Role of HCN channels in somatic sensation and pain

Lead Research Organisation: University of Cambridge
Department Name: Pharmacology

Abstract

Nerve cells communicate along the length of their axons by means of action potentials, or transient reversals (depolarisations) of the voltage across the cell membrane. When a sensory stimulus impinges on the skin surface it must, in order to be detected, elicit action potentials in the sensory nerve, or neurone, innervating the body surface at the point of contact. If the stimulus is sustained then it will often elicit a train of action potentials whose frequency encodes the intensity of the stimulus, with higher frequencies signalling a more intense stimulus. Each action potential in a train is followed by a return of the membrane potential to its former negative level (a repolarisation), and in order to elicit the next action potential in the train the membrane voltage must be depolarised again to threshold. The processes which mediate the rate of this depolarisation between action potentials is thus a crucial determinant of the action potential frequency and therefore of the perceived intensity of the stimulus. One important determinant of this rate is the strength of the stimulus, but it is not the only one. In many sensory neurones repolarisation switches on an inward current which then aids the depolarisation to threshold of the next action potential. This current, the hyperpolarisation-activated inward current, or Ih, is the subject of this grant application. Ih is interesting because it can be enhanced by many mediators which promote a sensation of pain, and it therefore may be important in hyperalgesia, or the enhanced pain which follows injury, and in neuropathic pain, an anomalous pain state characterised by ongoing pain and hypersensitivity to even moderate tactile and thermal stimuli. Neuropathic pain is not well understood and is poorly treated by currently available drugs. The condition is often life-long and causes a substantial reduction in quality of life for those who suffer from it. Ih ion channels are made up from various combinations of four different subunits, HCN1-4. Preliminary evidence leading up to this application has shown that there is a segregation in expression of these subunits, with the fast HCN1 subunit expressed in large neurones sensing light touch, and the slower HCN2 in small neurones, most of which sense painful stimuli of various kinds. Why is this? A possible reason is that HCN2 is enhanced by various mediators known to enhance pain, while HCN1 is unaffected. Thus this segregation may provide at least a partial explanation for the increase in pain following injury. We aim to find out more about which subunits are expressed in which types of sensory neurones, and how their behaviour is modulated by inflammatory mediators. There is also evidence from work in other labs that Ih is involved in neuropathic pain, but which subunit is important here and how it enhances neuropathic pain is unknown. We will tackle these and other questions by the use of mice in which each HCN subunits has been genetically deleted (knocked out). We will use a range of techniques to study these mice and to compare them with their wild-type littermates. One major technique will be to record the electrical responses from neurones, both in cell culture, where their behaviour can more readily be investigated, and in an isolated preparation of neurones in situ in skin, which has the advantage that the neurones are in their natural environment. In addition, we will study the behaviour of wild-type and HCN knockout mice in response to a mild painful stimulus, from which they are free with withdraw when it begins to hurt. These studies will advance our understanding of the role of HCN subunits in pain, and if particular subunits have crucial roles in some aspects of pain (e.g. in neuropathic pain) the work will act as a stimulus to the development of novel drugs aimed at specifically blocking those subunits.

Technical Summary

The hyperpolarization-activated membrane current, Ih, is an inward current which is activated by the membrane hyperpolarization following an action potential. This current plays an important role in many excitable tissues in bringing the membrane potential up to the level at which the following action potential is initiated, and is therefore an important determinant of action potential frequency. Ih ion channels are composed of Hyperpolarisation activated Cyclic Nucleotide gated (HCN) subunits 1-4. Ih is known to be present in primary sensory neurons but its importance is not clear. Ih seems to be a significant player in neuropathic pain but it is not clear which isoform is implicated. Our own preliminary studies show that HCN1 is expressed in large non-nociceptive neurons, while a slower cAMP-sensitive Ih, probably mediated by HCN2 and/or HCN4, is present in small nociceptive neurons. An underlying assumption of the proposed study is that this segregation will prove to play an important role in non-noxious somatosensation, which is mediated by large neurons, and in pain sensation, which is mainly mediated by small neurons, but with an important role for input from large neurons in the allodynia associated with neuropathic pain. The proposed study will determine the isoforms underlying Ih in various subclasses of sensory neurons. A second major objective will be to elucidate the role of Ih, and of the HCN isoforms which underlie it, in somatic sensation and in both inflammatory and neuropathic pain. We will tackle the project by implementing a broad range of techniques, from single-cell electrophysiology to whole-animal behavioural studies, and by correlating the results obtained by different techniques throughout the project. We will use global and nociceptor-specific HCN isoform mouse knockout models to elucidate the roles played by each HCN isoform, both at the single-cell level and in the pain behaviour of the whole animal.

