Comai Stefano, De Martin Sara, Mattarei Andrea, Guidetti Clotilde, Pappagallo Marco, Folli Franco, Alimonti Andrea, Manfredi Paolo L
Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35121 Padua, Italy.
Department of Biomedical Sciences, University of Padua, 35121 Padua, Italy.
Pharmaceuticals (Basel). 2024 Nov 30;17(12):1618. doi: 10.3390/ph17121618.
Uncompetitive NMDAR (N-methyl-D-aspartate receptor) antagonists restore impaired neural plasticity, reverse depressive-like behavior in animal models, and relieve major depressive disorder (MDD) in humans. This review integrates recent findings from in silico, in vitro, in vivo, and human studies of uncompetitive NMDAR antagonists into the extensive body of knowledge on NMDARs and neural plasticity. Uncompetitive NMDAR antagonists are activity-dependent channel blockers that preferentially target hyperactive GluN2D subtypes because these subtypes are most sensitive to activation by low concentrations of extracellular glutamate and are more likely activated by certain pathological agonists and allosteric modulators. Hyperactivity of GluN2D subtypes in specific neural circuits may underlie the pathophysiology of MDD. We hypothesize that neural plasticity is epigenetically regulated by precise Ca quanta entering cells via NMDARs. Stimuli reach receptor cells (specialized cells that detect specific types of stimuli and convert them into electrical signals) and change their membrane potential, regulating glutamate release in the synaptic cleft. Free glutamate binds ionotropic glutamatergic receptors regulating NMDAR-mediated Ca influx. Quanta of Ca via NMDARs activate enzymatic pathways, epigenetically regulating synaptic protein homeostasis and synaptic receptor expression; thereby, Ca quanta via NMDARs control the balance between long-term potentiation and long-term depression. This NMDAR Ca quantal hypothesis for the epigenetic code of neural plasticity integrates recent psychopharmacology findings into established physiological and pathological mechanisms of brain function.
非竞争性N-甲基-D-天冬氨酸受体(NMDAR)拮抗剂可恢复受损的神经可塑性,逆转动物模型中的抑郁样行为,并缓解人类的重度抑郁症(MDD)。本综述将非竞争性NMDAR拮抗剂的计算机模拟、体外、体内及人体研究的最新发现整合到关于NMDAR和神经可塑性的广泛知识体系中。非竞争性NMDAR拮抗剂是依赖活性的通道阻滞剂,优先靶向过度活跃的GluN2D亚型,因为这些亚型对低浓度细胞外谷氨酸的激活最为敏感,并且更有可能被某些病理性激动剂和变构调节剂激活。特定神经回路中GluN2D亚型的过度活跃可能是MDD病理生理学的基础。我们假设神经可塑性是由通过NMDAR进入细胞的精确钙量子进行表观遗传调控的。刺激到达受体细胞(检测特定类型刺激并将其转化为电信号的特化细胞)并改变其膜电位,调节突触间隙中谷氨酸的释放。游离谷氨酸与离子型谷氨酸能受体结合,调节NMDAR介导的钙内流。通过NMDAR的钙量子激活酶促途径,表观遗传调控突触蛋白稳态和突触受体表达;因此,通过NMDAR的钙量子控制长时程增强和长时程抑制之间的平衡。这种关于神经可塑性表观遗传密码的NMDAR钙量子假说将最近的精神药理学发现整合到已确立的脑功能生理和病理机制中。