The GABA Polarity Shift and Bumetanide Treatment: Making Sense Requires Unbiased and Undogmatic Analysis.

The GABA Polarity Shift and Bumetanide Treatment: Making Sense Requires Unbiased and Undogmatic Analysis.
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DOI:
10.3390/cells11030396
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发表时间:
2022-01-24
期刊:
影响因子:
6
通讯作者:
Cherubini E
Cherubini E
中科院分区:
生物学2区
文献类型:
--
作者:
Ben-Ari Y;Cherubini E

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由于细胞内氯化物浓度 ([Cl−]i) 水平的发育调节降低,GABA 使所有动物物种和大脑结构中的未成熟神经元去极化并经常兴奋。 [Cl−]i 水平的控制由氯离子协同转运蛋白 NKCC1 和 KCC2 介导,前者通常输入氯离子,后者输出氯离子。 GABA 极性转变已在多种实验条件下得到广泛验证,通常使用 NKCC1 氯化物输入拮抗剂布美他尼。尽管存在内在的异质性,但这种转变在许多与发育障碍相关的实验条件下被消除,包括自闭症、雷特综合征、脆性 X 综合征或母体免疫激活。使用布美他尼(一种 EMA 和 FDA 批准的药物),许多临床试验显示出有希望的结果和预期的副作用。凯拉等人。多次质疑这些实验和临床观察结果。在这里,我们回复 Kaila 等人最近的评论。强调GABA极性转变已被科学界广泛接受为了解大脑发育的重大发现,布美他尼在临床试验中显示出良好的效果。
GABA depolarizes and often excites immature neurons in all animal species and brain structures investigated due to a developmentally regulated reduction in intracellular chloride concentration ([Cl−]i) levels. The control of [Cl−]i levels is mediated by the chloride cotransporters NKCC1 and KCC2, the former usually importing chloride and the latter exporting it. The GABA polarity shift has been extensively validated in several experimental conditions using often the NKCC1 chloride importer antagonist bumetanide. In spite of an intrinsic heterogeneity, this shift is abolished in many experimental conditions associated with developmental disorders including autism, Rett syndrome, fragile X syndrome, or maternal immune activation. Using bumetanide, an EMA- and FDA-approved agent, many clinical trials have shown promising results with the expected side effects. Kaila et al. have repeatedly challenged these experimental and clinical observations. Here, we reply to the recent reviews by Kaila et al. stressing that the GABA polarity shift is solidly accepted by the scientific community as a major discovery to understand brain development and that bumetanide has shown promising effects in clinical trials.
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