Certain steroids are potent barbiturate-like modulators of the gamma-aminobutyric acidA (GABA) receptor-chloride ionophore complex in rat brain membranes. At nanomolar to low micromolar concentrations, these steroids stimulate [3H]flunitrazepam and [3H] muscimol binding and displace the convulsant [35S]t-butylbicyclophosphorothionate from its binding site in an allosteric manner, in addition to enhancing Cl- conductance responses to GABA recorded in cultured rat hippocampal and spinal neurons. A stringent structure-activity relationship exists for these interactions of steroids with the GABAA receptor complex. Comparison of the structure-activity relationship data obtained in this study with those for steroid-induced general anesthesia strongly suggests that steroidal anesthesia may result from the interaction between steroids and the GABAA receptor. The essential features of the active structures are a 5 alpha or 5 beta-reduced pregnane skeleton with a hydroxyl at C3 in the alpha-position and a ketone group at C20. These features are all present in some naturally occurring steroids, including metabolites of deoxycorticosterone and progesterone, that show potent activity at the GABAA receptor complex. Two of the compounds investigated are known to be formed in vivo as reduced metabolites of endogenous steroid hormones: 5 alpha-pregnane-3 alpha -ol-20-one and 5 alpha-pregnane-3 alpha,21-diol-20-one, which are derived from progesterone and deoxycorticosterone, respectively. These two steroids produce a striking prolongation of GABA-mediated inhibitory postsynaptic currents recorded at synapses between rat hippocampal neurons in culture and could conceivably regulate GABA-mediated inhibition under some physiologic and pathologic conditions.
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