Are the toxicities of pentobarbital and ethanol mediated by the GABA-benzodiazepine receptor-chloride ionophore complex?

Opposite effects of GABAA and NMDA receptor antagonists on ethanol-induced behavioral sleep in rats

The effects of the GABAA receptor antagonists, pentylenetetrazol, bicuculline, and picrotoxin, the glycine antagonist, strychnine, and the NMDA receptor antagonist, memantine, on ethanol-induced behavioral sleep and body temperature were investigated. Pentylenetetrazol, bicuculline, and picrotoxin given prior and following ethanol reduced the behavioral sleep and potentiated the hypothermia caused by ethanol. However, convulsions appeared when bicuculline, but not pentylenetetrazol and picrotoxin, were given following ethanol. After the reversal of unconsciousness in rats without convulsions the animals remained awake throughout the experiments without motor incoordination, hyperexcitability, and sedation, but they were in hypothermia within 12 h. The glycine antagonist, strychnine, given prior or after ethanol had virtually no effect on ethanol-induced behavioral sleep and hypothermia. Ethanol given prior or following strychnine failed to antagonize strychnine-induced convulsions. The NMDA receptor antagonist, memantine, given following ethanol potentiated the behavioral sleep and had virtually no effect on hypothermia induced by ethanol. It is suggested that the ethanol-induced behavioral sleep may be attributed to its ability to enhance the GABAergic mechanisms and to inhibit NMDA-mediated excitatory responses. However, the ethanol-induced hypothermia may be ascribed solely to the facilitation of GABAergic transmission. Further, it is postulated that a bidirectional inhibitory system subserves the regulation of behavioral sleep and convulsions. However, one-way inhibitory system underlies the ethanol-induced hypothermia.

Drugs acting at central benzodiazepine receptors attenuate ethanol-induced gastric lesions in rats

The characteristics of the receptors involved in the protective action of benzodiazepines against ethanol-induced gastric lesions were investigated by studying the effect of benzodiazepine ligands on such lesions in both intact and unilaterally vagotomized rats. Clonazepam [5-(2-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepine-2-one] a specific central-type receptor agonist (0.625-2.5 mg/kg p.o. or i.p.) and CGS 9896 [2-(4-chlorophenyl)-2,5-dihydropyrazolo(4,3-c)quinoline-3(3H)-one] a non-sedative partial agonist with anxiolytic properties (2.5-10 mg/kg p.o.) significantly reduced the gastric damage induced by ethanol (10 ml/kg of a 50% solution v/v p.o.) in non-vagotomized rats but Ro 5-4864 [7-chloro-5-(4-chlorophenyl)-1,3-dihydro-1-methyl-2H-1,4-benzodiazepine- 2 -one] a pure peripheral-type receptor agonist (5-20 mg/kg p.o.) failed to affect this damage. The protective action of clonazepam and CGS 9896 against ethanol-induced gastric lesions was blocked, dose dependently, by the central-type receptor antagonist, flumazenil [ethyl 8-fluoro-5,6-5-methyl-6-oxo-4H-imidazo(1,4)f1p4odiazepine-3-carbox ylate] (1.25-20 mg/kg i.p.). In the unilaterally vagotomized rat, ethanol produced lesions in the right (vagotomized) and the left (non-vagotomized) halves of the gastric mucosa to nearly the same extent, while clonazepam and CGS 9896 uniformly decreased the lesions in both halves. It is concluded that central-type benzodiazepine receptors located in the stomach, specifically those mediating the anxiolytic effect of benzodiazepines, are involved in the protective action of benzodiazepines against ethanol-induced gastric lesions.

Anaesthetic concentrations of alcohols potentiate GABAA receptor-mediated currents: lack of subunit specificity

Anaesthetic concentrations of ethanol (50-400 mM) and butanol (1-20 mM) were tested for their effects on GABAA receptor-mediated chloride currents in Xenopus oocytes expressing human GABAA receptor cDNAs. Significant potentiation of the currents was seen in all receptor constructs tested. Substituting the alpha 5 subunit for the alpha 1, or the beta 2 for the beta 1, did not affect the degree of ethanol potentiation. The effects of 200 mM ethanol and 20 mM butanol were also tested using a variety of GABA concentrations (0.3-1000 microM) on oocytes expressing alpha 1 beta 1 vs. alpha 1 beta 1 gamma 2S or alpha 1 beta 2 vs. alpha 1 beta 2 gamma 2S receptor constructs. The presence of the gamma 2S subunit generally did not appear to affect the degree of potentiation, except that butanol potentiation was greater in alpha 1 beta 1 than in alpha 1 beta 1 gamma 2S receptors. This phenomenon of anaesthetic concentrations of alcohols potentiating GABAA receptor responses appears to be distinct from the low (20 mM) ethanol potentiation previously reported in the literature.

GABA antagonist and benzodiazepine partial inverse agonist reduce motivated responding for ethanol

Brain gamma-aminobutyric acid (GABA) systems have long been associated with the behavioral actions of ethanol. This study investigated the effects of GABAergic agents on ethanol reinforcement. Rats were trained to orally self-administer ethanol in a 30-min, free-choice operant task. Responses at one of two levers produced contingent access to ethanol (10% w/v) or water. Pretreatment with RO 15-4513, a benzodiazepine inverse agonist (0.375 to 3.0 mg/kg ip), selectively reduced responses for ethanol, and a higher dose of RO 15-4513 (6.0 mg/kg) reduced both ethanol and water responses. Self-administration of saccharin in a free-choice task with access to saccharin (0.05%) and water was unaffected by RO 15-4513, suggesting that the effects of RO 15-4513 on ethanol reinforcement may not necessarily generalize to other reinforcers. Isopropylbicyclophosphate (IPPO), a picrotoxin ligand (5 and 10 micrograms/kg ip), selectively reduced responses for ethanol in alcohol-preferring, nonpreferring and Wistar rats. However, the highest dose of IPPO (20 micrograms/kg) reduced both ethanol and water responses. Chlordiazepoxide, a benzodiazepine, did not reduce responses for ethanol in the selectively bred animals, suggesting that this drug does not substitute for the reinforcing properties associated with acute ethanol intake. Together, these results suggest that compounds that act at the benzodiazepine inverse agonist and picrotoxin sites of the GABA/benzodiazepine receptor complex may decrease motivated responding for ethanol.

