Emerging potassium channel targets for the treatment of pain

Curr Opin Support Palliat Care. 2015 Jun;9(2):147-54. doi: 10.1097/SPC.0000000000000131.

Abstract

Purpose of review: Poor management of chronic pain remains a significant cause of misery with huge socioeconomic costs. Accumulating research in potassium (K+) channel physiology has uncovered several promising leads for the development of novel analgesics.

Recent findings: We now recognize that certain K+ channel subunits are directly gated to pain-relevant stimuli (Kv1.1, K2P) whereas others are specifically modulated by inflammatory processes (Kv7, BKCA, K2P). Genetic analyses illustrate that K+ channel gene variation can predict pain sensitivity (KCNS1, GIRKs), risk for persistent pain (KCNS1, GIRKs, TRESK) and analgesic effectiveness (GIRK2). Importantly, preclinical studies confirm that K+ channel dysfunction can be a pain trigger in traumatic neuropathies (Kv9.1/Kv2.1, Kv7, Kv1.2) and migraine (TRESK). Finally, emerging data suggest that even pain in diabetes, bone cancer and autoimmune neuropathies may have K+ channel dysfunction constituents.

Summary: There is a long-sought need for superior pharmacotherapy of pain syndromes. Although universal enhancement of K+ channel function in the periphery can decrease nociceptive excitability irrespective of the underlying cause, a more refined targeting of subunits with dominant nociceptive roles could yield highly efficacious treatments with fewer side-effects. The ongoing characterization of molecular interactions linking K+ channel dysfunction to pain is instrumental for identifying candidates with the most therapeutic potential.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesics / pharmacology*
  • Chronic Pain / drug therapy*
  • Chronic Pain / etiology
  • Diabetic Neuropathies / drug therapy
  • Diabetic Neuropathies / physiopathology
  • Drug Design*
  • Humans
  • Inflammation / complications
  • Inflammation / drug therapy
  • Inflammation / physiopathology
  • Migraine Disorders / drug therapy
  • Migraine Disorders / physiopathology
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Neoplasms / physiopathology
  • Neuralgia / drug therapy*
  • Neuralgia / etiology
  • Neuralgia / physiopathology
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / physiopathology
  • Potassium Channels / pharmacology
  • Potassium Channels / therapeutic use*

Substances

  • Analgesics
  • Potassium Channels