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Mice bearing an N265M point mutation in the gamma-aminobutyric acid (GABA)A receptor ß3 subunit resist various anesthetic effects of propofol and etomidate. They also require a 16% larger concentration of enflurane and a 21% larger concentration of halothane to abolish the withdrawal reflex than do wild-type mice. Using a Pavlovian test, we measured whether this mutation increased the concentration of isoflurane required to impair learning and memory relative to wild-type mice. We found that the concentration was not significantly increased. We also measured MAC (the minimum alveolar concentration required to eliminate movement in response to noxious stimulation in 50% of subjects). Isoflurane MAC for mutant mice (1.93% ± 0.0.03%; mean ± se; n = 14) was 17.0% larger than MAC for wild-type mice (1.65 ± 0.04; n = 14; P < 0.001). Similarly, the cyclopropane MAC for mutant mice (27.6% ± 0.55%; n = 16) was 13.6% larger than MAC for wild-type mice (24.3 ± 0.46; n = 8; P < 0.01). The increase in MAC for cyclopropane was unexpected, because published reports find only minimal actions at 1ß2 2 GABAA receptors whereas isoflurane provides a large enhancement. Consistent with previous work on 1ß2 2 GABAA receptors, we found in Xenopus oocytes that 5 MAC cyclopropane enhanced the effect of GABA on 1ß2 2 GABAA receptors by only 76%, and by a nearly identical enhancement in 1ß3 2, and 6ß3 2 receptors. In contrast, a much smaller concentration of isoflurane (1 MAC) produced a 160% to 310% enhancement in these receptors. If, relative to isoflurane, cyclopropane minimally increases GABA-induced chloride currents at any GABAA receptor subtype, the present data for MAC are consistent with the notion that GABAA receptors do not mediate the immobility produced by inhaled anesthetics.
Present investigations into mechanisms of general anesthetic action generally presume that effects on specific ligand-gated receptors or voltage-gated ion channels mediate the actions of specific anesthetics. Work with two injected anesthetics, etomidate and propofol, supports this presumption (1). Etomidate (2,3) and propofol (4) purportedly act primarily by enhancing the response of a subset of gamma-aminobutyric acid (GABA)A receptors to GABA. A single point mutation, N265M, in the ß3 subunit of the GABAA receptor markedly decreases the capacity of both these injected anesthetics to cause loss of righting and completely abolishes their capacity to block noxious-evoked withdrawal reflexes (1). It is not known whether the N265 residue forms part of the binding site for etomidate and propofol or whether it changes the conformation of the receptor, either change resulting in insensitivity to these drugs. This knockin mouse allows a powerful test of the mechanisms by which etomidate and propofol exert their effects. Like all knockin animals, in theory, the knocked in receptor acts like a wild-type receptor except in the presence of drug (e.g., anesthetic).
The N265M point mutation also affected the potency of enflurane and halothane, a finding consistent with a previous report that recombinant
We sought to further explore this implication in the present study. In particular, we examined whether the mutation could be used to assess the extent to which the subpopulation of ß3-containing GABAA receptors mediates MAC (the minimum alveolar concentration of inhaled anesthetic required to eliminate movement in response to noxious stimulation in 50% of subjects) for two inhaled anesthetics, isoflurane and cyclopropane. Bearing in mind that no in vitro data have determined the degree to which the ß3(N265M) point mutation affects the action of isoflurane and cyclopropane, we hypothesized that if the ß3-containing GABAA receptors mediate the reported increase in the duration of the "withdrawal reflex" or MAC for enflurane and halothane (1), then the increase in MAC should be less for an anesthetic that has a minimal effect on the
The target(s) mediating the amnesic action of inhaled anesthetics (e.g., isoflurane) is also unknown. In the present study, we therefore explored the potential involvement of ß3-containing GABAA receptors in the capacity of inhaled anesthetics to depress learning and memory by comparing the actions of isoflurane in conditioning paradigms in ß3(N265M) mice and wild-type mice. Furthermore, we wanted to quantify the contribution of ß3-containing GABAA receptors to the immobilizing action of isoflurane and cyclopropane. We assumed that, as for the
The Committee on Animal Research of the University of California, San Francisco approved our study of mice of both sexes consisting of wild-type (129/SvJ x 129/Sv) mice and mice having an altered ß3 subunit point mutation (N265M) (129/SvJ x 129/Sv). The embryonic stem cell used for gene targeting (R1) was a 129/SvJ x 129/Sv hybrid. The chimeras were crossed twice with 129/SvJ mice, so that the theoretical contribution of the 129/SvJ substrain is 87.5% and of the 129/Sv substrain 12.5%. Breeding pairs resulting from two generations of homozygous breedings (8) were transferred from Zurich to San Francisco. The first generation offspring of these pairs provided the subjects for the present studies. Offspring were 69 wk of age when studied. Animals were housed in our animal care facility under 12-h cycles of light and dark, and had continuous access to standard mouse chow and tap water before the study. Experiments were performed between 0900 and 1500 h.
