A single amino acid of the human gamma-aminobutyric acid type A receptor gamma 2 subunit determines benzodiazepine efficacy.

Incorporation of the gamma 2 subunit into gamma-aminobutyric acid type A (GABAA) receptors is required for the expression of benzodiazepine pharmacology, but the regions of the subunit responsible for benzodiazepine actions have not been defined. Using mutagenesis, we identified a single amino acid of the gamma 2 subunit of the human GABAA receptor that profoundly alters the nature of this pharmacology. When threonine 142 was mutated to serine, the benzodiazepine receptor antagonist, flumazenil, and the weak inverse agonist, Ro 15-4513, both acted as potent partial agonists. Further, potentiation of GABA responses by diazepam, alprazolam, clonazepam, or flunitrazepam doubled in receptors containing the Ser-142 gamma 2 subunit. In contrast, responses to the Type I benzodiazepine receptor selective ligands, zolpidem, alpidem, and CL218,872, were roughly halved. This change in pharmacology appears to occur at a stage following ligand binding, i.e. the mutation affects benzodiazepine efficacy. There was no effect on GABA affinity or efficacy or pentobarbital, Ro 5-4864, or alphaxalone modulation of GABA responses. These findings demonstrate that very minor changes in receptor structure can profoundly affect the efficacy of receptor ligands. Thus, agonism is determined not only by the structure of the drug, but also by the structure of the receptor, or protein complex, with which it interacts.