Excitotoxicity and the NMDA receptor


Dr. F. X. Sureda


1.- The excitotoxic concept.concept of excitotoxicity.


            Excitotoxicity, a phenomenon thatwhich was first described by Olney in the seventies, implies the activation in the CNS of the so-called glutamate receptors.nineteen-seventies1, involves the activation of glutamate receptors in the central nervous system (CNS). Glutamate, an excitatory amino acid, activates different types of ion channel forming receptors (named ionotropic)channel-forming receptors (ionotropic) and G-protein-coupled receptors (named metabotropic) to develop their essential role inthe functional activity of the brain. However, high concentrations of glutamate, or neurotoxins acting at the same receptors, cause cell death through the excessive activation of these receptors. In physiological conditions, the presence of glutamate in the synapse ishighly regulated byvery active, ATP-dependent transporters in neurones and glia. For instance, in CNS ischaemia a decrease in the levels of glucose exertscauses a decrease in ATP production, leading to an impairment of glutamate uptake. Moreover, the membrane potential of presynaptic neurones is lost and efflux of excitatory amino acids occurs, contributing to the excessive activation of post-synaptic glutamatepostsynaptic receptors2.


2.- The glutamate receptors.


            As pointed out earlier,above, glutamate and other amino acids can activate both ionotropic and metabotropic receptors (for review, 3). The latter are subdivided into three main families, and can be coupled to phospholipase C (PLC) or to adenylyl cyclase (AC). The ion channel formingchannel-forming receptors are subdivided into threedifferent receptor classes that are named by their selective agonists: AMPA (a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptors, kainate receptors and NMDA (N-methyl-D-aspartic acid) receptors. AMPA and kainate receptors trigger rapid excitatory neurotransmission in the CNS,CNS  by promoting entry of Na+ into neurones. However, a subset of neurones in the hippocampus, cortex andthe retina express AMPA receptors that are also permeable to Ca2+. NMDA receptors are associated to a high conductancewith a high-conductance Ca2+ channel that in resting, non-depolarising conditions is blocked by Mg2+ in a voltage-dependent manner. Their activation is secondary to AMPA or AMPA- or kainate-kainate receptor activation thatreceptor activation, which depolarises the neurone, allowing  for the reliefthe release of the Mg2+ blockade.


3.- Role of NMDA receptors in the excitotoxic process.


            The physiological role of the NMDA receptor seems to be related to synaptic plasticity. Also,In addition, working together with metabotropic glutamate receptors,  ensureit ensures the establishment ofthe long-term potentiationphenomenon (LTP), a process believed to be responsible for the acquisition of information. These functions are mediated by calcium entry through the NMDA receptor-associated channel. Calcium activates a number of Ca2+-dependent enzymes that influence a wide variety of cellular components, like cytoskeletal proteins or second- messenger synthases. However, overactivation at NMDA receptors triggers an excessive entry of Ca2+, initiating a series of cytoplasmic and nuclear processes that promote neuronal cell death. For instance, Ca2+-activated proteolytic enzymes, like calpains, can degrade essential proteins. Moreover, Ca2+/calmodulin kinase II (CaM-KII) is activated, and a number of different enzymes are phosphorilated, increasingenzymes are phosphorylated,  which increases their activity. DifferentTranscription transcription factors such as c-Fos, c-Jun or c-Myc are also expressed. Furthermore, Ca2+-dependent endonucleases can degrade DNA. Allof these mechanisms, together with enhanced oxidative stress (see below) can induce cell death through necrosis as well as apoptosis, a modeltype of programmed cell death that is described in several neurodegenerative diseases.

4.- Oxidative stress in the excitotoxic process.


            Mitochondria playshave an important role in the regulation of the intracellular calcium concentration. An increased entry of Ca2+ into the mitochondria is believed to enhance the mitochondrial electron transport, increasing the production of reactive oxygen species (ROS) such as ·O2-. Although mitochondria are the main source of ROS in the excitotoxicprocessmitochondria is the major source of ROS, process, there are many enzymatic systems that primarily or secondarily increase the presence of thosethese compounds in the CNS4. Calcium-dependent enzymes convert xanthine dehydrogenase to xanthine oxidase, leading to the production of ·O2- and H2O2. Moreover, Ca2+ activates the enzyme phospholipase A2 (PLA2), which leads to the production of arachidonic acid, thatwhich in turn, is transformed by cyclooxygenases, increasing the formation of ·O2-. Calcium also activates NO-synthase, increasing the presence of ·NO in the neurone and also in surrounding areas. ·NO has a double effect, since it activates guanylylcyclases and also reacts with ·O2- to form the highly toxic compound peroxynitrite (ONOO-). This is a strong oxidizing agent that causes nitration in proteins and oxidation of lipids, proteins and DNA, leading to a form of cell death that has the characteristics of apoptosis. Lipid peroxidation causes a disturbance inalters the structure of lipidic membranes, and leakage occurs in the cytoplasmic membrane occurs. Apart from the loss of ionic gradients,enhanced release of glutamate from presynaptic terminals take place, worsening the previously mentionedis enhanced, which exacerbates these effects.


5.- ImplicationInvolvement of excitotoxicity in neurodegenerative diseases.


            Excitotoxicity has been related to several acute neurological disorders, such as epileptic convulsions, where overactivity ofin which excitatory synapses exists.become over active. In ischaemic stroke and in post-traumatic lesions, the implicationinvolvement of excitotoxicity is well established. As mentioned earlier,above, in these particular pathological situations a decrease in ATP production evokes glutamate release through depolarisation of presynaptic terminals. In neurodegenerative disorders like Parkinson’s or Alzheimer’s diseases, Huntington’s chorea or in amyotrophic lateral sclerosis (ALS), a role for excitotoxicityin the pathogenesis of these diseases has also been postulated. Moreover, drugs that block NMDA or other glutamate receptors, as well as compounds that decrease glutamate release, attenuate some of the pathological manifestationssymptoms in experimental models of acute and chronic neurodegenerative diseases.


6.- Development of NMDA antagonists as neuroprotective drugs.


            Due to the relevance of the neurodegenerative diseasesalready mentioned above and the lack ofexisting, effective treatments, thetreatment,  research in the field of NMDA antagonists in the last decade has been extremely active. However, glutamate playshas a very important role in the CNS, and several clinical trials have been abandoned due to psychomimetic or cardiovascular side-effects. Although the search for agents active atcompounds that could act on NMDA receptors is still on,continues, other strategies like glutamate releaseglutamate-release inhibitors or non-NMDA receptor antagonists are leading the research onin the field of neuroprotective drugs5.




1 Olney JW., Sharpe LG., Feigin RD. J. Neuropathol. Exp. Neurol., 31:464-88, 1972.

2 Dirnagl U., Iadecola C., Moskowitz MA. Trends Neurosci., 22:391-397, 1999.

3 Michaelis EK. Prog. Neurobiol., 54:369-415, 1998.

4 Greene JG.,  Greenamyre JT. Prog. Neurobiol., 48:613-634, 1996.

5 Baudy RB. Exp. Opin. Ther. Patents 6:983-1033, 1996.