Unilateral cervical vagotomy decreases the magnitude of neurogenic inflammation induced by capsaicin in the ipsilateral bronchial tree of rats

A History of Psycho-Neuro-Endocrine Immune Interactions in Rheumatic Diseases

BACKGROUND

All active scientists stand on the shoulders of giants and many other more anonymous scientists, and this is not different in our field of psycho-neuro-endocrine immunology in rheumatic diseases. Too often, the modern world of publishing forgets about the collective enterprise of scientists. Some journals advise the authors to present only literature from the last decade, and it has become a natural attitude of many scientists to present only the latest publications. In order to work against this general unempirical behavior, neuroimmunomodulation devotes the 30th anniversary issue to the history of medical science in psycho-neuro-endocrine immunology.

SUMMARY

Keywords were derived from the psycho-neuro-endocrine immunology research field very well known to the authors (R.H.S. has collected a list of keywords since 1994). We screened PubMed, the Cochran Library of Medicine, Embase, Scopus database, and the ORCID database to find relevant historical literature. The Snowballing procedure helped find related work. According to the historical appearance of discoveries in the field, the order of presentation follows the subsequent scheme: (1) the sensory nervous system, (2) the sympathetic nervous system, (3) the vagus nerve, (4) steroid hormones (glucocorticoids, androgens, progesterone, estrogens, and the vitamin D hormone), (5) afferent pathways involved in fatigue, anxiety, insomnia, and depression (includes pathophysiology), and (6) evolutionary medicine and energy regulation - an umbrella theory.

KEY MESSAGES

A brief history on psycho-neuro-endocrine immunology cannot address all relevant aspects of the field. The authors are aware of this shortcoming. The reader must see this review as a viewpoint through the biased eyes of the authors. Nevertheless, the text gives an overview of the history in psycho-neuro-endocrine immunology of rheumatic diseases.

Chronic unilateral cervical vagotomy reduces renal inflammation, blood pressure, and renal injury in a mouse model of lupus

Systemic lupus erythematosus (SLE) is characterized by hypertension that results from chronic renal inflammation and dysautonomia in the form of dampened vagal tone. In health, the vagus nerve regulates inflammatory processes through mechanisms like the cholinergic anti-inflammatory pathway; so in the case of SLE, reduced efferent vagus nerve activity may indirectly affect renal inflammation and therefore hypertension. In this study, we sought to investigate the impact of disrupting vagal neurotransmission on renal inflammation and hypertension in the setting of chronic inflammatory disease. Female SLE (NZBWF1) and control (NZW) mice were subjected to a right unilateral cervical vagotomy or sham surgery and 3 wk later were implanted with indwelling catheters to measure blood pressure. Indices of splenic and renal inflammation, as well as renal injury, were assessed. Unilateral vagotomy blunted SLE-induced increases in mean arterial pressure, albumin excretion rate, and glomerulosclerosis. This protection was associated with reduced splenic T cells and attenuated SLE-induced increases in renal proinflammatory mediators. In summary, these data indicate that unilateral vagotomy reduces renal inflammation and reduces blood pressure in SLE mice. The vagus nerves have myriad functions, and perhaps other neuroimmune interactions compensate for the ligation of one nerve.

Histamine-induced changes in rat tracheal goblet cell mucin store and mucosal edema

