Sympathoinhibition by rilmenidine in conscious rabbits: involvement of alpha 2-adrenoceptors

Contribution of alpha2-adrenoceptors and Y1 neuropeptide Y receptors to the blunting of sympathetic vasoconstriction induced by systemic hypoxia in the rat

There is evidence that sympathetically evoked vasoconstriction in skeletal muscle is blunted in systemic hypoxia, but the mechanisms underlying this phenomenon are not clear. In Saffan-anaesthetized Wistar rats, we have studied the role of α₂-adrenoceptors and neuropeptide Y (NPY) Y₁ receptors in mediating vasoconstriction evoked by direct stimulation of the lumbar sympathetic chain by different patterns of impulses in normoxia (N) and systemic hypoxia (H: breathing 8% O₂). Patterns comprised 120 impulses delivered in bursts over a 1 min period at 40 or 20 Hz, or continuously at 2 Hz. Hypoxia attenuated the evoked increases in femoral vascular resistance (FVR) by all patterns, the response to 2 Hz being most affected (40 Hz bursts: N = 3.25 ± 0.75 arbitrary resistance units (RU); H = 1.14 ± 0.29 RU). Yohimbine (Yoh, α₂-adrenoceptor antagonist) or BIBP 3226 (Y₁-receptor antagonist) did not affect baseline FVR. In normoxia, Yoh attenuated the responses evoked by high frequency bursts and 2 Hz, whereas BIBP 3226 only attenuated the response to 40 Hz (40 Hz bursts: N + Yoh = 2.1 ± 0.59 RU; N + BIBP 3226 = 1.9 ± 0.4 RU). In hypoxia, Yoh did not further attenuate the evoked responses, but BIBP 3226 further attenuated the response to 40 Hz bursts. These results indicate that neither α₂-adrenoceptors nor Y₁ receptors contribute to basal vascular tone in skeletal muscle, but both contribute to constrictor responses evoked by high frequency bursts of sympathetic activity. We propose that in systemic hypoxia, the α₂-mediated component represents about 50% of the sympathetically evoked constriction that is blunted, whereas the contribution made by Y₁ receptors is resistant. Thus we suggest the importance of NPY in the regulation of FVR and blood pressure increases during challenges such as systemic hypoxia.

Mitogen-activated protein kinase phosphorylation in the rostral ventrolateral medulla plays a key role in imidazoline (i1)-receptor-mediated hypotension

Our previous study showed that rilmenidine, a selective I(1)-imidazoline receptor agonist, enhanced the phosphorylation of mitogen-activated protein kinase (MAPK)(p42/44), via the phosphatidylcholine-specific phospholipase C pathway in the pheochromocytoma cell line (PC12). In the present study, we tested the hypothesis that enhancement of MAPK phosphorylation in the rostral ventrolateral medulla (RVLM) contributes to the hypotensive response elicited by I(1)-receptor activation in vivo. Systemic rilmenidine (600 microg/kg i.v.) elicited hypotension and bradycardia along with significant elevation in MAPK(p42/44), detected by immunohistochemistry, in RVLM neurons. To obtain conclusive evidence that the latter response was I(1)-receptor-mediated, similar hypotensive responses were elicited by intracisternal (i.c.) rilmenidine (25 microg/rat) or the highly selective alpha(2)-agonist alpha-methylnorepinephrine (4 microg/rat). An increase in RVLM MAPK(p42/44) occurred only after rilmenidine. Furthermore, pretreatment with efaroxan (0.15 microg/rat i.c.), a selective I(1)-imidazoline receptor antagonist, or with PD98059 (2'-amino-3'-methoxyflavone) (5 microg/rat i.c.), a selective extracellular signal-regulated kinase 1/2 inhibitor, significantly attenuated the hypotensive response and the elevation in RVLM MAPK(p42/44) elicited by i.c. rilmenidine. The findings suggest that MAPK phosphorylation in the RVLM contributes to the hypotensive response induced by I(1)-receptor activation and presents in vivo evidence that distinguishes the neuronal responses triggered by the I(1)-receptor from those triggered by the alpha(2)-adrenergic receptor.

Recent advances in the identification of a 1- and a 2-adrenoceptor subtypes: therapeutic implications

The cloning of multiple subtypes of both alpha1- and alpha2-adrenoceptors has renewed interest in the therapeutic application of agents interacting with these receptors. Effort has primarily been directed towards the design of uroselective alpha1-adrenoceptor antagonists for the treatment of benign prostatic hyperplasia (BPH). Evidence is accumulating for the involvement of a novel alpha1-adrenoceptor, designated as alpha1L-adrenoceptor, in alpha1-adrenoceptor-mediated smooth muscle contraction in prostatic and other urogenital tissues. While several antagonists showing a high degree of uroselectivity in animal models have been identified, their clinical superiority over the currently available alpha1-adrenoceptor antagonists has not yet been demonstrated. It is possible that the interaction with alpha1-adrenoceptors, as yet uncharacterised subtypes, at non-prostatic sites contributes to the therapeutic activity of this drug class in BPH. The alpha1-adrenoceptor subtypes involved in the control of vascular tone are currently being evaluated, and the profile of interaction with the various alpha1-adrenoceptor subtypes may play a key role in the efficacy of cardiovascular drugs such as carvedilol. Alpha2-adrenoceptor agonists are now being employed for a variety of therapeutic applications, most involving actions on receptors within the central nervous system (CNS). These agents are useful in the treatment of hypertension, glaucoma, opiate withdrawal and attention deficit hyperactivity disorder (ADHD), and as analgesics and adjuncts to general anaesthesia. While subtype selectivity has not yet been applied to the design of new alpha2-adrenoceptor agonists for these applications, recent gene mutation/knock-out experiments have identified the alpha2-subtypes involved in some of these actions, and optimisation of a therapeutic profile may be possible. Furthermore, the design of agents combining affinities for multiple adrenoceptor subtypes, or the combination of a specific adrenoceptor affinity profile with another pharmacological action, may offer advantages over molecules selective for an individual adrenoceptor subtype.

