A Closer Look at the High Affinity Benzodiazepine Binding Site on GABAA Receptors

Ligands of the benzodiazepine binding site of the GABA(A) receptor come in three flavors: positive allosteric modulators, negative allosteric modulators and antagonists all of which can bind with high affinity. The GABA(A) receptor is a pentameric protein which forms a chloride selective ion channel and ligands of the benzodiazepine binding site stabilize three different conformations of this protein. Classical benzodiazepines exert a positive allosteric effect by increasing the apparent affinity of channel opening by the agonist gamma-aminobutyric acid (GABA). We concentrate here on the major adult isoform, the alpha(1)beta(2)gamma(2) GABA(A) receptor. The classical binding pocket for benzodiazepines is located in a subunit cleft between alpha(1) and gamma(2) subunits in a position homologous to the agonist binding site for GABA that is located between beta(2) and alpha(1) subunits. We review here approaches to this picture. In particular, point mutations were performed in combination with subsequent analysis of the expressed mutant proteins using either electrophysiological techniques or radioactive ligand binding assays. The predictive power of these methods is assessed by comparing the results with the predictions that can be made on the basis of the recently published crystal structure of the acetylcholine binding protein that shows homology to the N-terminal, extracellular domain of the GABA(A) receptor. In addition, we review an approach to the question of how the benzodiazepine ligands are positioned in their binding pocket. We also discuss a newly postulated modulatory site for benzodiazepines at the alpha(1)/beta(2) subunit interface, homologous to the classical benzodiazepine binding pocket.