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Clavé P, Ortega O, Rofes L, Alvarez-Berdugo D, Tomsen N. Brain and Pharyngeal Responses Associated with Pharmacological Treatments for Oropharyngeal Dysphagia in Older Patients. Dysphagia 2023; 38:1449-1466. [PMID: 37145201 DOI: 10.1007/s00455-023-10578-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 04/07/2023] [Indexed: 05/06/2023]
Abstract
Impaired pharyngo-laryngeal sensory function is a critical mechanism for oropharyngeal dysphagia (OD). Discovery of the TRP family in sensory nerves opens a window for new active treatments for OD. To summarize our experience of the action mechanism and therapeutic effects of pharyngeal sensory stimulation by TRPV1, TRPA1 and TRPM8 agonists in older patients with OD. Summary of our studies on location and expression of TRP in the human oropharynx and larynx, and clinical trials with acute and after 2 weeks of treatment with TRP agonists in older patients with OD. (1) TRP receptors are widely expressed in the human oropharynx and larynx: TRPV1 was localized in epithelial cells and TRPV1, TRPA1 and TRPM8 in sensory fibers mainly below the basal lamina. (2) Older people present a decline in pharyngeal sensory function, more severe in patients with OD associated with delayed swallow response, impaired airway protection and reduced spontaneous swallowing frequency. (3) Acute stimulation with TRP agonists improved the biomechanics and neurophysiology of swallowing in older patients with OD TRPV1 = TRPA1 > TRPM8. (4) After 2 weeks of treatment, TRPV1 agonists induced cortical changes that correlated with improvements in swallowing biomechanics. TRP agonists are well tolerated and do not induce any major adverse events. TRP receptors are widely expressed in the human oropharynx and larynx with specific patterns. Acute oropharyngeal sensory stimulation with TRP agonists improved neurophysiology, biomechanics of swallow response, and safety of swallowing. Subacute stimulation promotes brain plasticity further improving swallow function in older people with OD.
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Affiliation(s)
- Pere Clavé
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Omar Ortega
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Laia Rofes
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Daniel Alvarez-Berdugo
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Noemí Tomsen
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.
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Neural signalling of gut mechanosensation in ingestive and digestive processes. Nat Rev Neurosci 2022; 23:135-156. [PMID: 34983992 DOI: 10.1038/s41583-021-00544-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 12/29/2022]
Abstract
Eating and drinking generate sequential mechanosensory signals along the digestive tract. These signals are communicated to the brain for the timely initiation and regulation of diverse ingestive and digestive processes - ranging from appetite control and tactile perception to gut motility, digestive fluid secretion and defecation - that are vital for the proper intake, breakdown and absorption of nutrients and water. Gut mechanosensation has been investigated for over a century as a common pillar of energy, fluid and gastrointestinal homeostasis, and recent discoveries of specific mechanoreceptors, contributing ion channels and the well-defined circuits underlying gut mechanosensation signalling and function have further expanded our understanding of ingestive and digestive processes at the molecular and cellular levels. In this Review, we discuss our current understanding of the generation of mechanosensory signals from the digestive periphery, the neural afferent pathways that relay these signals to the brain and the neural circuit mechanisms that control ingestive and digestive processes, focusing on the four major digestive tract parts: the oral and pharyngeal cavities, oesophagus, stomach and intestines. We also discuss the clinical implications of gut mechanosensation in ingestive and digestive disorders.
