Robert Karoly

Non-synaptic receptors and transporters involved in brain functions and targets of drug treatment

Beyond direct synaptic communication, neurons are able to talk to each other without making synapses. They are able to send chemical messages by means of diffusion to target cells via the extracellular space, provided that the target neurons are equipped with high‐affinity receptors. While synaptic transmission is responsible for the ‘what’ of brain function, the ‘how’ of brain function (mood, attention, level of arousal, general excitability, etc.) is mainly controlled non‐synaptically using the extracellular space as communication channel. It is principally the ‘how’ that can be modulated by medicine. In this paper, we discuss different forms of non‐synaptic transmission, localized spillover of synaptic transmitters, local presynaptic modulation and tonic influence of ambient transmitter levels on the activity of vast neuronal populations. We consider different aspects of non‐synaptic transmission, such as synaptic–extrasynaptic receptor trafficking, neuron–glia communication and retrograde signalling. We review structural and functional aspects of non‐synaptic transmission, including (i) anatomical arrangement of non‐synaptic release sites, receptors and transporters, (ii) intravesicular, intra‐ and extracellular concentrations of neurotransmitters, as well as the spatiotemporal pattern of transmitter diffusion. We propose that an effective general strategy for efficient pharmacological intervention could include the identification of specific non‐synaptic targets and the subsequent development of selective pharmacological tools to influence them.

Direct Inhibitory Effect of Fluoxetine on N-Methyl-D-Aspartate Receptors in the Central Nervous System

BACKGROUND Data accumulated in the last decade indicate that N-methyl-D-aspartate (NMDA) receptors might be involved in the pathophysiology of depression and the mechanism of action of antidepressants, although a direct inhibitory effect has been reported only in connection with tricyclic compounds, which interact with a wide range of receptors. METHODS Using whole-cell patch-clamp recording in rat cortical cell cultures, we investigated whether the selective serotonin reuptake inhibitor fluoxetine, which has a much better adverse effect profile, has a direct effect on NMDA receptors, and we compared its action to that of the tricyclic desipramine. RESULTS Both desipramine (concentration that causes 50% inhibition (IC(50)) = 3.13 microM) and fluoxetine (IC(50) = 10.51 microM) inhibited NMDA-evoked currents with similar efficacy in the clinically relevant low micromolar concentration range. However, in contrast to desipramine, the inhibition by fluoxetine was not voltage-dependent, and fluoxetine partially preserved its ability to associate with NMDA receptor in the presence of Mg(2+), suggesting different binding sites for the two drugs. CONCLUSIONS The fact that different classes of antidepressants were found to be low-affinity NMDA antagonists suggests that direct inhibition of NMDA receptors may contribute to the clinical effects of antidepressants.

The mechanism of activity-dependent sodium channel inhibition by the antidepressants fluoxetine and desipramine.

The effect of monoamine uptake inhibitor-type antidepressants on sodium channels of hippocampal neurons was investigated. Members of the tricyclic group of antidepressants are known to modify multiple targets, including sodium channels, whereas selective serotonin-reuptake inhibitors (SSRIs) are regarded as highly selective compounds, and their effect on sodium channels was not investigated in detail. In this study, a representative member of each group was chosen: the tricyclic antidepressant desipramine and the SSRI fluoxetine. The drugs were roughly equipotent use-dependent inhibitors of sodium channels, with IC50 values ∼100 μMat -150 mV holding potential, and ∼1 μMat -60 mV. We suggest that therapeutic concentrations of antidepressants affect neuronal information processing partly by direct, activity-dependent inhibition of sodium channels. As for the mechanism of inhibition, use-dependent inhibition by antidepressants was believed to be due to a preferential affinity to the fast-inactivated state. Using a voltage and perfusion protocol by which relative affinities to fast-versus slow-inactivated states could be assessed, we challenged this view and found that the affinity of both drugs to slowinactivated state(s) was higher. We propose a different mechanism of action for these antidepressants, in which slow rather than fast inactivation plays the dominant role. This mechanism is similar but not equivalent with the novel mechanism of usedependent sodium channel inhibition previously described by our group (Neuroscience 125:1019-1028, 2004; Neuroreport 14:1945-1949, 2003). Our results suggest that different drugs can produce use-dependent sodium channel inhibition by different mechanisms.

Fast- or Slow-inactivated State Preference of Na+ Channel Inhibitors: A Simulation and Experimental Study

