Scorpion ␣-toxins Lqh␣IT, Lqh-2, and Lqh-3 are representatives of three groups of ␣-toxins that differ in their preference for insects and mammals. These ␣-insect, antimammalian, and ␣-like toxins bind to voltage-gated sodium channels and slow down channel inactivation. Sodium channel mutagenesis studies using various ␣-toxins have shown that they interact with receptor site 3, which is composed mainly of a short stretch of amino-acid residues between S3 and S4 of domain 4. Variation in this region results in marked differences between various subtypes of sodium channels with respect to their sensitivity to the three Lqh toxins. We incorporated the S3-S4 linker of domain 4 from hNa V 1.2/hNa V 1.1, hNa V 1.3, hNa V 1.6, and hNa V 1.7 channels as well as individual point mutations into the rNa V 1.4 skeletal muscle sodium channel. Our data show that the affinity of Lqh-3 and Lqh␣IT to sodium channels is markedly determined by an aspartate residue (Asp1428 in rNa V 1.4); when mutated to glutamate, as is present in Na V 1.1-1.3 channels, Lqh-3-channel interactions are abolished. The interaction of Lqh-2 and Lqh␣IT, however, is strongly reduced when a lysine residue (Lys1432 in rNa V 1.4) is replaced by threonine (as in hNa V 1.7), whereas this substitution is without effect for Lqh-3. The influence of Lys1432 on Lqh-2 and Lqh␣IT strongly depends on the context of the Asp/Glu site at position 1428, giving rise to a wide variety of toxicological phenotypes by means of a combinatorial mixing and matching of only a few residues in receptor site 3.Voltage-gated sodium (Na V ) channels consist of a large (ϳ260 kDa) pore-forming ␣-subunit, composed of four homologous domains (D1-D4), each with six transmembrane segments (S1-S6) and a hairpin-like pore region between S5 and S6. Because of their structural conservation in vertebrates and invertebrates and their pivotal role in cellular excitability, Na V channels are targeted by a large variety of chemically distinct toxins, many of which do not differentiate among channel subtypes (Catterall, 1992;Gordon, 1997). However, some scorpion neurotoxins show specificity for insect or mammalian Na V channels, and others are able to differentiate between Na V subtypes in mammalian neurons . This selectivity is attributed to differences of active sites on the toxins and to variations in receptor binding sites on distinct Na V channels that, when identified, may be used for design of selective drugs.Scorpion toxins affecting Na V channels are 61-to 76-residue polypeptides that comprise two major classes, ␣-and -toxins, according to their mode of action and binding properties to distinct sites (receptor sites-3 and -4, respectively) on Na V channels (Martin-Eauclaire and Couraud, 1995;Gordon et al., 1998). ␣-Toxins inhibit Na V channel inactivation in various excitable preparations, but they show vast differences in preference for insect and mammalian Na V channels. Accordingly, they are divided into classic ␣-toxins, which are highly active in mammalian brain [e.g., Lqh-2 (L...