Fact-checked by Grok 2 weeks ago

Calcium channel

Calcium channels are specialized transmembrane proteins that selectively permit the passage of calcium ions (Ca²⁺) across cell membranes, serving as critical regulators of intracellular in diverse physiological processes including , neuronal excitability, , and gene transcription. These channels encompass several subtypes, primarily voltage-gated calcium channels (VGCCs), which open in response to changes in , as well as ligand-gated and store-operated variants that respond to chemical signals or intracellular calcium stores. By controlling Ca²⁺ influx, they transduce electrical signals into biochemical cascades essential for cellular function across excitable and non-excitable tissues. The structure of VGCCs, the most extensively studied class, features a central pore-forming α₁ subunit composed of four homologous domains (I–IV), each containing six transmembrane helices (S1–S6), where the S1–S4 segments form the voltage-sensing domain and S5–S6 create the ion-conducting with a selectivity filter lined by glutamate/aspartate residues (EEEE or EEDD locus) for Ca²⁺ over other ions. Auxiliary subunits, including the intracellular β subunit, extracellular α₂δ complex, and sometimes γ, modulate channel assembly, trafficking, gating kinetics, and , enhancing and voltage sensitivity. High-resolution cryo-electron structures, such as those of Caᵥ1.1 at 2.6 Å , have revealed conformational states (closed, open, inactivated) and binding sites for modulators like dihydropyridines and toxins, illuminating mechanisms of activation and inhibition. Functionally, VGCCs are classified into high-voltage-activated (HVA) types—L-type (Caᵥ1), P/Q-type (Caᵥ2.1), N-type (Caᵥ2.2), and R-type (Caᵥ2.3)—which activate at depolarized potentials to trigger rapid Ca²⁺ entry, and low-voltage-activated (Caᵥ3), which facilitate burst firing at more hyperpolarized levels. In neurons and synapses, N-, P/Q-, and R-type channels couple action potentials to release, while L-type channels in cardiac and drive contraction and in endocrine cells stimulate . channels contribute to activity and dendritic signaling, underscoring their role in rhythmic behaviors and sensory processing. Dysfunction or genetic mutations in calcium channels underlie channelopathies such as (CACNA1A mutations in P/Q-type), Timothy syndrome (CACNA1C in L-type), and various epilepsies, highlighting their therapeutic targeting. Clinically, L-type blockers like dihydropyridines (e.g., amlodipine) are widely used to treat , , and arrhythmias by reducing Ca²⁺ influx and vascular/cardiac contractility, with ongoing research exploring T-type and N-type antagonists for pain, , and . Recent structural insights continue to advance , promising more selective modulators for these multifaceted signaling hubs. As of 2025, advances include de novo design of functional calcium channels using and novel state-dependent N-type blockers like C2230 for management.

Overview and Classification

Definition and General Properties

Calcium channels are integral membrane proteins that form selective pores for calcium ions (Ca²⁺), facilitating their rapid influx across plasma membranes or intracellular membranes such as those of the . These proteins enable controlled Ca²⁺ entry in response to various cellular stimuli, maintaining the steep concentration gradient typical of eukaryotic cells where extracellular [Ca²⁺] is approximately 1-2 mM compared to intracellular levels around 100 nM. A hallmark biophysical property of calcium channels is their exceptional selectivity for Ca²⁺ over monovalent cations like Na⁺ and K⁺, with selectivity ratios such as Ca²⁺/Na⁺ often exceeding 1000:1 under physiological conditions. This selectivity arises from specific structural motifs in the channel pore, including negatively charged residues that coordinate dehydrated Ca²⁺ ions. Single-channel conductance for these pores typically ranges from 1 to 30 pS, varying with channel type and ionic conditions, while behavior—predominantly inward rectification—limits outward current flow, enhancing efficiency during . In cellular signaling, Ca²⁺ influx through these channels serves as a key second messenger, triggering diverse downstream processes like enzyme activation and , in contrast to Na⁺ channels, which primarily drive initiation, or K⁺ channels, which stabilize resting potentials and repolarize membranes. The driving force for Ca²⁺ movement is governed by its , with the reversal potential described by the for divalent ions: E_{\text{Ca}} = \frac{RT}{2F} \ln \left( \frac{[\text{Ca}^{2+}]_o}{[\text{Ca}^{2+}]_i} \right) where R is the gas constant, T is the absolute temperature, F is the Faraday constant, [\text{Ca}^{2+}]_o is the extracellular concentration, and [\text{Ca}^{2+}]_i is the intracellular concentration; this typically yields a positive E_{\text{Ca}} around +120 to +150 mV. Major categories of calcium channels include voltage-gated and ligand-gated types, though others exist.

Historical Discovery and Nomenclature

The discovery of calcium channels began in the early 1950s with pioneering electrophysiological studies on excitable tissues. In 1953, Paul Fatt and recorded action potentials in muscle fibers that persisted in low-sodium solutions, suggesting a calcium-dependent mechanism; they proposed that calcium ions served as charge carriers for these "slow inward currents." Building on this, Susumu Hagiwara in the late 1950s and 1960s conducted extensive experiments on various preparations, including muscle and eggs, demonstrating the ubiquity of calcium spikes and identifying key properties like ion selectivity and blockade by divalent cations such as ; his 1966 work with Shigeru Nakajima differentiated calcium from sodium spikes using pharmacological agents. These findings established calcium channels as distinct entities essential for cellular excitability, shifting focus from sodium-dominated action potentials. The 1970s marked a breakthrough with voltage-clamp techniques that isolated and characterized calcium currents more precisely. Pavel Kostyuk and colleagues at the Bogomoletz Institute applied intracellular perfusion and voltage-clamp to snail neurons, confirming voltage-gated calcium channels in 1973 and revealing their activation by independent of sodium; by 1977, they detailed the kinetics and ionic dependence of these currents in molluscan neurons. Earlier studies on squid axons, such as those by and in 1957, quantified calcium influx during activity using radioactive tracers, providing foundational evidence for calcium's role in nerve signaling, though full voltage-clamp isolation of calcium currents in axons came later in the decade. The development of the patch-clamp technique by Erwin Neher and Bert Sakmann in 1976 revolutionized single-channel recordings, enabling direct observation of calcium channel openings in 1984 by Paul Hess, John Fox, and Richard Tsien, who identified distinct L-type currents in cardiac cells; this work earned Neher and Sakmann the 1991 in or . The 1980s advanced molecular identification, with the of the first calcium channel in by Tsutomu Tanabe, Haruo Takeshima, and colleagues, who isolated the dihydropyridine-sensitive receptor (now Caᵥ1.1) from rabbit , revealing its α1 subunit as the pore-forming component. Bertil Hille's biophysical analyses during this era, synthesized in his 1970s-1990s research and book Ion Channels of Excitable Membranes, elucidated channel selectivity and gating principles, emphasizing calcium's role in diverse physiological processes. evolved from descriptive terms like "slow inward current" or "T/L/N-types" (proposed by Nowycky, Fox, and Tsien in 1985 based on thresholds and ) to a standardized system in 2000 by the Union of Pharmacology (IUPHAR), designating voltage-gated channels as Caᵥ with subfamilies Caᵥ1 (L-type), Caᵥ2 (P/Q, N, R-types), and Caᵥ3 (). This classification, refined in subsequent IUPHAR updates, facilitates precise referencing across research.

