Use dependence of tetrodotoxin block of sodium channels: a revival of the trapped-ion mechanism.

The use-dependent block of sodium channels by tetrodotoxin (TTX) has been studied in cRNA-injected Xenopus oocytes expressing the alpha-subunit of rat brain IIA channels. The kinetics of stimulus-induced extra block are consistent with an underlying relaxation process involving only three states. Cumulative extra block induced by repetitive stimulations increases with hyperpolarization, with TTX concentration, and with extracellular Ca2+ concentration. We have developed a theoretical model based on the suggestion by Salgado et al. that TTX blocks the extracellular mouth of the ion pore less tightly when the latter has its external side occupied by a cation, and that channel opening favors a tighter binding by allowing the escape of the trapped ion. The model provides an excellent fit of the data, which are consistent with Ca2+ being more efficient than Na+ in weakening TTX binding and with bound Ca2+ stabilizing the closed state of the channel, as suggested by Armstrong and Cota. Reports arguing against the trapped-ion mechanism are critically discussed.