Sensory neuron–expressed FGF13 controls nociceptive signaling in diabetic neuropathy models
Aditya K. Singh, … , Subo Yuan, Fernanda Laezza
Aditya K. Singh, … , Subo Yuan, Fernanda Laezza
Published July 15, 2025
Citation Information: J Clin Invest. 2025;135(14):e183749. https://doi.org/10.1172/JCI183749.
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Research Article Neuroscience Public Health

Sensory neuron–expressed FGF13 controls nociceptive signaling in diabetic neuropathy models

Abstract

Nociception involves complex signaling, yet intrinsic mechanisms bidirectionally regulating this process remain unexplored. Here, we show that the fibroblast growth factor 13 (FGF13)/Nav1.7 protein–protein interaction (PPI) complex bidirectionally modulates nociception, and that the FGF13/Nav1.7 ratio is upregulated in type 2 diabetic neuropathy (T2DN). PW164, an FGF13/Nav1.7 channel C-terminal tail domain (CTD) PPI interface inhibitor, which reduces complex assembly, selectively suppressed Na+ currents sensitized by capsaicin-induced activation of TRPV1 channels in human induced pluripotent stem cell–derived (hIPSC-derived) sensory neurons and inhibited mechanical and thermal hyperalgesia in mice. FGF13 silencing mimics PW164 activity in culture and in vivo. Conversely, ZL192, an FGF13 ligand that stabilizes FGF13/Nav1.7 CTD assembly, sensitized Na+ currents in hIPSC-derived sensory neurons and exerted pronociceptive behavioral responses in mice. ZL192’s effects were abrogated by FGF13 silencing in culture and in vivo and recapitulated by FGF13 overexpression. In a model of T2DN, PW164 injection reduced mechanical hyperalgesia locally and contralaterally without systemic side effects. In donor-derived dorsal root ganglia neurons, FGF13 and Nav1.7 proteins colocalized, and the FGF13/Nav1.7 protein ratio was upregulated in patients with T2DN. Lastly, we found that SCN9A variant V1831F, associated with painless diabetic neuropathy, abolished PW164-directed modulation of the FGF13/Nav1.7 PPI interface. Thus, FGF13 is a rheostat of nociception and promising therapeutic target for diabetic neuropathy pain.

Authors

Aditya K. Singh, Matteo Bernabucci, Nolan M. Dvorak, Zahra Haghighijoo, Jessica Di Re, Nana A. Goode, Feni K. Kadakia, Laura A. Maile, Olumarotimi O. Folorunso, Paul A. Wadsworth, Cynthia M. Tapia, Pingyuan Wang, Jigong Wang, Haiying Chen, Yu Xue, Jully Singh, Kali Hankerd, Isaac J. Gamez, Makenna Kager, Vincent Truong, Patrick Walsh, Stephanie I. Shiers, Nishka Kuttanna, Hanyue Liao, Margherita Marchi, Erika Salvi, Ilaria D’Amato, Daniela D’Amico, Parsa Arman, Catharina G. Faber, Rayaz A. Malik, Marina de Tommaso, Dan Ziegler, Krishna Rajarathnam, Thomas A. Green, Peter M. Grace, Matthew R. Sapio, Michael J. Iadarola, Gregory D. Cuny, Diana S. Chow, Giuseppe Lauria Pinter, Steve Davidson, Dustin P. Green, Jun-Ho La, Jin Mo Chung, Jia Zhou, Theodore J. Price, Elizabeth Salisbury, Subo Yuan, Fernanda Laezza

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Figure 1

PW164 Inhibition of FGF13/Nav1.7 CTD complex formation selectively modulates Nav1.7 currents.

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PW164 Inhibition of FGF13/Nav1.7 CTD complex formation selectively modul...
(A) PW164 docking on FGF13 surface and docked pose overlay with Nav1.7-CTD; H-bond in purple. (B) Percentage luminescence as function of PW164 log10 concentration in LCA produced by assembly of CLuc-FGF13/CD4-Nav1.7-CTD-NLuc complex or CLuc-FGF13R110A/CD4-Nav1.7-CTD-NLuc with vehicle or PW164 (20 μM). (C) Representative SPR sensograms and SSI saturation curves for respective groups. (D) Representative traces of INa recorded from HEK-Nav1.7 cells of indicated groups in response to depolarizing voltage steps. (E and F) Bar graph of peak INa density at voltage step –10 mV and dose response curve (IC50 = 6.74 ± 0.5 μM) (n = 11–14 cells/group). Scale bar 5 ms, 100 pA/pF. (G and H) V½ of voltage-dependence of activation and steady state inactivation (n = 9–17 cells/group). (I and J) INa amplitudes as a function of time (test pulse number referred to as index or depolarization cycle) in response to trains of variable depolarization protocols denoting use dependency (I) or long-term inactivation (J) of Nav1.7 (K and L) Time course (top) and time constants (bottom) of Nav1.7 repriming (recovery from inactivation) shown for indicated groups. Bottom panel denotes INa amplitudes in response to depolarizing pulses to allow channels entering long-term inactivation (n = 8–17 cells/group). Data are mean ± SEM; *P < 0.05, **P < 0.01, *** P < 0.001, 1-way ANOVA with post hoc Tukey’s multiple comparisons test. Student t test compared time constants in panel L.