Types of Calcium Channels

Voltage-Gated Calcium Channels

Voltage-gated calcium channels (VGCCs) mediate calcium influx in response to depolarization, playing a pivotal role in excitation-contraction in muscle cells and synaptic in neurons. These channels are essential for converting electrical signals into chemical responses by permitting selective Ca²⁺ entry upon voltage-dependent activation. Unlike ligand-gated channels, which respond to chemical stimuli, VGCCs are triggered solely by changes in . VGCCs are broadly classified into high-voltage-activated (HVA) and low-voltage-activated (LVA) categories based on the threshold required for opening. HVA channels encompass L-type (Caᵥ1 family), N-type (Caᵥ2.2), P/Q-type (Caᵥ2.1), and R-type (Caᵥ2.3) subtypes, which require stronger to activate and exhibit slower inactivation. In contrast, LVA channels (Caᵥ3 family) activate at milder and inactivate rapidly, contributing to burst firing patterns in excitable cells. The functional diversity of VGCCs arises from their pore-forming α₁ subunits, encoded by specific genes that define subtype properties. For instance, CACNA1C encodes the Caᵥ1.2 isoform of L-type channels, while CACNA1A encodes the P/Q-type Caᵥ2.1. These subunits form the voltage-sensing and core, with auxiliary β, α₂δ, and γ subunits modulating kinetics and expression. of VGCCs involves conformational changes in the voltage-sensing domains of the α₁ subunit upon , leading to opening and Ca²⁺ . HVA channels typically reach activation thresholds around -20 mV, with peak currents at more positive potentials (0 to +10 mV), and display slow inactivation (time constants of hundreds of milliseconds). LVA T-type channels activate at thresholds near -60 mV, peaking around -40 mV, and undergo fast inactivation (time constants of 20-50 ms), enabling transient calcium signals. These kinetics ensure precise temporal control of Ca²⁺ entry during action potentials. Tissue distribution of VGCC subtypes reflects their specialized roles in depolarization-triggered Ca²⁺ signaling. L-type channels are abundant in cardiac and , where they couple excitation to contraction, and in neuronal and dendrites for gene regulation. -, P/Q-, and R-type channels predominate in presynaptic terminals of central and peripheral neurons, orchestrating release at synapses. channels are expressed in neuronal networks involved in rhythmicity, such as thalamic relay cells and tissues, supporting oscillatory activity. The following table summarizes key properties of VGCC subtypes, highlighting their molecular basis, pharmacological modulation, and primary locations:
Subtypeα₁ Gene ExampleActivatorsBlockersPrimary Locations
L-type (Caᵥ1)CACNA1C (Caᵥ1.2)Bay K 8644Dihydropyridines (e.g., )Cardiac/,
N-type (Caᵥ2.2)CACNA1BNone prominentω-Conotoxin GVIAPresynaptic neurons (CNS/PNS)
P/Q-type (Caᵥ2.1)CACNA1ANone prominentω-Agatoxin IVACerebellar/presynaptic neurons
R-type (Caᵥ2.3)CACNA1ENone prominentSNX-482Neurons (, sensory)
(Caᵥ3)CACNA1G (Caᵥ3.1)None prominentMibefradilThalamic neurons, pacemaker cells

Ligand-Gated Calcium Channels

Ligand-gated calcium channels, also known as ionotropic receptors, are a class of ion channels that open in response to the binding of specific neurotransmitters, allowing rapid influx of cations including Ca²⁺ to mediate fast synaptic transmission. Unlike voltage-gated channels, these receptors lack voltage sensitivity and are primarily activated by chemical ligands such as glutamate, , or ATP, enabling millisecond-scale signaling in neuronal and neuromuscular contexts. This direct ligand-induced gating facilitates Ca²⁺ entry that triggers intracellular cascades, contributing to processes like and muscle contraction. Prominent examples include N-methyl-D-aspartate (NMDA) receptors, nicotinic acetylcholine receptors (nAChRs), and P2X receptors. NMDA receptors are glutamate-gated channels co-permeable to Ca²⁺, Na⁺, and K⁺, predominantly expressed in the , particularly in hippocampal neurons where they support learning and formation. Nicotinic acetylcholine receptors encompass muscle-type (endplate) and neuronal subtypes; the muscle-type nAChRs at neuromuscular junctions mediate Ca²⁺-dependent excitation for contraction, while neuronal variants like α7 homopentamers exhibit high Ca²⁺ permeability in the . P2X receptors are ATP-gated channels found in sensory and autonomic neurons, where ATP release during or injury evokes Ca²⁺ influx to modulate signaling and release. Structurally, these channels form oligomeric complexes with ligand-binding domains and central selective for cations. NMDA receptors assemble as heterotetramers, typically comprising two obligatory GluN1 subunits (binding ) and two GluN2 subunits (binding glutamate), arranged in a 1-2-1-2 around a Ca²⁺-permeable formed by transmembrane helices. nAChRs are pentameric, with muscle-type channels consisting of two α1, one β1, one ε (or γ in fetal), and one δ subunit, featuring an extracellular ligand-binding at α-γ/α-δ interfaces and a cation-selective lined by M2 helices that permits Ca²⁺ passage. P2X receptors form trimers of P2X1-7 subunits, each with two transmembrane helices and a large ATP-binding extracellular ; the , flanked by TM1 and TM2 helices, enables Ca²⁺ permeation upon ATP-induced conformational dilation. Activation occurs via direct binding, inducing a conformational change that opens the channel on a milliseconds timescale and permits Ca²⁺ influx to drive downstream effects. For NMDA receptors, simultaneous binding of glutamate and relieves a Mg²⁺ block, allowing Ca²⁺ entry that activates kinases for and . In nAChRs, binding at subunit interfaces twists the extracellular domain, propagating to the pore for rapid and Ca²⁺ signaling in muscle endplates or neuronal . P2X receptors open upon ATP binding to their ectodomain "dolphin head" regions, leading to iris-like pore expansion and Ca²⁺-evoked release of neurotransmitters like glutamate.
ChannelLigandP_Ca/P_Na RatioPrimary Locations
(with co-agonist)>10 (learning and )
Muscle-type nAChR~0.2 ()
α7 nAChR (neuronal)~10 (rapid signaling)
P2X Receptor (e.g., P2X2/3)ATP~1.5-2.5Sensory neurons ( and )

Store-Operated and Other Calcium Channels

Store-operated calcium entry (SOCE) represents a fundamental mechanism for replenishing intracellular calcium stores, primarily mediated by channels in the plasma membrane coupled to stromal interaction molecule (STIM) proteins in the (ER). Upon ER Ca²⁺ depletion, typically triggered by IP₃-mediated release, STIM1 and STIM2 undergo a conformational change, oligomerize, and translocate to ER-plasma membrane junctions where they directly interact with and gate Orai1-3 channels, forming highly Ca²⁺-selective CRAC (calcium release-activated calcium) pores. This conformational coupling involves STIM1 binding to the of Orai1, propagating a signal that opens the channel's selectivity filter, enabling robust Ca²⁺ influx with minimal Na⁺ permeation. SOCE is crucial in non-excitable cells, such as immune cells, where it sustains prolonged Ca²⁺ signaling for processes like T-cell activation and production. Transient receptor potential (TRP) channels encompass a diverse family of Ca²⁺-permeable cation channels activated by sensory stimuli, distinct from store depletion pathways. Subfamilies like TRPC (canonical) and (vanilloid) exhibit non-selective permeation, with Ca²⁺-to-Na⁺ permeability ratios (P_Ca/P_Na) typically ranging from 5 to 10, allowing mixed cation influx that depolarizes the membrane and elevates cytosolic Ca²⁺. For instance, , expressed in sensory neurons, is activated by noxious heat (>43°C), , or protons, contributing to and through Ca²⁺-dependent release. TRPC channels, such as TRPC1 and TRPC3, respond to mechanical stretch or chemical agonists like diacylglycerol, facilitating Ca²⁺ entry in vascular and epithelial cells for processes including mechanotransduction. Other intracellular Ca²⁺ channels, including inositol 1,4,5-trisphosphate receptors (IP₃Rs) and ryanodine receptors (RyRs), function as ligand-gated release mechanisms from / stores, complementing plasma membrane entry pathways. IP₃Rs, tetrameric channels activated by the second messenger IP₃ (generated via G-protein-coupled receptor signaling), undergo a conformational shift upon IP₃ binding to their N-terminal domain, opening a Ca²⁺-selective while being biphasically regulated by cytosolic Ca²⁺ (activation at low micromolar levels, inhibition at high). RyRs, similarly tetrameric, are primarily gated by Ca²⁺ itself in a process termed Ca²⁺-induced Ca²⁺ release, with additional modulation by second messengers like cyclic ADP-ribose or ; RyR1 predominates in for excitation-contraction coupling, while RyR2 drives cardiac responses. These channels exhibit high Ca²⁺ selectivity and are essential for amplifying Ca²⁺ signals in diverse cellular contexts.
Channel TypeActivation TriggerSelectivity (P_Ca/P_Na)Key Roles
SOCE (Orai/STIM)ER Ca²⁺ store depletion>1000 (highly Ca²⁺-selective)Sustained Ca²⁺ signaling in immune cells (e.g., T-cell activation)
TRP (e.g., TRPV1)Heat, chemicals (e.g., capsaicin), mechanical stimuli~5-10 (non-selective cation)Pain and heat sensing in sensory neurons
IP₃RSecond messenger IP₃High Ca²⁺ selectivity (intracellular)Amplification of Ca²⁺ signals in signaling pathways
RyRCa²⁺-induced release, second messengers (e.g., cADPR)High Ca²⁺ selectivity (intracellular)Excitation-contraction coupling in muscle

