Cannabidiol Selectively Binds to the Voltage-Gated Sodium Channel Nav1.4 in Its Slow-Inactivated State and Inhibits Sodium Current

Cannabidiol (CBD), one of the cannabinoids from the cannabis plant, can relieve the myotonia resulting from sodium channelopathy, which manifests as repetitive discharges of muscle membrane. We investigated the binding kinetics of CBD to Na(v)1.4 channels on the muscle membrane. The binding affinity of CBD to the channel was evaluated using whole-cell recording. The CDOCKER program was employed to model CBD docking onto the Na(v)1.4 channel to determine its binding sites. Our results revealed no differential inhibition of sodium current by CBD when the channels were in activation or fast inactivation status. However, differential inhibition was observed with a dose-dependent manner after a prolonged period of depolarization, leaving the channel in a slow-inactivated state. Moreover, CBD binds selectively to the slow-inactivated state with a significantly faster binding kinetics (>64,000 M-1 s(-1)) and a higher affinity (K-d of fast inactivation vs. slow-inactivation: >117.42 mu M vs. 51.48 mu M), compared to the fast inactivation state. Five proposed CBD binding sites in a bundle crossing region of the Na(v)1.4 channels pore was identified as Val793, Leu794, Phe797, and Cys759 in domain I/S6, and Ile1279 in domain II/S6. Our findings imply that CBD favorably binds to the Na(v)1.4 channel in its slow-inactivated state.

Automated summary

The study revealed that CBD selectively binds to the slow-inactivated state of the Na(v)1.4 channel with a higher affinity and faster binding kinetics compared to the fast inactivation state. This differential inhibition of sodium current by CBD suggests its potential therapeutic benefit in treating myotonia resulting from sodium channelopathy.