Summary 1. The non-selective K(+) channel blocker
4-aminopyridine (4-AP) has shown clinical efficacy in the treatment of
neurological disorders such as
multiple sclerosis. The clinical usefulness of 4-AP is hampered by its ability to produce
seizures.
Nerispirdine, an analogue of 4-AP, is currently under clinical investigation for the treatment of
multiple sclerosis. In contrast with 4-AP,
nerispirdine is not proconvulsant, suggesting mechanistic differences between the two drugs. 2. Using whole-cell patch-clamp electrophysiology, we compared the effects of 4-AP and
nerispirdine on the cloned human K(+) channels K(v)1.1 and K(v)1.2, expressed in Chinese hamster ovary cells, and on voltage-dependent Na(+) channels recorded from human SH-SY5Y cells. 3.
Nerispirdine inhibited K(v)1.1 and K(v)1.2 with IC(50) values of 3.6 and 3.7 micromol/L, respectively.
4-Aminopyridine was approximately 50-fold less potent at blocking these channels.
Nerispirdine also inhibited voltage-dependent Na(+) channel currents recorded from human SH-SY5Y cells with an IC(50) of 11.9 micromol/L when measured from a -70 mV holding potential. In contrast, 4-AP had no effect on Na(+) channel currents. 4. The results demonstrate that
nerispirdine, like 4-AP, can inhibit axonal K(+) channels and that this mechanism may underlie the ability of the
drug to enhance neuronal conduction. Unlike 4-AP,
nerispirdine can also inhibit neuronal Na(+) channels, a mechanism that may explain why
nerispirdine lacks proconvulsant activity.