Review of Physiology, Pathology, and Pharmacology of Voltage-Gated Sodium Channels in Regards to the Potential Role of NaV 1.8 Selective Agonist, Suzetrigine, for Chronic Pain Management

Abstract: Voltage-gated sodium channels are integral for various physiologic processes including neurological signaling and cardiac contractility in humans. Classically a target to regulate cardiac arrhythmias, sodium channel inhibitors have held special interest as pharmacologic targets for pain management. However, the lack of receptor selectivity and specificity have resulted in various unwanted side effects and limited therapeutic ranges for nonspecific sodium channel blockers. Recently, suzetrigine, a voltage gated sodium channel subtype (NaV 1.8) selective inhibitor has been released and utilized for acute pain management with promising results. In this manuscript we highlight the physiology and pathology of voltage gated sodium channels along with current pharmacologic options in regards to its potential role for chronic pain management. Keywords: voltage gated sodium channels, pharmacology, neuropathic pain, chronic pain