Molecular Structure and Function

Subunit Composition and Architecture

Calcium channels are integral proteins that facilitate the selective of calcium ions across membranes, and their molecular architecture is primarily defined by a pore-forming subunit associated with auxiliary subunits that modulate function. In voltage-gated calcium channels (VGCCs), the principal α1 subunit forms the ion-conducting and voltage-sensing apparatus, consisting of approximately 2000 organized into four homologous repeats (I–IV), each containing six transmembrane helices (S1–S6). The S5–S6 helices from each repeat bundle to form the central pore domain (PD), while the S1–S4 segments constitute the voltage-sensing domains (VSDs), with the S4 helix featuring positively charged or residues that sense depolarization.00244-X) Auxiliary subunits enhance the assembly, trafficking, and gating properties of VGCCs. The intracellular β subunits (β1–β4 isoforms) bind to the α1 subunit via its α-interaction domain () in the cytoplasmic loop between repeats I and II, stabilizing the channel complex and influencing surface expression and kinetics. The extracellular α2δ subunits (α2δ-1 to -4) are disulfide-linked heterodimers that promote maturation and trafficking, featuring von Willebrand factor A (VWA) and domains for ligand binding and calcium coordination. In skeletal muscle VGCCs like Caᵥ1.1, a γ subunit with a claudin-like fold associates with the fourth VSD, further modulating channel activity, though it is absent in most neuronal isoforms.00244-X) The ion selectivity of VGCCs is conferred by a narrow selectivity filter in the pore loop between S5 and S6 of each repeat, lined by a signature EEEE motif (glutamate residues) in high-voltage-activated channels (Caᵥ1 and Caᵥ2 families), which coordinates Ca²⁺ ions with high affinity by forming intrachannel binding sites for one to two ions at physiological concentrations (0.5–10 mM). Low-voltage-activated T-type channels (Caᵥ3) feature an EEDD locus, contributing to their distinct permeation properties. Cryo-electron microscopy (cryo-EM) has provided atomic-level insights into this architecture; for instance, the 3.6 Å structure of rabbit Caᵥ1.1 revealed the asymmetric arrangement of the four repeats enclosing the central pore, the β subunit's core interaction with the α1 AID, and the positioning of α2δ and γ relative to the VSDs. Higher-resolution structures, such as the 2.9 Å Caᵥ1.1 complex, have further elucidated the filter's coordination geometry and auxiliary subunit interfaces.30495-7) While VGCCs exhibit this multi-subunit complexity, other calcium channels display simpler architectures with fewer auxiliaries. Ligand-gated calcium channels, such as NMDA receptors, form heterotetramers primarily from GluN1 and GluN2 subunits, each contributing two transmembrane helices and a reentrant loop to the pore, without β, α2δ, or γ equivalents, resulting in a symmetric tetrameric assembly focused on ligand-induced gating. This variation underscores how subunit composition adapts to channel type-specific roles in .

Gating and Permeation Mechanisms

Calcium channels exhibit diverse gating mechanisms that control their opening and closing in response to specific stimuli, ensuring precise regulation of Ca²⁺ influx. In voltage-gated calcium channels (VGCCs), gating is initiated by of the , which triggers conformational changes in the voltage-sensing domains (VSDs). Each VSD contains an S4 transmembrane segment lined with positively charged residues that serve as gating charges; upon depolarization, outward movement of these S4 segments displaces an effective total of approximately 10-13 elementary charges across the membrane electric field, leading to channel activation. This voltage-sensing process is coupled to the opening of the intracellular activation gate, typically involving the S6 helices in the pore domain. In ligand-gated calcium channels, such as NMDA receptors or P2X receptors, gating is induced by binding of extracellular ligands (e.g., glutamate or ATP), which promotes allosteric conformational changes that propagate to the channel pore, facilitating ion permeation. Permeation through calcium channels involves highly selective ion conduction, characterized by a multi-ion single-file mechanism within the narrow selectivity filter. In VGCCs, Ca²⁺ ions traverse the pore via a knock-on process, where incoming Ca²⁺ ions displace resident ions from multiple binding sites (designated I through IV) lined by negatively charged residues, such as the conserved EEEE locus formed by glutamate side chains in the pore loops. This cooperative occupancy, with typically 2-3 Ca²⁺ ions in the filter at a time, enhances selectivity over monovalent ions like Na⁺ by electrostatic repulsion and binding affinity. A hallmark of this mechanism is the anomalous mole fraction effect (AMFE), observed in single-channel recordings where Ca²⁺ conductance is paradoxically reduced in mixed Na⁺/Ca²⁺ solutions compared to pure solutions, reflecting competition at shared binding sites that favors multi-divalent occupancy for efficient permeation. The EEEE locus provides the primary high-affinity binding site (site II), with additional sites in the wider vestibules contributing to the overall knock-on dynamics.90100-0) The current through calcium channels can be described by the Goldman-Hodgkin-Katz (GHK) voltage equation, adapted for divalent ions with valence z = 2: I_\mathrm{Ca} = P_\mathrm{Ca} \cdot \frac{z^2 F^2 V}{[R](/page/Gas_constant)T} \cdot \frac{[\mathrm{Ca}]_\mathrm{i} \exp(zFV/RT) - [\mathrm{Ca}]_\mathrm{o}}{\exp(zFV/RT) - 1} where P_\mathrm{Ca} is the permeability coefficient, F is Faraday's constant, [R](/page/Gas_constant) is the , T is temperature, V is , and [\mathrm{Ca}]_\mathrm{i,o} are intracellular and extracellular concentrations. This equation accounts for the strong inward rectification observed in currents due to asymmetric concentrations and the channel's high selectivity, with P_\mathrm{Ca}/P_\mathrm{Na} ratios often exceeding 1000:1 under physiological conditions. Channel inactivation, a process that terminates ion flow to prevent cellular overload, occurs through distinct pathways in calcium channels. Ca²⁺-dependent inactivation (CDI) in VGCCs is mediated by intracellular calmodulin (CaM), which binds Ca²⁺ entering the channel and undergoes a conformational change to interact with the C-terminal domain, promoting closure of the activation gate; this feedback mechanism operates on a timescale of tens to hundreds of milliseconds and is prominent in L-type (Caᵥ1) and P/Q-type (Caᵥ2.1) channels.81048-2) In contrast, voltage-dependent inactivation (VDI) arises from sustained depolarization, involving conformational changes in the VSDs or pore that are independent of Ca²⁺ influx, often faster in T-type (Caᵥ3) channels. The S4 segments in the VSDs play a key role in coupling these inactivation processes to the gating machinery.

