Glutamate: a role in normal brain function, anaesthesia, analgesia and CNS injury
| Autor: | M J Hudspith |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Central Nervous System
Anesthetics General Excitatory Amino Acids Central nervous system Glutamic Acid Pain Neurotransmission Synaptic Transmission Synapse chemistry.chemical_compound Memory Postsynaptic potential Intensive care medicine Humans Neurotransmitter business.industry Glutamate receptor Anesthesiology and Pain Medicine medicine.anatomical_structure Receptors Glutamate chemistry Anesthesia NMDA receptor Analgesia business Excitatory Amino Acid Antagonists Neuroscience |
| Zdroj: | British Journal of Anaesthesia. 78:731-747 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/78.6.731 |
| Popis: | Glutamate is the major excitatory amino acid (EAA) neurotransmitter in the central nervous system (CNS). 78 EAA neurones and synapses are distributed widely throughout the CNS, 36 231 but they are concentrated particularly in the hippocampus, 91 the outer layer s of the cer ebr alor tex 91 and the substantia gelatinosa of the spinal cord. 194 Within these regions EAA play key roles in physiological processes including learning and memory (and hence awareness under anaesthesia), central pain transduction mechanisms and pathological processes such as excitotoxic neuronal injury which follows CNS trauma or ischaemia. Thus an understanding of the role of EAA in the CNS is relevant to normal higher brain function and to anaesthesia, analgesia and intensive care. A broad spectrum of pharmacological agents which alter EAA-mediated neurotransmission are already available and many more are under development. These include: (i) drugs that specifically target the re leasef EAA (e.g. theovel antiepileptic drugs felbamate and lamotrigine), (ii) drugs that modify the inter actions of EAA with specific re ceptors (e.g ketamine) and (iii) volatile and i.v. anaesthetic agents which may have a common mechanism of action that, at least in part, involves EAAmediated neurotransmission. To understand the potential applications of these agents it is necessary to consider fir stow EAA actt the levelf the synapse and the individual neurone. To do so involves a brief outline of EAA receptor subtypes and how their activation affects the postsynaptic neurone. It may then be possible to explain how EAA and their receptors are involved in cognition, anaesthesia, analgesia and neurointensive care and therefore to provide a framework to assess the possible clinical applications of drugs which modify EAA-mediated neurotransmission. |
| Databáze: | OpenAIRE |
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