Recent developments in the significance and therapeutic relevance of neuroactive steroids--Introduction to the special issue.

This special issue heralds an exciting time in the field when the significance of neuroactive steroids in the regulation of inhibitory transmission is being realized and translated to new treatments for intractable neurologic and psychiatric conditions. In the past year, the binding sites for neuroactive steroids on gamma-aminobutyric acid type A (GABA(A)) receptors have been discovered and clinical trials for epilepsy and traumatic brain injury have been successful. New data in animal models points to the potential value of neuroactive steroids in other central nervous system (CNS) disorders including depression, schizophrenia, alcoholism, multiple sclerosis and other neurodegenerative conditions. How can one class of compounds have so many potential applications? The answer may lie in the ability of neuroactive steroids to regulate synaptic and extrasynaptic inhibitory transmission across brain, hypothalamic-pituitary-adrenal (HPA) axis function, inflammatory processes and myelin formation. The manuscripts in this issue of Pharmacology and Therapeutics will bring you up to date on the sites of neurosteroid actions, the systemic and molecular consequences of these actions and the potential therapeutic relevance of neuroactive steroid effects for CNS disease. These studies point to the opportunity for more translational research into potential therapeutic applications and the need for evaluation of potential untoward side effects following long-term treatment.