Evidence mapPaperPMID 41977367Full record

ReviewInternational journal of molecular sciences2026

Chloride Homeostasis Failure in Human Disease: KCC2/NKCC1 Microdomain Dysfunction as a Driver of Cortical Network Collapse.

Dan Dumitrescu, Stefan Oprea, Raluca Tulin, Adrian Vasile Dumitru, Octavian Munteanu, George Pariza

Abstract readReview
In one paragraph

Review in International journal of molecular sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Dan DumitrescuFaculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.ORCID 0000-0001-8413-0977
Stefan OpreaFaculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.ORCID 0009-0004-6296-8364
Raluca TulinFaculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Adrian Vasile DumitruFaculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Octavian MunteanuFaculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
George ParizaFaculty of General Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The regulation of chloride levels is a crucial part of controlling inhibitory signals, but does not occur uniformly throughout the body. Recent data suggest that chloride is regulated within localized "microdomains" which are defined by the interaction of KCC2 and NKCC1, structural restraints on cells due to their internal structure, the metabolic condition of the cell, and the external environment modified by astrocytes. The gradients of chloride concentrations within these compartment-specific microdomains define the local chloride reversal potential, and thereby determine the directionality (i.e., whether excitatory or inhibitory), magnitude, and timing of GABAergic inhibition. The disruption of this organized chloride gradient within microdomains impairs the stability of inhibitory activity at multiple levels of integration, including dendritic input, spike timing, interneuron synchronization, and network oscillation. Disturbances in inhibitory stability have been found in a variety of diseases, including epilepsy, neonatal seizure, neuropathic pain, and schizophrenia-spectrum disorders. This supports the hypothesis that disturbances in chloride homeostasis lead to a loss of stability in cortical circuits. This review will provide a synthesis of the molecular, spatial, and circuit level principles involved in the regulation of chloride and discuss how failures of these mechanisms produce clinically relevant disturbances in inhibitory signal processing. In addition, we will be discussing new therapeutic strategies for the restoration of chloride homeostasis, including KCC2 repair, selective modulation of NKCC1, targeting astrocytes, and microenvironmental engineering. Overall, the studies reviewed here provide a unified model for understanding the pathophysiology of inhibitory dysfunction, and demonstrate that the regulation of chloride microdomains provides a novel and promising area of research for translational intervention.

Indexed as

Cerebral CortexChloridesHomeostasisSolute Carrier Family 12, Member 2SymportersAnimalsHumansK Cl- CotransportersChloridesK Cl- CotransportersSLC12A5 protein, humanSolute Carrier Family 12, Member 2Symportersastrocytic bufferingchloride microdomainscortical hyperexcitabilitygabaergic polarityinhibitory instabilitykcc2 regulationnkcc1 reactivation

Identifiers

PMID41977367
PMCPMC13073762

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.