Clonidine preconditioning decreases infarct size and improves neurological outcome from transient forebrain ischemia in the rat

Clonidine, a alpha(2)-adrenergic receptor agonist, has been demonstrated to be neuroprotective when administered during ischemia. It is not known whether clonidine can precondition brain against ischemia. We examined this possibility using a transient forebrain ischemia model. Rats received 40 microg/kg of clonidine intraperitoneally at 6, 18, 24 and 72 h as well as 1 week before the forebrain ischemia that was produced by bilateral common carotid arterial occlusion combined with hemorrhagic hypotension to mean arterial pressure 50 mm Hg for 30 min. They were intubated and ventilated with a gas mixture of 1.0% halothane in 30% O(2)/balance air during the procedure. Rats that received clonidine at 6, 18 and 24 h before the ischemia had significantly improved neurological deficit scores and reduced infarct sizes evaluated 3 days after the ischemia. A selective alpha(2)-adrenoceptor antagonist, yohimbine, abolished the neuroprotective effects of clonidine preconditioning. We conclude that there is time window for clonidine preconditioning to be neuroprotective and that alpha(2)-adrenoceptors are important in mediating clonidine preconditioning-induced neuroprotection.

Imidazoline antihypertensive drugs: a critical review on their mechanism of action

It was long thought that the prototypical centrally acting antihypertensive drug clonidine lowers sympathetic tone by activating alpha(2)-adrenoceptors in the brain stem. Supported by the development of two new centrally acting drugs, rilmenidine and moxonidine, the imidazoline hypothesis evolved recently. It assumes the existence of a new group of receptors, the imidazoline receptors, and attributes the sympathoinhibition to activation of I(1) imidazoline receptors in the medulla oblongata. This review analyzes the mechanism of action of clonidine-like drugs, with special attention given to the imidazoline hypothesis. Two conclusions are drawn. The first is that the arguments against the imidazoline hypothesis outweigh the observations that support it and that the sympathoinhibitory effects of clonidine-like drugs are best explained by activation of alpha(2)-adrenoceptors. The second conclusion is that this class of drugs lowers sympathetic tone not only by a primary action in cardiovascular regulatory centres in the medulla oblongata. Peripheral presynaptic inhibition of transmitter release from postganglionic sympathetic neurons contributes to the overall sympathoinhibition.

Involvement of imidazoline receptors in the baroreflex effects of rilmenidine in conscious rabbits

OBJECTIVE

It has been suggested that imidazoline receptors rather than alpha2-adrenoceptors are involved in the sympathoinhibitory action of centrally acting antihypertensive drugs such as rilmenidine. In the present study, we examined the relative importance of alpha2-adrenoceptors and imidazoline receptors in modulating the renal sympathetic and heart rate (HR) baroreflex in response to central administration of rilmenidine in conscious normotensive rabbits.

METHODS

In seven conscious rabbits, chronically instrumented with a fourth ventricular (4V) catheter, aortic and vena caval cuff occluders and a renal nerve electrode, we continuously recorded renal sympathetic nerve activity (RSNA), mean arterial pressure (MAP) and HR and assessed baroreflex MAP-RSNA and MAP-HR relationships with balloon-induced ramp rises and falls in MAP. Rabbits were treated with 4V rilmenidine (22 microg/kg) followed by 4V idazoxan (30 microg/kg; a mixed alpha2-adrenoceptor and imidazoline receptor antagonist) or 4V 2-methoxy-idazoxan (1 microg/kg; an alpha2-adrenoceptor antagonist with little affinity for imidazoline receptors).

RESULTS

Rilmenidine lowered blood pressure by 24% and reduced both upper and lower plateaus of the renal sympathetic baroreflex curve, such that the RSNA range (difference between plateaus) was reduced by 40% (-32 +/- 10 normalized units). Curves were shifted to the left with the fall in MAP. Idazoxan restored MAP, maximum RSNA and the RSNA baroreflex range. By contrast the alpha2-adrenoceptor antagonist 2-methoxy-idazoxan caused only a partial recovery of MAP and RSNA baroreflex upper plateau and range (-9 +/- 2 mmHg, 29 and 33% lower than control). Both antagonists partially restored the HR baroreflex.

CONCLUSION

These findings suggest that in conscious rabbits, both imidazoline receptors and alpha2-adrenoceptors are involved in the central antihypertensive and baroreflex actions of rilmenidine, but that activation of imidazoline receptors is more important for its renal sympathoinhibitory action.

Method for comparison of the hemodynamic effects of equi-antinociceptive oral doses of drugs in anesthetized rats

In a typical flowchart for discovery of novel analgesic (or other) agents, a critical path often involves maximization of the separation of the therapeutic endpoint from known adverse-effect (AE) endpoint(s). Although strategies can easily be designed for in vitro paradigms such as high-throughput screening, extension to in vivo testing can represent a major obstacle to the rapid progression to the next step in development. The problem can be particularly acute when the assessment is required for oral dosing, and when it is not known if the therapeutic and AE mechanism(s) of action are the same. As a case in point, alpha(2)-adrenoceptor (alpha(2)-AR) agonists have potential therapeutic use as analgesics, but they also produce cardiovascular (CV) effects. However, whether the two effects are inexorably linked has not been resolved, particularly for oral administration. The present study used a novel method for comparing the CV effects produced by alpha(2)-AR agonists given by intraduodenal administration to anesthetized rats at fixed ratios of the oral antinociceptive ED(50) dose of each agonist. The technique provided a useful screen of compounds. In addition,there was no correlation between CV endpoints and alpha(2A)-AR affinity, suggesting that oral alpha(2)-AR-mediated analgesia and CV effects might be separable or that other mechanisms might be involved.

Imidazoline receptors: from discovery to antihypertensive therapy (facts and doubts)

The hypothesis and indirect evidence of imidazoline receptors has been promoted since some 15 years ago and it gave a substantial impetus for research in this field, resulting in a better understanding of neuronal and cardiovascular regulatory processes. The nomenclature of the imidazoline receptors has been accepted by international forums but no direct proof for the existence of these receptors has been published. Authors summarise the most important available data, including facts and doubts as far as the discovery, characterisation, and function of imidazoline receptors and their subtypes, the differences between imidazoline receptors and alpha-2 adrenoceptors, and also on their participation in regulatory processes.

