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TRPM2 is a calcium-permeable nonselective cation channel that is opened by the binding of ADP-ribose (ADPR) to a C-terminal nudix domain. Channel activity is further regulated by several cytosolic factors, including cyclic ADPR (cADPR), nicotinamide adenine dinucleotide phosphate (NAADP), Ca2+ and calmodulin (CaM), and adenosine monophosphate (AMP). In addition, intracellular ions typically used in patch-clamp experiments such as Cs+ or Na+ can alter ADPR sensitivity and voltage dependence, complicating the evaluation of the roles of the various modulators in a physiological context. We investigated the roles of extra- and intracellular Ca2+ as well as CaM as modulators of ADPR-induced TRPM2 currents under more physiological conditions, using K+-based internal saline in patch-clamp experiments performed on human TRPM2 expressed in HEK293 cells. Our results show that in the absence of Ca2+, both internally and externally, ADPR alone cannot induce cation currents. In the absence of extracellular Ca2+, a minimum of 30 nM internal Ca2+ is required to cause partial TRPM2 activation with ADPR. However, 200 μM external Ca2+ is as efficient as 1 mM Ca2+ in TRPM2 activation, indicating an external Ca2+ binding site important for proper channel function. Ca2+ facilitates ADPR gating with a half-maximal effective concentration of 50 nM and this is independent of extracellular Ca2+. Furthermore, TRPM2 currents inactivate if intracellular Ca2+ levels fall below 100 nM irrespective of extracellular Ca2+. The facilitatory effect of intracellular Ca2+ is not mimicked by Mg2+, Ba2+, or Zn2+. Only Sr2+ facilitates TRPM2 as effectively as Ca2+, but this is due to Sr2+-induced Ca2+ release from internal stores rather than a direct effect of Sr2+ itself. Together, these data demonstrate that cytosolic Ca2+ regulates TRPM2 channel activation. Its facilitatory action likely occurs via CaM, since the addition of 100 μM CaM to the patch pipette significantly enhances ADPR-induced TRPM2 currents at fixed [Ca2+]i and this can be counteracted by calmidazolium. We conclude that ADPR is responsible for TRPM2 gating and Ca2+ facilitates activation via calmodulin.

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