Restoring ionotropic inhibition as an analgesic strategy

Neurosci Lett. 2013 Dec 17:557 Pt A:43-51. doi: 10.1016/j.neulet.2013.09.047. Epub 2013 Sep 27.

Abstract

Neuronal inhibition in nociceptive relays of the spinal cord is essential for the proper processing of nociceptive information. In the spinal cord dorsal horn, the activity of synaptic and extrasynaptic GABAA and glycine receptors generates rapid, Cl(-)-dependent neuronal inhibition. A loss of this ionotropic inhibition, particularly through the collapse of the inhibitory Cl(-)-gradient, is a key mechanism by which pathological pain conditions develop. This review summarizes the roles of ionotropic inhibition in the regulation of nociception, and explores recent evidence that the potentiation of GABAA or glycine receptor activity or the enhancement of inhibitory drive can reverse pathological pain.

Keywords: Analgesia; Chloride; Dorsal horn; GABA; Glycine; KCC2.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesics / therapeutic use*
  • Animals
  • Brain-Derived Neurotrophic Factor / metabolism
  • Humans
  • K Cl- Cotransporters
  • Microglia / physiology
  • Neural Inhibition / drug effects*
  • Neural Inhibition / physiology
  • Nociception / physiology
  • Pain / drug therapy
  • Pain / metabolism*
  • Receptors, GABA-A / metabolism*
  • Receptors, Glycine / metabolism*
  • Symporters / metabolism*

Substances

  • Analgesics
  • Brain-Derived Neurotrophic Factor
  • Receptors, GABA-A
  • Receptors, Glycine
  • Symporters