Mechanism of the sympathoinhibition produced by the clonidine-like drugs rilmenidine and moxonidine

The mechanism of the sympathoinhibition produced by two new derivatives of clonidine, rilmenidine and moxonidine, was studied. One aim was to determine the receptor responsible for the central sympathoinhibition by these drugs. Rilmenidine and moxonidine were injected into the cisterna cerebellomedullaris. They decreased blood pressure and the plasma noradrenaline concentration. After rilmenidine and moxonidine, two selective alpha 2-adrenoceptor antagonists (devoid of affinity for I1 binding sites), yohimbine and SK&F86466, were given intracisternally. They completely counteracted the hypotensive effects of rilmenidine and moxonidine, indicating that alpha 2-adrenoceptors are involved in the central sympathoinhibition produced by these drugs. The other aim was to determine if peripheral presynaptic inhibition of noradrenaline release from postganglionic sympathetic neurons contributes to the overall reduction of sympathetic tone. Rilmenidine and moxonidine were injected i.v. in pithed rabbits with electrically stimulated sympathetic outflow. They dose-dependently lowered blood pressure and the plasma noradrenaline concentration and inhibited stimulation-evoked cardioacceleration. Moreover, the doses necessary for these peripheral effects were identical to the doses that reduce the sympathetic nerve firing rate and blood pressure in conscious rabbits. These observations indicate that peripheral presynaptic inhibition of noradrenaline release from postganglionic sympathetic neurons contributes to the overall reduction of sympathetic tone produced by rilmenidine and moxonidine in intact animals.

Effect of the cannabinoid receptor agonist WIN55212-2 on sympathetic cardiovascular regulation

1. The aim of the present study was to analyse the cardiovascular actions of the synthetic CB1/CB2 cannabinoid receptor agonist WIN55212-2, and specifically to determine its sites of action on sympathetic cardiovascular regulation. 2. Pithed rabbits in which the sympathetic outflow was continuously stimulated electrically or which received a pressor infusion of noradrenaline were used to study peripheral prejunctional and direct vascular effects, respectively. For studying effects on brain stem cardiovascular regulatory centres, drugs were administered into the cisterna cerebellomedullaris in conscious rabbits. Overall cardiovascular effects of the cannabinoid were studied in conscious rabbits with intravenous drug administration. 3. In pithed rabbits in which the sympathetic outflow was continuously electrically stimulated, intravenous injection of WIN55212-2 (5, 50 and 500 microg kg(-1)) markedly reduced blood pressure, the spillover of noradrenaline into plasma and the plasma noradrenaline concentration, and these effects were antagonized by the CB1 cannabinoid receptor-selective antagonist SR141716A. The hypotensive and the sympathoinhibitory effect of WIN55212-2 was shared by CP55940, another mixed CB1/CB2 cannabinoid receptor agonist, but not by WIN55212-3, the enantiomer of WIN55212-2, which lacks affinity for cannabinoid binding sites. WIN55212-2 had no effect on vascular tone established by infusion of noradrenaline in pithed rabbits. 4. Intracisternal application of WIN55212-2 (0.1, 1 and 10 microg kg(-1)) in conscious rabbits increased blood pressure and the plasma noradrenaline concentration and elicited bradycardia; this latter effect was antagonized by atropine. 5. In conscious animals, intravenous injection of WIN55212-2 (5 and 50 microg kg(-1)) caused bradycardia, slight hypotension, no change in the plasma noradrenaline concentration, and an increase in renal sympathetic nerve firing. The highest dose of WIN55212-2 (500 microg kg(-1)) elicited hypotension and tachycardia, and sympathetic nerve activity and the plasma noradrenaline concentration declined. 6. The results obtained in pithed rabbits indicate that activation of CB1 cannabinoid receptors leads to marked peripheral prejunctional inhibition of noradrenaline release from postganglionic sympathetic axons. Intracisternal application of WIN55212-2 uncovered two effects on brain stem cardiovascular centres: sympathoexcitation and activation of cardiac vagal fibres. The highest dose of systemically administered WIN55212-2 produced central sympathoinhibition; the primary site of this action is not known.

Relationship between imidazoline and alpha2-adrenoceptors involved in the sympatho-inhibitory actions of centrally acting antihypertensive agents

Since the first suggestion of the existence of imidazoline receptors, there has been a continuing and yet unresolved debate as to their contribution to the antihypertensive actions of clonidine-like agents. In this review we bring together a number of studies from our laboratory which have examined the importance and interdependence of imidazoline receptors and alpha2-adrenoceptors in the mechanism of action of centrally acting antihypertensive drugs. Using conscious rabbits and a range of imidazoline and specific alpha2-adrenoceptor antagonists we have consistently found that second generation agents rilmenidine and moxonidine preferentially act via imidazoline receptors but that alpha2-adrenoceptors are important for the hypotension produced by clonidine and alpha-methyldopa. Despite this difference in receptor mechanism, the hypotension produced by all these drugs is dependent on central noradrenergic pathways. In other studies using anaesthetised rabbits and direct measures of sympathetic nerve activity we confirmed the generally held view that the major site of sympatho-inhibitory actions and sympathetic baroreflex effects of centrally acting antihypertensive agents is the rostral ventrolateral medulla (RVLM). We also found, using microinjection of specific antagonists, that alpha2-adrenoceptors in this nucleus appear to be activated as a consequence of imidazoline receptor activation. Thus, there appears to be a close relationship between imidazoline receptors and alpha2-adrenoceptors located in the RVLM in mediating the hypotension and inhibition of renal sympathetic nerve activity. Furthermore in recent studies using a noradrenergic neurotoxin microinjected into the RVLM we found that this treatment selectively blocked the actions of moxonidine but not clonidine, suggesting that I1-imidazoline receptors may be located on adrenergic terminals in situ. By contrast, clonidine acts predominantly via alpha2-adrenoceptors, perhaps located on cell bodies in the nucleus. We conclude that there is indeed a close nexus between 'presynaptic' imidazoline receptors on noradrenergic terminals and 'downstream' alpha2-adrenoceptors within the RVLM. Our hypothesis brings together opposing points of view that the mechanism for hypotension must involve either the imidazoline receptor or the alpha2-adrenoceptor. Clearly both are important.