Physiological Roles

Role in Excitable Cells

Calcium channels play a pivotal role in the electrical signaling and contractile functions of excitable cells, including neurons and muscle cells, by mediating calcium influx that couples membrane to intracellular responses. In neurons, voltage-gated calcium channels (VGCCs), particularly the N-type (CaV2.2), P/Q-type (CaV2.1), and R-type (CaV2.3) subtypes, are essential for triggering release at synapses. Upon presynaptic arrival, these channels open in response to depolarization, allowing rapid Ca²⁺ entry that binds to synaptotagmin sensors on synaptic vesicles, initiating their fusion with the plasma membrane and of s. R-type channels (CaV2.3) also contribute to release at certain synapses and mediate calcium entry in neuronal cell bodies and dendrites. T-type channels (CaV3 family) facilitate burst firing and repetitive s in neurons, contributing to activity and . L-type channels (CaV1 family), predominantly expressed in somatodendritic regions, contribute to dendritic integration by supporting calcium-dependent and signal propagation within neuronal dendrites. In cardiac muscle, L-type calcium channels (primarily CaV1.2) are critical for shaping the action potential plateau phase and initiating excitation-contraction coupling. These channels activate during the early phase of the action potential, permitting Ca²⁺ influx that sustains and triggers (CICR) from the via ryanodine receptors, thereby amplifying cytosolic Ca²⁺ levels to activate contraction. This process ensures coordinated force generation in cardiomyocytes, with the L-type current magnitude directly influencing contractile strength. In , the dihydropyridine receptor (CaV1.1), an L-type channel isoform, functions primarily as a voltage sensor rather than a major Ca²⁺ conductor for . of the T-tubule membrane induces a conformational change in CaV1.1, which mechanically couples to ryanodine receptors (RyR1) in the , directly gating Ca²⁺ release without requiring significant Ca²⁺ influx through the channel itself—a process termed orthograde signaling in excitation- coupling. In cells, L-type calcium channels (primarily CaV1.2) mediate depolarization-induced Ca²⁺ influx that triggers , regulating vascular tone, gastrointestinal motility, and other functions essential for organ homeostasis. Beyond immediate responses like vesicle release and , Ca²⁺ influx through these channels in excitable cells activates downstream signaling by binding to , forming a Ca²⁺- complex that stimulates kinases such as Ca²⁺/-dependent protein kinase II (CaMKII) and phosphatases like , thereby initiating phosphorylation/dephosphorylation cascades that regulate , , and cellular excitability.

Role in Non-Excitable Cells

In non-excitable cells, calcium channels facilitate prolonged that regulates , , and cellular , contrasting with the rapid, transient influxes in excitable tissues. Store-operated calcium entry (SOCE), primarily mediated by ORAI1 and STIM1, plays a pivotal in immune cells such as T lymphocytes, where it sustains intracellular calcium levels to activate and the NFAT, essential for production including IL-2, IL-4, IL-17, IFN-γ, and TNF-α. In cytotoxic T cells and natural killer cells, ORAI1-dependent SOCE is required for and granule , enabling target cell ; deficiency in ORAI1 or STIM1 severely impairs these processes, as evidenced by reduced CD107a surface expression and release like IFN-γ and TNF-α upon target recognition. In epithelial cells, transient receptor potential (TRP) channels mediate calcium entry that governs vectorial transport and fluid dynamics. For instance, TRPV6, a highly selective calcium channel in intestinal enterocytes, facilitates transcellular calcium absorption in the and , upregulated by 1,25-dihydroxyvitamin D₃ to enhance dietary calcium uptake during low-calcium states. Beyond absorption, TRP channels like TRPV4 in salivary and epithelia regulate fluid secretion by triggering calcium-dependent activation of channels (e.g., ANO1) and aquaporins, promoting and water efflux in response to stimuli such as muscarinic agonists. Endocrine cells, including pancreatic β cells, rely on voltage-gated calcium channels (VGCCs) for release through excitation- . In β cells, elevates the ATP/ADP ratio, closing ATP-sensitive (KATP) channels composed of Kir6.2 and SUR1 subunits, which depolarizes the membrane and activates L-type VGCCs—primarily CaV1.2 (contributing ~60-70% of influx) and CaV1.3—to permit calcium entry that triggers insulin granule . This process supports both first-phase and sustained insulin , with CaV1.2 being indispensable for rapid release. Calcium signaling in non-excitable cells extends to nuclear compartments, where it modulates transcription. Nuclear calcium influx, often propagated from plasma membrane channels, activates calcium/calmodulin-dependent protein kinase II (CaMKII), particularly the γ isoform, which shuttles Ca²⁺/calmodulin (CaM) into the nucleus to initiate a kinase cascade. There, CaM activates CaMKK and CaMKIV, leading to phosphorylation of the transcription factor CREB at Ser133, thereby driving gene expression such as c-fos for cellular adaptation and survival.

Pharmacology and Modulation

Channel Blockers and Inhibitors

Calcium blockers and inhibitors encompass a diverse array of pharmacological agents that reduce calcium influx through various subtypes, primarily by targeting voltage-gated or ligand-gated channels. These compounds are crucial for modulating cellular excitability and have been extensively studied for their therapeutic potential. The primary classes of blockers target L-type voltage-gated calcium channels and are categorized based on and binding properties. Dihydropyridines, such as , act as state-dependent inhibitors that preferentially bind to the inactivated conformation of L-type channels, shifting the voltage dependence of activation to more depolarized potentials and thereby reducing channel opening probability. Phenylalkylamines, exemplified by verapamil, exhibit use-dependent by directly occupying the pore of open or inactivated channels, leading to frequency-dependent inhibition particularly effective during repetitive depolarizations. Benzothiazepines, like , combine pore occlusion with allosteric effects on the channel's S6 helix, modulating gating kinetics and stabilizing closed states. For other channel subtypes, selective inhibitors include agents targeting channels and ligand-gated channels. Mibefradil, a benzimidazoyl tetraline derivative, selectively blocks calcium channels by inhibiting low-voltage-activated currents, though it was withdrawn from clinical use in 1998 due to off-target and drug interactions. Recent developments include investigational short-acting L-type blockers like etripamil, a under FDA review as of December 2025 for (PSVT). In the case of ligand-gated channels, antagonists such as non-competitively inhibit calcium-permeable s by binding within the pore, thereby attenuating excitotoxic calcium influx. Peptide toxins from natural sources provide high-selectivity tools for specific subtypes. For instance, ω-conotoxin GVIA, derived from cone snail venom, potently and reversibly blocks N-type calcium channels with nanomolar affinity by binding to the extracellular domain of the α1B subunit, exhibiting remarkable selectivity over other voltage-gated calcium channel types. Emerging N-type inhibitors, such as the novel compound C2230, show promise in preclinical models for pain relief, including neuropathic and orofacial pain, as reported in 2025 studies. Inhibitory mechanisms generally fall into three categories: direct pore block via occupancy of the ion conduction pathway, allosteric that alters voltage- or ligand-dependent gating, and targeting of auxiliary subunits to indirectly reduce channel function. block is exemplified by verapamil and , which physically obstruct ion flow. Allosteric , as seen with dihydropyridines and , involves binding to sites distant from the —such as the S4-S5 linker or S6 segments—to influence conformational changes and permeation. Auxiliary subunit targeting, particularly by on the α2δ-1 subunit, reduces calcium channel trafficking to the plasma membrane and diminishes without directly affecting the . These agents, particularly dihydropyridines and non-dihydropyridines, play a key role in treating by relaxing vascular through L-type channel inhibition.

