Gabra1, encoding the α1 subunit of heteropentameric gamma-aminobutyric acid A receptors (GABAARs), is crucial for primary inhibition in the brain [4]. GABAARs are involved in the pathogenesis of epilepsy, and Gabra1 is associated with a broad epilepsy spectrum, from genetic generalized epilepsies to developmental and epileptic encephalopathies [1,3]. It is also implicated in the control of intestinal fat absorption and in pathways related to influenza-induced sickness [2,5].

Variants in Gabra1 can lead to different phenotypes. Those in the extracellular domain and small transmembrane loops often show loss-of-function (LoF) effects, resulting in a milder phenotype with mild cognitive impairment and infantile onset epilepsy. In contrast, variants in the pore-forming transmembrane helices can have either gain-of-function (GoF) or LoF effects, with GoF variants associated with severe early onset neurodevelopmental disorders [1]. Conditional Gabra1 knockout in the dorsal motor nucleus of vagus (DMV) largely abolishes puerarin-induced intestinal fat loss, indicating its role in the DMV-vagus-jejunum axis controlling intestinal fat absorption [2].

In summary, Gabra1 is essential for brain inhibitory function and is involved in multiple biological processes. Studies, including those using knockout models, have revealed its significant role in epilepsy and intestinal fat absorption, enhancing our understanding of the related disease mechanisms and potentially guiding precision medicine approaches for Gabra1-related disorders [1,2].