(1)
Department of Anaesthesia, Royal Free Hospital, London, UK
Glutamate and GABA receptors are amino acid neurotransmitters present in the central nervous system. They are involved with nociception at multiple levels. Glutamate causes excitation and GABA causes inhibition.
15.1 Glutamate Receptors
15.1.1 Ionotropic Glutamate Receptors
N–methyl–D–aspartate (NMDA) receptor: it is a receptor-ion channel complex. It is blocked by magnesium and is composed of seven subunits. The receptors are widely distributed in the spinal cord and facilitate nociception. The receptors are involved in dorsal horn excitability seen after primary injury (central sensitisation). Phosphorylation of NMDA receptor is crucial for sensitisation. Wind-up of the dorsal horn is reduced by NMDA receptor antagonists.
Α–amino–3–hydroxy–5–methyl–4–isoxozolepropionic acid (AMPA) receptors: consist of five subunits GLUR1–4. The receptors are mostly found in the spinal cord and dorsal neurons. The receptors are associated with injury-induced plasticity and hyperalgesia. Calcium-permeable AMPA receptors are involved with synaptic plasticity, and thus drugs that can affect these receptors can contribute to analgesia.Full access? Get Clinical Tree