Functional properties of GABAA receptors in two rat lines selected for high and low alcohol sensitivity

The effects of lorazepam and sodium barbital on GABAA receptor function were evaluated in rat lines selected for differential sensitivity to the motor-impairing effects of ethanol [alcohol-insensitive (AT) and alcohol-sensitive (ANT) lines]. The effect of GABA on [3H]flunitrazepam and [3H]Ro 15-4513 binding and the effects of lorazepam and sodium barbital on [3H]muscimol binding were measured in cerebellar, cerebrocortical, and hippocampal membrane preparations. The effects of lorazepam and sodium barbital on muscimol-stimulated 36Cl- influx were measured using membrane vesicle suspensions from the same brain areas. No differences were found between the rat lines in the GABA-induced stimulation of [3H]flunitrazepam binding or in the lorazepam and sodium barbital-induced enhancement of either [3]muscimol binding or muscimol-stimulated 36Cl- flux. Neither was desensitization of the 36Cl- flux affected differently by ethanol, lorazepam, and barbital in vitro between the lines. The affinity of cerebellar diazepam-insensitive (DZ-IS) [3H]Ro 15-4513-binding sites for benzodiazepine agonists has been shown to be much greater in the ANT than the AT rats. In the present study, at 0 degrees C, GABA decreased [3H]Ro 15-4513 binding in the presence of diazepam only in ANT rats. Similarly, GABA decreased this binding at 37 degrees C in ANT rats having a high affinity for diazepam, whereas it enhanced the binding in all AT samples in those ANT samples where diazepam had a poor AT-like affinity. The decrease in binding in ANT samples is apparently caused by the enhancing effect of GABA on diazepam binding to DZ-IS [3H]Ro 15-4513-binding sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Ethanol-induced Cl- flux in rat cerebellar granule cells as measured by a fluorescent probe

Cl- fluxes through the GABAA receptor gated ion channels in cultured rat cerebellar granule cells were measured using the chloride-sensitive fluorescent probe SPQ (6-methoxy-N-(3-sulphopropyl)quinolinium) incorporated into the cells. The fluorescence of SPQ is quenched by Cl- ions. The cells were bathed in a low Cl- medium so that the Cl- gradient was directed outward. Ethanol increased the SPQ fluorescence indicating a decrease in intracellular Cl- due to Cl- efflux. Picrotoxin inhibited the effect at low concentrations of ethanol (less than 50 mM) in a concentration dependent manner. The effects of ethanol were potentiated at low concentrations (less than 10 microM) of gamma-aminobutyric acid (GABA), but inhibited at higher concentrations (0.3-2.0 mM). The results support the hypothesis that ethanol may act via the GABAA receptor gated ion channel. The results also suggest that SPQ is a suitable probe for measuring GABAA receptor-coupled Cl- fluxes through the GABAA receptor-gated channels in living cells.

Effect of ethanol on gamma-aminobutyric acid and glycine receptor-coupled Cl- fluxes in rat brain synaptoneurosomes

Chloride fluxes in synaptoneurosomes in response to additions of gamma-aminobutyric acid, glycine, and ethanol were measured using a chloride-sensitive fluorescent probe 6-methoxy-N-(3-sulfopropyl)quinolinium (SPQ). The Cl- gradient was directed outward by bathing cells in a medium low in Cl- concentration. The synaptoneurosomes responded to both gamma-aminobutyric acid and glycine by outflow of Cl- ions, as judged from an increase in SPQ fluorescence. These effects were inhibited by picrotoxin and strychnine, respectively. Ethanol also produced an outflow of Cl- ions from the synaptoneurosomes. Both picrotoxin and strychnine inhibited this effect. When the antagonists were used together, the inhibiting effect was additive. These results indicate that ethanol affects both gamma-aminobutyric acid and glycine receptor-linked chloride fluxes in the rat brain.

Protection against ethanol-induced gastric damage by drugs acting at the GABA-benzodiazepine receptor complex

The protective effects of drugs acting at the GABA-benzodiazepine receptor complex against ethanol-induced gastric damage in rats were investigated. Gastric lesions were induced by administration of 1 ml absolute ethanol orally to rats. Administration of clonazepam (0.625-2.5 mg/kg, IP), which binds with high affinity to the benzodiazepine binding site of the GABA-benzodiazepine receptor complex, or Ro 5-3663 (2.5 or 5 mg/kg), which binds to the piorotoxinin site of the receptor complex, protected against ethanol-induced gastric damage. The protective effect of clonazepam (1.25 mg/kg, IP) against ethanol-induced gastric damage was reversed, dose dependently, by the specific benzodiazepine antagonist, flumazenil (5-20 mg/kg, IP). This protective effect of clonazepam or Ro 5-3663 seems to be specific to ethanol-induced gastric damage, since neither drug protected against indomethacin-induced gastric damage. These results present for the first time evidence of the involvement of drugs acting at GABA-benzodiazepine receptors in protection against ethanol-induced gastric damage.

Modulation of benzodiazepine agonist and inverse-agonist receptor binding by GABA during ethanol withdrawal

1. The present study examined the capacity of GABA to modulate flunitrazepam and Ro15-4513 binding to putative GABAA receptors. Binding was measured in distinct brain regions both before and during selected periods of withdrawal from ethanol. 2. Rats were fed a nutritionally complete liquid ethanol (4.5% w/v) diet for 4 days and at various times after the last dose of ethanol (0, 12, 24, & 72 hr), rats were sacrificed and extensively washed brain membrane fractions were prepared. 3. Competitive inhibition of 3H-flunitrazepam binding by either flunitrazepam or Ro15-4513 (10(-10)M to 10(-7)M) was performed in the absence and presence of GABA (10(-5)M). In the presence of GABA, the apparent affinity for flunitrazepam was increased approximately 1.7 fold and the apparent affinity for Ro15-4513 was decreased by 1.7 fold. 4. No alteration in the capacity of GABA to modulate flunitrazepam or Ro15-4513 affinity (e.g. GABA-shift) was observed in cortical membrane preparations either 12 or 72 hr following ethanol cessation. 5. Further, no changes in GABA-modulation of flunitrazepam binding was evident 0, 12, 24, or 72 hr after the last ethanol dose in membranes prepared from cortex, hippocampus or cerebellum. 6. Therefore, results from the present study indicate that the capacity of GABA to modulate receptor affinity for benzodiazepine agonists and inverse-agonists in rat cortex, hippocampus or cerebellum is not altered during withdrawal from chronic ethanol.

