/kg had higher serum levels than those given intramuscular injection at a dose of 10 mg/kg; however, the drug was detectable in serum for 4 hr after intramuscular administration. The serum half-life in rats after intravenous injection was 2 min. Humans treated with 4 mg of pentamidine/kg by slow (1-2 hr) intravenous infusion had peak serum concentrations ranging from 0.5 to 3.4 micrograms/ml. The mean half-life of elimination from serum in humans was 17 +/- 4 min (n = 3). In two patients, studied after completion of therapy, urinary excretion rates declined with a half-life of five and nine days. In tissues obtained at autopsy from four patients who had received pentamidine, the drug was present in highest concentration in the spleen and liver, followed by kidneys, adrenals, and lungs.