The pathology of chronic asthma in human and mouse is characterized by inflammation and remodeling of airway tissues. As a result of repeated inflammatory insults to the lower airways, smooth muscle thickening, mucin secretion and airway hyperreactivity may develop. In ovalbumin (OVA)-sensitized mice with repeated challenges with OVA to the lower airways, the trachea and bronchi are characterized by goblet cell hyperplasia and mucus hypersecretion from goblet cells. Previous study reports that intravenous (i.v.) application of a high dose of capsaicin releases tachykinin from capsaicin-sensitive nerves, producing acute plasma leakage and mucosal edema formation and causing depletion of mucin granules in goblet cells that results in a reduction in the number and size of Alcian blue (AB)-positive goblet cells in the rat trachea within a few minute after capsaicin application. Histamine is an important non-neural mediator of asthma from mast cells. The present study investigated whether i.v. application of a high dose of histamine (18 μmol/ml/kg) could result in these acute changes and the similar time-course changes in rat trachea. The tracheal whole mounts stained with chloroacetate esterase reagent and AB and tracheal methacrylate sections stained with AB and periodic acid-Schiff reagent were used for evaluation of histological and cellular changes. At 5 min after histamine application, mucosal leaky venules were numerous and subepithelial edema ratio (% of length of edema along the mucosal epithelial circumference of tracheal cross section) was found to be 48.2 ± 4.9, which was greater (P < 0.01) than saline-treated rats. But, the number of AB-positive goblet cells, 2,030 ± 170/mm(2) of mucosal surface epithelium, was similar to saline-treated group (P > 0.05). One day later, edema ratio remained large and the number of AB-positive goblet cells was 1,140 ± 150/mm(2) epithelium, reduced to half the number of the group at 5 min after histamine (P < 0.01). It is suggested that mucus hypersecretion occurred at this time point. At 3 or 5 days after histamine, edema ratio gradually decreased. The number of AB-positive goblet cells continued to remain small on day 3. On day 5 after histamine, the number of AB-positive goblet cells restored to the level of rat group at 5 min after histamine application. At 7 days after histamine, edema ratio returned to the level of saline-treated group. It is concluded that degranulation and thinning of tracheal goblet cells and mucus hypersecretion lagged behind histamine-induced acute plasma leakage and edema, and restoration of mucin store in goblet cells was associated with remission of mucosal edema.

Spontaneous remission of edema and regranulation of goblet cells in rat tracheae after capsaicin-induced acute inflammation

Previous studies have investigated the short-term effect of capsaicin on edema formation and goblet-cell secretion in the trachea. The present study sought to investigate the long-term effect of a high dose of capsaicin (90 micro g/ml/kg), administered intravenously, on changes in the formation of endothelial gaps among venular endothelial cells, mucosal tissue edema and the secretory activity of goblet cells, including the number and size of goblet cells, and the mucus score and secretory ratio of goblet-cell mucus secretion in the trachea of rats. The tracheal whole mounts with silver staining, those stained with chloroacetate esterase reagent and Alcian blue and tracheal tissue sections stained with Alcian blue and periodic acid-Schiff reagent were used for evaluation. Formation of endothelial gaps occurred a few min after administration of capsaicin, and gaps almost closed within 12 min after capsaicin injection. Five min after capsaicin, the leaky blood vessels were numerous and the subepithelial edema ratio (% of length of edema along the inner circumference of tracheal cross section) was found to be 57.8+/-3.0% ( n=6). The number of Alcian blue-positive goblet cells (1,090+/-220 per mm(2) of mucosal surface) was reduced to half the number of goblet cells in the vehicle-treated rats (2,200+/-230). The mucus score of goblet cell secretion was not changed. The secretory ratio was greatly increased. One day after capsaicin, the edema ratio remained large and the number of Alcian blue-positive goblet cells was also small. The mucus score was also not changed. The secretory ratio was still large. On day 3, the edema ratio remained large, but the number of Alcian blue-positive goblet cells was increased to the level of the controls. The mucus score and secretory ratio returned to the control level. On day 5, the edema ratio was greatly decreased, but it was still significantly larger than that of the controls. The mucus score and secretory ratio remained at the baseline level. Seven days after capsaicin, the edema ratio was similar to the controls. The number of goblet cells was even larger than controls. It is concluded that capsaicin-induced acute inflammation in the rat trachea involves formation of endothelial gaps, extensive plasma extravasation and edema formation, and depletion of goblet-cell secretory granules. Spontaneous gradual remission of edema was accompanied by regranulation of goblet cells with gradual mucogenesis for several days.

