Muscarinic acetylcholine receptors expressed in the central nervous system mediate various functions, including cognition, memory, or reward. Therefore, muscarinic receptors represent potential pharmacological targets for various diseases and conditions, such as Alzheimer's disease, schizophrenia, addiction, epilepsy, or depression. Muscarinic receptors are allosterically modulated by neurosteroids and steroid hormones at physiologically relevant concentrations. In this review, we focus on the modulation of muscarinic receptors by neurosteroids and steroid hormones in the context of diseases and disorders of the central nervous system. Further, we propose the potential use of neuroactive steroids in the development of pharmacotherapeutics for these diseases and conditions.

• Keywords
• Alzheimer’s disease, Parkinson’s disease, cholesterol, depression, muscarinic receptors, neuroactive steroids, neurosteroids, schizophrenia, substance abuse,
• MeSH
• Central Nervous System MeSH
• Cholinergic Agents MeSH
• Hormones MeSH
• Neurosteroids * pharmacology   MeSH
• Receptors, Muscarinic MeSH
• Steroids pharmacology   physiology   MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Cholinergic Agents MeSH
• Hormones MeSH
• Neurosteroids * MeSH
• Receptors, Muscarinic MeSH
• Steroids MeSH

In this study, we investigated the delivery of synthetic neurosteroids into MCF-7 human breast adenocarcinoma cells via Organic Anionic Transporting Polypeptides (OATPs) (pH 7.4 and 5.5) to identify the structural components required for OATP-mediated cellular uptake and to get insight into brain drug delivery. Then, we identified structure-uptake relationships using in-house developed OATP1A2 homology model to predict binding sites and modes for the ligands. These binding modes were studied by molecular dynamics simulations to rationalize the experimental results. Our results show that carboxylic acid needs to be at least at 3 carbon-carbon bonds distance from amide bond at the C-3 position of the androstane skeleton and have an amino group to avoid efflux transport. Replacement of hydroxyl group at C-3 with any of the 3, 4, and 5-carbon chained terminal carboxylic groups improved the affinity. We attribute this to polar interactions between carboxylic acid and side-chains of Lys33 and Arg556. The additional amine group showed interactions with Glu172 and Glu200. Based on transporter capacities and efficacies, it could be speculated that the functionalization of acetyl group at the C-17 position of the steroidal skeleton might be explored further to enable OAT1A2-mediated delivery of neurosteroids into the cells and also across the blood-brain barrier.

• Keywords
• Organic Anion Transporting Polypeptides (OATPs), cellular uptake, docking, molecular modeling, neurosteroid,
• MeSH
• Biological Transport MeSH
• Humans MeSH
• Ligands MeSH
• MCF-7 Cells MeSH
• Neurosteroids * chemistry   metabolism   MeSH
• Organic Anion Transporters * metabolism   chemistry   MeSH
• Molecular Dynamics Simulation * MeSH
• Protein Binding MeSH
• Binding Sites MeSH
• Structure-Activity Relationship MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Ligands MeSH
• Neurosteroids * MeSH
• Organic Anion Transporters * MeSH
• SLCO1A2 protein, human MeSH Browser

Evidence from clinical and preclinical studies implicates dysfunction of N-methyl-D-aspartate receptors (NMDARs) in schizophrenia progression and symptoms. We investigated the antipsychotic effect of two neuroactive steroids in an animal model of schizophrenia induced by systemic application of MK-801. The neuroactive steroids differ in their mechanism of action at NMDARs. MS-249 is positive, while PA-Glu is a negative allosteric NMDAR modulator. We hypothesized that the positive NMDA receptor modulator would attenuate deficits caused by MK-801 co-application more effectively than PA-Glu. The rats were tested in a battery of tests assessing spontaneous locomotion, anxiety and cognition. Contrary to our expectations, PA-Glu exhibited a superior antipsychotic effect to MS-249. The performance of MS-249-treated rats in cognitive tests differed depending on the level of stress the rats were exposed to during test sessions. In particular, with the increasing severity of stress exposure, the performance of animals worsened. Our results demonstrate that enhancement of NMDAR function may result in unspecific behavioral responses. Positive NMDAR modulation can influence other neurobiological processes besides memory formation, such as anxiety and response to stress.

• Keywords
• MK-801, anxiety, cognition, neurosteroids, schizophrenia, stress,
• MeSH
• Antipsychotic Agents pharmacology   MeSH
• Bridged Bicyclo Compounds, Heterocyclic metabolism   MeSH
• Behavior, Animal drug effects   MeSH
• Dizocilpine Maleate pharmacology   MeSH
• HEK293 Cells MeSH
• Rats MeSH
• Humans MeSH
• Disease Models, Animal MeSH
• Rats, Long-Evans MeSH
• Rats, Wistar MeSH
• Pregnenolone metabolism   pharmacology   MeSH
• Receptors, N-Methyl-D-Aspartate antagonists & inhibitors   metabolism   MeSH
• Schizophrenia drug therapy   metabolism   MeSH
• Steroids pharmacology   MeSH
• Elevated Plus Maze Test MeSH
• Reflex, Startle drug effects   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Humans MeSH
• Male MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Antipsychotic Agents MeSH
• Bridged Bicyclo Compounds, Heterocyclic MeSH
• Dizocilpine Maleate MeSH
• Pregnenolone MeSH
• pregnenolone sulfate MeSH Browser
• Receptors, N-Methyl-D-Aspartate MeSH
• Steroids MeSH
• tert-butylbicyclophosphorothionate MeSH Browser

