Neurons, Receptors, Neurotransmitters, and Alcohol        David M. Lovinger, Ph.D.    
    David M. Lovinger, PH.D., is chief of the Laboratory for    Integrative Neuroscience at the National Institute on Alcohol    Abuse and Alcoholism, Bethesda, Maryland.  
    Nerve cells (i.e., neurons) communicate via a    combination of electrical and chemical signals. Within the    neuron, electrical signals driven by charged particles allow    rapid conduction from one end of the cell to the other.    Communication between neurons occurs at tiny gaps called    synapses, where specialized parts of the two cells (i.e., the    presynaptic and postsynaptic neurons) come within nanometers of    one another to allow for chemical transmission. The presynaptic    neuron releases a chemical (i.e., a neurotransmitter) that is    received by the postsynaptic neurons specialized proteins    called neurotransmitter receptors. The neurotransmitter    molecules bind to the receptor proteins and alter postsynaptic    neuronal function. Two types of neurotransmitter receptors    existligand-gated ion channels, which permit rapid ion flow    directly across the outer cell membrane, and G-proteincoupled    receptors, which set into motion chemical signaling events    within the cell. Hundreds of molecules are known to act as    neurotransmitters in the brain. Neuronal development and    function also are affected by peptides known as neurotrophins    and by steroid hormones. This article reviews the chemical    nature, neuronal actions, receptor subtypes, and therapeutic    roles of several transmitters, neurotrophins, and hormones. It    focuses on neurotransmitters with important roles in acute and    chronic alcohol effects on the brain, such as those that    contribute to intoxication, tolerance, dependence, and    neurotoxicity, as well as maintained alcohol drinking and    addiction. KEY WORDS: Alcohol and other drug effects    and consequences; brain; neurons; neuronal signaling; synaptic    transmission; neurotransmitter receptors; neurotrophins;    steroid hormones; -aminobutyric acid (GABA); glutamate;    dopamine; adenosine; serotonin; opioids; endocannabinoids  
    The behavioral effects of alcohol are produced through its    actions on the central nervous system (CNS) and, in particular,    the brain. Synaptic transmissionthe process by which neurons    in the CNS communicate with one anotheris a particular target    for alcohol actions that alter behavior. Intoxication is    thought to result from changes in neuronal communication taking    place while alcohol is present in the brain. Tolerance to    alcohol involves cellular and molecular adaptations that begin    during alcohol exposure; the adaptations develop and diversify    with repeated episodes of exposure and withdrawal and are    linked to the environment present during exposure. Alcohol    dependence develops after several exposure/withdrawal cycles    and involves neuroadaptive changes brought about by both the    exposure and withdrawal processes. Neurotoxicity produced by    alcohol ingestion involves a number of cellular and molecular    processes, and neurotransmitters can participate inand    modulatemany of these mechanisms. The actions of alcohol on    synaptic transmission also contribute to alcohol-seeking    behavior, excessive drinking, and alcoholism. Thus,    understanding all of these behavioral actions of alcohol    requires some knowledge of neuronal signaling in the brain and,    especially, the process of synaptic transmission. This article    will focus on the basic processes underlying neuronal    communication and review the neuronal actions of several    neurotransmitters, neurotrophic factors, and hormones thought    to be involved in the neural actions of alcohol. This    information, although admittedly incomplete, will provide a    foundation for the detailed information on alcohol actions    provided in subsequent articles in this issue and in Part 2.  
    Neurons are the cells within the brain that are responsible for    rapid communication of information. Although similar to other    cells in the body, neurons are specialized in ways that set    them apart from other cells and endow them with the properties    that allow them to carry out their unique role in the nervous    system. The neurons shape is one such unique feature. In    addition to the cell body, or soma, which is much like that of    other cells, neurons have specialized thin branches know as    dendrites and axons. Neurons receive chemical input from other    neurons through dendrites and communicate information to other    cells through axons. Neurons also are excitable cells. The    neuronal surface membrane contains an abundance of proteins    known as ion channels that allow small charged atoms to pass    through from one side of the membrane to the other. Some of    these channels are opened when the voltage across the cell    membrane changes. One subtype of these voltage-gated channels    allows the neuron to produce a rapid signal known as the    action potential, which is the fastest form of intracellular    electrical signal conduction in biology (see figure 1).  
