Denervation supersensitivity in skeletal muscle: analysis with a cloned cDNA probe.

Motor neurons regulate the acetylcholine sensitivity of the muscles they innervate: denervated muscle fiber become "supersensitive" to acetylcholine, due to insertion of newly synthesized acetylcholine receptors (AChRs) in the plasma membrane. We used hybridization analysis with a cloned cDNA specific for AChR alpha-subunit to compare the abundance of AChR mRNA in innervated and denervated adult mouse muscles. Within 3 d of denervation, levels of AChR mRNA increased 100-fold; levels of actin mRNA changed little. The increase in AChR mRNA level was sufficiently large and rapid to account for denervation supersensitivity.

Developmental alteration in GABAA receptor structure and physiological properties in cultured cerebellar granule neurons.

Although we now have extensive knowledge about the GABAA receptor subunits determining benzodiazepine modulation of channel function, little is known about subunits influencing other modulatory sites on the GABAA receptor-chloride channel complex. We have identified a developmental change in subunit composition of the GABAA receptor in cultured cerebellar granule neurons that eliminates benzodiazepine-mediated enhancement of GABA responses and alters modulation by a substituted gamma-butyrolactone. Based on data from sequential PCR experiments, we mimicked the functional properties of early and mature receptors with heterologous expression of specific subunit combinations. This report describes one of the most extensive cell- and site-specific developmental changes for an ion channel seen to date.

Slow death of postnatal hippocampal neurons by GABA(A) receptor overactivation.

Neurotransmitters can have both toxic and trophic functions in addition to their role in neural signaling. Surprisingly, chronic blockade of GABA(A) receptor activity for 5-8 d in vitro enhanced survival of hippocampal neurons, suggesting that GABA(A) receptor overactivation may be neurotoxic. Potentiating GABA(A) receptor activity by chronic treatment with the endogenous neurosteroid (3alpha,5alpha)-3-hydroxypregnan-20-one caused massive cell loss over 1 week in culture. Other potentiators of GABA(A) receptors, including benzodiazepines, mimicked the cell loss, suggesting that potentiating endogenous GABA activity is sufficient to produce neuronal death. Neurosteroid-treated neurons had lower resting intracellular calcium levels than control cells and produced smaller calcium rises in response to depolarizing challenges. Manipulating intracellular calcium levels with chronic elevated extracellular potassium or with the calcium channel agonist Bay K 8644 protected neurons. The results may have implications for the mechanisms of programmed cell death in the developing CNS as well as implications for the long-term consequences of chronic GABAmimetic drug use during development.

Substrate turnover by transporters curtails synaptic glutamate transients.

Although inhibitors of glutamate transport prolong synaptic currents at many glutamate synapses, the cause of the current prolongation is unclear. Transport inhibitors may prolong synaptic currents by simply interfering with synaptic glutamate binding to transporters, by inhibiting substrate translocation, or by promoting accumulation of ambient glutamate, which may act cooperatively at receptors with synaptic glutamate. We show that reversal of the membrane potential of astrocytes surrounding the synapse prolongs synaptic currents but does not decrease the apparent affinity of transporters or significantly alter glutamate-dependent kinetics of macroscopic transporter currents in excised membrane patches. Positive membrane potentials do not affect binding of a nontransported glutamate analog, nor do positive membrane potentials alter the number of transporters available to bind analog. We also test the hypothesis that glutamate accumulation during uptake inhibition by transporter substrates is the direct cause of synaptic current prolongations. Transporter substrates elevate ambient glutamate near synapses by fostering reverse transport of endogenous glutamate. However, increases in ambient glutamate cannot account for the prolongations of synaptic currents, because a nonsubstrate transport inhibitor does not foster reverse uptake yet it prolongs synaptic currents. Moreover, exogenous glutamate does not mimic synaptic current prolongations induced by substrate inhibitors. These results provide strong support for a major role of substrate translocation in determining the time course of the glutamate concentration transient at excitatory synapses.

Astrocytes exert a pro-apoptotic effect on neurons in postnatal hippocampal cultures.

