Presynaptic control of noradrenaline release from sympathetic nerves in human dental pulp

Presynaptic Adrenoceptors

Presynaptic α2-adrenoceptors are localized on axon terminals of many noradrenergic and non-noradrenergic neurons in the peripheral and central nervous systems. Their activation by exogenous agonists leads to inhibition of the exocytotic release of noradrenaline and other transmitters from the neurons. Most often, the α2A-receptor subtype is involved in this inhibition. The chain of molecular events between receptor occupation and inhibition of the exocytotic release of transmitters has been determined. Physiologically released endogenous noradrenaline elicits retrograde autoinhibition of its own release. Some clonidine-like α2-receptor agonists have been used to treat hypertension. Dexmedetomidine is used for prolonged sedation in the intensive care; It also has a strong analgesic effect. The α2-receptor antagonist mirtazapine increases the noradrenaline concentration in the synaptic cleft by interrupting physiological autoinhibion of release. It belongs to the most effective antidepressive drugs. β2-Adrenoceptors are also localized on axon terminals in the peripheral and central nervous systems. Their activation leads to enhanced transmitter release, however, they are not activated by endogenous adrenaline.

Human presynaptic receptors

Presynaptic receptors are sites at which transmitters, locally formed mediators or hormones inhibit or facilitate the release of a given transmitter from its axon terminals. The interest in the identification of presynaptic receptors has faded in recent years and it may therefore be justified to give an overview of their occurrence in the autonomic and central nervous system; this review will focus on presynaptic receptors in human tissues. Autoreceptors are presynaptic receptors at which a given transmitter restrains its further release, though in some instances may also increase its release. Inhibitory autoreceptors represent a typical example of a negative feedback; they are tonically activated by the respective endogenous transmitter and/or are constitutively active. Autoreceptors also play a role under pathophysiological conditions, e.g. by limiting the massive noradrenaline release occurring during congestive heart failure. They can be used for therapeutic purposes; e.g., the α₂-adrenoceptor antagonist mirtazapine is used as an antidepressant and the inverse histamine H₃ receptor agonist pitolisant has been marketed as a new drug for the treatment of narcolepsy in 2016. Heteroreceptors are presynaptic receptors at which transmitters from adjacent neurons, locally formed mediators (e.g. endocannabinoids) or hormones (e.g. adrenaline) can inhibit or facilitate transmitter release; they may be subject to an endogenous tone. The constipating effect of the sympathetic nervous system or of the antihypertensive drug clonidine is related to the activation of inhibitory α₂-adrenoceptors on postganglionic parasympathetic neurons. Part of the stimulating effect of adrenaline on the sympathetic nervous system during stress is related to its facilitatory effect on noradrenaline release via β₂-adrenoceptors.

GABA heteroreceptors modulate noradrenaline release in human dental pulp

γ-aminobutyric-acid-containing neurons and GABA(B) receptors have been identified in human dental pulp; however, their significance in pulpal physiology is unclear. The purpose of this study was to determine whether pre-synaptic GABAergic heteroreceptors influence the release of noradrenaline (NA). Segments of vital pulp were incubated in [(3)H]NA (0.6 μM) and superfused with Krebs solution. GABA, a GABA(B) receptor agonist (baclofen), GABA(A and B) receptor antagonists [bicuculline and (+)-(S)-5, 5-dimethylmorpholinyl-2-acetic acid (Sch 50911), respectively], and a GABA(A) receptor-mediated Cl(-) channel inhibitor (picrotoxin) were added to the superfusion medium at least 10 min prior to the second period of stimulation (S2). Sympathetic nerves were stimulated electrically after 70 (S1) and 115 (S2) min. We determined the effects of agonists/antagonists by comparing the overflow of [(3)H]NA at S2 with that at S1 in the presence and absence of the compound. Baclofen (3 µM) inhibited the release of [(3)H]NA (IC50 = 2 µM), an action reversed by Sch 50911 (10 µM). GABA (100 µM) inhibited the release of [(3)H]NA (IC50 = 75 µM), an effect reversed by Sch 50911 (10 µM) but not by bicuculline (10 µM). However, picrotoxin (100 µM) prevented the inhibitory action of GABA. GABA(B) and GABA(A) heteroceptors mediate the release of NA from sympathetic nerves in human dental pulp in vitro.

Uptake and release of [(3)H]GABA in human dental pulp

The purpose of this study was to determine whether (a) an uptake system for gamma-aminobutyric acid (GABA) exists in human dental pulp, (b) GABA can be released from nerves in this tissue, and (c) GABA(B) autoreceptors modulate release of this transmitter. Segments of vital pulp were incubated in [(3)H]GABA (0.1-10 microM) for up to 120 min, washed, and the retained [(3)H] extracted and assayed. Some tissues were treated with GABA uptake inhibitors (nipecotic acid or NO-711) prior to incubation. At concentrations of 0.1 and 1.0 microM the uptake of [(3)H]GABA was saturated after 90 min of incubation. At 10 microM, at least two uptake compartments were apparent, and the amount of [(3)H]GABA retained was five-fold greater than 0.1 microM. The uptake inhibitors reduced [(3)H]GABA accumulation by more than 80%. In the release study, pulp was incubated in [(3)H]GABA (0.5 microM) for 90 min, and superfused with Krebs solution containing NO-711 (5 microM). Electrical stimulation increased the overflow of [(3)H]; a GABA(B) autoreceptor agonist (baclofen) inhibited, whilst an antagonist, Sch 50911, enhanced this release. The effects of baclofen were reversed by Sch 50911. These results imply that GABA can be taken up and bound firmly in compartments within human dental pulp, GABA can be released from isolated pulp segments by electrical stimulation, and this release is modulated by GABA(B) autoreceptors.