Channel Activators and Enhancers

Calcium channel activators and enhancers are compounds that increase the probability of channel opening, prolong open states, or boost calcium influx, thereby amplifying cellular signaling. These agents are particularly relevant for voltage-gated calcium channels (VGCCs), where they modulate gating properties to enhance excitability in excitable cells. Synthetic agonists targeting L-type VGCCs, such as dihydropyridines and benzoylpyrroles, exemplify this class by binding to specific sites on the channel's alpha-1 subunit to facilitate activation. Bay K 8644, a dihydropyridine , acts as a potent for L-type calcium channels (CaV1 ), promoting prolonged channel opening by shifting the voltage-dependence of activation to more hyperpolarized potentials and inhibiting voltage-dependent inactivation. This results in a 2- to 3-fold increase in peak calcium current amplitude and extended duration of influx, as demonstrated in neuronal and cardiac preparations. Originally identified for its stereospecific enhancement of calcium currents, Bay K 8644 binds to the same site as dihydropyridine antagonists but stabilizes the open state, contrasting with blockers that favor closed conformations. FPL 64176, a benzoylpyrrole compound, serves as another key enhancer of L-type channels, exhibiting higher potency than Bay K 8644 with an of approximately 16 nM for increasing whole-cell currents. Unlike dihydropyridines, FPL 64176 binds to a distinct allosteric site, slowing both and deactivation kinetics while increasing single-channel open probability and conductance, often by 20-30% in cell-attached patch recordings. This modulation sustains elevated calcium entry, making it a valuable tool for studying biophysics and cardiac contractility. For ligand-gated calcium channels, such as NMDA receptors (which permit calcium permeation upon activation), native agonists like glutamate directly bind to induce channel opening and calcium influx critical for . Similarly, ATP activates P2X receptors, ligand-gated cation channels that conduct calcium, supporting roles in and . Non-native enhancers, including low micromolar concentrations of , can potentiate NMDA receptor currents in certain subunit compositions (e.g., GluN2B-containing), modestly increasing calcium permeability by altering gating kinetics, though higher concentrations typically inhibit. Natural toxins that enhance calcium channels are less common than inhibitors, but examples include from St. John's wort, which activates TRPC6 channels (a non-selective calcium-permeable channel) by increasing conductance and calcium entry, contributing to effects. Few toxins directly activate VGCCs; however, certain bacterial metabolites and plant-derived compounds mimic actions on store-operated channels, though their specificity remains under investigation.

Clinical and Pathological Significance

Associated Diseases and Channelopathies

Calcium channel dysfunction underlies a variety of genetic channelopathies, where mutations in genes encoding subunits disrupt normal ion flow, leading to multisystem disorders. These conditions often manifest as neurological, cardiac, or neuromuscular abnormalities due to altered channel gating, conductance, or expression. Timothy syndrome, a rare multisystem disorder, arises from gain-of-function mutations in the CACNA1C , which encodes the Cav1.2 subunit. These mutations, such as those in exon 8 or 8A, prolong channel opening, resulting in excessive calcium influx that contributes to , disorder, seizures, and with cardiac arrhythmias. The increased channel activity disrupts excitation-contraction coupling in cardiac cells and neuronal signaling, exacerbating developmental and electrophysiological defects. Familial hemiplegic migraine type 1 (FHM1) is linked to missense s in the CACNA1A gene, encoding the Cav2.1 P/Q-type calcium channel subunit predominant in neurons. These s, found in approximately 50% of affected families, shift the voltage dependence of channel activation and inactivation, enhancing calcium entry and promoting that triggers auras, , and sometimes or . A representative example is the G406R in Cav2.1, which alters gating kinetics by shifting activation to more negative potentials, thereby increasing presynaptic calcium influx and neuronal excitability. Lambert-Eaton myasthenic syndrome (LEMS) represents an acquired driven by autoantibodies targeting presynaptic P/Q-type voltage-gated calcium channels (VGCCs), often in association with . These antibodies reduce VGCC density and function at neuromuscular junctions, impairing release and causing proximal , autonomic dysfunction, and . In paraneoplastic cases, tumor-expressed VGCCs trigger the autoimmune response, with over 90% of patients showing antibodies against the Cav2.1 complex. As of 2025, NCCN guidelines recommend VGCC antibody testing to screen for in LEMS patients, facilitating early detection. T-type calcium channels, particularly those encoded by CACNA1H (Cav3.2), are implicated in absence epilepsy through variants that alter channel function. Gain-of-function mutations in CACNA1H have been implicated in childhood absence epilepsy, potentially enhancing thalamic burst firing and thalamocortical oscillations essential for seizure generation. In Andersen-Tawil syndrome, primarily caused by mutations in the KCNJ2 potassium channel gene, L-type calcium channel blockers like verapamil have shown efficacy in suppressing ventricular arrhythmias, though the condition is fundamentally a potassium channelopathy. Acquired disorders also involve calcium channel perturbations, such as linked to dysfunction in the Cav1.1 L-type channel (encoded by CACNA1S) in . Rare variants in CACNA1S increase susceptibility to statin exposure, leading to impaired excitation-contraction coupling, , and elevated levels through disrupted calcium handling. Additionally, hypoxia-induced calcium overload via dysregulated voltage-gated calcium channels contributes to neurodegeneration, as excessive influx triggers mitochondrial dysfunction, production, and neuronal death in conditions like Alzheimer's and .

Therapeutic Applications and Drug Targets

Calcium channel blockers targeting L-type channels, such as the dihydropyridine amlodipine, are cornerstone therapies for and by inhibiting calcium influx into vascular cells, thereby reducing contractility and promoting . Clinical trials have demonstrated amlodipine's efficacy in lowering systolic and diastolic , with once-daily dosing achieving sustained control in patients with mild to moderate , often in combination with other antihypertensives. These agents also mitigate cardiovascular events like by improving endothelial function and reducing . In , N-type calcium channel inhibition provides targeted relief for , exemplified by , a synthetic derived from venom administered intrathecally for refractory cases unresponsive to opioids. selectively blocks presynaptic N-type channels (CaV2.2), reducing neurotransmitter release and nociceptive signaling, with randomized trials showing significant pain reduction in patients with severe malignant and non-malignant pain. For , T-type channel blockers like remain first-line for absence seizures, modulating thalamic burst firing to suppress spike-wave discharges, with long-term studies confirming its superior efficacy over alternatives like in pediatric populations. Emerging therapies leverage store-operated calcium entry (SOCE) inhibition for autoimmune diseases, where compounds like GSK7975A, a selective CRAC channel blocker targeting Orai1, suppress immune cell activation and cytokine production in preclinical models of inflammation. These pyrazole derivatives, developed for immune disorders, demonstrate potential in reducing T-cell proliferation and autoantibody formation, as seen in rheumatoid arthritis models. For channelopathies, gene therapies including CRISPR-Cas9 editing of CACNA1C mutations offer promise in correcting gain-of-function defects underlying Timothy syndrome, with isogenic iPSC models validating restored channel function and neuronal excitability. Recent 2025 studies highlight alternative splicing in Caᵥ channels as a novel target for exon-specific interventions in channelopathies like Timothy syndrome. Such approaches aim to normalize L-type channel activity in affected tissues like the heart and brain. Therapeutic challenges include off-target effects, such as verapamil's inhibition of potassium channels alongside L-type blockade, which can prolong intervals and risk arrhythmias. Advances in the focus on subtype-selective small molecules, like the state-dependent N-type blocker C2230, which exhibits high potency in models with reduced side effects compared to non-selective agents, enabling oral or intranasal delivery.

