Although excitotoxic cell death is usually considered a Ca2+-dependent proc
ess, in certain neuronal systems there is strong evidence that excitotoxic
cell death is independent of Ca2+ and is instead remarkably dependent on ex
tracellular Cl-. We have shown (in isolated chick embryo retina) that at le
ast some of the lethal Cl- entry is through GABA and glycine receptors. Her
e we show that when all the GABA and glycine receptors are blocked by using
an appropriate cocktail of inhibitors, agonist-induced excitotoxic cell de
ath can be completely prevented. To determine if ligand-gated Cl- channels
contribute to excitotoxic cell death in other neurons, we examined KA-induc
ed cell death in cultured rat cerebellar granule cells. GABA receptor block
ade with either a competitive or noncompetitive antagonist provides complet
e neuroprotection. KA stimulates Cl- uptake by the granule cells, and this
is blocked by the GABA antagonists. Granule cell cultures take up [H-3]GABA
and release it in response to KA treatment. A subpopulation of neurons in
the cultures is shown to have GAD and high concentrations of GABA, and this
presumably is the source of the GABA that leads to receptor activation and
lethal Cl- entry. Finally, we show that retinal cell death due to 1 h of s
imulated ischemia (combined oxygen and glucose deprivation) is completely p
revented by blocking the inhibitory receptors. These results indicate that,
paradoxically, excitotoxic cell death is completely dependent on activatio
n of inhibitory receptors, in at least some neuronal systems, and this path
ological process may contribute to disease. (C) 1999 Academic Press.