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Somatosensory innervation of the oral mucosa of adult and aging mice. Sci Rep 2018; 8:9975. [PMID: 29967482 PMCID: PMC6028454 DOI: 10.1038/s41598-018-28195-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 06/18/2018] [Indexed: 02/06/2023] Open
Abstract
Oral mechanoreception is implicated in fundamental functions including speech, food intake and swallowing; yet, the neuroanatomical substrates that encode mechanical stimuli are not well understood. Tactile perception is initiated by intricate mechanosensitive machinery involving dedicated cells and neurons. This signal transduction setup is coupled with the topology and mechanical properties of surrounding epithelium, thereby providing a sensitive and accurate system to detect stress fluctuations from the external environment. We mapped the distribution of anatomically distinct neuronal endings in mouse oral cavity using transgenic reporters, molecular markers and quantitative histomorphometry. We found that the tongue is equipped with an array of putative mechanoreceptors that express the principal mechanosensory channel Piezo2, including end bulbs of Krause innervating individual filiform papillae and a novel class of neuronal fibers innervating the epithelium surrounding taste buds. The hard palate and gums are densely populated with three classes of sensory afferents organized in discrete patterns including Merkel cell-neurite complexes, Meissner’s corpuscles and glomerular corpuscles. In aged mice, we find that palatal Merkel cells reduce in number at key time-points that correlate with impaired oral abilities, such as swallowing and mastication. Collectively, this work identifies the mechanosensory architecture of oral tissues involved in feeding.
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Moayedi Y, Duenas-Bianchi LF, Lumpkin EA. Somatosensory innervation of the oral mucosa of adult and aging mice. Sci Rep 2018. [PMID: 29967482 DOI: 10.1038/s41598‐018‐28195‐2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Oral mechanoreception is implicated in fundamental functions including speech, food intake and swallowing; yet, the neuroanatomical substrates that encode mechanical stimuli are not well understood. Tactile perception is initiated by intricate mechanosensitive machinery involving dedicated cells and neurons. This signal transduction setup is coupled with the topology and mechanical properties of surrounding epithelium, thereby providing a sensitive and accurate system to detect stress fluctuations from the external environment. We mapped the distribution of anatomically distinct neuronal endings in mouse oral cavity using transgenic reporters, molecular markers and quantitative histomorphometry. We found that the tongue is equipped with an array of putative mechanoreceptors that express the principal mechanosensory channel Piezo2, including end bulbs of Krause innervating individual filiform papillae and a novel class of neuronal fibers innervating the epithelium surrounding taste buds. The hard palate and gums are densely populated with three classes of sensory afferents organized in discrete patterns including Merkel cell-neurite complexes, Meissner's corpuscles and glomerular corpuscles. In aged mice, we find that palatal Merkel cells reduce in number at key time-points that correlate with impaired oral abilities, such as swallowing and mastication. Collectively, this work identifies the mechanosensory architecture of oral tissues involved in feeding.
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Affiliation(s)
- Yalda Moayedi
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY, 10032, USA
| | - Lucia F Duenas-Bianchi
- SPURS Biomedical Research Program, Department of Physiology and Cellular Biophysics, Columbia University Medical Center, New York, NY, 10032, USA
| | - Ellen A Lumpkin
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY, 10032, USA. .,Department of Dermatology, Columbia University, New York, NY, 10032, USA. .,Program in Neurobiology and Behavior, Columbia University, New York, NY, 10032, USA.