We investigated conditions that promote basal and activity-dependent neuronal apoptosis in postnatal rat hippocampal cultures. Low-density mixed cultures of astrocytes and neurons exhibited lower sensitivity than high-density cultures to basal neuronal death and activity-sensitive neuronal death, induced with glutamate receptor blockers, sodium channel blockers, or calcium channel blockers. Although elevations of [Ca(2+)](i) protect neurons from apoptosis, low-density microcultures and mass cultures exhibited only minor differences in resting [Ca(2+)](i) and Ca(2+) current density, suggesting that these variables are unlikely to explain differences in susceptibility. Astrocytes, rather than neurons, were implicated in the neuronal loss. Several candidate molecules implicated in other astrocyte-dependent neurotoxicity models were excluded, but heat inactivation experiments suggested that a heat-labile factor is critically involved. In sum, our results suggest the surprising result that astrocytes can be negative modulators of neuronal survival during development and when the immature nervous system is challenged with drugs that dampen electrical excitability.

Insights into the structure and function of GABA-benzodiazepine receptors: ion channels and psychiatry.

OBJECTIVE: As a result of combined biophysical and molecular biological studies, important insights into the structure and function of gamma-aminobutyric acid (GABA) receptors have been achieved. These insights have helped to define the role of GABA receptors in synaptic inhibition and the ion channel mechanisms by which different neuropsychiatric drugs work. The authors' goal is to describe the actions of GABA as a neurotransmitter and discuss the modulation of receptor function by different drugs. DATA COLLECTION: The authors focus on more recent studies of the structure and physiology of the receptor-ion channel complex and the relevance of these studies to psychiatry. FINDINGS: The CNS effects of benzodiazepines, barbiturates, and alcohol have been linked to the GABA-chloride channel receptor complex. Multiple subunits of this complex have been cloned, sequenced, and expressed in heterologous systems. The results of cloning studies, coupled with membrane biophysics, have provided important insights into the structure and function of GABA receptors and their modulation by psychopharmacological agents. CONCLUSIONS: Future understanding of disease states, drug effects, and therapeutic successes and failures may be expressed in terms of differences in the structure and function of specific receptors and their associated ion channels. Furthermore, the ability to describe the molecular function of receptor subtypes offers the ability to tailor drug specificity by developing agents directed against a given receptor subtype. The current GABA studies also have important implications for the understanding of how neurotransmitter systems may be involved in illness.

Effects of neurosteroid and benz[e]indene enantiomers on GABAA receptors in cultured hippocampal neurons and transfected HEK-293 cells.

The effects of the enantiomers of the neurosteroid, 3 alpha-hydroxy-5 alpha-pregnan-20-one (DHP), and the benz[e]indene, BI-1, on gamma-aminobutyric acid (GABA) responses were studied using whole-cell recording techniques in cultured rat hippocampal neurons and human embryonic kidney cells (HEK-293) transfected with either alpha 1 beta 2 gamma 2 or alpha 6 beta 2 gamma 2 GABAA receptor subunits. At 10 microM, the (+)-enantiomers enhanced currents gated by 2 microM GABA in all cells, whereas the (-)-enantiomers were significantly less effective. The enhancement of 2 microM GABA responses in HEK-293 cells transfected with alpha 6 beta 2 gamma 2 subunits was about half that of hippocampal neurons or HEK-293 cells transfected with alpha 1 beta 2 gamma 2. The lower sensitivity of alpha 6 beta 2 gamma 2 receptors for (+)-DHP and (+)-BI-1 is accounted for by their greater apparent affinity for GABA. When the GABA concentration was decreased to 0.5 microM to take into account the four-fold higher apparent affinity of alpha 6 beta 2 gamma 2 receptors, these receptors exhibited enhancement similar to alpha 1 beta 2 gamma 2 receptors. These results indicate that both native and recombinant GABAA receptors have enantioselective sites at which neurosteroids and benz[e]indenes modulate GABA responses, and that differences in agonist affinity contribute to apparent differences in steroid sensitivity among GABAA receptors.

Potential clinical uses of neuroactive steroids.

Neuroactive steroids rapidly modulate gamma-aminobutyric acid (GABA) and glutamate receptors. GABA-enhancing steroids have potential clinical utility as anesthetics, hypnotics, anticonvulsants and anxiolytics. Furthermore, GABAergic neurosteroids may participate in regulating mood and the effects of alcohol on the nervous system, suggesting a potential role in major psychiatric disorders. Neuroactive steroids that alter the function of glutamate receptors could be useful for treating neurodegenerative disorders, and as cognitive enhancers. Recent progress in developing water-soluble steroids and steroids with enhanced oral efficacy foster optimism that certain neuroactive steroids will be developed for clinical use.