Ethanol selectively counteracts hypotension evoked by central I(1)-imidazoline but not alpha2-adrenergic receptor activation in spontaneously hypertensive rats

Previous studies from our laboratory showed that ethanol counteracts hypotensive responses to clonidine in spontaneously hypertensive rats. This study investigated whether this effect of ethanol involves interaction with central alpha2-adrenoceptors or I(1)-imidazoline receptors or both. The effects of ethanol (0.5 or 1 g/kg, i.v.) or an equal volume of saline on hypotensive and bradycardic responses to clonidine (mixed alpha2-adrenoceptor/I(1)-imidazoline receptor agonist), rilmenidine (selective I(1)-imidazoline receptor agonist), or alpha-methylnorepinephrine (selective alpha2-adrenoceptor agonist) were studied in conscious spontaneously hypertensive rats. Intracisternal administration of clonidine (0.5 microg), rilmenidine (25 microg), or alpha-methylnorepinephrine (4 microg) elicited similar decreases in mean arterial pressure (MAP; 25-30 mm Hg) that lasted > or =60 min. Subsequent administration of ethanol (0.5 and 1 g/kg, i.v.) counteracted the hypotensive effect of clonidine in a dose-related manner. Ethanol (1 g/kg) increased the blood pressure to levels similar to baseline (preclonidine) levels, and blood pressure remained significantly (p < 0.05) higher compared with the corresponding values in saline-treated rats. Similarly, ethanol (0.5 and 1 g/kg, i.v.) dose-dependently counteracted the hypotensive effect of rilmenidine. The antagonizing effects of ethanol on hypotension evoked by clonidine and rilmenidine were comparable in terms of both magnitude and duration. In contrast, ethanol (0.5 or 1 g/kg) had no effect on hypotension evoked by alpha-methylnorepinephrine. Except for a brief increase in blood pressure by ethanol (1 g/kg) at 5 min, blood pressure values obtained in alpha-methylnorepinephrine-treated rats receiving any of the two doses of ethanol were similar to postsaline values. Ethanol had no effect on bradycardic responses to any of the three hypotensive agents. Blood ethanol concentrations were similar regardless of the antihypertensive drug used. We concluded that the adverse hemodynamic effect of ethanol on centrally mediated hypotensive responses depends on the types of receptors involved in the elicitation of this response. That ethanol counteracts decreases in blood pressure evoked by clonidine and rilmenidine but not by alpha-methylnorepinephrine suggests an interaction between ethanol and central pathways involved in I(1)-imidazoline receptor-mediated hypotension.

Cardiovascular effects of central administration of clonidine in conscious cats

The effects on arterial blood pressure and heart rate after an intracerebroventricular (i.c.v.) administration of clonidine were investigated using conscious normotensive cats. Injection of clonidine (5-10 microg; 5 microl; i.c.v.) elicited a decrease in mean arterial pressure (MAP) and heart rate (HR) in a dose-dependent manner. The highest dose of 10 microg of clonidine decreased MAP and HR by 39 +/- 3 mmHg and 74 +/- 5 b.p.m., respectively (n = 7). Pretreatment with yohimbine, the alpha2-adrenoceptor antagonist (8 microg; 5 microl; i.c.v.) blocked the cardiovascular responses to a subsequent i.c.v. injection of 10 microg clonidine (n = 7). Furthermore, preadministration of cimetidine (100 microg; 5 microl; i.c.v.), the H2 histamine receptor antagonist with imidazoline receptor activating properties, prevented the decreases in MAP and HR to a subsequent i.c.v. injection of 10 microg clonidine (n = 7). By contrast, pretreatment with the specific I1 imidazoline receptor blocker, efaroxan (100-500 microg; 5 microl; i.c.v.), failed to inhibit the cardiovascular effects of an i.c.v. administration of 10 microg clonidine (n = 7). These results suggest that the effects of centrally administered clonidine on MAP and HR are probably not mediated through activation of the I1 subtype of imidazoline receptors in conscious cats. However, the cardiovascular effects elicited by i.c.v. administration of clonidine appear to result from stimulation of central alpha2-adrenergic or the H2 histaminergic-like receptors.

Effects of alpha 2-adrenoceptor antagonists and imidazoline2-receptor ligands on neuronal damage in global ischaemia in the rat

1. In the present study the neuroprotective effects of 3 mg/kg idazoxan, an alpha 2-adrenoceptor antagonist and imidazoline2-receptor (I2-receptor) ligand, 3 mg/kg methoxyidazoxan, a specific alpha 2-adrenoceptor antagonist, and 0.6 and 3 mg/kg BU224, a selective I2-receptor ligand, were evaluated following 10 min of global ischaemia in rats. 2. Neuronal cell counts in the CA1 region of the hippocampus 8 days postischaemia indicated 46-96% cell loss compared with control (P < 0.001) and a 320% increase in [3H]-PK11195 binding (P < 0.001) used as a marker of gliosis. No significant neuroprotective effect could be detected on these markers of neuronal damage in the active treatment groups. In a subset of idazoxan-treated rats, neuronal loss and gliosis was minimal. 3. Mean body temperature over 3 h postischaemia was lower in idazoxan-treated rats than in the other treatment groups (P < 0.001) and there was a correlation between mean body temperature and cell counts (P < 0.01) and mean body temperature and gliosis in this group (P = 0.057). 4. These results indicate that at the doses used neither BU224 nor methoxyidazoxan are neuroprotective in this ischaemia model and they raise the possibility that any neuroprotective effect of idazoxan may be related to hypothermic effects of the drug.