Sodium channels are one of the most intensively studied drug targets. Sodium channel inhibitors (e.g., local anesthetics, anticonvulsants, antiarrhythmics and analgesics) exert their effect by stabilizing an inactivated conformation of the channels. Besides the fast-inactivated conformation, sodium channels have several distinct slow-inactivated conformational states. Stabilization of a slow-inactivated state has been proposed to be advantageous for certain therapeutic applications. Special voltage protocols are used to evoke slow inactivation of sodium channels. It is assumed that efficacy of a drug in these protocols indicates slow-inactivated state preference. We tested this assumption in simulations using four prototypical drug inhibitory mechanisms (fast or slow-inactivated state preference, with either fast or slow binding kinetics) and a kinetic model for sodium channels. Unexpectedly, we found that efficacy in these protocols (e.g., a shift of the “steady-state slow inactivation curve”), was not a reliable indicator of slow-inactivated state preference. Slowly associating fast-inactivated state-preferring drugs were indistinguishable from slow-inactivated state-preferring drugs. On the other hand, fast- and slow-inactivated state-preferring drugs tended to preferentially affect onset and recovery, respectively. The robustness of these observations was verified: i) by performing a Monte Carlo study on the effects of randomly modifying model parameters, ii) by testing the same drugs in a fundamentally different model and iii) by an analysis of the effect of systematically changing drug-specific parameters. In patch clamp electrophysiology experiments we tested five sodium channel inhibitor drugs on native sodium channels of cultured hippocampal neurons. For lidocaine, phenytoin and carbamazepine our data indicate a preference for the fast-inactivated state, while the results for fluoxetine and desipramine are inconclusive. We suggest that conclusions based on voltage protocols that are used to detect slow-inactivated state preference are unreliable and should be re-evaluated.

Classification of drugs based on properties of sodium channel inhibition: a comparative automated patch-clamp study.

Background There is only one established drug binding site on sodium channels. However, drug binding of sodium channels shows extreme promiscuity: ∼25% of investigated drugs have been found to potently inhibit sodium channels. The structural diversity of these molecules suggests that they may not share the binding site, and/or the mode of action. Our goal was to attempt classification of sodium channel inhibitors by measuring multiple properties of inhibition in electrophysiology experiments. We also aimed to investigate if different properties of inhibition correlate with specific chemical properties of the compounds. Methodology/Principal Findings A comparative electrophysiological study of 35 compounds, including classic sodium channel inhibitors (anticonvulsants, antiarrhythmics and local anesthetics), as well as antidepressants, antipsychotics and neuroprotective agents, was carried out using rNav1.2 expressing HEK-293 cells and the QPatch automatic patch-clamp instrument. In the multi-dimensional space defined by the eight properties of inhibition (resting and inactivated affinity, potency, reversibility, time constants of onset and offset, use-dependence and state-dependence), at least three distinct types of inhibition could be identified; these probably reflect distinct modes of action. The compounds were clustered similarly in the multi-dimensional space defined by relevant chemical properties, including measures of lipophilicity, aromaticity, molecular size, polarity and electric charge. Drugs of the same therapeutic indication typically belonged to the same type. We identified chemical properties, which were important in determining specific properties of inhibition. State-dependence correlated with lipophilicity, the ratio of the neutral form of molecules, and aromaticity: We noticed that the highly state dependent inhibitors had at least two aromatic rings, logP>4.0, and pKa<8.0. Conclusions/Significance The correlations of inhibition properties both with chemical properties and therapeutic profiles would not have been evident through the sole determination of IC50; therefore, recording multiple properties of inhibition may allow improved prediction of therapeutic usefulness.

Rapid desensitization of the rat α7 nAChR is facilitated by the presence of a proline residue in the outer β‐sheet

The rat α7 nicotinic acetylcholine receptor (nAChR) has a proline residue near the middle of the β9 strand. The replacement of this proline residue at position 180 (P180) by either threonine (α7‐P180T) or serine (α7‐P180S) slowed the onset of desensitization dramatically, with half‐times of ∼930 and 700 ms, respectively, compared to 90 ms for the wild‐type receptor. To investigate the importance of the hydroxyl group on the position 180 side‐chains, the mutant receptors α7‐P180Y and α7‐P180F were studied and showed half‐times of desensitization of 650 and 160 ms, respectively. While a position 180 side‐chain OH group may contribute to the slow desensitization rates, α7‐P180S and α7‐P180V resulted in receptors with similar desensitization rates, suggesting that increased backbone to backbone H bonding expected in the absence of proline at position 180 would likely exert a great effect on desensitization. Single channel recordings indicated that for the α7‐P180T receptor there was a significantly reduced closed time without any change in single channel conductance (as compared to wild‐type). Kinetic simulations indicated that all changes observed for the mutant channel behaviour were reproduced by decreasing the rate of desensitization, and increasing the microscopic affinity to resting receptors. Molecular dynamics (MD) simulations on a homology model were used to provide insight into likely H bond interactions within the outer β‐sheet that occur when the P180 residue is mutated. All mutations analysed increased about twofold the predicted number of H bonds between the residue at position 180 and the backbone of the β10 strand. Moreover, the α7‐P180T and α7‐P180S mutations also formed some intrastrand H bonds along the β9 strand, although H bonding of the OH groups of the threonine or serine side‐chains was predicted to be infrequent. Our results indicate that rapid desensitization of the wild‐type rat α7 nAChR is facilitated by the presence of the proline residue within the β9 strand.

