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The P-type calcium channel is a type of
voltage-dependent calcium channel Voltage-gated calcium channels (VGCCs), also known as voltage-dependent calcium channels (VDCCs), are a group of voltage-gated ion channels found in the membrane of excitable cells (''e.g.'', muscle, glial cells, neurons, etc.) with a permeabi ...
. Similar to many other high-voltage-gated calcium channels, the α1 subunit determines most of the channel's properties. The 'P' signifies cerebellar
Purkinje cells Purkinje cells, or Purkinje neurons, are a class of GABAergic inhibitory neurons located in the cerebellum. They are named after their discoverer, Czech anatomist Jan Evangelista Purkyně, who characterized the cells in 1839. Structure The ...
, referring to the channel's initial site of discovery. P-type calcium channels play a similar role to the
N-type calcium channel N-type calcium channels also called Cav2.2 channels are voltage gated calcium channels that are localized primarily on the nerve terminals and dendrites as well as neuroendocrine cells. The calcium N-channel consists of several subunits: the primar ...
in neurotransmitter release at the presynaptic terminal and in neuronal integration in many neuronal types.


History

The calcium channel experiments that led to the discovery of P-type calcium channels were initially completed by Llinás and Sugimori in 1980. P type calcium channels were named in 1989 because they were discovered within mammalian Purkinje neurons. They were able to use an ''
in vitro ''In vitro'' (meaning in glass, or ''in the glass'') studies are performed with microorganisms, cells, or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in biology an ...
'' preparation to examine the ionic currents that account for Purkinje cells' electrophysiological properties. They found that there are calcium dependent
action potential An action potential occurs when the membrane potential of a specific cell location rapidly rises and falls. This depolarization then causes adjacent locations to similarly depolarize. Action potentials occur in several types of animal cells, ...
s which rise slowly and fall quickly then undergo hyperpolarization. The action potentials were voltage dependent and the afterhyperpolarizing potentials were connected to the spike bursts, located within the
dendrite Dendrites (from Greek δένδρον ''déndron'', "tree"), also dendrons, are branched protoplasmic extensions of a nerve cell that propagate the electrochemical stimulation received from other neural cells to the cell body, or soma, of the n ...
s of the Purkinje cells. Without calcium flux in the Purkinje cells, action potentials fire sporadically at a high frequency.


Basic features and structure

P-type calcium channels are
voltage-dependent calcium channel Voltage-gated calcium channels (VGCCs), also known as voltage-dependent calcium channels (VDCCs), are a group of voltage-gated ion channels found in the membrane of excitable cells (''e.g.'', muscle, glial cells, neurons, etc.) with a permeabi ...
s that are classified under the high voltage activated class channel, along with L-, N-, Q- and R-type channels. These channels require a strong
depolarization In biology, depolarization or hypopolarization is a change within a cell, during which the cell undergoes a shift in electric charge distribution, resulting in less negative charge inside the cell compared to the outside. Depolarization is esse ...
in order to be activated. They are found at axon terminals, as well as in somatodendritic areas of neurons within the central and peripheral nervous system. P-type calcium channels are also critical to
vesicle Vesicle may refer to: ; In cellular biology or chemistry * Vesicle (biology and chemistry), a supramolecular assembly of lipid molecules, like a cell membrane * Synaptic vesicle ; In human embryology * Vesicle (embryology), bulge-like features o ...
release, specifically
neurotransmitters A neurotransmitter is a signaling molecule secreted by a neuron to affect another cell across a synapse. The cell receiving the signal, any main body part or target cell, may be another neuron, but could also be a gland or muscle cell. Neur ...
and
hormones A hormone (from the Ancient Greek, Greek participle , "setting in motion") is a class of cell signaling, signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and beh ...
at synaptic terminals of
excitatory In neuroscience, an excitatory postsynaptic potential (EPSP) is a postsynaptic potential that makes the postsynaptic neuron more likely to fire an action potential. This temporary depolarization of postsynaptic membrane potential, caused by the ...
and
inhibitory An inhibitory postsynaptic potential (IPSP) is a kind of synaptic potential that makes a Chemical synapse, postsynaptic neuron less likely to generate an action potential.Purves et al. Neuroscience. 4th ed. Sunderland (MA): Sinauer Associates, Inc ...
synapses. Voltage-gated P-type calcium channels consist of a main pore-forming α1 subunit (which is more specifically referred to as CaV2.1), an α2δ subunit and a β subunit. There can be γ subunits found in calcium channels of skeletal muscles. The α1 subunit is encoded specifically by the ''CACNA1A'' gene and is composed of four domains, each containing six transmembrane (S1-S6) spanning α helices. The S1-S2 loop and the S6 region are thought to be responsible for the channel's inactivation, the S4 region serves as the voltage sensor and S5-S6 loop forms the pore. There are seven subunits within the α1 subunit. The A subunit, called α1ACa2+, corresponds to what is functionally defined as the P-type and Q-type isoforms. P-type and Q-type calcium channels are closely related as they are produced from the same gene via alternative splicing. As a complication of the alternative splicing, P-type and Q-type channels may have different subunit compositions. The β subunit regulates the kinetics and expression of the channel, along with the α2δ subunit.


