Familial episodic limb pain in kindreds with novel Nav1.9 mutations

PLoS One. 2018 Dec 17;13(12):e0208516. doi: 10.1371/journal.pone.0208516. eCollection 2018.

Abstract

We previously performed genetic analysis in six unrelated families with infantile limb pain episodes, characterized by cold-induced deterioration and mitigation in adolescence, and reported two new mutations p.R222H/S in SCN11A responsible for these episodes. As no term described this syndrome (familial episodic pain: FEP) in Japanese, we named it as"". In the current study, we recruited an additional 42 new unrelated Japanese FEP families, between March 2016 and March 2018, and identified a total of 11 mutations in SCN11A: p.R222H in seven families, and p.R225C, p.F814C, p.F1146S, or p.V1184A, in independent families. A founder mutation, SCN11A p.R222H was confirmed to be frequently observed in patients with FEP in the Tohoku region of Japan. We also identified two novel missense variants of SCN11A, p.F814C and p.F1146S. To evaluate the effects of these latter two mutations, we generated knock-in mouse models harboring p.F802C (F802C) and p.F1125S (F1125S), orthologues of the human p.F814C and p.F1146S, respectively. We then performed electrophysiological investigations using dorsal root ganglion neurons dissected from the 6-8 week-old mice. Dissected neurons of F802C and F1125S mice showed increased resting membrane potentials and firing frequency of the action potentials (APs) by high input-current stimulus compared with WT mice. Furthermore, the firing probability of evoked APs increased in low stimulus input in F1125S mice, whereas several AP parameters and current threshold did not differ significantly between either of the mutations and WT mice. These results suggest a higher level of excitability in the F802C or F1125S mice than in WT, and indicate that these novel mutations are gain of function mutations. It can be expected that a considerable number of potential patients with FEP may be the result of gain of function SCN11A mutations.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Child, Preschool
  • Cohort Studies
  • Extremities
  • Family
  • Female
  • Gene Knock-In Techniques
  • Humans
  • Infant
  • Japan
  • Male
  • Mice
  • Mice, Transgenic
  • Musculoskeletal Pain / genetics*
  • Musculoskeletal Pain / pathology
  • Mutation, Missense*
  • NAV1.9 Voltage-Gated Sodium Channel / genetics
  • Pedigree
  • Syndrome

Substances

  • NAV1.9 Voltage-Gated Sodium Channel
  • SCN11A protein, human

Grants and funding

This study was supported by research grants from JSPS KAKENHI (Grants-In-Aid for Scientific Research C: 15K08772 to HO, 17K10046 to TT; Challenging Exploratory Research: 26670330 to AK; JSPS Fellows: 17J04066 to RK, and Challenging Research (Pioneering): 17H06281 to KHH) (https://www.jsps.go.jp/english/) and AMED (JP17ek0610007 to HK) (http://www.amed.go.jp/en/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.