Pharmacological and physiological properties of a putative ganglionic nicotinic receptor, alpha 3 beta 4, expressed in transfected eucaryotic cells.

Neuronal nicotinic acetylcholine receptor subunits alpha 3 (PCA48E) and beta 4S (ZPC13) were expressed in human embryonic kidney (HEK)-293 cells by calcium phosphate transfection. In the presence of atropine, acetylcholine (ACh) induced fast activating currents which exhibited desensitization and inward rectification. The EC50 for ACh was 202 +/- 32 microM with a Hill coefficient of 1.9 +/- 0.4. The rank order of nicotinic agonist potency was 1,1-dimethyl-4-phenylpiperozinium (DMPP) > cytisine = nicotine approximately equal to ACh. The maximal response elicited by DMPP was substantially less than that elicited by other agonists, suggesting that DMPP is a partial agonist. ACh (500 microM) responses were very effectively blocked by equimolar concentrations (100 microM) of the ganglionic antagonists d-tubocurarine, mecamylamine and hexamethonium. Equal concentrations of the potent muscle receptor antagonist decamethonium and the competitive antagonist dihydro-beta-erythroidine were much less effective. alpha bungaro-toxin (1 microM) had little effect on ACh-induced responses. This physiological and pharmacological profile is consistent with a ganglionic nicotinic response.

Site-directed mutagenesis identifies amino acid residues associated with the dehydrogenase and isomerase activities of human type I (placental) 3beta-hydroxysteroid dehydrogenase/isomerase.

3beta-hydroxysteroid dehydrogenase/steroid delta5-->4-isomerase (3beta-HSD/isomerase) was expressed by baculovirus in Spodoptera fungiperda (Sf9) insect cells from cDNA sequences encoding human wild-type I (placental) and the human type I mutants - H261R, Y253F and Y253,254F. Western blots of SDS-polyacrylamide gels showed that the baculovirus-infected Sf9 cells expressed the immunoreactive wild-type, H261R, Y253F or Y253,254F protein that co-migrated with purified placental 3beta-HSD/isomerase (monomeric Mr=42,000 Da). The wild-type, H261R and Y253F enzymes were each purified as a single, homogeneous protein from a suspension of the Sf9 cells (5.01). In kinetic studies with purified enzyme, the H261R mutant enzyme had no 3beta-HSD activity, whereas the Km and Vmax values of the isomerase substrate were similar to the values obtained with the wild-type and native enzymes. The Vmax (88 nmol/min/mg) for the conversion of 5-androstene-3,17-dione to androstenedione by the Y253F isomerase activity was 7.0-fold less than the mean Vmax (620 nmol/min/mg) measured for the isomerase activity of the wild-type and native placental enzymes. In microsomal preparations, isomerase activity was completely abolished in the Y253,254F mutant enzyme, but Y253,254F had 45% of the 3beta-HSD activity of the wild-type enzyme. In contrast, the purified Y253F, wild-type and native enzymes had similar Vmax values for substrate oxidation by the 3beta-HSD activity. The 3beta-HSD activities of the Y253F, Y253,254F and wild-type enzymes reduced NAD+ with similar kinetic values. Although NADH activated the isomerase activities of the H261R and wild-type enzymes with similar kinetics, the activation of the isomerase activity of H261R by NAD+ was dramatically decreased. Based on these kinetic measurements, His261 appears to be a critical amino acid residue for the 3beta-HSD activity, and Tyr253 or Tyr254 participates in the isomerase activity of human type I (placental) enzyme.

Partial cDNA cloning and NGF regulation of a rat 5-HT3 receptor subunit.

Nerve growth factor (NGF) stimulates 5-HT3 receptor expression although the mechanism(s) responsible for this effect are unknown. We report the nucleotide and deduced amino acid sequences of a nearly complete rat 5-HT3 receptor subunit and use the sequence to develop a reverse transcription-polymerase chain reaction (RT-PCR) assay that measures 5-HT3 mRNA. Exposure of PC12 cells to NGF results in increasing steady-state levels of 5-HT3 mRNA. The four-fold increase in mRNA correlates with and is sufficient to account for increases in receptor measured by agonist induction of whole cell currents.

Possible involvement of opiate receptors in the pharmacological profiles of antidepressant compounds.

