Subtype Selective γ-Aminobutyric Acid Type A Receptor (GABAAR) Modulators Acting at the Benzodiazepine Binding Site: An Update

J Med Chem. 2020 Apr 9;63(7):3425-3446. doi: 10.1021/acs.jmedchem.9b01312. Epub 2019 Dec 5.

Abstract

γ-Aminobutyric acid (GABA) is the major inhibitory neurotransmitter within the central nervous system (CNS) with fast, transsynaptic, and modulatory extrasynaptic effects being mediated by the ionotropic GABA type A receptors (GABAARs). These receptors are of particular interest because they are the molecular target of a number of pharmacological agents, of which the benzodiazepines (BZDs), such as diazepam, are the best described. The anxiolytic, sedating, and myorelaxant effects of BZDs are mediated by separate populations of GABAARs containing either α1, α2, α3, or α5 subunits and the molecular dissection of the pharmacology of BZDs indicates that subtype-selective GABAAR modulators will have novel pharmacological profiles. This is best exemplified by α2/α3-GABAAR positive allosteric modulators (PAMs) and α5-GABAAR negative allosteric modulators (NAMs), which were originally developed as nonsedating anxiolytics and cognition enhancers, respectively. This review aims to summarize the current state of the field of subtype-selective GABAAR modulators acting via the BZD binding site and their potential clinical indications.

Publication types

  • Review

MeSH terms

  • Animals
  • Binding Sites
  • GABA Modulators / chemistry
  • GABA Modulators / pharmacology
  • GABA Modulators / therapeutic use*
  • GABA-A Receptor Agonists / chemistry
  • GABA-A Receptor Agonists / pharmacology
  • GABA-A Receptor Agonists / therapeutic use*
  • GABA-A Receptor Antagonists / chemistry
  • GABA-A Receptor Antagonists / pharmacology
  • GABA-A Receptor Antagonists / therapeutic use*
  • Humans
  • Molecular Structure
  • Protein Subunits / metabolism
  • Receptors, GABA-A / chemistry
  • Receptors, GABA-A / metabolism*

Substances

  • GABA Modulators
  • GABA-A Receptor Agonists
  • GABA-A Receptor Antagonists
  • Protein Subunits
  • Receptors, GABA-A