Channel distribution

The majority of P-type calcium channels are located in the nervous system and heart. Antibody labeling is the primary method used to identify channel location. Areas of high expression in mammalian systems include: *
Purkinje cell Purkinje cells, or Purkinje neurons, are a class of GABAergic inhibitory neurons located in the cerebellum. They are named after their discoverer, Czech people, Czech anatomist Jan Evangelista Purkyně, who characterized the cells in 1839. Stru ...
dendrites *
Smooth endoplasmic reticulum The endoplasmic reticulum (ER) is, in essence, the transportation system of the eukaryotic cell, and has many other important functions such as protein folding. It is a type of organelle made up of two subunits – rough endoplasmic reticulum ( ...
*
Cell membrane The cell membrane (also known as the plasma membrane (PM) or cytoplasmic membrane, and historically referred to as the plasmalemma) is a biological membrane that separates and protects the interior of all cells from the outside environment ( ...
*
Periglomerular cell Periglomerular cells mediate lateral inhibition in the olfactory system together with granule cells. They have inhibitory synapses on mitral cells and tufted cell Tufted cells are found within the olfactory glomeruli. They receive input from the r ...
s in the
olfactory bulb The olfactory bulb (Latin: ''bulbus olfactorius'') is a grey matter, neural structure of the vertebrate forebrain involved in olfaction, the sense of odor, smell. It sends olfactory information to be further processed in the amygdala, the orbitof ...
*
Cerebellar cortex The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cerebel ...
* Neurons in the
brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is cont ...
,
entorhinal The entorhinal cortex (EC) is an area of the brain's allocortex, located in the medial temporal lobe, whose functions include being a widespread network hub for memory, navigation, and the perception of time.Integrating time from experience in the ...
and piriform cortices, and the
habenula In neuroanatomy, habenula (diminutive of Latin ''habena'' meaning rein) originally denoted the stalk of the pineal gland (pineal habenula; pedunculus of pineal body), but gradually came to refer to a neighboring group of nerve cells with which the ...
.


Channel blockers

P-type calcium channel blockers act to impede the flow of calcium. The blocking of calcium currents may cause the organism to experience impaired functioning and viability. These effects can lead to various diseases which are described in more detail in the section below. The
pore Pore may refer to: Biology Animal biology and microbiology * Sweat pore, an anatomical structure of the skin of humans (and other mammals) used for secretion of sweat * Hair follicle, an anatomical structure of the skin of humans (and other m ...
of P-type calcium channels are sensitive to compounds that can be divided into three groups: #
Peptide Peptides (, ) are short chains of amino acids linked by peptide bonds. Long chains of amino acids are called proteins. Chains of fewer than twenty amino acids are called oligopeptides, and include dipeptides, tripeptides, and tetrapeptides. A ...
ion channel blockers # Low molecular weight compounds #
Therapeutics A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many different ...
There are only two peptide
toxin A toxin is a naturally occurring organic poison produced by metabolic activities of living cells or organisms. Toxins occur especially as a protein or conjugated protein. The term toxin was first used by organic chemist Ludwig Brieger (1849– ...
s that selectively block P-type channels: ω-
agatoxin Agatoxins are a class of chemically diverse polyamine and peptide toxins which are isolated from the venom of various spiders. Their mechanism of action includes blockade of glutamate -gated ion channels, voltage-gated sodium channels, or voltage- ...
IVA and ω-agatoxin IVB. The other blockers mentioned, such as the low molecular weight and therapeutic blockers, are nonselective. This means they act can act on P-type channels as well as other channels.


