Menthol pain relief through cumulative inactivation of voltage-gated sodium channels

Pain. 2012 Feb;153(2):473-484. doi: 10.1016/j.pain.2011.11.014. Epub 2011 Dec 14.

Abstract

Menthol is a natural compound of plant origin known to produce cool sensation via the activation of the TRPM8 channel. It is also frequently part of topical analgesic drugs available in a pharmacy, although its mechanism of action is still unknown. Compelling evidence indicates that voltage-gated Na(+) channels are critical for experiencing pain sensation. We tested the hypothesis that menthol may block voltage-gated Na(+) channels in dorsal root ganglion (DRG) neurons. By use of a patch clamp, we evaluated the effects of menthol application on tetrodotoxin (TTX)-resistant Nav1.8 and Nav1.9 channel subtypes in DRG neurons, and on TTX-sensitive Na(+) channels in immortalized DRG neuron-derived F11 cells. The results indicate that menthol inhibits Na(+) channels in a concentration-, voltage-, and frequency-dependent manner. Menthol promoted fast and slow inactivation states, causing use-dependent depression of Na(+) channel activity. In current clamp recordings, menthol inhibited firing at high-frequency stimulation with minimal effects on normal neuronal activity. We found that low concentrations of menthol cause analgesia in mice, relieving pain produced by a Na(+) channel-targeting toxin. We conclude that menthol is a state-selective blocker of Nav1.8, Nav1.9, and TTX-sensitive Na(+) channels, indicating a role for Na(+) channel blockade in the efficacy of menthol as topical analgesic compound.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics / pharmacology*
  • Animals
  • Cell Line, Tumor
  • Hybrid Cells
  • Male
  • Menthol / pharmacology*
  • Mice
  • Mice, Inbred C57BL
  • NAV1.8 Voltage-Gated Sodium Channel
  • NAV1.9 Voltage-Gated Sodium Channel
  • Neural Inhibition / physiology
  • Neuroblastoma / metabolism
  • Neuroblastoma / physiopathology
  • Pain / drug therapy*
  • Pain / metabolism
  • Pain / physiopathology*
  • Primary Cell Culture
  • Rats
  • Rats, Wistar
  • Sodium Channels / metabolism*
  • Sodium Channels / physiology

Substances

  • Analgesics
  • NAV1.8 Voltage-Gated Sodium Channel
  • NAV1.9 Voltage-Gated Sodium Channel
  • Scn10a protein, mouse
  • Scn10a protein, rat
  • Scn11a protein, mouse
  • Sodium Channels
  • Menthol