Tricyclic antidepressants and selected hydroxylated metabolites were found to inhibit [3H]naltrexone binding in whole rat brain. The drug concentrations required to inhibit binding appeared to be within pharmacological relevant brain concentrations. Carbamazepine and several monoamine oxidase inhibitors (with the exception of clorgyline) were inactive in this regard. The relative potency of the tricyclic antidepressants with regard to inhibitions of opiate binding in brain did not correlate with their clinical efficiency as antidepressants, suggesting that these compounds probably do not exert their antidepressant effects through opioid peptidergic systems in brain. In addition, we found that imipramine (30 mg/kg) had antinociceptive properties, as assessed by the hot plate procedure, which were partially, but not significantly, reversed by naloxone (2 mg/kg). The possibility that opioid receptors may be involved in the analgesic properties of the tricyclic antidepressants has been discussed.

Schizophrenia and the question of genetic heterogeneity.

Despite major advances in psychiatric diagnosis during the past 20 years, boundaries of the schizophrenic syndrome remain elusive. Moreover, in pedigrees containing cases of schizophrenia there are marked between-pedigree differences with respect to prognosis, familial patterns of psychiatric illness, drug response, and especially association of affected status with a specific chromosomal locus. Such between-pedigree differences suggest the syndrome may be made up of several different diseases. Linkage of affected status to specific loci may aid in resolving genetic heterogeneity. Large multigenerational informative pedigrees may permit the separation into those that do and do not link to a genomic locus of interest. Admixture analysis of smaller informative pedigrees may permit separation of linked and unlinked pedigrees on the basis of differences in the recombination fraction. Finally, biological "markers" can be used before the genetic analysis to separate putative linked and unlinked pedigrees. The combined study of genetic linkage and clinical heterogeneity will aid in the resolution of etiological heterogeneity of schizophrenia and the delineation of meaningful diagnostic boundaries.

Oligonucleotide pharmacotherapy: an antigene strategy.

Oligonucleotide pharmacotherapy, although in a very preliminary stage, promises to provide new, highly specific tools for the treatment of human diseases, such as viral illnesses and cancer. The agents have several proposed mechanisms of action, including inhibition of translation, splicing, and transcription. In addition, the bioefficacy of oligonucleotides may be enhanced by phosphorothioates, methylphosphonates, and alpha-oligonucleotides. The agents are delivered by the ex vivo or topical route, and new methods of administration are under study. It is predicted that within the decade these agents will be used routinely to treat several serious illnesses.

Potential clinical uses of neuroactive steroids.

Neuroactive steroids rapidly modulate gamma-aminobutyric acid (GABA) and glutamate receptors. GABA-enhancing steroids have potential clinical utility as anesthetics, hypnotics, anticonvulsants and anxiolytics. Furthermore, GABAergic neurosteroids may participate in regulating mood and the effects of alcohol on the nervous system, suggesting a potential role in major psychiatric disorders. Neuroactive steroids that alter the function of glutamate receptors could be useful for treating neurodegenerative disorders, and as cognitive enhancers. Recent progress in developing water-soluble steroids and steroids with enhanced oral efficacy foster optimism that certain neuroactive steroids will be developed for clinical use.

Reversible ischemic neurologic deficit after ECT.

We report the case of a 58-year-old woman with depression and hypertension in whom aphasia, right-sided hemiparesis, and a possible right visual field defect were identified during recovery from right unilateral electroconvulsive therapy (ECT). The neurologic deficits resolved over a 3-day period; the patient was diagnosed with a reversible ischemic neurologic deficit (RIND). Review of the patient literature suggests that such cerebrovascular events in the setting of ECT are extremely rare and possibly decreasing in frequency. Reasons for such a decrease may include improved screening for predisposing cardiovascular conditions and the widespread use of neuromuscular blockade, ventilatory support, and cardiovascular monitoring during the procedure. Prompt recognition of cerebrovascular events is important to prevent complications such as cerebral edema, seizures, and aspiration, as well as to use new treatments for stroke.

Combined alfentanil-methohexital anesthesia in electroconvulsive therapy.

Eight patients receiving electroconvulsive therapy (ECT) were anesthetized with alfentanil, 25 mcg/kg, plus 20 mg methohexital, alternating with standard methohexital anesthesia. Combination alfentanil-methohexital anesthesia was associated with a 45% increase in EEG seizure duration. Preliminary evidence suggests that ECT anesthesia using short-acting opiate compounds may prove to be a promising alternative to standard modified ECT, especially for patients with brief seizures.