Three studies were performed. First, using a Pavlovian approach, we determined whether the mutant mice were resistant to isofluranes capacity to impair learning and memory. Second, we determined whether the MAC values for isoflurane and cyclopropane differed for mutant versus wild-type mice. Third, we assessed the effects of cyclopropane and isoflurane on GABA-induced currents through Studies of learning and memory applied techniques described previously (911). Mice were exposed to target concentrations of isoflurane (confirmed with gas chromatography) for 30 min before training. Each animal was then rapidly transferred to a training chamber containing the target concentration and was allowed to explore the chamber for 3 min before training began. Animals then received 3 tone-shock pairs consisting of a 30-s tone (90 dB, A-scale, 2000 Hz) co-terminating with a 2-s electric shock (11-Hz bipolar square waves); shock pairs were 90 s apart. Animals were returned to their home cages within 60 s after the last shock. The shock currents were 1 or 2 mA at 0%, 0.1%, and 0.2% isoflurane, and 2 mA at 0.3% and 0.4% isoflurane. At all larger concentrations of isoflurane, we used 3-mA currents. Tone testing took place the day immediately after training in chambers providing an entirely different environment from that provided by the training chambers. We then assessed freezing to context. For tone testing, each animal was placed in the test chamber, and, after 3 min of exploration, a tone (90 dB, A-scale, 2000 Hz) was continuously sounded for 8 min; shocks were not administered. Four animals were observed simultaneously, one in each of four separate test chambers, via a video camera. Two hours after the tone test, each mouse was tested for fear conditioning to context by an 8-min observation in the identical chamber in which it was trained the previous day. Again, four animals were observed simultaneously, one in each of the four chambers, via a video camera. No personnel were in the tone or context testing rooms during testing. To score freezing to either tone or context, an observation of 1 of the 4 animals was made every 2 s. Therefore, each animal was scored once every 8 s. Behavior was judged as freezing if there was no visible movement except for breathing (12). The observation periods were also video recorded for scoring by a blinded observer. The percentage of time an animal froze during the 8-min observation periods was calculated as the number of observations judged to be freezing divided by the total number of observations in 8 min, i.e., 60 observations (12). For each group score at a given isoflurane concentration, the mean and standard error of the mean (sem) were calculated. Nonlinear regression was performed to calculate a 50% effective dose, Hill coefficient (n), and the maximal or starting value of the dose-response curve (A) for fear conditioning according to the equation:
A Students t-test was applied to comparisons of results for wild-type versus mutant mice. A value of P < 0.05 was regarded as significant for all comparisons. MAC (the minimum alveolar concentration of isoflurane or cyclopropane that produced immobility in 50% of mice in response to a tail clamp) was determined in groups of 48 mice using techniques previously described (13,14). Rectal temperatures were monitored and maintained between 35.9° and 38.7°C (range for all mice). Anesthetic concentrations were monitored with an infrared analyzer (as above). The initial anesthetic concentration was imposed for a 40-min equilibration period. A small initial target concentration was chosen to ensure response to tail clamp. We then increased the anesthetic concentration in steps of 15%20% of the preceding concentration, holding each step for a minimum of 20 (cyclopropane) to 30 (isoflurane) min before again applying the tail clamp. This continued until all mice ceased moving in response to the tail clamp. At the end of each step (after application of the tail clamp), a sample of gas was taken for anesthetic analysis by gas chromatography. The gas chromatograph was calibrated with secondary standards from tanks containing isoflurane or from concentrations obtained by serial dilution from 100% cyclopropane. For the tests of learning and memory, for each group, the isoflurane concentration was calculated as the mean and standard error (se) of the concentrations measured in the cylinders and in the training chambers before and after training of that group. For the studies of MAC, the MAC for each mouse was calculated as the mean of the concentrations that bracketed movement-nonmovement. The group MAC and se were calculated from these individual values. Differences between wild-type and mutant mice were assessed with a Students t-test. We accepted P < 0.05 as significant.