References

  1. [1]
    Biochemistry, Calcium Channels - StatPearls - NCBI Bookshelf
    Jul 25, 2023 · Calcium channels are the structural components of cardiac cells that provide a mechanism to modulate the force of contraction.Fundamentals · Cellular Level · Molecular Level · Function
  2. [2]
    Voltage-gated calcium channels (Ca V ): Introduction
    Voltage-gated Ca2+ channels mediate Ca2+ influx in response to membrane depolarization and regulate intracellular processes such as contraction, secretion, ...
  3. [3]
    Voltage-gated calcium channels - PubMed - NIH
    Aug 1, 2011 · Voltage-gated calcium (Ca(2+)) channels are key transducers of membrane potential changes into intracellular Ca(2+) transients that initiate many physiological ...
  4. [4]
    Structural biology of voltage-gated calcium channels - PMC
    Dec 7, 2023 · Voltage-gated calcium (Ca v ) channels mediate Ca 2+ influx in response to membrane depolarization, playing critical roles in diverse physiological processes.
  5. [5]
    How do calcium channels transport calcium ions? - PubMed
    Voltage-dependent Ca2+ channels are the most selective ion channels known. Under physiological conditions, they prefer Ca2+ over Na+ by a ratio of about 1000:1.Missing: Ca2 | Show results with:Ca2
  6. [6]
    Structural basis for Ca2+ selectivity of a voltage-gated calcium channel
    Voltage-gated calcium (CaV) channels catalyze rapid, highly selective influx of Ca2+ into cells despite 70-fold higher extracellular concentration of Na+.
  7. [7]
    Potentiated L-type Ca2+ Channels Rectify - PMC
    For both the wild-type and mutated channels, we observed strong inward rectification of potentiation: strong depolarization had little effect on outward tail ...
  8. [8]
    Nernst Potential Calculator - PhysiologyWeb
    Dec 20, 2005 · The Nernst equation calculates the equilibrium potential (also referred to as the Nernst potential) for an ion based on the charge on the ion.
  9. [9]
  10. [10]
  11. [11]
  12. [12]
  13. [13]
    Voltage-gated calcium channels (Ca<sub>V</sub>) | Ion channels
    The nomenclature for Ca2+channels was proposed by [14] and approved by the NC-IUPHAR Subcommittee on Ca2+ channels [9]. Most Ca2+ channels form hetero- ...
  14. [14]
  15. [15]
    Voltage‐gated calcium channels and their auxiliary subunits
    There are three main subdivisions of calcium channel, defined by the pore‐forming α1 subunit, the CaV1, CaV2 and CaV3 channels. For all the subtypes of voltage‐ ...Missing: paper | Show results with:paper
  16. [16]
    Molecular Properties of Voltage-Gated Calcium Channels - NCBI - NIH
    Voltage-gated calcium channels are divided into low-voltage (LVA) and high-voltage (HVA) types, with HVA channels further categorized into L, N, P/Q, and R ...High Voltage-Activated Ca2+... · Low Voltage-Activated (T-Type...
  17. [17]
    Calcium permeability of the nicotinic acetylcholine receptor
    Oct 1, 1990 · The calcium permeability of the mouse muscle nicotinic ACh receptor (nAChR) was determined using patch-clamp techniques.
  18. [18]
    Molecular Physiology of P2X Receptors
    P2X receptors are membrane ion channels that open in response to the binding of extracellular ATP. Seven genes in vertebrates encode P2X receptor subunits, ...
  19. [19]
    Structural insights into NMDA receptor pharmacology - PMC
    Jul 11, 2023 · Most NMDARs are composed of two glycine-binding GluN1 subunits and two glutamate binding GluN2 subunits, in an alternating GluN1–N2–N1–N2 ...
  20. [20]
    ATP-Gated P2X Receptor Channels - Annual Reviews
    Feb 10, 2019 · This review focuses on work published in the last five years and provides an overview of (a) structural studies, (b) the molecular basis of ...<|control11|><|separator|>
  21. [21]
    Structure, function, and allosteric modulation of NMDA receptors
    NMDA-type glutamate receptors are ligand-gated ion channels that mediate a Ca 2+ -permeable component of excitatory neurotransmission in the central nervous ...
  22. [22]
    Nicotinic acetylcholine receptor-mediated calcium signaling in the ...
    May 18, 2009 · The nAChRs are known to be differentially permeable to calcium ions, with the α7 nAChR subtype having one of the highest permeabilities to ...
  23. [23]
    Insights into the channel gating of P2X receptors from structures ...
    Jan 4, 2016 · P2X receptors, as ATP-gated non-selective trimeric ion channels, are permeable to Na+, K+ and Ca2+. Comparing with other ligand-gated ion ...
  24. [24]
    Dynamic control of NMDA receptor Ca 2+ permeability by ... - PNAS
    NMDA receptors conduct Ca2+-rich excitatory currents, which are essential for learning and memory, and are culprits in severe neuropsychiatric conditions.
  25. [25]
    α7 nicotinic ACh receptors as a ligand-gated source of Ca2+ ions
    Among nAChRs, the α7 nAChR exhibits the highest permeability ratio of Ca2+ over Na+ ions (PCa/PNa) (90–97). The high Ca2+ permeability of α7 nAChRs suggests ...Missing: sodium P_Na
  26. [26]
    Calcium permeability and block at homomeric and heteromeric ...
    The calcium permeability of the P2X2 receptor is 2.5 times that of sodium, when measured with 5 mM calcium added to the external solution. This result confirms ...Missing: P_Na | Show results with:P_Na
  27. [27]
    Store-operated calcium entry: mechanisms and modulation - PMC
    This review traces the history of research on store-operated calcium entry, the discovery of STIM and ORAI as central players in calcium entry, and the role of ...Discovery Of Stim And Orai · Calcium Sensing · Stim-Orai Modulation
  28. [28]
  29. [29]
  30. [30]
    Transient Receptor Potential Channels and Calcium Signaling - PMC
    First, as Ca2+-permeable channels that respond to a variety of stimuli, TRP channels can directly initiate cellular Ca2+ signals.
  31. [31]
  32. [32]
    IP3 Receptors: Toward Understanding Their Activation - PMC
    IP 3 binds to receptors that release calcium from intracellular stores. It causes a conformational change in the receptor, which is transmitted to a pore.
  33. [33]
    Intracellular calcium release channels: an update - PMC
    Ryanodine receptors (RyRs) and inositol 1,4,5‐trisphosphate receptors (IP3Rs) are calcium (Ca2+) release channels on the endo/sarcoplasmic reticulum (ER/SR).
  34. [34]
  35. [35]
  36. [36]
  37. [37]
  38. [38]
    Voltage‐gated calcium channels and their auxiliary subunits ...
    Jun 8, 2016 · There are three main subdivisions of calcium channel, defined by the pore-forming α1 subunit, the CaV1, CaV2 and CaV3 channels. For all the ...
  39. [39]
    Structure and function of the β subunit of voltage-gated Ca2 + ...
    The voltage-gated Ca2 + channel β subunit is a cytosolic auxiliary subunit that plays an essential role in regulating the surface expression and gating ...
  40. [40]
    Structure and Pharmacology of Voltage-Gated Sodium and Calcium ...
    Jan 6, 2020 · Here we review this recent literature and integrate findings on sodium and calcium channels to reveal the structural basis for their voltage- ...
  41. [41]
    Structure of the voltage-gated calcium channel Cav1.1 at 3.6 Å ...
    Aug 31, 2016 · Here we present the cryo-electron microscopy structure of the rabbit Cav1.1 complex at a nominal resolution of 3.6 Å. The inner gate of the ion- ...
  42. [42]
