Abstract

N-methyl-D-aspartate receptors (NMDARs) are an essential target for the analgetic action of tricyclic antidepressants (TCAs). Their therapeutic blood concentrations achieve 0.5–1.5 μM, which, however, are insufficient to cause in vitro the open-channel block known as the only effect of TCAs on NMDARs. Whereas structures of amitriptyline (ATL), desipramine (DES), and clomipramine (CLO) are rather similar these compounds manifest different therapeutic profiles and side effects. To study structure-activity relationships of DES and CLO on NMDARs, we measured IC50s as a function of extracellular calcium ([Ca2+]) and membrane voltage (Vm) of NMDAR currents recorded in cortical neurons. Here two components of TCA action on NMDARs are described, which could be characterized as the Ca2+-dependent inhibition and the open-channel block. DES demonstrated a profound Ca2+-dependent inhibition of NMDARs, while the CLO effect was weak. DES IC50 exhibited an e-fold change with a [Ca2+] shift of 0.59 mM, which is consistent with ATL. The Ca2+ dependence of NMDAR inhibition by DES disappeared in BAPTA loaded neurons, suggesting that Ca2+ acts from the inside. Since CLO differs from DES and ATL by the presence of Cl-atom in the structure, most likely, this is the atom which is responsible for the loss of pronounced [Ca2+] dependence. As for the NMDAR open-channel block, both DES and CLO were about 5-folds more potent than ATL due to their slow rates of dissociation either from open and closed states. DES demonstrated stronger Vm-dependence than CLO, suggesting a deeper location of the DES binding site within the ion pore. Because DES and CLO differ from ATL by the nitrogen-containing tricycle, presumably this moiety of the molecules determines their high-affinity binding with the NMDAR channel, while the aliphatic chain mono-methyl amino-group of DES allows a deep permeation in the channel. Thus, different structure-activity relationships of the Ca2+-dependent inhibition and Vm-dependent open-channel block of NMDARs by DES and CLO suggest that these processes are independent and most likely may represent an action on different molecular targets. The proposed model of TCA action on NMDARs predicts well the experimental values of IC50s at physiological [Ca2+] and within a wide range of Vms.

Highlights

  • Tricyclic antidepressants (TCAs, Figure 1) are widely utilized for the therapy of depression, neuropathic pain, and itch

  • We demonstrate that N-methyl-D-aspartate receptors (NMDARs) calcium-dependent inhibition and open-channel block have different dependence on the tricyclic antidepressants (TCAs) structure

  • An Extent of NMDAR Ca2+-dependent Inhibition Induced by Desipramine and Clomipramine Differs

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Summary

Introduction

Tricyclic antidepressants (TCAs, Figure 1) are widely utilized for the therapy of depression (for review Gillman 2007), neuropathic pain, and itch (for review Belinskaia et al, 2019). The pool of clinically used TCAs demonstrate numerous different molecular targets and cause inhibition of monoamine uptake, M-cholinolytic, antihistamine, and αadrenolytic activities (for review Belinskaia et al, 2019), block of Na+, K+ and Ca2+ channels (Lavoie et al, 1990; Pancrazio et al, 1998; Zahradník et al, 2008; Lawson 2017). Among antidepressants with analgesic properties, ATL has long been successfully used to treat pain (Bryson and Wilde 1996). These observations make it possible to consider inhibitors of NMDARs as perspective compounds against neuropathic pain (Peterson et al, 2021). The efficacy of ATL, DES, clomipramine (CLO), and other TCAs against neuropathic pain is not associated with the inhibition of monoamine uptake (for review Gillman 2007) but depends on inhibition of NMDARs (Eisenach and Gebhart 1995). DES exhibits antidepressant properties inhibiting NMDARs at clinically relevant micromolar concentrations measured in human blood plasma (Kiss et al, 2012; Santos et al, 2017)

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