PT  - JOURNAL ARTICLE
AU  - Howard, Paul
TI  - HCN channels: novel therapeutic targets for peripheral neuropathic pain
AID  - 10.1136/spcare-2025-005509
DP  - 2025 Apr 15
TA  - BMJ Supportive & Palliative Care
PG  - spcare-2025-005509
4099  - http://spcare.bmj.com/content/early/2025/04/15/spcare-2025-005509.short
4100  - http://spcare.bmj.com/content/early/2025/04/15/spcare-2025-005509.full
AB  - Hyperpolarisation-activated cyclic nucleotide-gated (HCN) channels control neuronal firing thresholds. Together with sodium channels, they accumulate at sites of nerve injury, creating ectopic foci of action potential generation (EFAPG) that result in neuropathic pain.Their presence may explain why EFAPG do not always respond to sodium channel blockers (eg, lacosamide). Further, several current analgesics (clonidine, dexmedetomidine, ketamine and systemic lidocaine) block HCN channels in addition to their better-known actions. Future research could explore the use of ivabradine (an HCN blocker) and multichannel blockade for refractory EFAPG and develop tools to distinguish EFAPG from secondary ‘upstream’ pain mechanisms (eg, central sensitisation).There are no data in this work.