GABAA receptor negative allosteric modulator
Drug class
A GABAA receptor negative allosteric modulator is a negative allosteric modulator (NAM), or inhibitor, of the GABAA receptor , a ligand-gated ion channel of the major inhibitory neurotransmitter γ-aminobutyric acid (GABA).[ 1] [ 2] They are closely related and similar to GABAA receptor antagonists .[ 1] [ 2] The effects of GABAA receptor NAMs are functionally the opposite of those of GABAA receptor positive allosteric modulators (PAMs) like the benzodiazepines , barbiturates , and ethanol (alcohol ).[ 1] [ 2] Non-selective GABAA receptor NAMs can produce a variety of effects including convulsions , neurotoxicity , and anxiety , among others.[ 1] [ 2]
Selective NAMs (or "inverse agonists ") of α5 subunit -containing GABAA receptors, such as basmisanil and α5 IA , do not have convulsant or anxiogenic effects but instead show cognitive - and memory -enhancing or nootropic -like effects.[ 3] [ 4] [ 5] [ 6] They are under investigation for the treatment of cognitive impairment in conditions like Down syndrome and schizophrenia .[ 4] [ 5] [ 6] In addition, the selective α5 subunit-containing GABAA receptor NAMs L-655,708 and MRK-016 have been found to produce rapid-acting antidepressant effects in animals similar to those of the NMDA receptor antagonist ketamine , and are of interest for the potential treatment of depression .[ 7] [ 8] [ 9] Additional selective α5 subunit-containing GABAA receptor NAMs include PWZ-029 , Ro4938581 , and TB-21007 .
Certain drugs show weak GABAA receptor NAM activity as an off-target activity that is responsible for undesirable side effects like anxiety , insomnia , and seizures . Examples include fluoroquinolone antibiotics like ciprofloxacin ,[ 10] β-lactam antibiotics like penicillin , ceftriaxone , and imipenem ,[ 10] [ 11] nonsteroidal antiandrogens like enzalutamide and apalutamide ,[ 12] and the antidepressant bupropion .[ 13]
Other GABAA NAMs, mostly non-selective, include amentoflavone , bemegride , bilobalide , cicutoxin , dieldrin , FG-7142 , fipronil , flurothyl , iomazenil , laudanosine , lindane , oenanthotoxin , pentylenetetrazol , phenylsilatrane , picrotoxin , radequinil , Ro15-4513 , sarmazenil , suritozole , terbequinil , tetramethylenedisulfotetramine (TETS), and ZK-93426 as well as the endogenous neurosteroids dehydroepiandrosterone sulfate (DHEA-S), pregnenolone sulfate , epipregnanolone , and isopregnanolone . Some naturally occurring GABAA receptor NAMs like cicutoxin and picrotoxin are considered to be toxins . Other GABAA receptor NAMs like dieldrin and fipronil are used as insecticides (IRAC group 2), and TETS is used as a rodenticide , and yet other GABAA receptor NAMs like bemegride, flurothyl, and pentylenetetrazol are used for clinical purposes.
See also
References
^ a b c d Johnston GA (2005). "GABA(A) receptor channel pharmacology". Curr. Pharm. Des . 11 (15): 1867– 85. doi :10.2174/1381612054021024 . PMID 15974965 .
^ a b c d Harry Majewski (29 October 2009). Pharmacology - Volume I . EOLSS Publications. pp. 58–. ISBN 978-1-84826-180-8 .
^ Martin LJ, Bonin RP, Orser BA (December 2009). "The physiological properties and therapeutic potential of alpha5-GABAA receptors". Biochem. Soc. Trans . 37 (Pt 6): 1334– 7. doi :10.1042/BST0371334 . PMID 19909271 .
^ a b Soh MS, Lynch JW (2015). "Selective Modulators of α5-Containing GABAA Receptors and their Therapeutic Significance" (PDF) . Curr Drug Targets . 16 (7): 735– 46. doi :10.2174/1389450116666150309120235 . PMID 25751008 .
^ a b Rudolph U, Möhler H (2014). "GABAA receptor subtypes: Therapeutic potential in Down syndrome, affective disorders, schizophrenia, and autism" . Annu. Rev. Pharmacol. Toxicol . 54 : 483– 507. doi :10.1146/annurev-pharmtox-011613-135947 . PMC 3997216 . PMID 24160694 .
^ a b Gill KM, Grace AA (2014). "The role of α5 GABAA receptor agonists in the treatment of cognitive deficits in schizophrenia" . Curr. Pharm. Des . 20 (31): 5069– 76. doi :10.2174/1381612819666131216114612 . PMC 4074253 . PMID 24345268 .
^ Duman RS (2018). "Ketamine and rapid-acting antidepressants: a new era in the battle against depression and suicide" . F1000Res . 7 : 659. doi :10.12688/f1000research.14344.1 . PMC 5968361 . PMID 29899972 .
^ Zanos P, Thompson SM, Duman RS, Zarate CA, Gould TD (March 2018). "Convergent Mechanisms Underlying Rapid Antidepressant Action" . CNS Drugs . 32 (3): 197– 227. doi :10.1007/s40263-018-0492-x . PMC 6005380 . PMID 29516301 .
^ Fischell J, Van Dyke AM, Kvarta MD, LeGates TA, Thompson SM (October 2015). "Rapid Antidepressant Action and Restoration of Excitatory Synaptic Strength After Chronic Stress by Negative Modulators of Alpha5-Containing GABAA Receptors" . Neuropsychopharmacology . 40 (11): 2499– 509. doi :10.1038/npp.2015.112 . PMC 4569955 . PMID 25900119 .