A novel procedure for mediastinal vagotomy inhibits neurogenic inflammation in rat bronchial tree

Tachykinin-containing sensory axons originating from the cervical vagal nerves and the first several pairs of thoracic spinal nerves are involved in neurogenic inflammation evoked by capsaicin in the bronchial tree. Unilateral degeneration of the cervical vagal trunk by surgical lesion inhibits neurogenic inflammation in the ipsilateral bronchial airways. The vagal trunk has two main branches, the thoracic vagus nerve and recurrent laryngeal nerve in the thorax. The main purpose of this study was to determine whether the thoracic vagus nerve or recurrent laryngeal nerve was significantly involved in the neural control of bronchial inflammation in the rat. A novel and safe surgical procedure was used for selectively cutting the right thoracic vagal trunk, thoracic vagus nerve, or recurrent laryngeal nerve by introducing the surgical instrument through an aperture between the first and second ribs in the ventral wall of the rostral mediastinum. This surgical operation could be completed without causing a pneumothorax. After 2 postoperative weeks, the effects of denervation on capsaicin-induced plasma extravasation in the respiratory tract were tested. Either right thoracic vagal trunk transection or thoracic vagus section significantly decreased plasma extravasation in the right bronchial tree. Thoracic vagus section was obviously more effective. Evans blue extravasation in the right lobar bronchi was reduced by 44-78% after thoracic vagal trunk transection, while that in the right mainstem and lobar bronchi was reduced by 58-81% after thoracic vagus section. Area densities of India ink-labeled leaky blood vessels in the right lobar bronchi were reduced by 40-65% after thoracic vagal trunk transection, and those in the right mainstem and lobar bronchi were reduced by 83-88% after thoracic vagus neurectomy. Recurrent laryngeal neurectomy did not change the plasma extravasation induced by capsaicin in the trachea and bronchi. These results suggest that capsaicin-sensitive fibers running in the vagal trunk, which largely mediated neurogenic inflammation in the bronchial tree, were projected into the thoracic vagus nerve which, in turn, sent these nerve fibers to the ipsilateral bronchial tree. For the trachea, the remaining sensory fibers surviving denervation might provide sufficient tachykinins to trigger neurogenic inflammation.

Postvagotomy changes in neurogenic plasma extravasation in rat bronchi

The present study was carried out to test if plasma extravasation induced by capsaicin (90 micrograms/kg) in the bronchi of Sprague-Dawley rats could be reduced 10-30 min (0 day), 20-24 h (1 day), 3, 7 or 14 days after unilateral midcervical vagotomy. The second aim of this study was to demonstrate if substance P (3 micrograms/kg) could intensify neurogenic plasma extravasation in the bronchi in which sensory innervation was partially deprived by vagotomy. In the rats 0 days after vagotomy (0 days postvagotomy) that received capsaicin, plasma extravasation in the mainstem and secondary bronchi ipsilateral to vagotomy did not decrease. Capsaicin-evoked plasma extravasation in the secondary bronchi ipsilateral to vagotomy decreased significantly 1, 3, 7 and 14 days after vagotomy as compared with that of 0 days postvagotomy. Differences in extravasation between the secondary bronchi of the two sides were usually significant in animals 3, 7 or 14 days postvagotomy. The effect of unilateral vagotomy on plasma extravasation in the mainstem bronchi was variable. Plasma extravasation produced by substance P in the mainstem and secondary bronchi of rats 0 days postvagotomy was similar to that of unoperated rats receiving either capsaicin or substance P. Unilateral vagotomy did not decrease the amount of substance-P-induced plasma extravasation in the mainstem or secondary bronchi ipsilateral to vagotomy in rat groups 1, 3, 7 or 14 days postvagotomy as compared with that of their contralateral bronchi. This study suggests that the secondary bronchi were the chief location of the bronchial tree that could be desensitized after unilateral cervical vagotomy to stimulation by the irritant capsaicin. This desensitization developed within 1 day after vagotomy, therefore the capsaicin-evoked neurogenic inflammation in the bronchi of the vagotomized side was reduced. Exogenous substance P resulted in mucosal edema and degranulation of goblet cells in the bronchi of both vagotomized and opposite sides. The number of mediator-sensitive blood venules did not decrease following vagotomy operation. It is suggested that substance P was insufficient after vagal denervation, but substance-P receptors on the endothelial cells and goblet cells in the denervated regions were still operative.