FM Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
Sooyeon Jo
Department of Neurobiology, Harvard Medical School, Boston, United States
Sébastien Talbot
Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
Han-Xiong Bear Zhang
Department of Neurobiology, Harvard Medical School, Boston, United States
Masakazu Kotoda
FM Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
Nick A Andrews
FM Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
Michelino Puopolo
Department of Anesthesiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, United States
Pin W Liu
Department of Neurobiology, Harvard Medical School, Boston, United States
Thomas Jacquemont
FM Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
Maud Pascal
FM Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
Laurel M Heckman
FM Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
Aakanksha Jain
FM Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States
Jinbo Lee
Sage Partner International, Andover, United States
Clifford J Woolf
FM Kirby Neurobiology Research Center, Boston Children's Hospital, Boston, United States; Department of Neurobiology, Harvard Medical School, Boston, United States
Voltage-dependent sodium and calcium channels in pain-initiating nociceptor neurons are attractive targets for new analgesics. We made a permanently charged cationic derivative of an N-type calcium channel-inhibitor. Unlike cationic derivatives of local anesthetic sodium channel blockers like QX-314, this cationic compound inhibited N-type calcium channels more effectively with extracellular than intracellular application. Surprisingly, the compound is also a highly effective sodium channel inhibitor when applied extracellularly, producing more potent inhibition than lidocaine or bupivacaine. The charged inhibitor produced potent and long-lasting analgesia in mouse models of incisional wound and inflammatory pain, inhibited release of the neuropeptide calcitonin gene-related peptide (CGRP) from dorsal root ganglion neurons, and reduced inflammation in a mouse model of allergic asthma, which has a strong neurogenic component. The results show that some cationic molecules applied extracellularly can powerfully inhibit both sodium channels and calcium channels, thereby blocking both nociceptor excitability and pro-inflammatory peptide release.