Toxicology of selected pesticides, drugs, and chemicals. Short-chain alcohols

Widespread utilization of short-chain alcohols in solvents and alcoholic beverages provides small animals with numerous opportunities for exposure. Toxicosis most commonly occurs following ingestion but may also arise from inhalation and/or dermal absorption. The actions of short-chain alcohols are believed to result from nonspecific interactions with biomembranes altering the function of membrane-bound proteins, including the GABAA receptor. Mortality in alcohol toxicosis typically occurs because of respiratory and cardiac arrest as a result of profound CNS depression; therefore, general measures for resuscitation prevail in the initial treatment of severe alcohol toxicosis. Metabolism of alcohols alters the redox state in the liver, leading to hypoglycemia and lactic acidosis in some cases. In primates, treatment for methanol toxicosis is aimed at reducing accumulation of formate, thereby diminishing the metabolic acidosis and ocular damage characteristic in these species.

Plus-maze behavior and susceptibility to 3-mercaptopropionate-induced seizures in rat lines selected for high and low alcohol sensitivity

Selective outbreeding for high and low acute alcohol sensitivity has produced two rat lines (alcohol-sensitive ANT and alcohol-insensitive AT lines) that also differ in their sensitivity to GABAergic drugs, benzodiazepines and barbiturates. These rats were now compared in two behavioral tests believed to involve central GABAergic mechanisms, in elevated plus-maze test and in 3-mercaptopropionate-induced seizure test. The AT animals spent more time in the open arms of the plus-maze than the ANT rats, suggesting that the AT's behave less anxiously. The ANT's were more susceptible to seizures induced by 3-mercaptopropionate (50 mg/kg, IP) than the AT's, suggesting the ANT's having greater sensitivity to a decrease in brain GABA concentration. At the time of the first seizure signs, there was a tendency, though a nonsignificant one, to greater decreases in brain GABA in the ANT's than AT's. These results suggest that there are differences in GABA-related behaviors between ethanol-naive rats of the lines produced by selective outbreeding for differences in alcohol sensitivity. In theory, these behavioral line differences might physiologically counteract alcohol effects in the ANT's and enhance them in the AT's. In elevated plus-maze test, however, an acute dose of ethanol (1 g/kg, IP) significantly changed the behavior of the ANT animals, but only up to level of the AT rats. The apparent sensitivity to ethanol may thus be dependent on the naive behavior of the alcohol-insensitive AT and alcohol-sensitive ANT rats.

Barbiturates and the GABAA receptor complex

The GABA synapse plays an important role in the pharmacologic effects of barbiturates and the mechanisms involved in barbiturate tolerance and dependence. A synopsis of the effects which have been reported to date is found in Tables 1 and 2. Although the acute changes in neurotransmitter uptake and release are nonselective, a lag in the ability of the GABA synapse to compensate for discontinuation of barbiturate exposure may be important in the symptoms of withdrawal. Barbiturates cause changes in the properties of many receptors, but manipulations of the GABAA receptor in vivo correlate with changes in the therapeutic and toxicologic responses to barbiturates, indicating that the GABAA receptor complex plays a pivotal role in the effects of barbiturates. Experiments done in several laboratories show that barbiturate tolerance and dependence cause subtle changes in the properties of the GABAA receptor complex. These observations suggest that decreased GABA-stimulated chloride channel activity and reduced ability to modulate it may be important in causing barbiturate tolerance and the symptoms observed in withdrawal. Selection of drug-resistant rodent strains suggests that there may be genetic factors involved in drug tolerance and dependence. The complexity of the responses of the GABA synapse to both acute and prolonged exposure to barbiturates indicates that it is a valuable model for understanding how the central nervous system responds to drugs and the mechanisms involved in drug addiction.

Determination of GABA receptor-linked Cl- fluxes in rat cerebellar granule cells using a fluorescent probe SPQ

Gamma-Aminobutyric acid (GABA)-induced Cl- fluxes in cultured rat cerebellar granule cells were measured using the chloride-sensitive fluorescent probe SPQ (6-methoxy-N-(3-sulphopropyl)quinolinium) incorporated into the cells. The fluorescence of SPQ is quenched by Cl-ions. GABA and pentobarbitone increased the fluorescence of the probe when the Cl- gradient was directed outward by bathing cells, grown in the presence of GABA, in a low Cl- medium. Picrotoxin and bicuculline inhibited the response to GABA. The results suggest that SPQ is a suitable probe for measuring GABA-induced Cl- fluxes in living cells.

Effect of GABAergic drugs on motor impairment from ethanol, barbital and lorazepam in rat lines selected for differential sensitivity to ethanol

The effect of GABAergic drugs on the motor-impairing effects of ethanol, barbital, and lorazepam were studied in the ethanol-sensitive ANT (Alcohol Nontolerant) and ethanol-insensitive AT (Alcohol Tolerant) rat lines, selected for differential ethanol-induced motor impairment on the tilting plane. The basic population from which these rat lines were derived, the mixed (M) line, was also included in the study. The ANT rats were more sensitive to the intoxicating effects of ethanol, barbital, and lorazepam than the AT and M rats at the dose ranges tested. Picrotoxin antagonized motor impairment from all three drugs. Flumazenil (Ro 15-1788) antagonized only the effects of lorazepam, and isoniazid did not modify motor impairment induced by any of the three drugs. These results confirm that the selection of AT and ANT lines has not been specific to ethanol, and that it has increased sensitivity to ethanol, barbital, and lorazepam in the ANT rats rather than decreasing it in the AT rats relative to the M rats. The finding that picrotoxin counteracted motor impairment from ethanol, barbital, and lorazepam support the view that the GABAA receptor complex is important in mediating the intoxicating effects of these drugs. These results also suggest that the genetically-determined difference in sensitivity to ethanol between the rat lines involves GABAergic mechanisms, but it remains to be determined whether any part of the GABAA receptor itself has been affected by the selection program.

Cerebellar GABAA receptor binding and function in vitro in two rat lines developed for high and low alcohol sensitivity

The Bmax of the [3H]muscimol binding in the cerebellum of ethanol-naive alcohol-sensitive ANT (Alcohol Non-Tolerant) rats was only about 70% of that in the alcohol-insensitive AT (Alcohol Tolerant) rats. There were no line differences in the muscimol binding to cerebrocortical and hippocampal membranes. In the alcohol-sensitive rats, the cerebellar [3H]muscimol binding (5 nM) negatively correlated with the ethanol-induced motor-impairment measured in the tilting plane test. Muscimol stimulated the flux of 36Cl- in cerebellar synaptoneurosomes and non-filtered microsacs to the same extent in both rat lines. Ethanol produced only a small, although statistically significant, enhancement of the muscimol-stimulated chloride flux in both rat lines. The present data confirms our earlier finding of a low level of muscimol binding in the cerebellar membranes of alcohol-sensitive rats as compared to alcohol-insensitive rats. Further studies are needed to determine the relationship between the Cl- flux stimulation by muscimol and the differential muscimol binding in the cerebellum of these rat lines, and its importance for alcohol sensitivity.

