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Astrocyte-neurone crosstalk mediates dexmedetomidine sedation
Beverley A Orser1, Connor T A Brenna2, Mervyn Maze3
1Perioperative Brain Health Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Physiology, University of Toronto, Toronto, ON, Canada; Department of Anesthesiology & Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Anesthesiology and Pain Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
None:
As the clinical applications of dexmedetomidine expand, advances in neuroscientific research have provided further insights into its mechanisms of action. We provide a focused overview of the role that astrocytes play in the changes in neurotransmission that accompany the sedative action of dexmedetomidine. After activation of astrocytic α2A-adrenergic receptors, the subsequent rise in cytosolic calcium increases the permeability of bestrophin-1 channels, facilitating the release of γ-aminobutyric acid (GABA) that stimulates extrasynaptic GABAA receptors on glutamatergic neurones. This signalling cascade, involving multiple receptor systems, reduces neuronal excitability.
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