The CNS abundantly expresses P2X receptor channels for ATP; of these the most widespread in the brain is the P2X₄ channel. We show that ivermectin (IVM) is a specific positive allosteric effector of heterologously expressed P2X₄ and possibly of heteromeric P2X₄/P2X₆channels, but not of P2X₂, P2X₃, P2X₂/P2X₃, or P2X₇ channels. In the submicromolar range (EC₅₀, ∼250 nM) the action of IVM was rapid and reversible, resulting in increased amplitude and slowed deactivation of P2X₄ channel currents evoked by ATP. IVM also markedly increased the potency of ATP and that of the normally low-potency agonist α,β-methylene-ATP in a use- and voltage-independent manner without changing the ion selectivity of P2X₄ channels. Therefore, IVM evokes a potent pharmacological gain-of-function phenotype that is specific for P2X₄ channels. We also tested whether IVM could modulate endogenously expressed P2X channels in the adult trigeminal mesencephalic nucleus and hippocampal CA1 neurons. Surprisingly, IVM produced no significant effect on the fast ATP-evoked inward currents in either type of neuron, despite the fact that IVM modulated P2X₄ channels heterologously expressed in embryonic hippocampal neurons. These results suggest that homomeric P2X₄ channels are not the primary subtype of P2X receptor in the adult trigeminal mesencephalic nucleus and in hippocampal CA1 neurons