^ a b Norman Delanty (27 November 2001). Seizures: Medical Causes and Management . Springer Science & Business Media. pp. 203–. ISBN 978-1-59259-094-0 .
^ Amakhin DV, Soboleva EB, Zaitsev AV (May 2018). "Cephalosporin antibiotics are weak blockers of GABAa receptor-mediated synaptic transmission in rat brain slices". Biochem. Biophys. Res. Commun . 499 (4): 868– 874. doi :10.1016/j.bbrc.2018.04.008 . PMID 29625107 .
^ Foster WR, Car BD, Shi H, Levesque PC, Obermeier MT, Gan J, Arezzo JC, Powlin SS, Dinchuk JE, Balog A, Salvati ME, Attar RM, Gottardis MM (April 2011). "Drug safety is a barrier to the discovery and development of new androgen receptor antagonists". Prostate . 71 (5): 480– 8. doi :10.1002/pros.21263 . PMID 20878947 . S2CID 24620044 .
^ Thompson, Jeremy M.; Pappu, Aneesh; Pandhare, Akash; Jansen, Michaela (2015). "Complex Modulation of the GABAA α1β2γ2 Receptor Function by Bupropion" . Biophysical Journal . 108 (2): 433a. Bibcode :2015BpJ...108..433T . doi :10.1016/j.bpj.2014.11.2366 . ISSN 0006-3495 .
Ionotropic
GABAA Tooltip γ-Aminobutyric acid A receptor
Positive modulators (abridged; see here for a full list): α-EMTBL
Alcohols (e.g., drinking alcohol , 2M2B )
Anabolic steroids
Avermectins (e.g., ivermectin )
Barbiturates (e.g., phenobarbital )
Benzodiazepines (e.g., diazepam )
Bromide compounds (e.g., potassium bromide )
Carbamates (e.g., meprobamate )
Carbamazepine
Chloralose
Chlormezanone
Clomethiazole
Dihydroergolines (e.g., ergoloid (dihydroergotoxine) )
Etazepine
Etifoxine
Fenamates (e.g., mefenamic acid )
Flavonoids (e.g., apigenin , hispidulin )
Fluoxetine
Flupirtine
Imidazoles (e.g., etomidate )
Kava constituents (e.g., kavain )
Lanthanum
Loreclezole
Monastrol
Neuroactive steroids (e.g., allopregnanolone , cholesterol , THDOC )
Niacin
Niacinamide
Nonbenzodiazepines (e.g., β-carbolines (e.g., abecarnil ), cyclopyrrolones (e.g., zopiclone ), imidazopyridines (e.g., zolpidem ), pyrazolopyrimidines (e.g., zaleplon ))
Norfluoxetine
Petrichloral
Phenols (e.g., propofol )
Phenytoin
Piperidinediones (e.g., glutethimide )
Propanidid
Pyrazolopyridines (e.g., etazolate )
Quinazolinones (e.g., methaqualone )
Retigabine (ezogabine)
ROD-188
Skullcap constituents (e.g., baicalin )
Stiripentol
Sulfonylalkanes (e.g., sulfonmethane (sulfonal) )
Topiramate
Valerian constituents (e.g., valerenic acid )
Volatiles /gases (e.g., chloral hydrate , chloroform , diethyl ether , paraldehyde , sevoflurane )
Negative modulators: 1,3M1B
3M2B
11-Ketoprogesterone
17-Phenylandrostenol
α3IA
α5IA (LS-193,268)
β-CCB
β-CCE
β-CCM
β-CCP
β-EMGBL
Anabolic steroids
Amiloride
Anisatin
β-Lactams (e.g., penicillins , cephalosporins , carbapenems )
Basmisanil
Bemegride
Bicyclic phosphates (TBPS , TBPO , IPTBO )
BIDN
Bilobalide
Bupropion
CHEB
Chlorophenylsilatrane
Cicutoxin
Cloflubicyne
Cyclothiazide
DHEA
DHEA-S
Dieldrin
(+)-DMBB
DMCM
DMPC
EBOB
Etbicyphat
FG-7142 (ZK-31906)
Fiproles (e.g., fipronil )
Flavonoids (e.g., amentoflavone , oroxylin A )
Flumazenil
Fluoroquinolones (e.g., ciprofloxacin )
Flurothyl
Furosemide
Golexanolone
Iomazenil (123 I)
IPTBO
Isopregnanolone (sepranolone)
L-655,708
Laudanosine
Lindane
MaxiPost
Morphine
Morphine-3-glucuronide
MRK-016
Naloxone
Naltrexone
Nicardipine
Nonsteroidal antiandrogens (e.g., apalutamide , bicalutamide , enzalutamide , flutamide , nilutamide )
Oenanthotoxin
Pentylenetetrazol (pentetrazol)
Phenylsilatrane
Picrotoxin (i.e., picrotin , picrotoxinin and dihydropicrotoxinin )
Pregnenolone sulfate
Propybicyphat
PWZ-029
Radequinil
Ro 15-4513
Ro 19-4603
RO4882224
RO4938581
Sarmazenil
SCS
Suritozole
TB-21007
TBOB
TBPS
TCS-1105
Terbequinil
TETS
Thujone
U-93631
Zinc
ZK-93426
GABAA -ρ Tooltip γ-Aminobutyric acid A-rho receptor
Metabotropic
GABAB Tooltip γ-Aminobutyric acid B receptor