Rapid optical control of nociception with an ion channel photoswitch

Local anesthetics are effective in suppressing pain sensation, but most of these compounds act non-selectively, inhibiting the activity of all neurons. Moreover, their actions abate slowly, preventing precise spatial and temporal control of nociception. We have developed a photoisomerizable molecule named QAQ (Quaternary ammonium – Azobenzene – Quaternary ammonium) that enables rapid and selective optical control of nociception. QAQ is membrane-impermeant and it has no effect on most cells, but it infiltrates pain-sensing neurons through endogenous ion channels that are activated by noxious stimuli, primarily TRPV1. After QAQ accumulates intracellularly, it blocks voltage-gated ion channels in the trans but not the cis form. QAQ enables reversible optical silencing of mouse nociceptive neuron firing without exogenous gene expression and can serve as a light-sensitive analgesic in rats in vivo. Moreover, because intracellular QAQ accumulation is a consequence of nociceptive ion channel activity, QAQ-mediated photosensitization provides a new platform for understanding signaling mechanisms in acute and chronic pain.