    Crystal structure of a heterotetrameric NMDA receptor ion channel
    The NMDA receptors are arranged as a dimer of GluN1-GluN2B heterodimers with the two-fold symmetry axis running through the entire molecule composed of an amino ...Inter-Subunit Interfaces And... · Transmembrane Domain And The... · References And Notes
  43. [43]
  44. [44]
    Inactivation of CaV1 and CaV2 channels - Rockefeller University Press
    Jan 30, 2025 · This review considers the inactivation mechanisms of CaV1 and CaV2 voltage-gated calcium channels and their role in normal physiology and ...
  45. [45]
    Voltage-Gated Calcium Channels - PMC - PubMed Central
    Subunit Structure. Ca2+ channels purified from skeletal muscle transverse tubules are complexes of α1, α2, β, γ, and δ subunits (Fig. 1) (Curtis and Catterall ...
  46. [46]
    The role of voltage-gated calcium channels in neurotransmitter ...
    Voltage-gated calcium channels (VGCCs) allow for rapid calcium entry and are expressed during early neural stages, making them likely regulators of activity- ...Missing: paper | Show results with:paper
  47. [47]
    Dendritic Calcium Channels and Their Activation by Synaptic ... - NIH
    Three prominent sources of Ca2+ in many dendrites in general are voltage-gated Ca2+ channels (VGCCs), glutamate-gated channels, and release from internal stores ...
  48. [48]
    Calcium Signaling in Dendrites and Spines - ScienceDirect.com
    Sep 25, 2008 · In CA1 pyramidal neurons, Ca influx to dendritic shafts occurs via L-type, R-type, and low-threshold T-type VSCCs (Christie et al., 1995, Magee ...
  49. [49]
    The L-type calcium channel in the heart: the beat goes on - PMC
    This review examines the role of Ca 2+ and the L-type voltage-dependent Ca 2+ channels in cardiac disease.
  50. [50]
    Integrative Analysis of Calcium Cycling in Cardiac Muscle
    Abstract—The control of intracellular calcium is central to regulation of contractile force in cardiac muscle. This review illustrates how analysis of the ...
  51. [51]
    L-type Ca2+ current in ventricular cardiomyocytes - ScienceDirect.com
    The present review highlights some of the recent findings on L-type Ca2+ channel function, regulation, and alteration in acquired pathologies such as cardiac ...
  52. [52]
    CaV1.1: The atypical prototypical voltage-gated Ca2+ channel - PMC
    This article reviews the dual functions of the skeletal muscle L-type Ca2+ channel. ... CaV1.1 is the voltage sensor for excitation-contraction coupling in ...
  53. [53]
    Skeletal muscle excitation–contraction coupling - ScienceDirect.com
    There is an overwhelming body of work supporting the idea that excitation–contraction coupling in skeletal muscle depends on a physical interaction.
  54. [54]
    Regulatory Cascades Involving Calmodulin-Dependent Protein ...
    The increase in intracellular Ca 2+ initiates signaling cascades that lead to essential biological processes such as secretion, cell proliferation, ...
  55. [55]
    Calcium signaling via voltage‐dependent L‐type Ca2+ channels
    Dec 2, 2004 · Recently, the molecular mechanisms by which Ca2+ influx through L-type Ca2+ channels can activate specific signal cascades have been clarified.
  56. [56]
    Store-operated Ca2+ entry through ORAI1 is critical for T cell ... - NIH
    T and B cells from Orai1KI/KI mice display severely impaired SOCE and CRAC channel function resulting in a strongly reduced expression of several key cytokines ...
  57. [57]
    ORAI1-mediated calcium influx is required for human cytotoxic ... - NIH
    This study identifies SOCE mediated by STIM1 and ORAI1 as the key mechanism of extracellular Ca2+ influx required for granule exocytosis and cytotoxicity in ...
  58. [58]
    TRP channels in calcium homeostasis: from hormonal control to ...
    Calcium is absorbed from the food in the epithelial cells of the intestine (enterocytes). This occurs by TRPV6, which is under the control of vitamin D ...
  59. [59]
    TRP Channels as Molecular Targets to Relieve Endocrine-Related ...
    As cation transport channels and physical and chemical stimulation receptors, TRPs play an important role in regulating secretion, interfering with cell ...
  60. [60]
    Role of High Voltage-Gated Ca2+ Channel Subunits in Pancreatic β ...
    The high voltage-gated Ca 2+ channels (HVCCs) occupy a central role in pancreatic hormone release both as a source of Ca 2+ required for excitation-secretion ...
  61. [61]
    ATP-regulated potassium channels and voltage-gated calcium ...
    Jun 7, 2014 · Closure of ATP-regulated K + channels (K ATP channels) plays a central role in glucose-stimulated insulin secretion in beta cells.
  62. [62]
    γCaMKII shuttles Ca2+/CaM to the nucleus to trigger CREB ... - NIH
    Once delivered to the nucleus by γCaMKII, Ca2+/CaM triggers a highly cooperative activation of the nuclear CaMK cascade, rapid phosphorylation of CREB and ...
  63. [63]
    Calcium Channel Blockers - StatPearls - NCBI Bookshelf
    Feb 22, 2024 · CCBs are often classified into 2 major categories—non-dihydropyridines or dihydropyridines. The non-dihydropyridines include verapamil, ...
  64. [64]
    Structural Basis for Diltiazem Block of a Voltage-Gated Ca2+ Channel
    The dihydropyridine Ca2+ channel blocker amlodipine binds at a distinct site and allosterically modulates the binding sites for diltiazem and Ca2+ Our studies ...
  65. [65]
    Mibefradil: a selective T-type calcium antagonist - PubMed
    Its novel mechanism of action is characterized by L-type and selective T-type calcium channel blockade. Mibefradil is selective for smooth muscle over ...
  66. [66]
    NMDA Receptor Antagonists: Repositioning of Memantine ... - PubMed
    NMDA receptor antagonists especially memantine block the NMDA receptor and can reduce the influx of calcium (Ca2+) ions into neuron, thus, toxic ...
  67. [67]
    Selectivity of omega-conotoxin GVIA for n-type calcium ... - PubMed
    The selectivity of omega-conotoxin GVIA (omega-CTX) for prejunctional N-type voltage-operated calcium channels (VOCC) was examined in rat isolated small ...Missing: ω- | Show results with:ω-
  68. [68]
    Structural basis for inhibition of a voltage-gated Ca 2+ channel by ...
    Sep 1, 2016 · The 1,4-dihydropyridines are used primarily for treatment of hypertension and angina pectoris and are thought to act as allosteric modulators ...
  69. [69]
    Pharmacological disruption of calcium channel trafficking by ... - PNAS
    Gabapentin (GBP) binds to an exofacial epitope of the α2δ-1 and α2δ-2 auxiliary subunits of voltage-gated calcium channels, but acute inhibition of calcium ...
  70. [70]
  71. [71]
    The calcium channel ligand FPL 64176 enhances L-type but inhibits ...
    This study examines the effects of the benzoyl pyrrole FPL 64176 (FPL) on L-type Ca(2+) currents and compares them to those of the dihydropyridine (+)-202-791.
  72. [72]
    FPL 64176 modification of Ca(V)1.2 L-type calcium channels
    FPL 64176 (FPL) is a nondihydropyridine compound that dramatically increases macroscopic inward current through L-type calcium channels and slows activation ...Missing: enhancer | Show results with:enhancer
  73. [73]
  74. [74]
    Calcium channel gating - PMC - PubMed Central - NIH