Ethanol and the benzodiazepine-GABA receptor-ionophore complex

Ethanol has a pharmacological profile similar to that of classes of drugs like benzodiazepines and barbiturates, which enhance GABAergic transmission in the mammalian CNS. Several lines of behavioral, electrophysiological and biochemical studies suggest that ethanol may bring about most of its effects by enhancing GABAergic transmission. Recently, ethanol at relevant pharmacological concentrations has been shown to enhance GABA-induced 36Cl-fluxes in cultured spinal cord neurons, synaptoneurosomes and microsacs. These enhancing effects of ethanol were blocked by GABA antagonists. Ro15-4513, an azido analogue of classical BZ antagonist Ro15-1788, reversed most of the behavioral effects of ethanol and other effects involving 36Cl-flux studies. The studies summarized below indicate that most of the pharmacological effects of ethanol can be related to its effects on GABAergic transmission.

Effects of picrotoxin treatment on GABAA receptor supramolecular complexes in rat brain

The effects of acute and chronic administration of a subconvulsive dose of picrotoxin on t-[35S]butylbicyclophosphorothionate ([3S]TBPS), [3H]muscimol, and [3H]flunitrazepam binding characteristics in various regions and on the convulsant potency of picrotoxin in Sprague-Dawley rats were examined. Acute administration of a subconvulsive dose of picrotoxin (3 mg/kg, i.p.) significantly increased [35S]TBPS and [3H]muscimol binding in cerebellum (CB) with no change in frontal cortex (FC). In rats treated chronically with picrotoxin (3 mg/kg, i.p., daily for 10 days), the Bmax of [35S]TBPS binding site was significantly decreased in the FC, striatum (ST), and CB with no change in KD values. Neither [3H]muscimol binding in the FC and CB nor [3H]flunitrazepam binding in the FC was affected in these rats. In addition, the potency of pentobarbital to inhibit [35S]TBPS binding in vitro was not altered following acute or chronic treatment of picrotoxin. Chronic administration of picrotoxin did not affect convulsive ED50 or LD50 of picrotoxin; however, it delayed the onset of convulsions and increased the time to death. These results suggest that treatment with picrotoxin at a subconvulsive dose for 10 days causes down-regulation of [35S]TBPS binding sites and that this down-regulation might be related, at least in part, to the decreased extent of convulsant potency of picrotoxin. In addition, the results indicate possible interaction between convulsant binding sites and GABAA receptor sites in the CB following picrotoxin treatment.

Convulsant properties of GABA antagonists and anticonvulsant properties of ethanol in selectively bred long- and short-sleep mice

The convulsant potency of bicuculline, a GABA antagonist, was shown to be greater in Short-Sleep (SS) mice than in Long-Sleep (LS) mice. LS mice, selectively bred for lengthy ethanol-induced narcosis, had longer latencies to myoclonus and clonus following administration of bicuculline and picrotoxin than did ethanol-resistant SS mice. SS mice were also more susceptible to pentylenetetrazol-induced myoclonus, but not clonus. F1 hybrids showed bicuculline seizure sensitivity intermediate to the two parent lines. Ethanol weakly inhibited bicuculline-induced myoclonus in both LS and SS mice. Clonus was clearly antagonized by ethanol in both lines, but to a similar degree. These data provide evidence for a GABAergic role in genotype-dependent sensitivity to ethanol.

Benzodiazepines in the treatment of alcoholism

This chapter comprises three sections that cover the main aspects of benzodiazepines and alcohol: (1) the basic pharmacology of benzodiazepines; (2) use of benzodiazepines in the treatment of withdrawal; and (3) the use of benzodiazepines in treating alcoholics. The basic studies suggest that a major site of action of alcohol may be the GABA/benzodiazepine receptor complex and that compensatory alterations in this complex may underly withdrawal. In the section on alcohol withdrawal, interactions between the GABA/benzodiazepine receptor complex, sympathetic nervous system, and hypothalamic-pituitary-adrenal axis are discussed. Use of benzodiazepines in the treatment of the alcohol withdrawal syndrome are reviewed, including the possibility that the benzodiazepines may prevent withdrawal-induced "kindling." Lastly, we review indications for, and efficacy of, benzodiazepines in long-term treatment of patients with alcoholism. Benzodiazepines are not indicated for the treatment of alcoholism. Furthermore, they have very few indications in alcoholics and their dependency-producing potency has to be appreciated when they are used in patients with alcoholism.

RO15-4513 but not FG-7142 reverses anticonvulsant effects of ethanol against bicuculline- and picrotoxin-induced convulsions in rats

The reversal of anticonvulsant effect of ethanol against chemoconvulsions by RO15-4513 was investigated in rats as this novel imidazobenzodiazepine (ethyl-8 azido-5, 6-dihydro-5-methyl-6-Oxo-4H-imidazo [1,5a] [1,4] benzodiazepine-3-carboxylate) is reported to antagonize the acute behavioral and biochemical effects of ethanol in animals. Reversal of ethanol effects on onset of myoclonic jerks, tonic extensor phase, mortality time and percent protection against mortality were compared with not only other anticonvulsant pentobarbital but also with another inverse agonist FG-7142. Pretreatment with RO15-4513 (4 mg/kg) reversed the protective effect of ethanol against bicuculline-induced tonic extensor phase and mortality (87%). This response was sensitive to reversal by RO15-1788 (10 mg/kg). However, onset of myoclonic jerks and duration of clonus were not significantly altered. It also reversed the effect against picrotoxin but the reversal against mortality was up to 50%. As compared to ethanol, RO15-4513 reversed partially the protective effect of pentobarbital against bicuculline- and picrotoxin-induced convulsions. FG-7142 failed to reverse the protective effect of ethanol and pentobarbital against bicuculline-induced tonic extensor phase although it reversed the effect against onset and mortality. It had no effect on the protective effect against picrotoxin-induced convulsions. Both RO15-4513 and FG-7142 possessed proconvulsant effects against bicuculline but not against picrotoxin. These observations suggest that RO15-4513 has a more preferential action against ethanol effects as compared to the other inverse agonist.

