NMDA receptors have received much attention over the last few decades, due to their role in many types of neural plasticity on the one hand, and their involvement in excitotoxicity on the other hand. There is great interest in developing clinically relevant NMDA receptor antagonists that would block excitotoxic NMDA receptor activation, without interfering with NMDA receptor function needed for normal synaptic transmission and plasticity. This review summarizes current understanding of the structure of NMDA receptors and the mechanisms of NMDA receptor activation and modulation, with special attention given to data describing the properties of various types of NMDA receptor inhibition. Our recent analyses point to certain neurosteroids as NMDA receptor inhibitors with desirable properties. Specifically, these compounds show use-dependent but voltage-independent block, that is predicted to preferentially target excessive tonic NMDA receptor activation. Importantly, neurosteroids are also characterized by use-independent unblock, compatible with minimal disruption of normal synaptic transmission. Thus, neurosteroids are a promising class of NMDA receptor modulators that may lead to the development of neuroprotective drugs with optimal therapeutic profiles.

Membrane currents induced by noxious heat (Iheat) were studied in cultured dorsal root ganglion (DRG) neurones from newborn rats using ramps of increasing temperature of superfusing solutions. I heat was observed in about 70 % of small (< 25 μm) DRG neurones. At ‐60 mV, Iheat exhibited a threshold at about 43 °C and reached its maximum, sometimes exceeding 1 nA, at 52 °C (716 ± 121 pA; n= 39). I heat exhibited a strong temperature sensitivity (temperature coefficient over a 10 °C temperature range (Q10) = 17·8 ± 2·1, mean ± s.d., in the range 47‐51 °C; n= 41), distinguishing it from the currents induced by capsaicin (1 μM), bradykinin (5 μM) and weak acid (pH 6·1 or 6·3), which exhibited Q10 values of 1·6‐2·8 over the whole temperature range (23‐52 °C). Repeated heat ramps resulted in a decrease of the maximum Iheat and the current was evoked at lower temperatures. A single ramp exceeding 57 °C resulted in an irreversible change in Iheat. In a subsequent trial, maximum Iheat was decreased to less than 50 %, its threshold was lowered to a temperature just above that in the bath and its maximum Q10 was markedly lower (5·6 ± 0·8; n= 8). DRG neurones that exhibited Iheat were sensitive to capsaicin. However, four capsaicin‐sensitive neurones out of 41 were insensitive to noxious heat. There was no correlation between the amplitude of capsaicin‐induced responses and Iheat. In the absence of extracellular Ca2+, Q10 for Iheat was lowered from 25·3 ± 7·5 to 4·2 ± 0·4 (n= 7) in the range 41‐50 °C. The tachyphylaxis, however, was still observed. A high Q10 of Iheat suggests a profound, rapid and reversible change in a protein structure in the plasma membrane of heat‐sensitive nociceptors. It is hypothesized that this protein complex possesses a high net free energy of stabilization (possibly due to ionic bonds) and undergoes disassembly when exposed to noxious heat. The liberated components activate distinct cationic channels to generate Iheat. Their affinity to form the complex at low temperatures irreversibly decreases after one exposure to excessive heat.

No abstract