Selective peptide toxin ω-agatoxin

The two known blockers which are specific to P-type calcium channels are peptides derived from the spider venom of ''
Agelenopsis aperta ''Agelenopsis aperta'', also known as the desert grass spider or funnel-web spider, is a species of spider belonging to the family Agelenidae and the genus ''Agelenopsis''. It is found in dry and arid regions across the southern United States a ...
''. The toxins from this
venom Venom or zootoxin is a type of toxin produced by an animal that is actively delivered through a wound by means of a bite, sting, or similar action. The toxin is delivered through a specially evolved ''venom apparatus'', such as fangs or a sti ...
which show selectivity for P-type channels are ω-agatoxin IVA and ω-agatoxin IVB. Each of these peptide toxins are made of 48
amino acids Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha am ...
which are bound by four
disulfide bond In biochemistry, a disulfide (or disulphide in British English) refers to a functional group with the structure . The linkage is also called an SS-bond or sometimes a disulfide bridge and is usually derived by the coupling of two thiol groups. In ...
s. Although ω-agatoxin IVA and ω-agatoxin IVB have the same affinity and selectivity for P-type channels, their kinetics are different. The ω-agatoxin IVA effects the gating mechanism of the P-type channel. When there is a strong
depolarization In biology, depolarization or hypopolarization is a change within a cell, during which the cell undergoes a shift in electric charge distribution, resulting in less negative charge inside the cell compared to the outside. Depolarization is esse ...
to activate the channel, ω-agatoxin IVA can no longer block the channel. Therefore, ω-agatoxin IVA has a very low affinity for the channel when it is open. It binds to the α1A subunit on the outside of the pore. The ω-agatoxin IVA
receptor Receptor may refer to: * Sensory receptor, in physiology, any structure which, on receiving environmental stimuli, produces an informative nerve impulse *Receptor (biochemistry), in biochemistry, a protein molecule that receives and responds to a ...
on the P-type channel is located at the S3-S4 linker. On the other hand, channel blocking by ω-agatoxin IVB occurs much more slowly. Yet, similar to ω-agatoxin IVA, ω-agatoxin IVB cannot bind to the channel upon a strong depolarization.


