Sex Differences in GABAA Signaling in the Periaqueductal Gray Induced by Persistent Inflammation

The ventrolateral periaqueductal gray (vlPAG) is a key structure in the descending pain modulatory circuit. Activation of the circuit occurs via disinhibition of GABAergic inputs onto vlPAG output neurons. In these studies, we tested the hypothesis that GABAergic inhibition is increased during persistent inflammation, dampening activation of the descending circuit from the vlPAG. Our results indicate that persistent inflammation induced by Complete Freund's adjuvant (CFA) modulates GABA signaling differently in male and female rats. CFA treatment results in increased presynaptic GABA release but decreased high-affinity tonic GABA(A) currents in female vlPAG neurons. These effects are not observed in males. The tonic currents in the vlPAG are dependent on GABA transporter activity and are modulated by agonists that activate GABA(A) receptors containing the delta subunit. The GABA(A) delta agonist THIP (gaboxadol) induced similar amplitude currents in naive and CFA-treated rats. In addition, a positive allosteric modulator of the GABA(A) delta subunit, DS2 (4-chloro-N-[2-(2-thienyl) imidazo[1,2-a] pyridin-3-yl] benzamide), increased tonic currents. These results indicate that GABA(A) delta receptors remain on the cell surface but are less active in CFA-treated female rats. In vivo behavior studies showed that morphine induced greater antinociception in CFA-treated females that was reversed with microinjections of DS2 directly into the vlPAG. DS2 did not affect morphine antinociception in naive or CFA-treated male rats. Together, these data indicate that sex-specific adaptations in GABA(A) receptor signaling modulate opioid analgesia in persistent inflammation. Antagonists of GABA(A) delta receptors may be a viable strategy for reducing pain associated with persistent inflammation, particularly in females.