Some 40 million patients are given general anesthesia each year in the USA using agents that haven't changed for decades. General anesthetics are used as hypnotics during procedures, sedatives in the ICU, and as anticonvulsants. These drugs have low safety margins and are particularly harmful to newborns, the severely ill, and the elderly. The molecular mechanisms of general anesthesia have proved difficult to reveal, hampering the design of improved agents. This interdisciplinary PPG brings together a group of experienced scientists to focus on mechanisms underlying the ability of general anesthetics to enhance the activity of the inhibitory GABAA receptors (GABAAR) and glycine receptors (GlyR), major targets of anesthetics. The overall hypothesis is that the various actions of general anesthetics are mediated by a number of distinct binding sites on these receptors, that their location and affinity varies with the receptor's subunit composition and conformational state. The overall aims of the PPG are to: (i) locate the anesthetic binding sites on heteromeric GABAARs and GlyRs using anesthetic photolabels, (ii) define anesthetic structure-activity relationships at distinct sites, and (iii) define how their occupancy allostericlly modulates receptor function using electrophysiology and targeted mutations. Project 1 (PI: Cohen) will locate the unknown binding sites for steroids and propofol anesthetics and a convulsant barbiturate on synaptic alpha-1-beta-3 gamma-2 and extrasynaptic alpha-4-beta-3-delta GABAARs and on alpha-1-beta GlyRs. Project 2 (PI: Miller) focuses on exploring the molecular pharmacology of the different anesthetic binding sites that the PPG has discovered on alpha-1-beta-3-gamma-2 and alpha-4-beta-3-delta GABAARs, with the objective of understanding how to improve the specificity of anesthetic action on synaptic and extrasynaptic receptors. In addition, new binding sites that have high affinity for the activated states will be sought. Project 3 (PI: Forman) will use mutations and electrophysiology to define the functional roles, including drug specificity, of distinct general anesthetic binding sites, particularly the iter-subunit transmembrane sites on alpha-1-beta-3-gamma-2 and alpha-4-beta-3-delta GABAARs and alpha-1-beta GlyRs. Photolabeling results and homology models will guide mutagenesis, while allosteric co-agonist modeling will be used as a quantitative analytical framework for electrophysiological data. The Projects are supported by four Core facilities. An Administrative Core (Core A;PI: Miller) coordinates the activities of the components of the PPG, also arranging external oversight through a distinguished Advisory Board. A Synthetic Chemistry Core (Core B;PI: Bruzik) develops and supplies novel general anesthetics for photolabeling and structure activity relationships. A Protein Chemistry Core (Core C;PI: Cohen) locates anesthetic sites of photoincorporation and develops homology models of receptors to guide research. A Protein Production Core (Core D;co-PIs: Miller &Forman) supplies nanomoles of heterologously expressed, purified and functionally reconstituted human neuronal receptors for photolabeling and other studies.

Public Health Relevance

General anesthetics are essential to modern medicine, yet they have low safety margins especially in sick or elderly patients, requiring delivery by highly trained clinicians. General anesthetics interact with many receptors in the brain to cause both anesthesia and side effects. This Program Project aims to provide new knowledge so that new anesthetics can target just the anesthetic receptors and not those responsible for side effects.

National Institute of Health (NIH)
Research Program Projects (P01)
Project #
Application #
Study Section
Special Emphasis Panel (ZGM1)
Program Officer
Cole, Alison E
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Massachusetts General Hospital
United States
Zip Code
Forman, Stuart A; Chiara, David C; Miller, Keith W (2015) Anesthetics target interfacial transmembrane sites in nicotinic acetylcholine receptors. Neuropharmacology 96:169-77
Feng, H-J; Jounaidi, Y; Haburcak, M et al. (2014) Etomidate produces similar allosteric modulation in *1*3ýý and *1*3ýý2L GABA(A) receptors. Br J Pharmacol 171:789-98
Jayakar, Selwyn S; Zhou, Xiaojuan; Chiara, David C et al. (2014) Multiple propofol-binding sites in a ?-aminobutyric acid type A receptor (GABAAR) identified using a photoreactive propofol analog. J Biol Chem 289:27456-68
Dostalova, Zuzana; Zhou, Xiaojuan; Liu, Aiping et al. (2014) Human ?1?3?2L gamma-aminobutyric acid type A receptors: High-level production and purification in a functional state. Protein Sci 23:157-66
Olsen, Richard W; Li, Guo-Dong; Wallner, Martin et al. (2014) Structural models of ligand-gated ion channels: sites of action for anesthetics and ethanol. Alcohol Clin Exp Res 38:595-603
Hamouda, Ayman K; Stewart, Deirdre S; Chiara, David C et al. (2014) Identifying barbiturate binding sites in a nicotinic acetylcholine receptor with [3H]allyl m-trifluoromethyldiazirine mephobarbital, a photoreactive barbiturate. Mol Pharmacol 85:735-46
Chiara, David C; Gill, Jonathan F; Chen, Qiang et al. (2014) Photoaffinity labeling the propofol binding site in GLIC. Biochemistry 53:135-42
Jayakar, Selwyn S; Dailey, William P; Eckenhoff, Roderic G et al. (2013) Identification of propofol binding sites in a nicotinic acetylcholine receptor with a photoreactive propofol analog. J Biol Chem 288:6178-89
Stewart, Deirdre S; Hotta, Mayo; Desai, Rooma et al. (2013) State-dependent etomidate occupancy of its allosteric agonist sites measured in a cysteine-substituted GABAA receptor. Mol Pharmacol 83:1200-8
Forman, Stuart A (2013) A paradigm shift from biophysical to neurobiological: the fading influence of Claude Bernard's ideas about general anesthesia. Anesthesiology 118:984-5

Showing the most recent 10 out of 85 publications