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The mechanism of Cl− ion permeation through single cystic fibrosis transmembrane conductance regulator (CFTR) channels was studied using the channel-blocking ion gluconate. High concentrations of intracellular gluconate ions cause a rapid, voltage-dependent block of CFTR Cl− channels by binding to a site ∼40% of the way through the transmembrane electric field. The affinity of gluconate block was influenced by both intracellular and extracellular Cl− concentration. Increasing extracellular Cl− concentration reduced intracellular gluconate affinity, suggesting that a repulsive interaction occurs between Cl− and gluconate ions within the channel pore, an effect that would require the pore to be capable of holding more than one ion simultaneously. This effect of extracellular Cl− is not shared by extracellular gluconate ions, suggesting that gluconate is unable to enter the pore from the outside. Increasing the intracellular Cl− concentration also reduced the affinity of intracellular gluconate block, consistent with competition between intracellular Cl− and gluconate ions for a common binding site in the pore. Based on this evidence that CFTR is a multi-ion pore, we have analyzed Cl− permeation and gluconate block using discrete-state models with multiple occupancy. Both two- and three-site models were able to reproduce all of the experimental data with similar accuracy, including the dependence of blocker affinity on external Cl− (but not gluconate) ions and the dependence of channel conductance on Cl− concentration. The three-site model was also able to predict block by internal and external thiocyanate (SCN−) ions and anomalous mole fraction behavior seen in Cl−/SCN− mixtures.

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