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降低过度的 GABA 介导的紧张性抑制可促进中风后的功能恢复。

Reducing excessive GABA-mediated tonic inhibition promotes functional recovery after stroke.

机构信息

Department of Neurology, The David Geffen School of Medicine at UCLA, 635 Charles Young Drive South, Los Angeles, California 90095, USA.

出版信息

Nature. 2010 Nov 11;468(7321):305-9. doi: 10.1038/nature09511. Epub 2010 Nov 3.

Abstract

Stroke is a leading cause of disability, but no pharmacological therapy is currently available for promoting recovery. The brain region adjacent to stroke damage-the peri-infarct zone-is critical for rehabilitation, as it shows heightened neuroplasticity, allowing sensorimotor functions to re-map from damaged areas. Thus, understanding the neuronal properties constraining this plasticity is important for the development of new treatments. Here we show that after a stroke in mice, tonic neuronal inhibition is increased in the peri-infarct zone. This increased tonic inhibition is mediated by extrasynaptic GABA(A) receptors and is caused by an impairment in GABA (γ-aminobutyric acid) transporter (GAT-3/GAT-4) function. To counteract the heightened inhibition, we administered in vivo a benzodiazepine inverse agonist specific for α5-subunit-containing extrasynaptic GABA(A) receptors at a delay after stroke. This treatment produced an early and sustained recovery of motor function. Genetically lowering the number of α5- or δ-subunit-containing GABA(A) receptors responsible for tonic inhibition also proved beneficial for recovery after stroke, consistent with the therapeutic potential of diminishing extrasynaptic GABA(A) receptor function. Together, our results identify new pharmacological targets and provide the rationale for a novel strategy to promote recovery after stroke and possibly other brain injuries.

摘要

中风是导致残疾的主要原因,但目前尚无促进康复的药物治疗方法。中风损伤区域周围的脑区对于康复至关重要,因为它表现出更高的神经可塑性,允许感觉运动功能从受损区域重新映射。因此,了解限制这种可塑性的神经元特性对于开发新的治疗方法非常重要。在这里,我们发现在小鼠中风后,损伤周围区域的神经元持续抑制增加。这种增强的持续抑制是由 extrasynaptic GABA(A)受体介导的,是由 GABA(γ-氨基丁酸)转运蛋白(GAT-3/GAT-4)功能障碍引起的。为了对抗增强的抑制,我们在中风后延迟体内给予一种针对含有α5 亚基的 extrasynaptic GABA(A)受体的苯二氮䓬类反向激动剂。这种治疗方法早期和持续地恢复了运动功能。降低负责持续抑制的α5 或δ亚基 GABA(A)受体的数量也被证明对中风后恢复有益,这与减少 extrasynaptic GABA(A)受体功能的治疗潜力一致。总之,我们的研究结果确定了新的药物治疗靶点,并为促进中风后恢复提供了新的策略的原理,可能对其他脑损伤也有治疗作用。

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