Non-selective peptide toxins

* ω-Grammotoxin SIA is a peptide toxin derived from the venom of the spider ''Grammostola spatulata''. It acts to modify the P-type channel gating. * ω-PnTx3-3, PnTx3-3, and phonetoxin IIA are all toxins from the spider ''Phonoetrica nigriventer'' which act to block the current through the P-type calcium channels. * DW13.3 is a peptide toxin from the spider ''Filistata hibernalis'' and it is composed of 74 amino acids. It also functions to block the current through P-type calcium channels. * ω-
Conotoxin A conotoxin is one of a group of neurotoxic peptides isolated from the venom of the marine cone snail, genus ''Conus''. Conotoxins, which are peptides consisting of 10 to 30 amino acid residues, typically have one or more disulfide bonds. Cono ...
s are derived from the venom of
cone snails A cone is a three-dimensional geometric shape that tapers smoothly from a flat base (frequently, though not necessarily, circular) to a point called the apex or vertex. A cone is formed by a set of line segments, half-lines, or lines co ...
. ω-Conotoxin MVIIC acts within the
hippocampal The hippocampus (via Latin from Greek , 'seahorse') is a major component of the brain of humans and other vertebrates. Humans and other mammals have two hippocampi, one in each side of the brain. The hippocampus is part of the limbic system, an ...
CA1
pyramidal neuron Pyramidal cells, or pyramidal neurons, are a type of multipolar neuron found in areas of the brain including the cerebral cortex, the hippocampus, and the amygdala. Pyramidal neurons are the primary excitation units of the mammalian prefrontal cor ...
s to block the P-type channels. Also, within the hippocampal CA3 neurons, this toxin blocks
synaptic transmission Neurotransmission (Latin: ''transmissio'' "passage, crossing" from ''transmittere'' "send, let through") is the process by which signaling molecules called neurotransmitters are released by the axon terminal of a neuron (the presynaptic neuron), ...
. Its effects are slow. *
Calcicludine Calcicludine (CaC) is a protein toxin from the venom of the green mamba that inhibits high-voltage-activated calcium channels, especially L-type calcium channels. Sources Calcicludine is a toxin in the venom of the green mamba ''(Dendroaspis a ...
is from venom of ''Dendroaspis angusticeps'', which is a green mamba. It has the ability to voltage-dependently block P-type channels. * Kurotoxin is from venom of the
scorpion Scorpions are predatory arachnids of the order Scorpiones. They have eight legs, and are easily recognized by a pair of grasping pincers and a narrow, segmented tail, often carried in a characteristic forward curve over the back and always end ...
''Parabuthus''. In
neuron A neuron, neurone, or nerve cell is an electrically excitable cell that communicates with other cells via specialized connections called synapses. The neuron is the main component of nervous tissue in all animals except sponges and placozoa. N ...
s in the
thalamus The thalamus (from Greek θάλαμος, "chamber") is a large mass of gray matter located in the dorsal part of the diencephalon (a division of the forebrain). Nerve fibers project out of the thalamus to the cerebral cortex in all directions, ...
, kurtoxin decreases high threshold calcium currents, however, in the
Purkinje cell Purkinje cells, or Purkinje neurons, are a class of GABAergic inhibitory neurons located in the cerebellum. They are named after their discoverer, Czech people, Czech anatomist Jan Evangelista Purkyně, who characterized the cells in 1839. Stru ...
s, it increases the calcium currents.


Low molecular weight P-type channel blockers

Low molecular weight channel blockers have advantages over peptide blockers in drug development. One advantage of low molecular weight channel blockers is that they can penetrate tissue, which is important for crossing the
