Quinolinate and related excitotoxins: Mechanisms of neurotoxicity and disease relevance

Abstract

There are many ways in which neuronal damage can be produced in the brain, including the overactivation of depolarizing receptors, exposure to high levels of pro-inflammatory proteins such as cytokines, or miscellaneous toxins, but the kynurenine pathway has emerged as a novel but potentially major factor in regulating neuronal viability or death. It is the major route for the metabolism of the essential amino acid tryptophan, which is oxidized by indoleamine- 2,3-dioxygenase (IDO) to a series of compounds which can activate, block, or modulate conventional neurotransmitter receptors. Quinolinic acid is an agonist at N-methyl-D-aspartate receptors, kynurenic acid is an antagonist at these and other glutamate receptors, and other kynurenine metabolites are highly redox- active. Superimposed on the discovery of this neuromodulatory pathway have been observations that activity in the pathway is linked to neurological and psychiatric disorders, correlating with disease state (as in Huntington's disease) or cognitive function (as following bypass surgery). Together, the data accumulated to date make a strong case for this hitherto obscure pathway being a major factor in determining cell damage, death, or recovery in health and disease.