Antagonism of ethanol effects by Ro 15-4513: an electrophysiological analysis

Ethanol (ETH) and general anesthetics have been reported to facilitate the chloride channel opening, possibly, or at least partly, through an interaction with the GABA-benzodiazepine (BZ) receptor-gated chloride ionophore "supramolecular complex". Recently Ro 15-4513, a novel BZ ligand, has been indicated as a potent and selective antagonist of various ETH-induced behavioral and biochemical effects. However, since its precise characterization is still a matter of debate, we have tested and compared the effect of Ro 15-4513, as well as its antagonism against ETH, in two objective electrophysiological parameters, i.e., the electroencephalograph (EEG) pattern in freely moving rats and single unit activity of reticulata neurons. Ro 15-4513 produced an EEG state of alertness and antagonized the behavioral impairment and the EEG deterioration by ETH. However, while its protective action was consistent against moderate doses (2 g/kg) of ETH, it was much less evident versus higher doses (4 and 8 g/kg). On reticulata cells, Ro 15-4513 potently stimulated their spontaneous firing and reversed the depression by both ETH and Na-pentobarbital. Moreover, the beta-carboline DMCM also had similar effects. The "pure" BZ antagonist Ro 15-1788 was completely inefective against ETH, yet fully cancelled the reversing actions of Ro 15-4513 and DMCM upon ETH or Na-pentobarbital effects. It is concluded that Ro 15-4513 behaves as a BZ inverse agonist, so that its opposition to ETH and Na-pentobarbital is probably the result of its "negative" coupling with the BZ recognition site that triggers the closing of chloride channels. It suggests that BZ inverse agonists might constitute, in the near future, a new class of analeptic drugs.

GABAA receptor-mediated chloride flux in brain homogenates from rat lines with differing innate alcohol sensitivities

Muscimol stimulation of 36Cl- flux through GABAA receptor-associated ion channels was compared in combined cerebral cortical and cerebellar homogenates from two lines of rats produced by selective outbreeding for high and low alcohol sensitivities. There was no difference in the muscimol effects between ethanol-naive alcohol-sensitive and alcohol-insensitive rats. Acute administration of ethanol (2 g/kg, i.p.) and lorazepam (3 mg/kg, i.p.) significantly reduced the percentage stimulation by muscimol in the alcohol-sensitive animals. The results suggest that genetic selection towards differences in the sensitivity to motor-impairing effects of moderate ethanol doses does not produce alterations in the direct agonist-induced GABAA receptor function. This receptor function was, however, down-regulated in the alcohol-sensitive rats by acute ethanol and benzodiazepine treatments, indicating the involvement of GABAergic activity in the mechanisms of, or in the neural adaptations to, acute intoxication in genetically sensitive animals.

Picrotoxinin receptor ligand blocks anti-punishment effects of alcohol

Ethanol at low doses produces a release of punished responding in an operant rat conflict test similar to that observed for benzodiazepines and phenobarbital. It has been hypothesized that these anti-punishment effects are mediated via the GABA-benzodiazepine receptor-ionophore complex but not at the benzodiazepine binding site. In the present study isopropylbicyclophosphate (IPPO), which binds at the picrotoxinin site, reversed the release of punished responding produced by ethanol, pentobarbital and chlordiazepoxide; at low doses IPPO (less than 10 micrograms/kg) appeared to be most effective against ethanol but at higher doses (greater than 15 micrograms/kg) was also effective against pentobarbital and chlordiazepoxide. At still higher doses IPPO produced a decrease in punished and unpunished responding. These results suggest that the "anxiolytic" actions of ethanol may involve a direct action on the GABA-benzodiazepine receptor-ionophore complex and this action may underlie some of the intoxicating effects of ethanol.

Reversal of alcohol-induced amnesia by the benzodiazepine inverse agonist Ro 15-4513

We investigated the effects of benzodiazepine inverse agonists on ethanol-induced amnesia using a passive avoidance task. Pretraining treatment of mice with ethanol significantly impaired the passive avoidance response: there was a significant reduction in the % retention and step-down latency. The benzodiazepine inverse agonists, Ro 15-4513 and beta-CCM, significantly increased the % retention and prolonged the step-down latencies in mice treated with ethanol, but FG 7142 did not. The anti-amnesic effects of Ro 15-4513 were completely antagonized by co-administration of Ro 15-1788, a benzodiazepine antagonist. These results suggest that the anti-amnesic effect of Ro 15-4513 on alcohol-induced amnesia is mediated by benzodiazepine receptors.

Molecular interactions of ethanol with GABAergic system and potential of RO15-4513 as an ethanol antagonist

The behavioral and biochemical effects of ethanol in man and animals have been investigated for a long time. A role of catecholamines in the central stimulatory action and during withdrawal has been envisaged, but more recent observations have revealed the involvement of inhibitory synaptic transmitter, GABA, in the actions of ethanol. Ethanol-induced motor incoordination, hypnosedation, antianxiety, and anticonvulsant actions are reported to be GABA-mediated. Involvement of the GABA system has been implicated in ethanol withdrawal-induced seizures in animals. More direct evidences using Cl- influx studies in synaptoneurosomes and spinal neuronal culture studies confirm such a mode of action of ethanol, probably influencing the chloride channel modulation at the GABA-benzodiazepine receptor ionophore complex. RO15-4513 (ethyl-8-azido-5,6-dihydro-5-methyl-6-Oxo-4H-imidazo [1,5-alpha], [1,4] benzodiazepine-3-carboxylate), a novel imidazobenzodiazepine, an analogue of the classical benzodiazepine antagonist is reported to possess alcohol antagonistic properties. RO15-4513 reverses both the behavioral and biochemical effects of ethanol, including the action of GABA-induced Cl- fluxes. But its potential clinical application may be restricted due to its inverse agonistic property. The present review focuses on the GABA-linked behavioral and biochemical actions of ethanol and discusses the potential of RO15-4513 as an alcohol antagonist.