blood–brain barrier The blood–brain barrier (BBB) is a highly selective semipermeable membrane, semipermeable border of endothelium, endothelial cells that prevents solutes in the circulating blood from ''non-selectively'' crossing into the extracellular fluid of ...
. There is no specific low molecular weight channel blocker for P-type channels. However, there are a number of these blocker compounds which can effect the activity of the P-type channels. These include: * Roscovitine is an inhibitor of
cyclin-dependent kinase Cyclin-dependent kinases (CDKs) are the families of protein kinases first discovered for their role in regulating the cell cycle. They are also involved in regulating transcription, mRNA processing, and the differentiation of nerve cells. They a ...
. It increases the current of calcium in neostriatal
interneuron Interneurons (also called internuncial neurons, relay neurons, association neurons, connector neurons, intermediate neurons or local circuit neurons) are neurons that connect two brain regions, i.e. not direct motor neurons or sensory neurons. I ...
s by slowing the deactivation of the channel. Also, roscovitine can either act as an
agonist An agonist is a chemical that activates a receptor to produce a biological response. Receptors are cellular proteins whose activation causes the cell to modify what it is currently doing. In contrast, an antagonist blocks the action of the ago ...
or
antagonist An antagonist is a character in a story who is presented as the chief foe of the protagonist. Etymology The English word antagonist comes from the Greek ἀνταγωνιστής – ''antagonistēs'', "opponent, competitor, villain, enemy, riv ...
for the P-type calcium channels in the presynaptic membrane. *
Isoprenaline Isoprenaline, or isoproterenol (brand name: Isoprenaline Macure), is a medication used for the treatment of bradycardia (slow heart rate), heart block, and rarely for asthma. It is a non-selective β adrenoceptor agonist that is the isopropylam ...
is a β-adrenoceptor agonist and it causes an increase in P-type calcium channel current. Isoprenaline acts through a cAMP signaling pathway. *
Eliprodil Eliprodil (codenamed SL-82.0715) is an NMDA antagonist drug candidate which selectively inhibits the NR2B (GLUN2B) subtype NMDA receptor at submicromolar concentrations. Eliprodil failed a Phase III clinical trial for the treatment of acute ische ...
and
antazoline Antazoline is a 1st generation antihistamine with anticholinergic properties used to relieve nasal congestion and in eye drops, usually in combination with naphazoline, to relieve the symptoms of allergic conjunctivitis. To treat allergic conjunc ...
are
NMDA receptor antagonists NMDA receptor antagonists are a class of drugs that work to antagonize, or inhibit the action of, the ''N''-Methyl-D-aspartate receptor (NMDAR). They are commonly used as anesthetics for animals and humans; the state of anesthesia they induce ...
and act to block P-type channels. Eliprodil can decrease P-type channel currents in the Purkinje neurons in the
cerebellum The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cerebel ...
. * Dodecylamine can only block P-type channels when they are in the open state. *
Ethanol Ethanol (abbr. EtOH; also called ethyl alcohol, grain alcohol, drinking alcohol, or simply alcohol) is an organic compound. It is an Alcohol (chemistry), alcohol with the chemical formula . Its formula can be also written as or (an ethyl ...
can block P-type channels when at a high enough concentration. The blocking of the P-type channels could be the reason for
ataxia Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements. Ataxia is a clinical manifestation indicating dysfunction of ...
when drinking
alcohol Alcohol most commonly refers to: * Alcohol (chemistry), an organic compound in which a hydroxyl group is bound to a carbon atom * Alcohol (drug), an intoxicant found in alcoholic drinks Alcohol may also refer to: Chemicals * Ethanol, one of sev ...
.