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Alvarez-Berdugo D, Rofes L, Casamitjana JF, Padrón A, Quer M, Clavé P. Oropharyngeal and laryngeal sensory innervation in the pathophysiology of swallowing disorders and sensory stimulation treatments. Ann N Y Acad Sci 2016; 1380:104-120. [DOI: 10.1111/nyas.13150] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/19/2016] [Accepted: 05/25/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Daniel Alvarez-Berdugo
- Gastrointestinal Motility Laboratory, Hospital de Mataró; Consorci Sanitari del Maresme; Mataró Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas; Instituto de Salud Carlos III; Barcelona Spain
| | - Laia Rofes
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas; Instituto de Salud Carlos III; Barcelona Spain
| | | | - Andreína Padrón
- Department of Pathology, Hospital de Mataró; Consorci Sanitari del Maresme; Mataró Spain
| | - Miquel Quer
- ENT and Cervicofacial Pathology Department of Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - Pere Clavé
- Gastrointestinal Motility Laboratory, Hospital de Mataró; Consorci Sanitari del Maresme; Mataró Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas; Instituto de Salud Carlos III; Barcelona Spain
- Fundació Institut de Investigació Germans Trias i Pujol; Badalona Spain
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GüÇlü B, Mahoney GK, Pawson LJ, Pack AK, Smith RL, Bolanowski SJ. Localization of Merkel cells in the monkey skin: An anatomical model. Somatosens Mot Res 2009; 25:123-38. [DOI: 10.1080/08990220802131234] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Burak GüÇlü
- Institute for Sensory Research, Syracuse, NY, USA
- Biomedical Engineering Institute, Boğaziçi University, Istanbul, Turkey
| | - Greer K. Mahoney
- Institute for Sensory Research, Syracuse, NY, USA
- Department of Biomedical & Chemical Engineering, Syracuse University, Syracuse, NY, USA
| | - Lorraine J. Pawson
- Institute for Sensory Research, Syracuse, NY, USA
- Department of Biomedical & Chemical Engineering, Syracuse University, Syracuse, NY, USA
| | - Adam K. Pack
- Institute for Sensory Research, Syracuse, NY, USA
- Department of Biology, Utica College, Utica, NY, USA
| | - Robert L. Smith
- Institute for Sensory Research, Syracuse, NY, USA
- Department of Biomedical & Chemical Engineering, Syracuse University, Syracuse, NY, USA
| | - Stanley J. Bolanowski
- Institute for Sensory Research, Syracuse, NY, USA
- Department of Biomedical & Chemical Engineering, Syracuse University, Syracuse, NY, USA
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Abstract
Efforts to quantify the public health impact of chemosensation present significant challenges, including a strong need for testing methods suitable for field assessment. This discussion highlights several promising approaches to the population-based study of taste function; it also identifies key principles that should be considered when adapting laboratory-based taste tests for field use.
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Affiliation(s)
- Derek J Snyder
- Neuroscience, Yale University, New Haven, Connecticut, USA.
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Bartoshuk LM, Duffy VB, Hayes JE, Moskowitz HR, Snyder DJ. Psychophysics of sweet and fat perception in obesity: problems, solutions and new perspectives. Philos Trans R Soc Lond B Biol Sci 2006; 361:1137-48. [PMID: 16815797 PMCID: PMC1642698 DOI: 10.1098/rstb.2006.1853] [Citation(s) in RCA: 256] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Psychophysical comparisons seem to show that obese individuals experience normal sweet and fat sensations, they like sweetness the same or less, but like fat more than the non-obese do. These psychophysical comparisons have been made using scales (visual analogue or category) that assume intensity labels (e.g. extremely) which denote the same absolute perceived intensity to all. In reality, the perceived intensities denoted by labels vary because they depend on experiences with the substances to be judged. This variation makes comparisons invalid. Valid comparisons can be made by asking the subjects to rate their sensory/hedonic experiences in contexts that are not related to the specific experiences of interest. Using this methodology, we present the evidence that the sensory and hedonic properties of sweet and fat vary with body mass index. The obese live in different orosensory and orohedonic worlds than do the non-obese; the obese experience reduced sweetness, which probably intensifies fat sensations, and the obese like both sweet and fat more than the non-obese do. Genetic variation as well as taste pathology contribute to these results. These psychophysical advances will impact experimental as well as clinical studies of obesity and other eating disorders.
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Affiliation(s)
- Linda M Bartoshuk
- Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, CT 06520-8041, USA.