Central cardiovascular actions of agmatine, a putative clonidine-displacing substance, in conscious rabbits

Agmatine, an endogenous clonidine-displacing substance, has been shown to have an affinity for both alpha 2-adrenoceptors and imidazoline receptors (IR). In conscious rabbits, we have examined the cardiovascular effects of agmatine and its interaction with clonidine, a presumed agonist and 2-methoxyidazoxan, an antagonist at alpha 2-adrenoceptors. We have also examined the effect of agmatine on agents having high affinity for I1-imidazoline receptors namely moxonidine (agonist) and efaroxan (antagonist). Initial dose-response studies showed that agmatine administered in low doses (0.01-10 micrograms/kg) into the fourth ventricle did not change mean arterial pressure but did produce a dose-dependent bradycardia (maximum -16 +/- 3 beats/min). A higher dose of 100 micrograms/kg produced an adverse reaction in the conscious animals accompanied by a marked increase in mean arterial pressure and a reversal of the bradycardia. This is in contrast to the effects of fourth ventricular clonidine and moxonidine, which caused a dose-dependent fall in both mean arterial pressure and heart rate. Agmatine when administered at the highest well-tolerated dose of 10 micrograms/kg did not further alter the clonidine-induced hypotension but produced a greater bradycardia (-12 +/- 4 beats/min clonidine; -29 +/- 4 beats/min clonidine plus agmatine; p < 0.05). Similarly, the hypotension induced by moxonidine was not altered by agmatine but heart rate was reduced after the addition of agmatine (p < 0.01). Efaroxan and 2-methoxy-idazoxan, at doses which produced no effects when given alone, similarly reversed the fall in heart rate elicited by agmatine and caused a small but significant rise in mean arterial pressure. We have previously shown that the doses of these antagonists used in this study produce an equal reversal of the bradycardia induced by fourth ventricular alpha-methyldopa (alpha 2-adrenoceptor agonist) and clonidine and hence have similar alpha 2-adrenoceptor blocking effects. Our results show that agmatine produces bradycardia as does moxonidine and clonidine but does not mimic or block the hypotensive responses to these agents. These findings do not support the hypothesis that agmatine is an endogenous ligand for IR. However, the bradycardia induced by agmatine may be mediated via alpha 2-adrenoceptors since it was equally blocked by efaroxan and 2-methoxy-idazoxan. Thus while alpha 2-adrenoceptor actions of agmatine on heart rate are evident at relatively low doses, the reason for the lack of alpha 2-adrenoceptor mediated hypotension is not known.

Rilmenidine and reflex renal sympathetic nerve activation in Wistar and hypertensive rats

1. This study sets out to examine the effect of rilmenidine administered systemically on basal and reflexly activated renal nerve activity in Wistar and stroke prone spontaneously hypertensive rats (SHRSP). 2. Animals were anaesthetized with chloralose/urethane, stimulating electrodes were placed on the brachial plexi and the renal nerves were isolated and put on recording electrodes. Both brachial nerves were stimulated electrically at 0.8, 1.6 and 3.2 Hz (15 V, 0.2 ms) in the absence and in the presence of rilmenidine given at 100 and 200 micrograms kg-1 i.v. in a cumulative manner. 3. Stimulation of the brachial nerves caused graded increases in blood pressure, heart rate and integrated renal nerve activity (P < 0.05) in both Wistar and SHRSP. Fast Fourier transformation of the renal nerve activity signal to generate a power spectrum demonstrated that both total power and percentage power at heart rate was higher in the SHRSP than Wistar (P < 0.05). Total power was raised during brachial nerve stimulation in both Wistar and SHRSP by some 200-300% (P < 0.05) but the percentage power at heart rate was decreased by some 60% (P < 0.01) in the Wistar but was raised by some 40-50% (P < 0.05) in the SHRSP. 4. Administration of rilmenidine caused dose-related decreases in blood pressure and heart rate and integrated renal nerve activity in both Wistar and SHRSP (all P < 0.05). Both doses of rilmenidine decreased (P < 0.05) the total power in the signal in both strains of rat by about one-half but the power occurring at heart rate only fell at the higher dose of compound in the Wistar, whereas in the SHRSP it was decreased by both doses by approximately 60-70%. In the presence of rilmenidine, coherence of the renal nerve signal was reduced in the Wistar and SHRSP and although the drug had no effect on phase difference in the Wistar, this parameter was decreased in the SHRSP by the low and high doses of rilmenidine (P < 0.05). 5. In the presence of 100 micrograms kg-1 rilmenidine, stimulation of the brachial nerves caused increases in total power in the Wistar and SHRSP (two to three fold, P < 0.05), together with a decrease (P < 0.05) in the percentage power occurring at heart rate in the Wistar, of some 60%, and an increase (P < 0.01) in the SHRSP, of some two to three times, which were very similar in magnitude and pattern to those obtained in the absence of the drug. Following the 200 micrograms kg-1 dose of rilmenidine, brachial nerve stimulation increased total power in the Wistar and SHRSP groups (P < 0.05) and whereas in the Wistar the percentage power at heart rate did not change in the SHRSP it was again increased in response to the electrical stimulation of the brachial plexus (P < 0.001) by between two to three fold. 6. These results showed that in both the Wistar and SHRSP rilmenidine depressed blood pressure, heart rate and integrated renal nerve activity. Moreover, rilmenidine did not affect the reflex activation of renal nerve activity via the somatosensory system although the characteristics within the power spectra underwent certain changes which might have a functional impact at the level to the kidney.

Interactions of the cardiac chronotropic effects of rilmenidine with the autonomic nervous system in conscious dogs: comparison with clonidine

1. The cardiac chronotropic effects of rilmenidine (10-100 micrograms kg-1) and clonidine (1-10 micrograms kg-1) were studied in conscious dogs with chronic atrioventricular block. 2. Rilmenidine and clonidine initially (< 3 min) decreased atrial rate, although the effect was not related to dose. More lastingly, ventricular rate was decreased in a dose-related manner (ratio, 1:21). Rilmenidine lowered mean blood pressure only at 100 micrograms kg-1, while clonidine had the same effect at doses of 5 micrograms kg-1 upward (ratio, 1:15). 3. When administered after atropine and pindolol, rilmenidine (50 micrograms kg-1) produced a decrease in atrial rate, with an identical intensity but longer duration than under basal conditions. When clonidine (2.5 micrograms kg-1) was given after atropine, no chronotropic atrial effect was observed. However, when clonidine (2.5 micrograms kg-1) was given after pindolol, it produced a decrease in atrial rate that was more marked, both in intensity and duration, than under basal conditions. After phenoxybenzamine, rilmenidine decreased atrial rate with a more marked and lasting effect than observed under basal conditions. Clonidine produced a bradycardic atrial effect identical to the basal effect. After yohimbine, rilmenidine and clonidine decreased atrial rate with an intensity similar to that under basal conditions, although the time course was totally different. 4. When given after atropine, rilmenidine (50 micrograms kg-1) and clonidine (2.5 micrograms kg-1) decreased ventricular rate as under basal conditions, whereas after pindolol and phenoxybenzamine, both drugs decreased ventricular rate less markedly than under basal conditions, both in intensity and duration. After yohimbine, rilmenidine and clonidine produced no chronotropic ventricular effect. 5. These results show that (a) the initial atrial bradycardia caused by rilmenidine results from both a decrease in sympathetic tone and an increase in cholinergic activity; while the effect of clonidine is caused mainly by the enhancement of cholinergic activity. For both drugs, alpha 2-adrenoceptors are involved at least in the initiation of the effect; (b) the very short duration of atrial bradycardia may result from reflex buffering in response to ventricular bradycardia. This buffering is less effective when heart rate was high; and (c) the ventricular bradycardia caused by both drugs is mainly the result of a decrease in sympathetic tone in response to the stimulation of alpha 2-adrenoceptors. The results also suggest that negative chronotropic postsynaptic alpha 2-adrenoceptors could be involved in the ventricular bradycardia.

