Steroid and barbiturate modulation of the GABAa receptor. Possible mechanisms.

This review describes the modulation of the GABAa receptor by steroid hormones and barbiturates and proposes guidelines for further research. Having examined the complex organization of the GABAa receptor complex and the multiple allosteric interactions between its drug and transmitter/modulator binding sites, the possibility that conformational changes of the receptor molecule may explain most of its characteristics is explored. On the basis of considerable evidence, we propose that the GABAa receptor may adopt as many as five different conformations. However, the heterogeneity of central GABAa receptor binding cannot only be explained by different configurations of a single protein. It also has been shown that different GABAa receptor subtypes exist within different brain regions. These receptor subtypes may differ from each other in their subunit composition. By describing the GABAa receptor as a macromolecular complex that may adopt different conformations and whose subunit composition may vary, it becomes possible to understand the molecular mechanisms by which steroid hormones modulate the receptor. This has led to two models of hormone actions. A first model addresses the direct effects that steroids exert on the GABAa receptor and predicts that steroid hormones may cause the conformation of the receptor complex to change between active and inactive states. A second model, which addresses the observed heterogeneity of GABAa receptor binding within the brain, suggests that steroid hormones may change the expression of the different subunits of the receptor complex by acting at the genomic level. This review complements other recent reviews describing the modulation of the GABAa receptor (Olsen and Venter, 1986; Gee, 1988).