Acute ethanol poisoning and the ethanol withdrawal syndrome

Ethanol, a highly lipid-soluble compound, appears to exert its effects through interactions with the cell membrane. Cell membrane alterations indirectly affect the functioning of membrane-associated proteins, which function as channels, carriers, enzymes and receptors. For example, studies suggest that ethanol exerts an effect upon the gamma-aminobutyric acid (GABA)-benzodiazepine-chloride ionophore receptor complex, thereby accounting for the biochemical and clinical similarities between ethanol, benzodiazepines and barbiturates. The patient with acute ethanol poisoning may present with symptoms ranging from slurred speech, ataxia and incoordination to coma, potentially resulting in respiratory depression and death. At blood alcohol concentrations of greater than 250 mg% (250 mg% = 250 mg/dl = 2.5 g/L = 0.250%), the patient is usually at risk of coma. Children and alcohol-naive adults may experience severe toxicity at blood alcohol concentrations less than 100 mg%, whereas alcoholics may demonstrate significant impairment only at concentrations greater than 300 mg%. Upon presentation of a patient suspected of acute ethanol poisoning, cardiovascular and respiratory stabilisation should be assured. Thiamine (vitamin B1) and then dextrose should be administered, and the blood alcohol concentration measured. Subsequent to stabilisation, alternative aetiologies for the signs and symptoms observed should be considered. There are presently no agents available for clinical use that will reverse the acute effects of ethanol. Treatment consists of supportive care and close observation until the blood alcohol concentration decreases to a non-toxic level. In the non-dependent adult, ethanol is metabolised at the rate of approximately 15 mg%/hour. Haemodialysis may be considered in cases of a severely ill child or comatose adult. Follow-up may include referral for counselling for alcohol abuse, suicide attempts, or parental neglect (in children). The ethanol withdrawal syndrome may be observed in the ethanol-dependent patient within 8 hours of the last drink, with blood alcohol concentrations in excess of 200 mg%. Symptoms consist of tremor, nausea and vomiting, increased blood pressure and heart rate, paroxysmal sweats, depression, and anxiety. Alterations in the GABA-benzodiazepine-chloride receptor complex, noradrenergic overactivity, and hypothalamic-pituitary-adrenal axis stimulation are suggested explanations for withdrawal symptomatology.(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of ethanol on [3H]dopamine release in rat nucleus accumbens and striatal slices

Ethanol (10-200 mM) transiently increased tritium overflow from superfused rat nucleus accumbens slices previously incubated with [3H]dopamine (DA) and [14C]choline. The effect was greater in striatal tissue and did not appear to be a non-specific membrane effect since [14C]acetylcholine (ACh) release was not affected. Lack of antagonism by picrotoxin suggested that gamma-aminobutyric acid (GABA) receptors were not involved. Calcium was not a requirement and the DA uptake blocker, nomifensine, was without effect. Ethanol appeared to be causing [3H]DA release into the cytoplasm. K+ -stimulated release of [3H]DA and [14C]ACh from nucleus accumbens and striatal slices was not affected. Clonidine-mediated inhibition of the K+-evoked release of [3H]DA remained unaltered. Ethanol attenuated the isoproterenol-induced enhancement of [3H]DA release. Ethanol therefore appeared to interact with components of the DA terminal causing a transient increase in the release of neurotransmitter without impairing K+-evoked release but apparently interfering with the isoproterenol-induced effect.

GABA/benzodiazepine receptor/chloride ionophore complex in brains of rat lines selectively bred for differences in ethanol-induced motor impairment

In vitro ligand binding studies were used to compare GABA/benzodiazepine receptor/chloride ionophore complexes in various brain regions of ethanol-sensitive ANT and ethanol-insensitive AT rats. In naive rats, there were several, but fairly small line differences in the binding parameters of [3H]muscimol and [3H]flunitrazepam to cerebral cortical, cerebellar or hippocampal membranes washed with or without a detergent. GABA-stimulation of flunitrazepam binding in the cerebral cortex membranes was slightly greater in the AT than ANT rats. In detergent solubilized receptors, the GABA-stimulation of flunitrazepam binding emerged only in the presence of ethanol in most AT samples, whereas the GABA-stimulation was always observed in ANT samples and ethanol had no further effect. Pharmacological characteristics of [3H]t-butylbicycloorthobenzoate binding displaceable by picrotoxin were similar in both lines. Chronic ethanol administration tended to increase the number of these binding sites in the cerebral cortex of AT rats and to decrease them in the ANT rats. Although many differences between the lines were observed, our results indicate that the ethanol-sensitivity difference between the AT and ANT rat lines cannot be explained by enhanced function of the GABA/benzodiazepine receptor/chloride ionophore complex as far as this is revealed by in vitro binding studies. It remains to be studied whether these lines differ in presynaptic GABAergic mechanisms or in the actual function of the postsynaptic chloride channels before the role of GABA can be more accurately assessed in this genetic model for ethanol-induced motor impairment.

Failure of Ro 15-4513 to antagonize ethanol in rat lines selected for differential sensitivity to ethanol and in Wistar rats

An imidazobenzodiazepine, Ro 15-4513, acting as a partial inverse agonist at the central benzodiazepine receptors has been recently reported to reverse efficiently the intoxicating effects of ethanol. In studies designed to delineate the role of benzodiazepine receptors in the ethanol-induced motor impairment difference between two rat lines selectively bred for high and low sensitivity to ethanol, however, we could not antagonize the effects of ethanol by Ro 15-4513 in the tilting plane and horizontal wire tests. Neither could we observe any consistent antagonism of ethanol actions in Han:Wistar rats, although we used a wide range of Ro 15-4513 doses, injected the drug intraperitoneally or intragastrically and before or after ethanol administration, and carried out the tests for motor impairment (rotarod, horizontal wire test and intoxication rating) at various times after the drug administration. The ex vivo assay of flunitrazepam binding in brain homogenates revealed the presence of compound(s) inhibiting the binding after administration of Ro 15-4513. Ro 15-4513 antagonized the motor impairing effects of lorazepam. In conclusion, Ro 15-4513 failed to function as a specific antagonist of moderate doses of ethanol in several tests for motor impairment in different rat lines.

Initial sensitivity and tolerance to ethanol in mice genetically selected for diazepam sensitivity

The benzodiazepine (BZ) receptor is coupled with a GABA-receptor chloride-ionophore complex. The BZs augment the GABA-induced increase in chloride conductance, which leads to postsynaptic inhibition. This effect is believed to be responsible for antianxiety, sedative, muscle relaxant, and anticonvulsant effects, but the mechanisms underlying these behavioral effects are poorly understood. Various other sedative-hypnotics, including ethanol and barbiturates, interact with this system, probably contributing to their behavioral effects. We have recently conducted a selective breeding program to develop lines of mice which are diazepam-resistant (DR) and sensitive (DS) (Gallaher EJ, Hollister LE, Gionet SE, Crabbe JC. Psychopharmacology, 93:25-30, 1987); when tested for the duration of rotarod impairment after 20 mg/kg diazepam the DR line was impaired for 71 +/- 13 min compared with 200 +/- 18 min in the DS line. In the current study we tested mice from the DR and DS lines to determine if BZ sensitivity generalized to ethanol. DS mice became ataxic with lower brain ethanol concentrations, and recovered at later times and with lower blood ethanol concentrations, than did DR mice, indicating that sensitivity differences did extend to ethanol. Following a series of sequential doses over 5 to 6 hr DS mice developed minimal rapid tolerance, whereas DR mice developed considerable tolerance. By the end of the day DS mice were therefore much more sensitive to ethanol than were DR mice; this difference was greater in males than in females. High dose ethanol toxicity was studied by assaying brain ethanol concentrations at the cessation of respiration; no differences were found between lines or sexes.

