Local anesthetic inhibition of m1 muscarinic acetylcholine signaling

• Published in: Anesthesiology (Philadelphia) Vol. 93; no. 2; pp. 497 - 509
• Main Authors: HOLLMANN, M. W, FISCHER, L. G, BYFORD, A. M, DURIEUX, M. E
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.08.2000
• Subjects: Acetylcholine - antagonists & inhibitors; Anesthetics, Local - pharmacology; Anesthetics. Neuromuscular blocking agents; Animals; Benzocaine - pharmacology; Binding Sites; Biological and medical sciences; Cells, Cultured; CHO Cells; Choline - analogs & derivatives; Choline - pharmacology; Cricetinae; Electrophysiology; GTP-Binding Proteins - drug effects; Lidocaine - analogs & derivatives; Lidocaine - pharmacology; Medical sciences; Neuropharmacology; Patch-Clamp Techniques; Pharmacology. Drug treatments; Quinuclidinyl Benzilate - metabolism; Receptors, Muscarinic - drug effects; Receptors, Muscarinic - metabolism; Signal Transduction - drug effects; Xenopus; Local anesthetic; M1 Muscarinic receptor; Cholinergic receptor; Organic amide; Lidocaine; Mechanism of action; In vitro; Site of action
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/00000542-200008000-00030

Local anesthetics inhibit lipid mediator signaling (lysophosphatidate, thromboxane) by acting on intracellular domains of the receptor or on the G protein. On receptors for polar agonists, the ligand-binding pocket could form an additional site of interaction, possibly resulting in superadditive inhibition. The authors therefore investigated the effects of local anesthetics on m1 muscarinic receptor functioning. The authors expressed receptors in isolation using Xenopus oocytes. Using a two-electrode voltage clamp, the authors measured the effects of lidocaine, QX314 (permanently charged), and benzocaine (permanently uncharged) on Ca2+-activated Cl- currents elicited by methylcholine. The authors also characterized the interaction of lidocaine with [3H] quinuclydinyl benzylate ([3H]QNB) binding to m1 receptors. Lidocaine inhibited muscarinic signaling with a half-maximal inhibitory concentration (IC50 18 nm) 140-fold less than that of extracellularly administered QX314 (IC50 2.4 microm). Intracellularly injected QX314 (IC50 0.96 mm) and extracellularly applied benzocaine (IC50 1.2 mm) inhibited at high concentrations only. Inhibition of muscarinic signaling by extracellularly applied QX314 and lidocaine was the result of noncompetitive antagonism. Intracellularly injected QX314 and benzocaine inhibited muscarinic and lysophosphatidate signaling at similar concentrations, suggesting an action on the common G-protein pathway. Combined administration of intracellularly injected (IC50 19 microm) and extracellularly applied QX314 (IC50 49 nm) exerted superadditive inhibition. Lidocaine did not displace specific [3H]QNB binding to m1 receptors. m1 Muscarinic signaling is inhibited by clinically relevant concentrations of lidocaine and by extracellularly administered QX314, suggesting that the major site of action is a extracellular domain of the muscarinic receptor. An additional less potent but superadditive inhibitory effect on the G-protein is suggested.