Renal effects of infusion of rilmenidine and guanabenz in conscious dogs: contribution of peripheral and central nervous system alpha 2-adrenoceptors

1. We tested the renal effects of the alpha 2-adrenoceptor agonists, rilmenidine and guanabenz and the antagonists, 2-methoxyidazoxan and idazoxan, in conscious dogs. Our aim was to test the hypothesis that putative imidazoline (I) receptors influence renal function. We reasoned that since rilmenidine and guanabenz are selective for I1- and I2-binding sites respectively, an influence of one of these receptive sites on renal function would be reflected in qualitative differences between the effects of these agents. Moreover, effects mediated by putative I-receptors should be relatively resistant to antagonism by the selective alpha 2-adrenoceptor antagonist, 2-methoxyidazoxan. Since the effects of these drugs on renal function could be mediated in the central nervous system or periphery, the dogs were studied under both normal and ganglion-blocked conditions. 2. In dogs with intact autonomic reflexes, 2-methoxyidazoxan (15 micrograms kg-1 plus 0.6 micrograms kg-1 min-1) produced effects consistent with a generalized increase in sympathetic drive, including increases in mean arterial pressure and plasma renin activity, and a reduction in sodium excretion. In ganglion-blocked dogs, 2-methoxyidazoxan reduced sodium excretion but had no discernible effect on systemic or renal haemodynamics. We conclude that an alpha 2-adrenoceptor-mediated mechanism in the central nervous system tonically inhibits sympathetic drive in the conscious dog. 3. In ganglion-blocked dogs idazoxan (3-300 micrograms kg-1) dose-dependently increased arterial pressure. This was not abolished by concomitant administration of 2-methoxyidazoxan (0.3-30 micrograms kg-1). The pressor effect of idazoxan is therefore probably mediated by an agonist action at alpha 1-adrenoceptors. 4. The effects of infusions of rilmenidine (0.1-1.0 mg kg-1) and guanabenz (10-100 micrograms kg-1) were indistinguishable. They comprised dose-dependent increases in mean arterial pressure, urine excretion, and glomerular filtration rate (the latter in ganglion blocked dogs only), and dose-dependent reductions in heart rate, renal blood flow and sodium excretion (only in dogs with intact autonomic reflexes). All of these effects were antagonized by 2-methoxyidazoxan. 5. We conclude that the renal effects of rilmenidine and guanabenz infusions in conscious dogs are predominantly, if not completely, attributable to activation of alpha 2-adrenoceptors. Our results do not support the hypothesis that putative I-receptors contribute towards the renal effects of these agents.

Involvement of alpha 2-adrenoceptors in the cardiovascular effects of moxonidine

The central sympathoinhibition caused by moxonidine has been explained by activation of alpha 2-adrenoceptors on the one hand, and by an action at imidazoline I1 receptors on the other hand. In order to examine these possibilities, effects of moxonidine were compared with those of 5-bromo-6-(2-imidazolin-2-ylamino)-quinoxaline (UK 14304), an alpha 2-adrenoceptor agonist with very low affinity for I1 receptors, in conscious rabbits. The interaction with yohimbine, an alpha 2-adrenoceptor antagonist with very low affinity for imidazoline I1 receptors, was also studied. Moxonidine 3-100 micrograms kg-1 and UK 14304 1-30 micrograms kg-1 i.v. elicited similar effects: they decreased arterial blood pressure after a transient increase, decreased renal sympathetic nerve activity (recorded with chronically implanted electrodes), decreased heart rate and decreased the plasma noradrenaline concentration. Yohimbine given i.v. antagonized the effects of moxonidine and of UK 14304 in a similar manner. Yohimbine injected into the cisterna magna (i.c.) prevented the hypotension but did not change the decrease in plasma noradrenaline and heart rate, again in the case of both moxonidine and UK 14304. The agreement of the effect patterns of moxonidine and UK 14304, and the similar antagonism of yohimbine against either drug, demonstrate involvement of alpha 2-adrenoceptors in their central sympathoinhibitory action. The resistance of the bradycardia and the plasma noradrenaline fall against yohimbine i.c. indicates a contribution of presynaptic alpha 2-adrenergic inhibition of transmitter release from postganglionic sympathetic neurons to the overall reduction of sympathetic tone.

Involvement of peripheral presynaptic inhibition in the reduction of sympathetic tone by moxonidine, rilmenidine and UK 14304

We studied the possibility that presynaptic inhibition of transmitter release from postganglionic sympathetic neurons contributes to the overall reduction of sympathetic tone produced by moxonidine, rilmenidine and 5-bromo-6-(2-imidazolin-2-ylamino)-quinoxaline tartrate (UK 14304). In pithed rabbits without electric stimulation, moxonidine, rilmenidine and UK 14304 caused a long-lasting, > 10 min, increase in arterial pressure. Heart rate was not changed. In pithed rabbits in which sympathetic tone was created by electric stimulation through the pithing rod (2 Hz), the same doses of moxonidine, rilmenidine and UK 14304 caused only a brief, < 10 min, blood pressure rise. Heart rate was decreased, as were the plasma concentrations of noradrenaline and adrenaline. Dose-response curves for the effects on the plasma noradrenaline concentration (stimulated pithed rabbits) were compared with previously obtained dose-response curves for depression of renal sympathetic nerve activity (conscious rabbits). For each drug, the curve describing peripheral presynaptic inhibition and the curve describing central sympathoinhibition were very similar. Both the power and the dose dependence of the peripheral inhibitory effect support its contribution to the overall decrease in sympathetic tone produced by clonidine-like drugs in intact animals. The peripheral effect in all likelihood consists in activation of presynaptic alpha 2-autoreceptors. The agreement of the dose-response curves for the peripheral and for the central effect supports the view that the central effect, like the peripheral one, is mediated through alpha 2-adrenoceptors.

