Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Mar 6;214(3):569-578.
doi: 10.1084/jem.20161673. Epub 2017 Feb 16.

Therapeutic targeting of the pathological triad of extrasynaptic NMDA receptor signaling in neurodegenerations

Affiliations
Review

Therapeutic targeting of the pathological triad of extrasynaptic NMDA receptor signaling in neurodegenerations

Hilmar Bading. J Exp Med. .

Abstract

Activation of extrasynaptic N-methyl-d-aspartate (NMDA) receptors causes neurodegeneration and cell death. The disease mechanism involves a pathological triad consisting of mitochondrial dysfunction, loss of integrity of neuronal structures and connectivity, and disruption of excitation-transcription coupling caused by CREB (cyclic adenosine monophosphate-responsive element-binding protein) shut-off and nuclear accumulation of class IIa histone deacetylases. Interdependency within the triad fuels an accelerating disease progression that culminates in failure of mitochondrial energy production and cell loss. Both acute and slowly progressive neurodegenerative conditions, including stroke, Alzheimer's disease, amyotrophic lateral sclerosis, and Huntington's disease, share increased death signaling by extrasynaptic NMDA receptors caused by elevated extracellular glutamate concentrations or relocalization of NMDA receptors to extrasynaptic sites. Six areas of therapeutic objectives are defined, based on which a broadly applicable combination therapy is proposed to combat the pathological triad of extrasynaptic NMDA receptor signaling that is common to many neurodegenerative diseases.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
The pathological triad of extrasynaptic NMDA receptor signaling as a common converging point in neurodegenerative conditions. The pathological triad leads to impairments of cognitive functions and culminates in bioenergetics failure and neuronal cell death.
Figure 2.
Figure 2.
Schematic illustration of the antagonism by extrasynaptic NMDA receptors of both local signaling and synapse-to-nucleus signaling activated by synaptic NMDA receptors. Not depicted, for simplicity, is the contribution of back-propagating action potential firing and opening of L-type voltage-gated calcium channels to activity-driven, synaptic NMDA receptor–dependent gene expression (Bading, 2013). Synapse-to-nucleus signaling is mediated by a propagating calcium signal (Bading, 2013) but in addition can involve protein-based communication pathways including the ERK-MAPK cascade, Jacob, and TORC1/2 (Hagenston and Bading, 2011; Panayotis et al., 2015). NMDA receptor–interacting protein (NIP) indicates a putative extrasynaptic NMDA receptor–interacting protein that may be part of the death-signaling complex. Local signaling and plasticity refers in particular to dendritic mRNA translation, AMPA receptor trafficking, and control of synaptic efficacy (Steward and Schuman, 2001; Kelleher et al., 2004; Kim et al., 2005; Costa-Mattioli et al., 2009). The six areas of therapeutic objectives described in this paper are indicated as A1–A6.

Similar articles

Cited by

References

    1. Ahlgren H., Bas-Orth C., Freitag H.E., Hellwig A., Ottersen O.P., and Bading H.. 2014. The nuclear calcium signaling target, activating transcription factor 3 (ATF3), protects against dendrotoxicity and facilitates the recovery of synaptic transmission after an excitotoxic insult. J. Biol. Chem. 289:9970–9982. 10.1074/jbc.M113.502914 - DOI - PMC - PubMed
    1. Bading H. 2013. Nuclear calcium signalling in the regulation of brain function. Nat. Rev. Neurosci. 14:593–608. 10.1038/nrn3531 - DOI - PubMed
    1. Bhosale G., Sharpe J.A., Sundier S.Y., and Duchen M.R.. 2015. Calcium signaling as a mediator of cell energy demand and a trigger to cell death. Ann. N. Y. Acad. Sci. 1350:107–116. 10.1111/nyas.12885 - DOI - PMC - PubMed
    1. Bormann J. 1989. Memantine is a potent blocker of N-methyl-D-aspartate (NMDA) receptor channels. Eur. J. Pharmacol. 166:591–592. 10.1016/0014-2999(89)90385-3 - DOI - PubMed
    1. Bossy-Wetzel E., Schwarzenbacher R., and Lipton S.A.. 2004. Molecular pathways to neurodegeneration. Nat. Med. 10:S2–S9. 10.1038/nm1067 - DOI - PubMed

Publication types

MeSH terms

Substances