Therapeutics

There are therapeutics used clinically which can effect the activity of P-type calcium channels. However, the primary
target Target may refer to: Physical items * Shooting target, used in marksmanship training and various shooting sports ** Bullseye (target), the goal one for which one aims in many of these sports ** Aiming point, in field artillery, fi ...
of these therapeutics are not thought to be P-type channels. For example,
calcium antagonist Calcium channel blockers (CCB), calcium channel antagonists or calcium antagonists are a group of medications that disrupt the movement of calcium () through calcium channels. Calcium channel blockers are used as antihypertensive drugs, i.e., as ...
s, which are used to treat
coronary heart disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...
,
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
, and
cardiac arrhythmia Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...
, act by inhibiting L-type or T-type calcium channels. Some of these calcium antagonists include
verapamil Verapamil, sold under various trade names, is a calcium channel blocker medication used for the treatment of high blood pressure, angina (chest pain from not enough blood flow to the heart), and supraventricular tachycardia. It may also be used ...
,
diltiazem Diltiazem, sold under the brand name Cardizem among others, is a calcium channel blocker medication used to treat high blood pressure, angina, and certain heart arrhythmias. It may also be used in hyperthyroidism if beta blockers cannot be used ...
,
amlodipine Amlodipine, sold under the brand name Norvasc among others, is a calcium channel blocker medication used to treat high blood pressure and coronary artery disease. It is taken by mouth. Common side effects include swelling, feeling tired, ab ...
,
benidipine Benidipine is a dihydropyridine calcium channel blocker for the treatment of high blood pressure (hypertension). It is a triple L-, T-, and N-type calcium channel blocker. It is reno- and cardioprotective. It was patented in 1981 and approve ...
,
cilnidipine Cilnidipine is a calcium channel blocker. Cilnidipine is approved for use in Japan, China, India, Nepal, and Korea for hypertension. It is a calcium antagonist accompanied with L-type calcium channel, L-type and N-type calcium channel, N-type ...
,
nicardipine Nicardipine (Cardene) is a medication used to treat high blood pressure and angina. It belongs to the dihydropyridine class of calcium channel blockers (CCBs). It is also used for Raynaud's phenomenon. It is available in by mouth and intravenous ...
, and
barnidipine Barnidipine (INN Inns are generally establishments or buildings where travelers can seek lodging, and usually, food and drink. Inns are typically located in the country or along a highway; before the advent of motorized transportation they al ...
. Although their main target is not P-type channels, these calcium antagonists also act to block the function of P-type channels. Moreover,
flunarizine Flunarizine, sold under the brand name Sibelium among others, is a drug classified as a calcium antagonist which is used for various indications. It is not available by prescription in the United States or Japan. The drug was discovered at Janss ...
is another calcium antagonist which is used to treat
migraine Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
s. Its main targets are
voltage-gated calcium channels Voltage-gated calcium channels (VGCCs), also known as voltage-dependent calcium channels (VDCCs), are a group of voltage-gated ion channels found in the membrane of excitable cells (''e.g.'', muscle, glial cells, neurons, etc.) with a permeabili ...
and
sodium channels Sodium channels are integral membrane proteins that form ion channels, conducting sodium ions (Na+) through a cell's membrane. They belong to the superfamily of cation channels and can be classified according to the trigger that opens the channel ...
. Flunarizine inhibits the P-type channels that are located in the neocortical slices. It works to inhibit the inward flux of calcium. The migraines that it helps to prevent are due to mutations within the "cacna1a" gene of the P-type channel subunit. Also, compounds that block P-type channels are shown to help with
seizures An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or neural oscillation, synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much o ...
. Epileptic seizures are caused by increased
neurotransmission Neurotransmission (Latin: ''transmissio'' "passage, crossing" from ''transmittere'' "send, let through") is the process by which signaling molecules called neurotransmitters are released by the axon terminal of a neuron (the presynaptic neuron), ...
, which is partially a result of P-type channels. Compounds such as
levetiracetam Levetiracetam, sold under the brand name Keppra among others, is a medication used to treat epilepsy. It is used for partial-onset, myoclonic, or tonic–clonic seizures and is taken either by mouth as an immediate or extended release formul ...
,
lamotrigine Lamotrigine, sold under the brand name Lamictal among others, is a medication used to treat epilepsy and stabilize mood in bipolar disorder. For epilepsy, this includes focal seizures, tonic-clonic seizures, and seizures in Lennox-Gastaut synd ...
, and
carbamazepine Carbamazepine (CBZ), sold under the trade name Tegretol among others, is an anticonvulsant medication used primarily in the treatment of epilepsy and neuropathic pain. It is used as an adjunctive treatment in schizophrenia along with other medi ...
are known to block the P-type channels, which have helped to decrease the occurrence of seizures. Overall, there are various non-selective calcium channel blockers that help alleviate symptoms of
hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
,
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
,
cardiac arrhythmia Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...
,
epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical ...
,
pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...
,
asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...
,
bradycardia Bradycardia (also sinus bradycardia) is a slow resting heart rate, commonly under 60 beats per minute (BPM) as determined by an electrocardiogram. It is considered to be a normal heart rate during sleep, in young and healthy or elderly adults, a ...
,
angina pectoris Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of obstru ...
and
Alzheimer's disease Alzheimer's disease (AD) is a neurodegeneration, neurodegenerative disease that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in short-term me ...
. Although many of the therapeutic compounds' main target is not P-type channels, further research needs to determine if the clinical effects of these compounds are also influenced by the P-type channel blockage.


Related diseases

There are a number of
neurological diseases A neurological disorder is any disorder of the nervous system. Structural, biochemical or electrical abnormalities in the brain, spinal cord or other nerves can result in a range of symptoms. Examples of symptoms include paralysis, muscle weak ...
that have been attributed to malfunctioning or mutated P/Q type channels.