Mechanism of sympathoinhibition by imidazolines

The aim of the present study is to characterize the cardiovascular effects of rilmenidine and moxonidine, two recently developed centrally acting antihypertensive drugs. Rilmenidine and moxonidine are alpha 2-adrenoceptor agonists and, in addition, possess affinity for imidazoline (I1)-receptors. To determine if alpha 2- or I1-receptors are involved in sympathoinhibition, rilmenidine and moxonidine were compared with UK 14304, an alpha 2-agonist devoid of affinity for I1-receptors, and antagonism by the "pure" alpha 2-adrenoceptor antagonists yohimbine, SK&F86466, and RX821002 was studied. When injected intravenously into conscious rabbits, rilmenidine and moxonidine, on the one hand, and UK 14304, on the other, elicited a similar pattern of effects. Thus, transient hypertension was followed by long-lasting hypotension accompanied by a decrease in heart rate, renal sympathetic nerve firing rate, and plasma norepinephrine concentration. The effects of rilmenidine, moxonidine, and UK 14304 were antagonized by intravenously administered yohimbine, SK&F86466, and RX821002. The effects of moxonidine and UK 14304 were also prevented by yohimbine injected into the cisterna magna. Altogether, the degree of antagonism of the effects of rilmenidine and moxonidine did not differ from the degree of antagonism of the effects of UK 14304. Rilmenidine, moxonidine, and UK 14304 were also given to pithed rabbits in which a constant sympathetic tone was maintained by electrical stimulation of the sympathetic nerves. At doses that caused sympathoinhibition in conscious rabbits, they lowered the plasma norepinephrine concentration markedly. Our experiments show by direct measurement of sympathetic nerve activity and plasma norepepinephrine concentration that rilmenidine, moxonidine, and UK 14304 cause sympathoinhibition. As a consequence, blood pressure and heart rate decrease. The simplest interpretation of the blockade of central sympathoinhibition by the selective alpha 2-adrenoceptor antagonists is that rilmenidine, moxonidine, and UK 14304 primarily activated alpha 2-adrenoceptors. The decrease in plasma norepinephrine in pithed rabbits indicates peripheral presynaptic alpha 2-adrenoceptor-mediated inhibition of norepinephrine release per action potential from postganglionic sympathetic axons and suggests a contribution of this mechanism to the overall reduction in sympathetic tone.

Possible structural and functional relationships between imidazoline receptors and alpha 2-adrenoceptors

Although it is now well established that imidazoline receptors and alpha 2-adrenoceptors are discrete entities with distinct endogenous ligands, the two receptor classes apparently have several common features. While the catecholamines stimulate alpha 2-adrenoceptors but not imidazoline receptors, agmatine, a guanidine analog that may be an endogenous imidazoline receptor ligand, can interact with both I1 and I2 imidazoline receptors as well as alpha 2-adrenoceptors, although, interestingly, other guanidines such as guanabenz are highly selective for alpha 2-adrenoceptors versus I1 receptors. Most I1 receptor agonists such as moxonidine, rilmenidine, and clonidine can also stimulate alpha 2-adrenoceptors, and the same physiological response is produced by activation of central I1 receptors and alpha 2-adrenoceptors, but their anatomical locations differ. The imidazoline idazoxan is an antagonist at I1, I2, and alpha 2-receptors, but minor structural alterations of idazoxan can result in molecules with selectivity for either alpha 2-adrenoceptors or imidazoline receptors. The precise mode of interaction of imidazoline agonists and antagonists with the alpha 2-adrenoceptor is not yet understood, and structures of the imidazoline receptors are still unknown. Nevertheless, the fact that many agents can stimulate or block both receptor classes, combined with the fact that alpha 2-adrenoceptors and I1 receptors can mediate identical physiological responses, suggests that many common structural features may be present.

Importance of imidazoline receptors in the cardiovascular actions of centrally acting antihypertensive agents

Increasing evidence indicates that the hypotensive effect of centrally acting antihypertensive drugs is not due to stimulation of alpha 2-adrenoceptors but to action on imidazoline receptors (IR). This has led to the development and recent clinical use of second generation agents such as rilmenidine and moxonidine that possess a much greater selectivity toward these nonadrenergic receptors. However, relatively few studies have examined the role of these receptors in conscious animals or have adequately accounted for the alpha 2-adrenoceptor antagonist properties of IR antagonists such as idazoxan. We have taken the approach of initially calibrating the alpha 2-adrenoceptor antagonist potency of intracisternally (ic) administered idazoxan and the IR-1 receptor antagonist efaroxan against 2-methoxyidazoxan, a highly selective alpha 2-adrenoceptor antagonist with little or no imidazoline antagonist effect. This was done using alpha-methyldopa, a hypotensive agent affecting only alpha 2-adrenoceptors. Thus, we chose doses of the antagonists with equal alpha 2-adrenoceptor blocking action such that differences in the ability of idazoxan or efaroxan compared to 2-methoxy-idazoxan to reverse the hypotension produced by rilmenidine, moxonidine, or clonidine indicate an interaction with IR. By this method we found that the hypotensive effects of rilmenidine and moxonidine at moderate intracisternal doses were more readily reversed by the imidazoline antagonists than by 2-methoxy-idazoxan, indicating that IR were largely responsible for their hypotensive actions. By contrast, clonidine's effects were equally reversed by all antagonists, suggesting interaction mainly with alpha 2-adrenoceptors. In conscious rabbits with chronic renal sympathetic nerve electrodes we examined the effect of rilmenidine and alpha-methyldopa on the renal sympathetic baroreflex. Both drugs reduced renal sympathetic nerve activity and sympathetic baroreflex responses, but only the effect of rilmenidine was preferentially reversed by idazoxan. Thus, both IR and central alpha 2-adrenoceptor receptors can influence the renal baroreflex, but the former are relatively more important for the actions of rilmenidine. We recently examined the possible sites of action of rilmenidine in anesthetized rabbits and showed that sixfold lower doses were required to reduce blood pressure when the drug was injected into the rostral ventrolateral medulla compared to intracisternal administration. At this site rilmenidine also reduced renal sympathetic tone and inhibited renal sympathetic baroreflex responses. By contrast, rilmenidine was relatively ineffective when injected into the nucleus of the solitary tract. These experiments support the view that rilmenidine acts primarily at IR in the rostral ventrolateral medulla to reduce sympathetic tone and modulate sympathetic baroreflexes.

