Key result
Activation of 5-HT1A receptors with agonists like 8-OH-DPAT or buspirone overcame opiate-induced respiratory depression by modulating glycinergic inhibitory synapses, without reversing analgesia.
5-HT(1A)R activation stabilizes the rhythmicity of breathing during opiate medication by modulating glycinergic synapses in the respiratory network.
May warrant exploration of 5-HT1A agonists to counter opiate respiratory depression; animal data leave open human translation and require clinical trials.
The cellular effects of serotonin (5-HT), a neuromodulator with widespread influences in the central nervous system, have been investigated. Despite detailed knowledge about the molecular biology of cellular signalling, it is not possible to anticipate the responses of neuronal networks to a global action of 5-HT. Heterogeneous expression of various subtypes of serotonin receptors (5-HTR) in a variety of neurons differently equipped with cell-specific transmitter receptors and ion channel assemblies can provoke diverse cellular reactions resulting in various forms of network adjustment and, hence, motor behaviour. Using the respiratory network as a model for reciprocal synaptic inhibition, we demonstrate that 5-HT(1A)R modulation primarily affects inhibition through glycinergic synapses. Potentiation of glycinergic inhibition of both excitatory and inhibitory neurons induces a functional reorganization of the network leading to a characteristic change of motor output. The changes in network operation are robust and help to overcome opiate-induced respiratory depression. Hence, 5-HT(1A)R activation stabilizes the rhythmicity of breathing during opiate medication of pain.
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Manzke et al. (2009) studied Opiate-induced respiratory depression. 5-HT1A receptor agonists (8-OH-DPAT, buspirone) vs. Control / Fentanyl alone was evaluated on Respiratory minute airflow (rRMA) and phrenic nerve activity (mPNA). Activation of 5-HT1A receptors with agonists like 8-OH-DPAT or buspirone overcame opiate-induced respiratory depression by modulating glycinergic inhibitory synapses, without reversing analgesia.
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