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The GABA Synapse as a Target for Antiepileptic Drugs: A Historical Overview Focused on GABA Transporters

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Abstract

It is clear that normal neuronal function relies on a tight balance between excitatory and inhibitory neurotransmission. Inhibitory signaling through the GABAergic system can be tightly regulated at the level of GABA uptake via GABA transporters (GAT). As such, selectively modulating the GABA uptake process through pharmacological agents has been an area of active investigation over several decades. These studies have demonstrated that inhibition of astroglial, but not neuronal, GATs may be preferred for anticonvulsant action. To date, four distinct GAT subtypes have been identified and efforts to selectively target these transporters have led to the proliferation of pharmacological agents aimed at augmenting extrasynaptic GABA levels. These pharmacological tools have provided novel and informative insight into the role of GABA and GABAergic signaling in the brain, but have also provided critical information concerning the regulation of CNS disorders associated with an imbalance in inhibitory tone, such as epilepsy. One such compound with notable inhibitory effects at GATs, tiagabine, has demonstrated clinical anticonvulsant efficacy, and is, to date, the only approved GAT inhibitor for clinical use. Thus, efforts to identify and develop GAT subtype-specific compounds continue to be an area of active investigation for the management of epilepsy and other CNS disorders. Herein, the historical efforts to elucidate the role of GABA in the synapse, as well as the role of GAT inhibitors as anticonvulsants, are described.

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  1. Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, 2100, Copenhagen, Denmark

    Arne Schousboe & Karsten K. Madsen

  2. Anticonvulsant Drug Development Program, Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, 417 Wakara Way, Suite 3211, Salt Lake City, UT, 84108, USA

    Melissa L. Barker-Haliski & H. Steve White

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  1. Arne Schousboe
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Special Issue: In honor of Krogsgaard-Larsen.

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Schousboe, A., Madsen, K.K., Barker-Haliski, M.L. et al. The GABA Synapse as a Target for Antiepileptic Drugs: A Historical Overview Focused on GABA Transporters. Neurochem Res 39, 1980–1987 (2014). https://doi.org/10.1007/s11064-014-1263-9

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