Effect of intravenously-administered putative and potential antagonists of ethanol on sleep time in ethanol-narcotized mice

Groups of male CD-1 mice (n = 12/group) were injected intraperitoneally (IP) with 5 g ethanol/kg of body weight. After loss of righting reflex, they were given vehicle or one of 2-3 doses of reputed or potential antagonists of ethanol intravenously (IV). Sleep time was measured from loss to return of righting reflex. Mean sleep time (MST) was increased significantly (P less than 0.05) by a large dose of dl-amphetamine (24 mg/kg) and by 4-aminopyridine (1, 5 mg/kg). Significant (P less than 0.01) increases were also produced by small and large doses of aminophylline (25, 100 mg/kg) and by yohimbine (1, 5 mg/kg). MST was not altered significantly by small and medium doses of dl-amphetamine (6, 12 mg/kg), a medium dose of aminophylline (50 mg/kg), or by any doses of naloxone, thyrotropin-releasing hormone, propranolol, physostigmine, doxapram, or Ro 15-4513. When Ro 15-4513 was given IP 15 minutes before ethanol (n = 6/group), onset and duration of narcosis were not altered. None of the compounds tested was an effective IV antidote for deep ethanol narcosis because of drug side effects, toxicity, prolongation of MST, or insufficient shortening of MST.

Amelioration of hepatic encephalopathy by pharmacologic antagonism of the GABAA-benzodiazepine receptor complex in a rabbit model of fulminant hepatic failure

Three separate, but allosterically interacting, sites on the gamma-aminobutyric acid (GABA) supramolecular complex in the brain were pharmacologically blocked in rabbits with hepatic encephalopathy due to galactosamine-induced fulminant hepatic failure to determine whether decreased GABAergic neurotransmission can ameliorate the syndrome of hepatic encephalopathy. Bicuculline (a GABAA receptor blocker), Ro 15-1788 (a benzodiazepine receptor antagonist), or isopropylbicyclophosphate (a chloride channel blocker) consistently induced a transient but unequivocal decrease in the clinical severity of the encephalopathy and also corrected the abnormal pattern of the visual evoked response associated with hepatic encephalopathy. Rabbits with hepatic encephalopathy exhibited increased resistance to the convulsive effects of bicuculline. In encephalopathies induced in rabbits by gamma-vinyl-GABA (an inhibitor of GABA catabolism) or diazepam (a benzodiazepine receptor agonist), abnormalities of the visual evoked response similar to those found in hepatic encephalopathy occurred and were corrected by bicuculline and Ro 15-1788, respectively. These findings suggest that in hepatic encephalopathy due to fulminant hepatic failure (a) there is increased GABAergic tone, (b) an amelioration of encephalopathy can be induced by blockade of GABA or benzodiazepine receptors, (c) benzodiazepine receptor antagonists may be of clinical value in the management of hepatic encephalopathy, and (d) an endogenous substance with GABA potentiating properties may be present in hepatic encephalopathy.

Lack of effect of the benzodiazepine receptor antagonist Ro 15-1788 on ethanol-induced intoxication in mice

The effects of 3, 6 and 48 mg/kg of the benzodiazepine receptor antagonist Ro 15-1788 on the ethanol-induced depressant action were evaluated in mice. These results support and extend previous findings in experimental animals and show that Ro 15-1788 in doses devoid of intrinsic effects, does not antagonize the motor impairment, hypnotic effect or lethality induced by ethanol.

The benzodiazepine receptor inverse agonists FG 7142 and RO 15-4513 both reverse some of the behavioral effects of ethanol in a holeboard test

The intrinsic effect of the benzodiazepine receptor inverse agonists RO 15-4513 and FG 7142 on the behavior of mice in a holeboard were investigated. Both drugs caused dose-related decreases in exploratory head-dipping. The highest dose of FG 7142 (40 mg/kg) also reduced locomotor activity. RO 15-4513 (1.5 and 3.0 mg/kg) and FG 7142 (10 and 20 mg/kg) reversed the reductions in the number of head-dips caused by ethanol (2 g/kg). The higher doses of these two drugs also partially reversed the locomotor stimulant action of ethanol. Animals that received ethanol in combination with either inverse agonist spent less time head-dipping than vehicle-treated controls. These data indicate that FG 7142 and RO 15-4513 can reverse, at least in part, some of the behavioral effects of ethanol. Neither drug significantly altered blood alcohol concentrations suggesting that the antagonism does not result from pharmacokinetic changes.

Interactions of Ro 15-4513 with diazepam, sodium pentobarbital and ethanol in a holeboard test

Ro 15-4513 (1.5 mg/kg) decreased the exploratory activity of mice in a holeboard test. This effect was reversed by diazepam (1 mg/kg), ethanol (1 g/kg) and sodium pentobarbital (15 mg/kg). Higher doses of these three agents reduced the number of exploratory head-dips, and Ro 15-4513 antagonised these effects. These observations are consistent with the suggestion that Ro 15-4513 is a partial inverse agonist at benzodiazepine receptors and acts by reducing the efficacy of GABA. Ro 15-4513's interaction with ethanol in the holeboard closely resembled its interaction with the barbiturate.

Effect of an imidazobenzodiazepine, Ro15-4513, on the incoordination and hypothermia produced by ethanol and pentobarbital

The imidazobenzodiazepine, Ro15-4513, which is a partial inverse agonist at brain benzodiazepine receptors, reversed the incoordinating effect of ethanol in mice, as measured on an accelerating Rotarod. This effect was blocked by benzodiazepine receptor antagonists. In contrast, Ro15-4513 had no effect on ethanol-induced hypothermia in mice. However, Ro15-4513 reversed the hypothermic effect of pentobarbital, and, at a higher dose, also reversed the incoordinating effect of pentobarbital in mice. The data support the hypothesis that certain of the pharmacological effects of ethanol are mediated by actions at the GABA-benzodiazepine receptor-coupled chloride channel.

