Electrostatic tuning of NaV channel activation by the domain II S3-S4 extracellular loop.

How NaV channel isoforms set their activation voltages - and thereby define their specific functional roles in excitable cells - remains poorly understood. We show that extracellular charges in the domain II (DII) S3-S4 loop critically tune voltage-sensor activation in NaV1.7. Introducing positively charged residues in this loop depolarizes activation, whereas additional negative charges shift it in the hyperpolarizing direction. Extracellular Ca2 + further modulates these effects through electrostatic screening, demonstrating that local surface charge is a key determinant of voltage-sensor function. The NaV1.7-selective spider toxin Pn3a, which binds the DII S3-S4 loop, produces enhanced depolarizing shifts when its net positive charge is increased, showing that ligand electrostatics can fine-tune gating. Together, these results demonstrate that the local electrostatic environment near the DII voltage sensor controls NaV1.7 activation, providing a general mechanism - likely conserved across all voltage-gated ion channels - by which loop charges, extracellular ions or bound ligands can modulate channel function. By showing that local electrostatics near the DII voltage sensor govern activation, our findings provide a mechanistic explanation for isoform-specific gating and a framework for precisely tuning NaV channel function with engineered charged ligands. KEY POINTS: Voltage-gated sodium (NaV) channels are essential for generating electrical signals in nerves, muscles and the heart, yet how different NaV types are tuned to open at specific voltages was not well understood. This study shows that charged amino acids on the outer part of NaV1.7 help set the voltage at which the channel activates, with positive charges making it harder to open and negative charges making it easier. We find that extracellular calcium can influence this process, demonstrating that the local electrical environment around the channel shapes its activity. A naturally occurring spider toxin, Pn3a, can also adjust channel activation depending on its surface charge, suggesting that we can engineer ligands to fine-tune excitability. Together, these results explain how NaV channels achieve isoform-specific gating and provide a framework for designing molecules that selectively control activation, with potential implications for pain and other disorders.