    The gating process is determined by distinct sub-processes: movement of voltage-sensing domains (charged S4 segments) as well as opening and closure of S6 gates ...Missing: seminal paper
  75. [75]
    Gain-of-function mutations in the calcium channel CACNA1C (Cav1 ...
    Gain-of-function mutations in CACNA1C, encoding the L-type Ca(2+) channel Cav1.2, cause Timothy syndrome (TS), a multi-systemic disorder with dysmorphic ...
  76. [76]
    Novel Gain-of-Function Variant in CACNA1C Associated With ...
    Nov 14, 2020 · Timothy syndrome (TS) is a rare multisystem disorder attributed to rare gain-of-function variants in CACNA1C, which codes for the ...
  77. [77]
    Update on the Molecular Genetics of Timothy Syndrome - PMC - NIH
    May 17, 2021 · Currently, gain of function variants in the CACNA1C gene are more likely to result in a diagnosis of non-syndromic LQT8. Variants in this gene ...
  78. [78]
    The Clinical Spectrum of Familial Hemiplegic Migraine Associated ...
    Jul 5, 2001 · Mutations in CACNA1A, which encodes a neuronal calcium channel, are present in 50 percent of families with hemiplegic migraine, including all those with ...
  79. [79]
    Variable clinical expression of mutations in the P/Q-type calcium ...
    We identified missense mutations in a brain-specific calcium channel alpha1A-subunit (CACNA1A) gene on 19p13 segregating with FHM and truncating mutations in ...
  80. [80]
    Familial hemiplegic migraine type-1 mutated cav2.1 calcium ...
    Familial hemiplegic migraine type-1 (FHM-1) is caused by missense mutations in the CACNA1A gene that encodes the α1A pore-forming subunit of CaV2.1 Ca(2+) ...
  81. [81]
    Voltage gated calcium channel antibody-related neurological diseases
    Voltage gated calcium channel (VGCC) antibodies are generally associated with Lambert-Eaton myasthenic syndrome. However the presence of this antibody has ...
  82. [82]
    Calcium-Channel Antibodies in the Lambert–Eaton Syndrome and ...
    Jun 1, 1995 · Voltage-gated calcium channels in small-cell lung carcinomas may initiate autoimmunity in the paraneoplastic neuromuscular disorder Lambert–Eaton syndrome.
  83. [83]
    Lambert-Eaton Myasthenic syndrome: early diagnosis is key
    May 13, 2019 · Approximately 90% of LEMS patients present antibodies against presynaptic membrane P/Q-type voltage-gated calcium channels (VGCC). These ...
  84. [84]
    The prognosis of epilepsy patients with CACNA1H missense variants
    Some loss-of-function variants of CACNA1H are also responsible for epilepsy, as they may alter the timing of neuronal firing patterns or the balance between ...
  85. [85]
    Mechanisms by which a CACNA1H mutation in epilepsy patients ...
    This point warrants further study as loss-of-function mutations in CACNA1H have been linked to disorders on the autism spectrum (Splawski et al. 2006). In ...
  86. [86]
    Andersen-Tawil Syndrome - GeneReviews® - NCBI Bookshelf
    Nov 22, 2004 · Andersen-Tawil syndrome (ATS) is characterized by a triad of: episodic flaccid muscle weakness (ie, periodic paralysis); ventricular arrhythmias and prolonged ...Diagnosis · Molecular Genetics · Literature Cited
  87. [87]
    Cardiac characteristics and long-term outcome in Andersen–Tawil ...
    Jul 17, 2013 · Calcium-channel blockers have been proposed and some authors have reported cases of complex ventricular arrhythmias suppression in ATS.7,16,17 ...
  88. [88]
    Statin-Related Myotoxicity: A Comprehensive Review of ... - MDPI
    Rare variants in several metabolic myopathy genes including CACNA1S, CPT2, LPIN1, PYGM and RYR1 increase myopathy/rhabdomyolysis risk following statin exposure.Missing: Cav1. | Show results with:Cav1.
  89. [89]
    Calcium-Handling Defects and Neurodegenerative Disease - PMC
    As a result of excess calcium release from ER stores, mitochondrial calcium overload occurs, leading to metabolic dysfunction, increased production of reactive ...Missing: hypoxia- | Show results with:hypoxia-
  90. [90]
    Interaction of Mitochondrial Calcium and ROS in Neurodegeneration
    Mitochondrial ROS under hypoxic conditions in astrocytes play a signaling role to trigger calcium signaling and a physiological response to hypoxia [21]. Free ...2. Huntington's Disease · 3. Alzheimer's Disease · 6. Amyotrophic Lateral...<|separator|>
  91. [91]
    Amlodipine - StatPearls - NCBI Bookshelf
    Amlodipine, an oral dihydropyridine calcium channel blocker, demonstrates prolonged efficacy by inhibiting voltage-dependent L-type calcium channels.Continuing Education Activity · Indications · Mechanism of Action · Administration
  92. [92]
    Amlodipine in the current management of hypertension - PMC
    Aug 7, 2023 · Several mechanisms have been proposed to explain the benefits of CCBs/amlodipine on stroke protection: (1) Amlodipine has a longer duration of ...
  93. [93]
    The Evolving Role of Calcium Channel Blockers in Hypertension ...
    Jun 22, 2024 · Certain CCBs, such as amlodipine and lacidipine, have demonstrated efficacy in reducing atherosclerosis. Their mechanism involves reducing ...
  94. [94]
    Ziconotide - StatPearls - NCBI Bookshelf
    Jan 19, 2025 · This medication demonstrates efficacy in managing intractable, severe chronic pain associated with both malignant and non-malignant conditions.
  95. [95]
    Ziconotide: a review of its pharmacology and use in the treatment of ...
    Intrathecal ziconotide's clinical efficacy is consistent with the hypothesis that spinal N-type calcium channels are key regulators of nociceptive signaling in ...
  96. [96]
    Ethosuximide - StatPearls - NCBI Bookshelf - NIH
    Due to its effectiveness and relatively limited adverse event profile, ethosuximide is considered the first-line therapy for absence epilepsy. If absence ...Continuing Education Activity · Indications · Mechanism of Action · Administration
  97. [97]
    Low threshold T-type calcium channels as targets for novel epilepsy ...
    This review discusses the literature concerning the role of T-type calcium channels in physiological and pathological processes related to epilepsy.
  98. [98]
    ORAI1 Ca2+ Channel as a Therapeutic Target in Pathological ...
    A key effector downstream of PDGF receptors is store-operated calcium entry (SOCE) mediated through the plasma membrane calcium ion channel, ORAI1, which is ...Vsmc Phenotypic Switching · Orai1 Channel · Orai1 In Pathological...
  99. [99]
    A store-operated calcium channel inhibitor attenuates collagen ...
    This study provides the first evidence that inhibition of SOC entry prevents and relieves rheumatoid arthritis (RA) and arthritic pain. These effects are ...
  100. [100]
    Genome engineering of isogenic human ES cells to model autism ...
    Mar 11, 2015 · The CACNA1C G406R mutation that is conserved in patients with TS was introduced into the non-disease H1 hESC background to generate an isogenic ...
  101. [101]
    Drug-induced Inhibition and Trafficking Disruption of ion Channels
    Verapamil is an effective inhibitor of IKr currents [77]. However, verapamil also blocks L-type calcium channels and decreases transmural dispersion of ...Missing: off- | Show results with:off-
  102. [102]
    The N-type calcium channel rises from the ashes - PMC - NIH
    Feb 17, 2025 · N-type calcium channels play a crucial role as therapeutic targets for managing chronic pain. In this issue of the JCI, Tang et al. introduce ...