Spa treatment can effectively reestablish mood balance in patients with psychiatric disorders. In light of the adrenal gland's role as a crossroad of psychosomatic medicine, this study evaluated changes in 88 circulating steroids and their relationships with a consolidation of somatic, psychosomatic and psychiatric components from a modified N-5 neurotic questionnaire in 46 postmenopausal 50+ women with anxiety-depressive complaints. The patients underwent a standardized one-month intervention therapy with physical activity and an optimized daily regimen in a spa in the Czech Republic. All participants were on medication with selective serotonin reuptake inhibitors. An increase of adrenal steroidogenesis after intervention indicated a reinstatement of the hypothalamic-pituitary-adrenal axis. The increases of many of these steroids were likely beneficial to patients, including immunoprotective adrenal androgens and their metabolites, neuroactive steroids that stimulate mental activity but protect from excitotoxicity, steroids that suppress pain perception and fear, steroids that consolidate insulin secretion, and steroids that improve xenobiotic clearance. The positive associations between the initial values of neurotic symptoms and their declines after the intervention, as well as between initial adrenal activity and the decline of neurotic symptoms, indicate that neurotic impairment may be alleviated by such therapy provided that the initial adrenal activity is not seriously disrupted.

• Keywords
• adrenal, mood balance, postmenopausal females, spa treatment, steroid metabolome,
• MeSH
• Affect * MeSH
• Exercise * MeSH
• Middle Aged MeSH
• Humans MeSH
• Adrenal Glands metabolism   MeSH
• Postmenopause * MeSH
• Projective Techniques MeSH
• Psychotherapy * MeSH
• Aged MeSH
• Steroids biosynthesis   MeSH
• Symptom Assessment MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Steroids MeSH

BACKGROUND AND PURPOSE: NMDA receptors are glutamatergic ionotropic receptors involved in excitatory neurotransmission, synaptic plasticity and excitotoxic cell death. Many allosteric modulators can influence the activity of these receptors positively or negatively, with behavioural consequences. 20-Oxo-5β-pregnan-3α-yl sulphate (pregnanolone sulphate; PA-6) is an endogenous neurosteroid that inhibits NMDA receptors and is neuroprotective. We tested the hypothesis that the interaction of PA-6 with the plasma membrane is critical for its inhibitory effect at NMDA receptors. EXPERIMENTAL APPROACH: Electrophysiological recordings and live microscopy were performed on heterologous HEK293 cells expressing GluN1/GluN2B receptors and cultured rat hippocampal neurons. KEY RESULTS: Our experiments showed that the kinetics of the steroid inhibition were slow and not typical of drug-receptor interaction in an aqueous solution. In addition, the recovery from steroid inhibition was accelerated by β- and γ-cyclodextrin. Values of IC(50) assessed for novel synthetic C3 analogues of PA-6 differed by more than 30-fold and were positively correlated with the lipophilicity of the PA-6 analogues. Finally, the onset of inhibition induced by C3 analogues of PA-6 ranged from use-dependent to use-independent. The onset and offset of cell staining by fluorescent analogues of PA-6 were slower than those of steroid-induced inhibition of current responses mediated by NMDA receptors. CONCLUSION AND IMPLICATIONS: We conclude that steroid accumulation in the plasma membrane is the route by which it accesses a binding site on the NMDA receptor. Thus, our results provide a possible structural framework for pharmacologically targeting the transmembrane domains of the receptor.

• MeSH
• Action Potentials drug effects   MeSH
• Excitatory Amino Acid Antagonists chemistry   pharmacology   MeSH
• Cell Membrane drug effects   metabolism   MeSH
• Microscopy, Fluorescence MeSH
• HEK293 Cells MeSH
• Rats MeSH
• Humans MeSH
• Models, Molecular MeSH
• Molecular Structure MeSH
• Neurons drug effects   metabolism   MeSH
• Neuroprotective Agents chemistry   pharmacology   MeSH
• Neurotransmitter Agents chemistry   pharmacology   MeSH
• Pregnanes chemistry   pharmacology   MeSH
• Receptors, N-Methyl-D-Aspartate antagonists & inhibitors   genetics   MeSH
• Transfection MeSH
• Dose-Response Relationship, Drug MeSH
• Structure-Activity Relationship MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• 20-oxo-5beta-pregnan-3alpha-yl sulfate MeSH Browser
• Excitatory Amino Acid Antagonists MeSH
• Neuroprotective Agents MeSH
• Neurotransmitter Agents MeSH
• Pregnanes MeSH
• Receptors, N-Methyl-D-Aspartate MeSH