Subclassification of presynaptic alpha 2-adrenoceptors: alpha 2D-autoreceptors and alpha 2D-adrenoceptors modulating release of acetylcholine in guinea-pig ileum

The study was designed to classify in terms of alpha 2A, alpha 2B, alpha 2C and alpha 2D the presynaptic alpha 2-autoreceptors, as well as the alpha 2-receptors modulating the release of acetylcholine, in the myenteric plexus-longitudinal muscle (MPLM) preparation of the guinea-pig ileum. A set of antagonists was chosen that was able to discriminate between the four subtypes. Small pieces of the MPLM preparation were preincubated with 3H-noradrenaline or 3H-choline and then superfused and stimulated electrically. The stimulation periods used (3H-noradrenaline: 3 trains of 20 pulses, 50 Hz, train interval 60 s; 3H-choline: single trains of 30 pulses, 0.2 Hz) did not lead to alpha 2-autoinhibition or inhibition of 3H-acetylcholine release by endogenous noradrenaline. The alpha 2-selective agonist 5-bromo-6-(2-imidazolin-2-ylamino)-quinoxaline (UK 14,304) reduced the evoked overflow of tritium in both 3H-noradrenaline and 3H-choline experiments. Most (3H-noradrenaline) or all (3H-choline) of the 10 antagonists shifted the concentration-inhibition curves of UK 14,304 to the right. pKd values of the antagonists were calculated from the shifts. pKd values from 3H-noradrenaline experiments correlated with pKd values from 3H-choline experiments (r = 0.981). It is concluded that alpha 2-autoreceptors and alpha 2-heteroreceptors modulating the release of acetylcholine in the MPLM preparation are of the same subtype. Comparison with antagonist affinities for prototypic native alpha 2 binding sites, binding sites in cells transfected with alpha 2 subtype genes, and previously classified presynaptic alpha 2-adrenoceptors--all taken from the literature--indicates that both are alpha 2D.(ABSTRACT TRUNCATED AT 250 WORDS)

Clonidine and rilmenidine suppress hypotension-induced Fos expression in the lower brainstem of the conscious rabbit

Our current knowledge of the sites of action of the centrally-acting antihypertensive drug clonidine is based almost entirely on experiments in anesthetized animals. The aim of this study was to determine, in conscious rabbits, the sites of action in the brainstem of systemically administered clonidine, as well as its oxazoline analog rilmenidine. Three groups of experiments were carried out. In the first group, hypotension was produced by continuous intravenous infusion of sodium nitroprusside, at a rate sufficient to decrease arterial pressure by 20-30 mmHg, maintained for a period of 60 min. In the second and third groups of experiments, sustained hypotension was also produced by nitroprusside infusion as in the first group, but this was preceded by intravenous injection of clonidine (7-30 micrograms/kg i.v.) or rilmenidine (150-300 micrograms/kg i.v.), respectively. In confirmation of our previous study [Li Y.-W. and Dampney R. A. L. (1994) Neuroscience 61, 613-634], hypotension produced by nitroprusside alone induced a large increase (compared to sham control experiments) in the neuronal expression of Fos (a marker of neuronal activation) in the nucleus of the solitary tract, area postrema, the rostral, intermediate and caudal parts of the ventrolateral medulla, A5 area, locus coeruleus and subcoeruleus, and parabrachial nucleus. In comparison with this group, in rabbits pretreated with clonidine the numbers of Fos-positive cells were greatly reduced (by 76-94%) in the rostral, intermediate and caudal parts of the ventrolateral medulla, area postrema, A5 area, locus coeruleus and subcoeruleus. Clonidine pretreatment also caused a more moderate reduction (by 45%) in the number of Fos-positive cells in the nucleus of the solitary tract, but had no effect on Fos expression in the parabrachial nucleus. Double-labeling for tyrosine hydroxylase and Fos immunoreactivity showed that clonidine pretreatment greatly reduced the numbers of both catecholamine and non-catecholamine Fos-positive neurons. Rilmenidine pretreatment also greatly reduced Fos expression in the lower brainstem, with a very similar pattern to that observed after clonidine pretreatment. The results indicate that in conscious animals both clonidine and rilmenidine cause a widespread but selective inhibition of neurons in the pons and medulla that are normally activated by a hypotensive stimulus. In contrast to previous observations in anesthetized animals, the results suggest that (i) systemic administration of both drugs inhibits non-catecholamine as well as catecholamine neurons in the ventrolateral medulla, and (ii) the regional pattern of neuronal inhibition following administration of equipotent hypotensive doses of both drugs is very similar.

GABA-mediated inhibition of pacemaker neurons of rostral ventrolateral medulla by clonidine in vitro

In vitro, clonidine (1, 10, or 30 microM) dose-dependently and reversibly inhibited tonically active pacemaker neurons that correspond to the relatively fast-conducting reticulospinal vasomotor neurons of the rostral ventrolateral reticular nucleus of the medulla oblongata in rats. The clonidine-induced membrane-hyperpolarizing response of these neurons was abolished by either tetrodotoxin, bicuculline, a GABAA receptor antagonist, or 4,4'-diisothiocyano-1,2'-disulphonic stilbene acid, a Cl- channel blocker. We conclude that the clonidine-induced inhibition of the pacemaker neurons of the rostral ventrolateral reticular nucleus is indirect, mediated by synaptic release of gamma-aminobutyric acid (GABA) or GABA-like substances, which activate Cl- channels of the pacemaker neurons of the rostral ventrolateral reticular nucleus.