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Bartoshuk LM, Duffy VB, Chapo AK, Fast K, Yiee JH, Hoffman HJ, Ko CW, Snyder DJ. From psychophysics to the clinic: missteps and advances. Food Qual Prefer 2004. [DOI: 10.1016/j.foodqual.2004.05.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Moritani M, Yoshida A, Honma S, Nagase Y, Takemura M, Shigenaga Y. Morphological differences between fast and slowly adapting lingual afferent terminations in the principal and oral nuclei in the cat. J Comp Neurol 1998; 396:64-83. [PMID: 9623888 DOI: 10.1002/(sici)1096-9861(19980622)396:1<64::aid-cne6>3.0.co;2-g] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Previous studies indicated that fast-adapting (FA) and slowly adapting (SA) mechanoreceptive afferents innervating the facial or intraoral structures give rise to morphologically distinct terminal arbors in the individual subdivisions of the trigeminal sensory nuclear complex. The present study examined the collateral morphologies of lingual afferents in the nuclei principalis (Vp) and oralis (Vo) of the cat. Seven FA and six SA lingual afferents were physiologically characterized and stained by the intra-axonal horseradish peroxidase (HRP) injection technique. The two types of afferents established terminal arbors in the dorsomedial subdivision (Vpd) of the Vp, and the rostrodorsomedial (Vo.r) and dorsomedial subdivisions (Vo.dm) of the Vo, but the collateral morphologies are different between the two types. The FA afferents gave rise to mediolaterally extended oblong arbors in each subdivision, but the arbors were better developed in the Vo.r than in the Vpd and Vo.dm. The number of collaterals, intercollateral distance, number of boutons per collateral, and bouton size were also different among the subdivisions. The SA afferents were divided into two subtypes; one had a preferential projection into the Vpd or the Vo.r and Vo.dm, and others lacked a selected projection. Although the shape of their arbors varied from a stringy form to a roundish form, the general profile was denser, better developed, and rounder than that of FA afferents in each subdivision. The intercollateral distance and bouton size were different among the subdivisions. The number of boutons per collateral, bouton density, and bouton size were larger in SA than FA afferents in each subdivision. The present study demonstrated that two functionally distinct lingual afferents manifest unique morphological differences in the Vpd and Vo.
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Affiliation(s)
- M Moritani
- Department of Oral Anatomy, Osaka University Faculty of Dentistry, Suita, Japan
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Nagai T, Delay RJ, Welton J, Roper SD. Uptake and release of neurotransmitter candidates, [3H]serotonin, [3H]glutamate, and [3H]?-aminobutyric acid, in taste buds of the mudpuppy,Necturus maculosus. J Comp Neurol 1998. [DOI: 10.1002/(sici)1096-9861(19980309)392:2<199::aid-cne4>3.0.co;2-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Abstract
Sections of tissues containing lingual and extra-lingual taste buds were evaluated with monoclonal antibodies against cytokeratins. In the caudal third of the rat's tongue, keratin 20 immunoreactivity was restricted to taste buds, whereas keratins 7, 8, 18, and 19 were expressed in vallate and foliate taste buds and in cells of salivary ducts that merge with these taste epithelia. Hence, antibodies against keratin 20 most clearly distinguished differentiated taste cells from all other cells. In rat epiglottis, taste buds and isolated bipolar cells were keratin-20-positive. In rat nasopalatine papilla and palate, antibodies against keratin 20 identified Merkel cells, none of which was near to the keratin-20-negative taste buds. Nor were Merkel cells present at epiglottal taste buds or the keratin-20-negative fungiform taste buds or elsewhere in rat tongue. Hence, Merkel cells make no contribution to rat fungiform, epiglottal, nasopalatine, or palatal taste buds. Human and rat keratin-20-positive tissues are reported to be endodermal derivatives with the exception of Merkel cells and luminal urothelial cells. In rats the distribution of keratin-20-positive taste buds was in full agreement with the classical view that the posterior third of the tongue is derived from endoderm (keratin-20-positive taste buds), whereas the anterior two-thirds of the tongue is derived from stomadeal ectoderm (keratin-20-negative taste buds). The equally intense keratin 20 immunoreactivity of human fungiform and vallate taste buds violates this traditional rostro-caudal segregation and suggests that endodermally derived tissues may be present in the tip of the human tongue.
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Affiliation(s)
- C Zhang
- Department of Biology, University of Michigan, Ann Arbor 48109, USA
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Witt M. Carbohydrate histochemistry of vertebrate taste organs. PROGRESS IN HISTOCHEMISTRY AND CYTOCHEMISTRY 1996; 30:1-168. [PMID: 8724455 DOI: 10.1016/s0079-6336(96)80006-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- M Witt
- Department of Anatomy, Technical University Dresden, Germany
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