Inhibitory effect of the DA uptake blocker GBR 12909 on sodium channels of hippocampal neurons

The effect of the selective dopamine uptake inhibitor GBR 12909 on TTX-sensitive sodium channels of cultured hippocampal neurons was investigated using whole cell patch-clamp technique. GBR 12909 dose-dependently inhibited sodium currents evoked by trains of depolarizing pulses with an IC50 of 6.3 μM. A weaker inhibition (IC50 = 17–35 μM) could be observed when currents were evoked by either single pulse depolarization or from hyperpolarized holding membrane potential. These data indicate that the extent of inhibition caused by GBR 12909 depends on the physiological activity pattern of neurons. Our results suggest that caution is needed for the interpretation of data when GBR 12909 is used for the inhibition of dopamine uptake at concentrations above the submicromolar range.

A novel modulatory mechanism of sodium currents: Frequency-dependence without state-dependent binding

We have previously found that the dopamine uptake inhibitor 1-(2-[bis(4-fluorophenyl)methoxy]ethyl)-4-(3-phenylpropyl)piperazine dihydrochloride (GBR 12909) inhibits neuronal sodium channels. The inhibition was profoundly dependent on the voltage protocol, suggesting that the effect is determined by the activity pattern of individual neurons. Our present study was aimed to understand more thoroughly the mechanism of this inhibition. The effect of GBR 12909 on sodium currents was investigated using whole-cell patch clamp recordings on cultured hippocampal neurons. Repetitive trains of depolarizations revealed two distinct components of inhibition: a frequency-dependent, transient and a frequency-independent, sustained component. Frequency-dependent inhibition can reflect dynamic equilibrium of binding or gating. In order to decide which is the dominant mechanism in the case of GBR 12909, we studied the rates of association and dissociation. We found an unexpectedly fast rate of association (tau=819.2 ms) to resting ion channels kept at hyperpolarized membrane potential (-150 mV), while the rate of dissociation was too slow to explain recovery between trains of stimulation (tau=248 s). These data suggest that frequency-dependent inhibition cannot be explained by binding and unbinding, but rather it is due to conformational transitions of the liganded channel, which can only be explained if ligand binding is assumed to enhance slow inactivation. We studied, therefore, the rate of slow inactivation in the presence of different concentrations of GBR 12909. We have found that GBR 12909 accelerates slow inactivation substantially (time constants more than hundredfold lower at concentrations above 10 microM), causing the time range of slow inactivation to overlap with the time range of fast inactivation. Slow inactivation can even be the dominant process, especially during subthreshold depolarizations in the presence of >10 microM of GBR 12909. This mechanism of inhibition could provide a selective inhibition of neurons not only with high frequency bursting activity but also with moderately depolarized membrane potential.

Evidence against a separate high affinity binding site on the P2X3 receptor

It has been proposed that P2X3 receptors possess a unique mechanism of agonist-induced conformational transitions. Recovery from ATP-induced desensitization was found to be very slow; during this period a special agonist binding site was supposed to be formed which should bind the agonist with high affinity and promote desensitization without activation. The authors supposed that this high affinity binding site is absent from non-activated receptors. The theory was supported by an unexpected outcome of an experiment in which a low concentration of agonist was applied at different phases during recovery from desensitization. The inhibition by a low concentration of agonist was stronger when it was applied during the early phase of recovery when more desensitized receptors were present. The authors used different agonists for initial desensitization and for prolonged perfusion at low concentration. We repeated the experiment on HEK 293 cells expressing human P2X3 receptors with the same results. However, when we used the same agonist at both concentrations the inhibition was stronger when the low concentration was applied during the late phase. Simulations revealed that formation of high affinity binding sites does not require any unique mechanism and can be readily described by an allosteric mechanism. Furthermore, they predict that the unexpected phenomenon can only occur when a rapidly dissociating drug is replaced by a slowly dissociating drug on the receptor. from 13th Scientific Symposium of the Austrian Pharmacological Society (APHAR). Joint Meeting with the Austrian Society of Toxicology (ASTOX) and the Hungarian Society for Experimental and Clinical Pharmacology (MFT) Vienna, Austria. 22–24 November 2007

Exploring the heterogeneity of use-dependent sodium channel inhibitor drugs. I: Fast- vs. slow-inactivated state preference

Certain drugs evidently exert their therapeutic effects via sodium channel inhibition: local anesthetics, class I antiarrhythmics and certain anticonvulsants. Novel sodium channel inhibitor compounds are actively investigated for other indications involving stroke, ischemia, various neurodegenerative conditions and pain syndromes. All these drugs cause voltageand use-dependent inhibition of sodium channels. However, biophysical properties of inhibition can differ widely even between use-dependent sodium channel inhibitors which seem to act similarly. Recently it has been proposed that the mechanism of inhibition can be more important than potency or isoform selectivity regarding the therapeutical potential of the drugs (e.g. [1]). One important question is which conformational state is preferred by the drug. In this study we attempted to discriminate preference to fastvs. slow-inactivated conformations. Slow association to fast-inactivated state and fast association to slow-inactivated state cannot be distinguished using traditional protocols. We have recently developed a protocol to test fastvs. slowinactivated state preference using electrophysiology only, i.e. without mutagenesis or enzymatic treatment experiments. We tested 28 use-dependent sodium channel inhibitors of different chemical structure and therapeutic indication using this protocol, and found that the mechanisms primarily overlap with the latter.