Publications

10 25 50
 
Description Final report already submitted
Exploitation Route Final report already submitted
Sectors Healthcare,Pharmaceuticals and Medical Biotechnology

 
Description HCN2 ion channels as a novel analgesic drug targets
Amount £450,000 (GBP)
Organisation Merck 
Department Merck Sharp and Dohme Ltd
Sector Private
Country United Kingdom
Start 06/2019 
End 07/2021
 
Description HCN2 ion channels: a novel target for treatment of migraine
Amount £190,058 (GBP)
Funding ID 201718-16 
Organisation Brain Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 12/2018 
End 11/2020
 
Description Molecular basis of arthritic pain: roles of HCN ion channels and AT2 receptors
Amount £232,985 (GBP)
Funding ID 21522 
Organisation Versus Arthritis 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2017 
End 04/2020
 
Description Seeding Drug Discovery Initiative
Amount £4,500,000 (GBP)
Funding ID 099259/Z/12/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 10/2012 
End 01/2017
 
Title Nav1.8Cre/fHCN2 mouse line 
Description Development of a mouse line with selective deletion of HCN2 ion channels in nociceptive (pain-sensitive) peripheral nerve fibres. The deletion of HCN2 is targeted to nociceptive neurons expressing the sodium channel Nav1.8 using a Cre-driver system. 
Type Of Material Model of mechanisms or symptoms - mammalian in vivo 
Year Produced 2015 
Provided To Others? Yes  
Impact The specific deletion of HCN2 in nociceptive neurons has allowed us to demonstrate a specific role of HCN2 in pain arising from nerve damage and from diabetic neuropathy. 
URL http://science.sciencemag.org/content/333/6048/1462.full
 
Description Collaboration with Menon group, University of Cambridge 
Organisation University of Cambridge
Department School of Clinical Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution The McNaughton lab at KCL carried out preclinical research which has provided the impetus for two clinical trials at the Medical School, University of Cambridge, headed by Prof David Menon.
Collaborator Contribution One clinical trial has completed, the second is still in progress.
Impact The completed trial is reported at http://www.isrctn.com/ISRCTN97420179. Progress with a second trial that is still underway is reported at http://www.isrctn.com/ISRCTN68734605.
Start Year 2012
 
Description Collaboration with Merck Inc 
Organisation Merck
Department Merck Sharp and Dohme Ltd
Country United Kingdom 
Sector Private 
PI Contribution Work conducted under MRC and BBSRC-funded grant identified HCN2 ion channels as primary drivers of chronic pain. We have since developed novel analgesics that act by selectively blocking the HCN2 ion channel, work that was funded by the Wellcome Trust. Three patents have recently been filed. Merck have bought the rights to further development of these compounds, as part of a deal worth up to $440 million plus royalties.
Collaborator Contribution As part of our collaboration agreement, Merck will fund 2 postdoc positions plus research funding in the McNaughton lab, and will also provide development compounds plus some services (e.g. PK analysis) free of charge.
Impact No outputs to date as the collaboration has just commenced.
Start Year 2019
 
Description Article in Financial Times 9 March 2019 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact Following on from a successful drug development project in the McNaughton lab, King's College London concluded an outlicensing deal with Merck Sharp and Dohme Inc to develop an HCN2-blocking drug as a novel analgesic. This article, published in the Financial Times on 9 March 2019, reports on the successful conclusion of the outlicensing deal.
Year(s) Of Engagement Activity 2019
URL https://www.ft.com/join/licence/7e7bc1e4-960a-4f83-b263-b71174d5d56b/details?ft-content-uuid=18d8a12...
 
Description Article in London Evening Standard 8 March 2019 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Following on from a successful drug development project in the McNaughton lab, King's College London concluded an outlicensing deal with Merck Sharp and Dohme Inc to develop an HCN2-blocking drug as a novel analgesic. This article, published 8 March 2019, reports on the successful conclusion of the outlicensing deal.
Year(s) Of Engagement Activity 2019
 
Description Article in The Economist 1843 magazine, published 23 Sept 2019 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact The grantholder (PMcN) was interviewed in March 2019 for an article in the Economist 1843 magazine. The full article, title "Will there ever be a cure for chronic pain?" appeared on 23 September 2019, and covered work from the McNaughton lab regarding the development of blockers of the HCN2 ion channel as novel analgesics that may be effective in a wide range of conditions, including neuropathic pain, inflammatory pain and migraine. The journalist who wrote the article, Sophie Elmhirst, was nominated for a prize for journalism as a result.
Year(s) Of Engagement Activity 2019
URL https://www.1843magazine.com/features/will-there-ever-be-a-cure-for-chronic-pain
 
Description Open day (KCL) 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Neuroscience open day at KCL, attended by academics but also pharma company scientists, undergraduates and some school students
Year(s) Of Engagement Activity 2015
 
Description Public lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact I gave a public lecture on the work of my lab at the University of York. Around 100 people attended, some from the University, others member of the public.
Year(s) Of Engagement Activity 2017
URL https://www.york.ac.uk/news-and-events/events/public-lectures/autumn-17/conquer-pain/
 
Description School visits to lab at KCL 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact Tours of the lab and discussions about science in general and neuroscience in particular; also about neuroscience as a career
Year(s) Of Engagement Activity Pre-2006,2006,2007,2008,2009,2010,2011,2012,2013,2014,2015,2016