Alzheimer's disease

In
Alzheimer's disease Alzheimer's disease (AD) is a neurodegeneration, neurodegenerative disease that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in short-term me ...
, there is a progressive accumulation of β-amyloid protein (Aβ) in brain.
Amyloid Amyloids are aggregates of proteins characterised by a Fibril, fibrillar morphology of 7–13 Nanometer, nm in diameter, a beta sheet (β-sheet) Secondary structure of proteins, secondary structure (known as cross-β) and ability to be Staining, ...
plaques develop which result in the key symptoms of Alzheimer Disease. Aβ globulomer protein is an artificial substance used in research experiments that has similar properties to Aβ oligomer which is present in the body. Aβ oligomer directly regulates P/Q type calcium channels. The α1A subunit is the responsible for the conduction of calcium current. When only P/Q type calcium channels are present with Aβ globulomer protein, there is a direct effect on the α1A subunit and results in an increased calcium current through the P/Q type calcium channel. The response is dose dependent as concentrations of 20nM and 200nM of Aβ globulomer are necessary for significant increase of calcium current through channel in ''
Xenopus ''Xenopus'' () (Gk., ξενος, ''xenos''=strange, πους, ''pous''=foot, commonly known as the clawed frog) is a genus of highly aquatic frogs native to sub-Saharan Africa. Twenty species are currently described within it. The two best-known ...
'' oocytes, showing that a certain buildup of Aβ globulomer is necessary before the effects are seen. When the calcium current is increased,
neurotransmitter A neurotransmitter is a signaling molecule secreted by a neuron to affect another cell across a synapse. The cell receiving the signal, any main body part or target cell, may be another neuron, but could also be a gland or muscle cell. Neuro ...
release also rises, offering a possible cause for the toxicity in Alzheimer's disease patients.


Migraine headaches

The '' CACNA1A gene'' codes for the alpha subunit of the P/Q type calcium channel. The R192Q mutation of the CACNA1A gene is a gain of function
mutation In biology, a mutation is an alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA. Viral genomes contain either DNA or RNA. Mutations result from errors during DNA or viral replication, mi ...
for P2X3 receptors. P2X3 receptors are present in trigeminal ganglion neurons and are believed to be a main contributor to
familial hemiplegic migraine Familial hemiplegic migraine (FHM) is an autosomal dominant type of hemiplegic migraine that typically includes weakness of half the body which can last for hours, days, or weeks. It can be accompanied by other symptoms, such as ataxia, coma, ...
. By using a knockin experiment, this mutation could be expressed in mice so research could be conducted. The mutant mouse has a significantly higher P2X3 receptor activity than the wild type mouse due to increased channel open probability and channel activation at lower voltages. This increased receptor activity results in a higher flux of calcium through the P/Q type calcium channel. The increased intracellular calcium concentration may contribute to the acute trigeminal pain that typically results in a headache. Evidence supports that
migraine Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
s are a disorder of brain excitability characterized by deficient regulation of the cortical excitatory–inhibitory balance.


Seizures

Levetiracetam Levetiracetam, sold under the brand name Keppra among others, is a medication used to treat epilepsy. It is used for partial-onset, myoclonic, or tonic–clonic seizures and is taken either by mouth as an immediate or extended release formul ...
is an anti-epileptic drug than can be used to treat
partial Partial may refer to: Mathematics * Partial derivative, derivative with respect to one of several variables of a function, with the other variables held constant ** ∂, a symbol that can denote a partial derivative, sometimes pronounced "partial ...
and
generalized seizures Generalized epilepsy is a form of epilepsy characterised by generalised seizures with no apparent cause. Generalized seizures, as opposed to focal seizures, are a type of seizure that impairs consciousness and distorts the electrical activity of ...
. Levetiracetam inhibits P/Q channel-mediated
glutamate Glutamic acid (symbol Glu or E; the ionic form is known as glutamate) is an α-amino acid that is used by almost all living beings in the biosynthesis of proteins. It is a non-essential nutrient for humans, meaning that the human body can syn ...
release and decreases the excitatory post synaptic currents of both
AMPA α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid, better known as AMPA, is a compound that is a specific agonist for the AMPA receptor, where it mimics the effects of the neurotransmitter glutamate. There are several types of glutamatergic ...
and
NMDA receptor The ''N''-methyl-D-aspartate receptor (also known as the NMDA receptor or NMDAR), is a glutamate receptor and ion channel found in neurons. The NMDA receptor is one of three types of ionotropic glutamate receptors, the other two being AMPA rece ...
s in the
hippocampus The hippocampus (via Latin from Greek , 'seahorse') is a major component of the brain of humans and other vertebrates. Humans and other mammals have two hippocampi, one in each side of the brain. The hippocampus is part of the limbic system, a ...
, specifically the
dentate gyrus The dentate gyrus (DG) is part of the hippocampal formation in the temporal lobe of the brain, which also includes the hippocampus and the subiculum. The dentate gyrus is part of the hippocampal trisynaptic circuit and is thought to contribute ...
, which is known to propagate seizure activities. The inhibition of glutamate release results in an anti-epileptic response in patients because it decreases the excitatory postsynaptic current. There are many different types of calcium channels, so to prove that the P/Q type calcium channels are directly involved, a P/Q type voltage gated calcium channel inhibitor, omega-agatoxin TK, was used to block the channel. When blocked, patients no longer benefited from the anti-epileptic effects from the drugs. When blockers for L type and N type calcium channels were used, the effects of Levetiracetam were still seen. This is strong evidence that the P/Q type calcium channels are involved in the Levetiracetam treatment which allow for relief from seizures.


