Reviewer #3 (Public Review):
1. The described studies seek to test a plausible hypothesis having important biological implications: that Ca2+ coming through TRP channels and/or from intracellular stores during cold stimulation activates anoctamin Cl- channels, which further depolarize the CIII neuron via inward Cl- current (outward Cl- diffusion) resulting from high intracellular Cl- concentration caused by high expression of the outwardly directed Cl- transporter ncc69, thereby driving the intense electrical activity in CIII neurons needed to trigger cold-specific behavioral responses.
2. Elegant phylogenetic analysis is provided to show that Drosophila subdued and white walker are orthologous to human TMEM16/anoctamins ANO1/2 and ANO8, respectively, to go along with ncc69 already known to be orthologous to human NKCC1.
3. Strong genetic and behavioral evidence shows that knocking down the expression of subdued or white walker globally or selectively in CIII neurons reduces the incidence and magnitude of a cold-specific contraction response ("CT") to 5 degree C stimulation but not responses to gentle touch.
4. These knock-downs also reduce electrical activity recorded in cell bodies of CIII neurons induced by cooling to 15 or 10 degrees C in a semi-intact ("fillet") preparation.
5. CIII-specific knock-down of ncc69 reduces CT responses while overexpression of kcc (which should have the opposite effect on intracellular Cl- concentration) also tends to reduce these responses, indicating that the balance of Cl- pump activity in these neurons favors excitation when Cl- channels are opened (e.g., during cold stimulation).
6. Optogenetic activation of an exogenously expressed Cl- channel (Aurora) in CIII neurons evokes CT responses, showing that Cl- currents are sufficient to produce these responses, presumably by strongly activating the CIII neurons.
7. Reducing extracellular Cl- enhances ongoing electrical activity of CIII neurons, strengthening the conclusion that opening Cl- channels excites these neurons.
8. Overexpressing ncc69 in CIII neurons enhances basal and evoked electrical activity, and sensitizes larvae CT responses to cooling to 10 degrees C, further strengthening the conclusion that opening Cl- channels excites CIII neurons and suggesting that this specific genetic manipulation could provide a model in Drosophila for detailed investigations into a potentially general mechanism contributing to neuropathic sensitization and pain.
9. The authors integrate findings from the present study with those from their recent cold acclimation paper to make the speculative but interesting suggestion that mechanisms selected during evolution to enable cold acclimation might also be recruited in neuropathic contexts to produce maladaptive sensitization.
There are also several modest weaknesses in the paper:
1. A notable gap remains in the evidence for the hypothesized mechanisms that enhance electrical activity during cold stimulation and the proposed role of anoctamins (Fig. 8) - the lack of evidence for Ca2+-dependent activation of Cl- current. The recording methods used in the fillet preparation should enable direct tests of this important part of the model.
2. The behavioral and electrophysiological consequences of knocking down either of the two anoctamins are incomplete (Fig.2), raising the significant question of whether combined knock-down of both anoctamins in the CIII neurons would largely eliminate the cold-specific responses.
3. Blind procedures were not used to minimize unconscious bias in the analyses of video-recorded behavior, although some of the analyses were partially automated.
4. The term "hypersensitization" is confusing. Pain physiologists typically use "sensitization" when behavioral or neural responses are increased from normal. In the case of increased neuronal sensitivity, if the mechanism involves an increase in responsiveness to depolarizing inputs or an increased probability of spontaneous discharge, the term "hyperexcitability" is appropriate. Hypersensitization connotes an extreme sensitization state compared to a known normal sensitization state (which already signifies increased sensitivity). In contrast, the effects of ncc69 overexpression in this manuscript are best described simply as sensitization (increased reflexive and neuronal sensitivity to cooling) and hyperexcitability (expressed as increased spontaneous activity at room temperature).