Protection against the lethal effects of pentobarbital in mice by a benzodiazepine receptor inverse agonist, 6,7-dimethoxy-4-ethyl-3-carbomethoxy-beta-carboline

The benzodiazepine receptor inverse agonist 6,7-dimethoxy-4-ethyl-3-carbomethoxy-beta-carboline (DMCM) (1.5-15 mg/kg) was administered to mice 5 min after a lethal (LD94) injection of pentobarbital. DMCM (1.5-5 mg/kg) increased short-term (1 h) survival in a dose-dependent fashion, with an optimum survival rate more than five times greater than mice receiving pentobarbital alone. Statistically significant increases in long-term (24 h) survival were also observed after both 5 and 10 mg/kg of DMCM (34 and 33%, respectively) compared with animals receiving pentobarbital alone (6%). Two doses of DMCM (5 and 2.5 mg/kg, respectively) administered 55 min apart produced an even greater increase (58%) in 24-h survival rates. Doses of DMCM that increased 1- and 24-h survival were not lethal when administered alone, and were below the dose that produced convulsions in 50% (CD50) of the animals. The protective effects of DMCM were blocked by pretreatment with the benzodiazepine receptor agonist ethyl-8-fluoro-5,6-dihydro-5-methyl-6-oxo- 4H-imidazo[1,5a][1,4]benzodiazodiazepine-3-carboxylate (Ro 15-1788), which suggests the effects of DMCM are mediated through the benzodiazepine receptor. These findings suggest that DMCM or another benzodiazepine receptor ligand with full inverse agonist qualities could prove effective as an antidote for barbiturate intoxication in man.

Involvement of neuronal chloride channels in ethanol intoxication, tolerance, and dependence

Studies of the role of neuronal chloride channels in ethanol action have focused on chloride channels coupled to gamma-aminobutyric acid (GABA) receptors. Ethanol intoxication is hypothesized to result from enhancement of GABA action, leading to increased chloride conductance and decreased neuronal excitability. Chronic ethanol treatment is suggested to produce a subsensitivity to GABA, leading to decreased action of ethanol and hyperexcitability on withdrawal of ethanol. Behavioral, electrophysiological, and biochemical studies of acute and chronic ethanol treatments on the GABA-regulated chloride channels of brain are reviewed.

Marked variation in diazepam sensitivity in Swiss albino mice

Using the righting reflex as the critical level, sleep was measured in Swiss albino mice at a dose of 35 mg/kg diazepam, i.p. Sleep times varied markedly from zero to 120 min with a mean +/- s.d. of 44 +/- 37 (N = 202). The distribution is skewed to the left with a coefficient of skewness of 0.33 +/- 0.17. The sleep times of the two sexes, when analyzed separately, showed similar range, mean and s.d., except that the distribution tended to be more clearly bimodal in males than in females. These animals also exhibited marked variations in their response to either ethanol (4 g/kg) or pentobarbital (45 mg/kg). The diazepam sleep time failed to correlate with the ethanol sleep time. Significant correlation, however, was obtained between diazepam and pentobarbital sleep times. On further analysis with least-squares fit to a straight line, the data yielded a line with a slope of 0.16; thus despite the correlation reaching a significant level, there is no significant difference in the pentobarbital sleep times between mice that have the longest or the shortest diazepam sleep times. By monitoring the plasma and brain levels of diazepam and N-desmethyldiazepam in mice at awakening, it was found that the variations in sleep time cannot be explained by individual differences in drug disposition. The phenomenon is discussed in terms of individual variations in diazepam sensitivity and the possibility of development of tolerance to diazepam almost immediately after diazepam administration.

Muscle relaxant action of phenobarbitone in genetically spastic rats: an electromyographic study

The muscle relaxant effect of phenobarbitone was studied in genetically spastic rats which exhibit spontaneous tonic activity in the electromyogram (EMG) of the gastrocnemius muscle. Phenobarbitone, 10-30 mg/kg i.p., reduced the tonic activity in the EMG of the gastrocnemius muscle of such rats in a dose- and time-dependent manner. The GABA antagonists bicuculline, 2 mg/kg i.p., and picrotoxin, 2 and 3 mg/kg i.p., reduced the muscle relaxant effect of phenobarbitone, 20 and 30 mg/kg. The benzodiazepine receptor antagonists, Ro 15-1788, 5 mg/kg, and CGS 8216, 5 mg/kg (doses which do not affect tonic activity in the EMG), failed to alter the depressant effect of phenobarbitone 30 mg/kg, in the EMG. Beta-Carboline-3-carboxylic acid methylester (beta-CCM), 2 mg/kg i.p., while not affecting the tonic activity in the EMG, reversed the depressant effect of phenobarbitone, 30 mg/kg. Both Ro 15-1788, 5 mg/kg, and CGS 8216, 5 mg/kg, prevented the reversal of the depressant action of phenobarbitone, 30 mg/kg, produced by beta-CCM, 2 mg/kg. The results indicate that the muscle relaxant action of phenobarbitone in genetically spastic rats is mediated via GABA-related mechanisms and add further support to the hypothesis that both Ro 15-1788 and CGS 8216 are specific antagonists at benzodiazepine receptors, devoid of intrinsic activity at moderate doses. The results also suggest that reversal of the muscle relaxant action of phenobarbitone by beta-CCM is mediated via a GABA/benzodiazepine receptor/chloride ionophore complex.

The benzodiazepine antagonist Ro 15-1788 does not antagonize the ethanol withdrawal syndrome

It has been suggested that the signs and symptoms of the ethanol withdrawal syndrome may be due to the increased production of an "inverse agonist" that binds to the central benzodiazepine (BZ) recognition site in the brain. Ro 15-1788 (a potent antagonist at the central BZ recognition site), diazepam, and Ro 15-1788 plus diazepam were administered to groups of rats undergoing overt ethanol withdrawal. Ro 15-1788 did not alter the severity of the ethanol withdrawal reactions, but antagonized the ameliorative effect of diazepam. The results of our studies suggest that (1) the ethanol withdrawal syndrome is not produced by an endogenous ligand acting on the central BZ recognition site, and (2) diazepam decreases the severity of the ethanol withdrawal syndrome, at least in part, by its action at the central BZ recognition site.

The effect of in vitro and in vivo ethanol administration on [35S]t-butylbicyclophosphorothionate binding in C57 mice

Previous studies have shown that ethanol may produce some of its effects by facilitation of GABAergic transmission. One of the potential sites of drug action at the GABA receptor complex is the picrotoxin site, which can be studied with [35S]t-butylbicyclophosphorothionate (TBPS). Ethanol inhibited the binding of [35S]TBPS to C57 mice brain regions in vitro. This inhibition appears to be noncompetitive since ethanol decreased the Bmax and not the KD value of [35S]TBPS. C57 mice were chronically treated with ethanol in liquid diet to determine if the sensitivity of TBPS binding is altered following chronic treatment or during withdrawal. Chronic treatment with ethanol and during withdrawal did not alter the KD or Bmax values of [35S]TBPS binding in C57 mice brain regions. It is suggested that the sensitivity of picrotoxin site on the oligomeric GABA receptor complex is not altered during ethanol tolerance or withdrawal. The effects of ethanol on GABA system may be mediated by its interaction with the coupling mechanism(s) or a direct effect on the chloride channels.