Mutation studies

Many P-type calcium channels mutations result in a decreased level of intracellular free calcium. Maintaining calcium homeostasis is essential for normally functioning neurons. Changing the cellular calcium ion concentration acts as a trigger for multiple diseases, in severe cases these diseases can result in mass neuronal death. Mutation studies allow experimenters to study genetically inherited
channelopathies Channelopathies are a group of diseases caused by the dysfunction of ion channel subunits or their interacting proteins. These diseases can be inherited or acquired by other disorders, drugs, or toxins. Mutations in genes encoding ion channels, wh ...
. A channelopathy is any disease that results from an ion channel with malfunctioning subunits or regulatory proteins. One example of a P-type calcium channel channelopathy is shown in homozygous
ataxic Ataxia is a neurological sign consisting of lack of voluntary Motor coordination, coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements. Ataxia is a clinical manifestation indicati ...
mice, who are recessive for both the ''tottering'' and ''leaner'' genes. These mice present with mutations in the alpha1A subunit of their P/Q type channels. Mutations in these channels result in deficiencies within the cerebellar Purkinje cells that dramatically reduce the channels current density. The tottering mutations within mice result from a
missense mutation In genetics, a missense mutation is a point mutation in which a single nucleotide change results in a codon that codes for a different amino acid. It is a type of nonsynonymous substitution. Substitution of protein from DNA mutations Missense m ...
and causes delayed-onset of seizures and ataxia. The ''tottering'' mutation substitutes a single proline instead of a leucine within the P-region of the channel. The P-region is responsible for the formation of the
ion channel pore Ion channels are pore-forming membrane proteins that allow ions to pass through the channel pore. Their functions include establishing a resting membrane potential, shaping action potentials and other electrical signals by gating the flow of io ...
. The ''leaner'' mutation, which results in more severe symptoms than the ''tottering'' mutation, has been shown to result from a single nucleotide substitution that causes splicing failures within the channels open reading frame. Mutations in the pore forming subunit of P type calcium channels cause ataxia, severely altered respiration, by decreasing
minute ventilation Minute ventilation (or respiratory minute volume or minute volume) is the volume of gas inhaled (inhaled minute volume) or exhaled (exhaled minute volume) from a person's lungs per minute. It is an important parameter in respiratory medicine due ...
and producing symptoms associated with
atelectasis Atelectasis is the collapse or closure of a lung resulting in reduced or absent gas exchange. It is usually unilateral, affecting part or all of one lung. It is a condition where the alveoli are deflated down to little or no volume, as distinct ...
. Mutations to CaV2.1 have also been shown to affect transmission within the
pre-Bötzinger Complex The preBötzinger complex, sometimes written pre-Bötzinger complex (preBötC), is a functionally and anatomically specialized site in the ventral-lateral region of the lower medulla oblongata (i.e., lower brainstem). The preBötC is part of the ven ...
, a cluster of interneurons in the brainstem which help to regulate breathing.


See also

* Cav2.1 *
voltage-dependent calcium channel Voltage-gated calcium channels (VGCCs), also known as voltage-dependent calcium channels (VDCCs), are a group of voltage-gated ion channels found in the membrane of excitable cells (''e.g.'', muscle, glial cells, neurons, etc.) with a permeabi ...


References

{{Ion channels, g1 Ion channels Electrophysiology Integral membrane proteins Calcium channels