Isolation, injection, and electrophysiological studies were conducted as previously described (6) with small differences detailed below. The cDNAs encoding the GABAA subunits were generously provided by Drs. M. H. Akabas (rat
The values for learning freezing to context or to tone were not affected (not significantly different) by the milliampere applied at a given concentration of isoflurane in all of 12 comparisons. For example, freezing to tone at 0% isoflurane (control) was 77 ± 5 (mean ± se; n = 16) at 1 mA and 76 ± 5 (n = 6) at 2 mA. Thus, the summary results (Table 1) show combined data.
In the absence of isoflurane (control), mutant mice did not freeze as much as wild-type mice. Percentages of time spent freezing for context and for tone in wild-type mice were 73% ± 4% and 77% ± 4% (n = 22) versus 48% ± 5% and 36% ± 4% (n = 36; P < 0.01 for context and P < 0.001 for tone). The nature of and the reasons for this difference in reactivity have not been investigated in detail. Nonetheless, the EC50 values for context did not differ significantly between wild-type and mutant mice (0.19% ± 0.037% isoflurane for the wild-type; n = 83; 0.28% ± 0.044% for the mutant; n = 134; P = 0.14; Fig. 1). Similarly, the EC50 values for tone did not differ (0.46% ± 0.043% versus 0.68% ± 0.13%; P = 0.17; Fig. 2).
The isoflurane MAC for mutant mice (1.93% ± 0.03%; mean ± se; n = 14) was 17.0% larger than MAC for wild-type mice (1.65 ± 0.04; n = 14; P < 0.001). Similarly, the cyclopropane MAC for mutant mice (27.6% ± 0.55%; n = 16) was 13.6% larger than MAC for wild-type mice (24.3 ± 0.46; n = 8; P < 0.01). Ten of the 16 mutant mice died before completion of the study with cyclopropane (i.e., at the highest step of the study). The MAC of the 6 surviving mice was 27.2% ± 0.41%, a value 11.9% larger than that for the wild-type mice (P < 0.05). For the mice that died, we assumed that movement would not have occurred at the next step, 15% more than the step at which movement had occurred. Thus, the MAC we calculated for cyclopropane in mutant mice probably underestimated the true MAC.
A saturated solution of cyclopropane (100% cyclopropane, equivalent to approximately 5 MAC) increased the current induced by EC5 GABA by 76% ± 4% in
The results for the present study suggest that the single point mutation, N265M, in the ß3 subunit of the GABAA receptor, does not increase resistance to the depressant effects of isoflurane on learning and memory (Table 1; Figs. 1 and 2). Perhaps some other measure of learning and memory would have revealed a difference, but we found no significant difference. Given the variability in fear conditioning in these animals, and the limited differences in isoflurane action between genotypes, we would have needed to study approximately twice as many mice (i.e., 268 knockin mice and 166 wild-type mice) for the EC50 shifts for tone and context conditioning to have achieved statistical significance. The finding of a nonsignificant trend to greater average EC50 values for the mutant mice presents one limitation of this study. Another limitation is the finding that the control (no anesthetic) freeze scores were smaller for the mutant mice. That is, although the present work finds no difference in the effect of isoflurane on learning and memory for wild-type versus mutant mice, we cannot exclude the possibility that there is a difference (and thus an effect of mutation on anesthetic potency).
