A number of diseases in humans have a proven association with
genetic mutations of glutamate receptor genes, or
autoantigen/
antibody interactions with glutamate receptors or their genes. Glutamate receptors and impaired regulation (in particular, those resulting in excessive glutamate levels) are also one cause of
excitotoxicity (described above), which itself has been implicated or associated with a number of specific
neurodegenerative conditions where neural
cell death or degradation within the brain occurs over time. At the same time, the
aminosulfonic acid taurine plays an important role as an
endogenous and
exogenous modulator of this
metabolic process. Glutamate receptors have been found to have an influence in cancer,
ischemia/
stroke,
seizures,
Parkinson's disease,
Huntington's disease, and aching, addiction and an association with both
ADHD and
autism. In most cases these are areas of ongoing research.
Aching Hyperalgesia is directly involved with spinal NMDA receptors. Administered NMDA antagonists in a clinical setting produce significant side effects, although more research is being done in
intrathecal administration.
Attention deficit hyperactivity disorder (ADHD) In 2006 the glutamate receptor subunit gene
GRIN2B (responsible for key functions in
memory and
learning) was associated with
ADHD. This followed earlier studies showing a link between glutamate modulation and
hyperactivity (2001), and then between the
SLC1A3 solute carrier gene-encoding part of the glutamate transporter process that mapped to
chromosome 5 (5p12) noted in multiple ADHD
genome scans. Further mutations to four different
metabotropic glutamate receptor genes were identified in a study of 1013 children with
ADHD compared to 4105 controls with non-ADHD, replicated in a subsequent study of 2500 more patients. Deletions and duplications affected GRM1, GRM5, GRM7 and GRM8. The study concluded that "
CNVs affecting metabotropic glutamate receptor genes were enriched across all cohorts (P = 2.1 × 10−9)", "over 200 genes interacting with glutamate receptors
[…] were collectively affected by CNVs", "major hubs of the (affected genes') network include
TNIK50,
GNAQ51, and CALM", and "the fact that children with ADHD are more likely to have alterations in these genes reinforces previous evidence that the GRM pathway is important in ADHD".
Autism The etiology of
autism may include excessive glutamatergic mechanisms. In small studies,
memantine has been shown to significantly improve language function and social behavior in children with autism. Research is underway on the effects of memantine in adults with autism spectrum disorders. A link between glutamate receptors and autism was also identified via the
structural protein ProSAP1 SHANK2 and potentially
ProSAP2 SHANK3. The study authors concluded that the study "illustrates the significant role glutamatergic systems play in autism" and "By comparing the data on ProSAP1/Shank2−/− mutants with ProSAP2/Shank3αβ−/− mice, we show that different abnormalities in synaptic glutamate receptor expression can cause alterations in social interactions and communication. Accordingly, we propose that appropriate therapies for autism spectrum disorders are to be carefully matched to the underlying synaptopathic phenotype." Research is being done to address the possibility of using
hyperglycemia and
insulin to regulate these receptors and restore cognitive functions.
Pancreatic islets regulating insulin and glucagon levels also express glutamate receptors. In addition to similar mechanisms causing Parkinson's disease with respect to NMDA or AMPA receptors, Huntington's disease was also proposed to exhibit metabolic and mitochondrial deficiency, which exposes striatal neurons to the over activation of NMDA receptors. This could decrease the effect glutamate has on glutamate receptors and reduce cell response to a safer level, not reaching
excitotoxicity.
Ischemia During ischemia, the brain has been observed to have an unnaturally high concentration of extracellular glutamate. This is linked to an inadequate supply of ATP, which drives the glutamate transport levels that keep the concentrations of glutamate in balance. This usually leads to an excessive activation of glutamate receptors, which may lead to neuronal injury. After this overexposure, the postsynaptic terminals tend to keep glutamate around for long periods of time, which results in a difficulty in depolarization.
Multiple sclerosis Inducing
experimental autoimmune encephalomyelitis in animals as a model for
multiple sclerosis(MS) has targeted some glutamate receptors as a pathway for potential therapeutic applications. This research has found that a group of drugs interact with the NMDA, AMPA, and kainate glutamate receptor to control neurovascular permeability, inflammatory mediator synthesis, and resident glial cell functions including CNS myelination.
Oligodendrocytes in the CNS myelinate axons; the myelination dysfunction in MS is partly due to the excitotoxicity of those cells. By regulating the drugs which interact with those glutamate receptors, regulating glutamate binding may be possible, and thereby reduce the levels of Ca2+ influx. The experiments showed improved oligodendrocyte survival, and remyelination increased. Furthermore, CNS inflammation, apoptosis, and axonal damage were reduced.
Rasmussen's encephalitis In 1994, GluR3 was shown to act as an
autoantigen in
Rasmussen's encephalitis, leading to speculation that
autoimmune activity might underlie the condition. This is suggested by upregulation of
GABA, an inhibitory neurotransmitter. In schizophrenia, the expression of the NR2A subunit of
NMDA receptors in mRNA was experimentally undetectable in 49-73% in GABA neurons that usually express it. These are mainly in GABA cells expressing the calcium-buffering protein
parvalbumin (PV), which exhibits fast-spiking firing properties and target the perisomatic (basket cells) and
axo-axonic (chandelier cells) compartments of
pyramidal neurons. and the expression of the mRNA for the GluR5 kainate receptor in GABA neurons has also been found to be changed in people with schizophrenia. Current research is targeting glutamate receptor antagonists as potential treatments for schizophrenia.
Memantine, a weak, nonselective NMDA receptor antagonist, was used as an add-on to clozapine therapy in a clinical trial. Refractory schizophrenia patients showed associated improvements in both negative and positive symptoms, underscoring the potential uses of GluR antagonists as
antipsychotics. Furthermore, administration of noncompetitive NMDA receptor antagonists have been tested on rat models. Scientists have proposed that specific antagonists can act on GABAergic interneurons, enhancing cortical inhibition and preventing excessive glutamatergic transmission associated with schizophrenia. These and other atypical antipsychotic drugs can be used together to inhibit excessive excitability in pyramidal cells, decreasing the symptoms of schizophrenia.
Seizures Glutamate receptors have been discovered to have a role in the onset of
epilepsy. NMDA and metabotropic types have been found to induce epileptic convulsions. Using
rodent models, labs have found that the introduction of antagonists to these glutamate receptors helps counteract the epileptic symptoms. Since glutamate is a
ligand for ligand-gated ion channels, the binding of this neurotransmitter will open gates and increase sodium and calcium conductance. These ions play an integral part in the causes of seizures. Group 1 metabotropic glutamate receptors (mGlu1 and mGlu5) are the primary cause of seizing, so applying an antagonist to these receptors helps in preventing convulsions. == Other diseases suspected of glutamate receptor link ==