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GENERAL ARTICLES

Dual Action of Isoflurane on the -aminobutyric Acid (GABA)-Mediated Currents Through Recombinant ₁ß_22L-GABA_A-Receptor Channels

Susanne Neumahr, MD^*, Gerhard Hapfelmeier, MD^*, Michaela Scheller, MD^*, Hajo Schneck, MD^*, Christian Franke, PhD, and Eberhard Kochs, MD^*

Departments of *Anesthesiology and Neurology, Klinikum rechts der Isar, Technische Universität, Munich, Germany

Address correspondence and reprint requests to Susanne Neumahr, MD, Institut für Anaesthesiologie der Technischen Universität München, Klinikum rechts der Isar, Ismaninger Straße 22, D-81675 München, Germany.

Isoflurane (ISO) increased the agonist-induced chloride flux through the -aminobutyric acid A receptor (GABA_AR). This may reflect an anesthetic-induced increase in the apparent agonist affinity. A dual effect of anesthetics was postulated for both the nicotinic acetylcholine receptor (nAChR) and the GABA_AR. We tested the hypothesis that, in addition to a blocking effect, ISO increases -aminobutyric acid (GABA)-gated currents through recombinant GABA_AR channels. HEK293 cells were transfected with rat cDNA for ₁,ß₂,_2L subunits. Currents elicited by 1 mM or 0.01 mM GABA, respectively, alone, or with increasing concentrations of ISO, were recorded by using standard patch clamp techniques. ISO reduced the peak current elicited by 1 mM GABA. Currents induced by 0.01 mM GABA were potentiated by small ISO (twofold at 0.5 mM ISO) and inhibited by larger concentrations. Withdrawal of ISO and GABA induced rebound currents, suggesting an open-channel block by ISO. These currents increased with increasing concentrations of ISO. At large concentrations of ISO, the inhibitory effect predominated and was caused by, at least partly, an open-channel block. At small concentrations of ISO, potentiation of the GABA-gated currents was more prominent. This dual action of ISO indicates different binding sites at the GABA_AR. The balance between potentiation and block depends on the concentrations of both ISO and GABA.

Implications: Isoflurane (ISO) interacts with the inhibitory -aminobutyric acid (GABA) receptor. This patch clamp study demonstrates that it may block or potentiate the type A of GABA receptor studied, depending on the concentrations of ISO and of GABA used. At clinically relevant concentrations, ISO considerably potentiates this receptor. This may partly explain its clinical effect.

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