Had we found a difference in tone or context conditioning, we would have measured the effect of the point mutation on the depression of learning and memory produced by cyclopropane. Our rationale would have been that if the ß3-containing GABAA receptors mediate part or all of the capacity of inhaled anesthetics to depress learning and memory, the mutation should have had less influence on the effect of cyclopropane than of isoflurane because cyclopropane has a far smaller capacity to enhance the in vitro action of GABA on GABAA receptors, based on previous in vitro studies at the The reasoning of a potential differential sensitivity of GABAA receptors for isoflurane and cyclopropane also applied to our study of MAC in the wild-type versus the ß3(N265M) mutant mice. Consistent with the reported effects of halothane and enflurane (1), we found that the mutant mice had a 17% larger MAC for isoflurane than did the wild-type mice (P < 0.001). If the ß3-containing GABAA receptors mediate the capacity of inhaled anesthetics to produce immobility, then we anticipated a smaller effect would be seen with cyclopropane. However, the effect of cyclopropane on MAC was comparable to that for isoflurane; MAC for cyclopropane in the mutant mice was 13.6% larger than MAC in wild-type mice (P < 0.01). We probably underestimated this larger MAC because, as noted in the results, 10 of the 16 mutant mice given cyclopropane died before the response at the largest concentration could be tested. Some of the results for MAC and learning and memory are unexpected and we speculate on their explanation.
a) Our assumption that ß3-containing wild-type GABAA receptors are much more sensitive to isoflurane than to cyclopropane was based, in part, on published in vitro data obtained for the
To expand on the previous findings in recombinant
Consistent with the possibility that specific and as yet undefined GABAA receptor subtypes may be sensitive to cyclopropane, the sensitivity of GABAA receptors to ethanol is determined by the type of ß,
b) In
c) As mentioned in the Introduction, the ß3(N265M) point mutation does not completely abolish enfluranes action in vitro (5), and isofluranes and cyclopropanes actions at this point mutation have not been studied in vitro. Potentially, point mutations in the We demonstrated previously that intrathecal administration of the GABAA receptor blocker picrotoxin did not increase the MAC of isoflurane more than the MAC of cyclopropane (19,20). In addition, other evidence suggests that GABAA receptors are not crucial to the immobilizing effects of inhaled anesthetics (reviewed in Ref. 19). Notwithstanding the aforementioned assumptions made in this study, if ß3-containing GABAA receptors were the only or the major targets mediating the immobilizing response to isoflurane and cyclopropane, we would have expected increases parallel to the observations made on etomidate and propofol which were unable to immobilize the ß3(N265M) mice (1). Because this is clearly not the case, our present finding that the MACs for isoflurane and cyclopropane are increased only partially in ß3(N265M) mice is consistent with targets other than ß3-containing GABAA receptors having a major role in mediating the immobilizing actions of these drugs. In summary, we suggest that although the ß3(N265M) point mutation markedly influences the potency of propofol and etomidate, and thus that ß3-containing GABAA receptors are a likely site of action for these injected anesthetics (1), ß3-containing GABAA receptors are of essentially no or of limited importance as mediators of the amnesia or immobility produced by inhaled anesthetics.
This work was supported by National Institutes of Health Grant 1PO1GM47818-10. The isoflurane used in this study was donated by Baxter Healthcare Corp. EIE is a paid consultant to Baxter Healthcare Corp. Accepted for publication December 8, 2004.
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