    Individual neurons usually are completely separated from one    another by their outer cell membranes and thus cannot directly    share electrical or chemical signals. The exception to this    situation is the so-called electrical synapse, in which    ion-conducting pores made from proteins called connexins    connect the intracellular compartments of adjacent neurons,    allowing direct ion flow from cell to cell (Kandel et al.    2000). This form of interneuronal communication is much less    common in the mammalian CNS than chemical transmission and will    not be discussed any further. Rather, the focus will be on    chemical interneuronal communication involving the release of a    neurotransmitter from one neuron, which alters the activity of    the receiving neuron. This chemical communication usually    occurs at a specialized structure called a synapse, where parts    of the two cells are brought within 20 to 50 nanometers of one    another (see figure 2). The neuron that releases the chemical    is called the presynaptic neuron. A specialized structure at    the tip of the axon of the presynaptic neuron, termed the axon    terminal, contains small packets known as vesicles, which are    filled with neurotransmitter molecules. When an action    potential reaches the axon terminal and stimulates a rise in    the concentration of calcium, this ion stimulates the vesicle    to fuse with the cell membrane and release the neurotransmitter    into the small synaptic gap between cells.  
    The neuron that is acted upon by the chemical is termed the    postsynaptic neuron. The neurotransmitter molecules released    from the presynaptic vesicles traverse the synaptic gap and    bind to proteins, termed neurotransmitter receptors, on the    surface membrane of the postsynaptic neuron.  
          Figure 1. Schematic drawing of a neuron          showing dendrites, where neurons receive chemical input          from other neurons; soma (cell body); and axon terminal,          where neurons communicate information to other cells.          Voltage-gated sodium channels in the membrane of the          soma, axon, and axon terminal allow positively charged          sodium ions to enter the neuron and produce rapid (in          milliseconds) conduction of the excitatory action          potential to the terminal. This signal stimulates          neurotransmitter release at the axon terminal.        
    Neurotransmitter receptors are divided into two major classes:    ligand-gated ion channel (LGIC) receptors and G-proteincoupled    receptors (GPCRs). LGIC receptors are proteins specialized for    rapid transduction of the neurotransmitter chemical signal    directly into an electrical response (Brunton et al. 2005;    Kandel et al. 2000) (see figure 3A). One part of the protein is    specialized to bind the neurotransmitter molecule. This    binding site is on the extracellular side of the protein. The    part of the protein that is buried within the cell surface    membrane forms an ion pore, which is basically a fluid-filled    hole in the membrane through which the Figure 1 Schematic    drawing of a neuron showing dendrites, where neurons receive    chemical input from other neurons; soma (cell body); and axon    terminal, where neurons communicate information to other cells.    Voltage-gated sodium channels in the membrane of the soma,    axon, and axon terminal allow positively charged sodium ions to    enter the neuron and produce rapid (in milliseconds) conduction    of the excitatory action potential to the terminal. This signal    stimulates neurotransmitter release at the axon terminal.    charged ions can pass (ions cannot pass through lipids or other    solid membrane constituents). The time between neurotransmitter    binding and opening of the ion pore is on the order of    microseconds to milliseconds. Thus, at synapses using    ligand-gated channels, the time between action potential    depolarization1 (1For a definition of    this and other technical terms, see the Glossary, pp. 279283.)    of the axon terminal and the beginning of the current flowing    through the postsynaptic LGIC is a matter of 1 to 2    milliseconds. This type of synaptic transmission produces a    rapid and strong influence on postsynaptic neuron function.  
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