Ovarian Hormones and Migraine Headache: Understanding Mechanisms and Pathogenesis-Part I

Ovarian hormones have a significant effect on the central nervous system of female migraineurs. Reproductive milestones such as menarche, pregnancy, and menopause are associated with changes in the clinical course of migraine headache. Migraine attacks are commonly triggered during declines in serum estrogen levels that occur before and during the time of menstruation. Therefore, substantial clinical evidence suggests that changes in ovarian hormones affect migraine headache. This represents the first of two manuscripts defining the role of ovarian hormones in the pathogenesis of migraine headache. The purpose of the first article will be to review the molecular and neurophysiologic effects of estrogen and progesterone on neurotransmitter systems and pain processing networks relevant to migraine headache. The second manuscript will focus on the clinical studies detailing the influence of estrogen and progesterone on migraine headache.

Uptake and release of [3H]adenosine in human dental pulp

The purpose of this study was to examine the uptake and release of adenosine in human dental pulp. Pulp was removed from extracted teeth and incubated in [3H]adenosine (0.02-3.2 micromol/l) for 30-90 min, washed for 30 min and the residual [3H]adenosine extracted and assayed. At 0.02 and 0.4 micromol/l the uptake was saturated after 30 min, whereas at 3.2 micromol/l it was not, even after 90 min. Destruction of the sympathetic nerves by 6-hydroxydopamine prior to incubation in [3H]adenosine (0.4 micromol/l) decreased the uptake of [3H] by 40%. Addition of S(4-nitrobenzyl)-6-thioguanosine (NBTG; 0.1 micromol/l), an inhibitor of adenosine uptake, blocked 90% of the uptake. Electrical stimulation of sympathetic nerves following incubation of pulp in [3H]adenosine (0.4 micromol/l) increased the overflow of [3H] into the medium superfusing the tissue segments. NBTG (0.1 micromol/l) had no effect on this overflow, whereas denervation with 6-hydroxydopamine prior to incubation decreased the overflow by 85%. Although the contribution of post-junctional elements, such as smooth muscle, to this release was not determined it is proposed that most of the purine released was derived from sympathetic nerves.

Failure of presynaptic purinoceptors to modulate noradrenaline release from sympathetic nerves in human dental pulp

The effects of putative presynaptic P1- and/or P2-purinoceptors on the release of noradrenaline from sympathetic nerves in human dental pulp were examined by testing the effects of agonists and an antagonist of these receptors on the stimulation-induced overflow of [(3)H]noradrenaline from tissue treated with desipramine (0.3 micromol/l) and preincubated with [(3)H]noradrenaline (0.6 micromol/l). The P1-purinoceptor agonists adenosine (1.0 mmol/l) and 2-chloroadenosine (0.01-1.0 mmol/l) and the antagonist 8-cyclopentyl-1,3-dipropyl xanthine (1.0 micromol/l), and the P2-purinoceptor agonists ATP (0.1 mmol/l) and beta, gamma-methylene-ATP (0.01 mmol/l), did not modulate the release of noradrenaline. Adenosine was also without effect in dental pulp treated with the alpha(2)-adrenoceptor antagonist rauwolscine. It is concluded that presynaptic P1-purinoceptors and those P2-purinoceptors activated by adenine nucleotides are either not present on sympathetic nerves in human dental pulp or that they exert little or no effect on the release of noradrenaline.

Inhibitory effects of adrenaline on the release of noradrenaline from sympathetic nerves in human dental pulp

The effects of adrenaline on the release of noradrenaline from sympathetic nerves in human dental pulp in vitro were examined. Sympathetic nerves were stimulated at 5 Hz for 100 sec following incubation of pulp with [3H]noradrenaline (0.6 micromol/l). In the presence of desipramine (DMI, 0.3 micromol/l), adrenaline (0.1 and 1.0 micromol/l) inhibited the release of [3H]noradrenaline, an effect which was inhibited by the alpha2-adrenoceptor antagonist rauwolscine (0.1 micromol/l) and by the alpha2-adrenoceptor agonist UK 14,304 (0.1 micromol/l). The release of [3H]noradrenaline was unaffected by adrenaline (0.001 and 0.01 micromol/l) in the presence of DMI and DMI plus rauwolscine. Although presynaptic inhibitory alpha2- and facilitatory beta-adrenoceptors are present on sympathetic nerves in human dental pulp, these results imply that adrenaline activates only the inhibitory alpha2-receptors.

Modulation by presynaptic beta-adrenoceptors of noradrenaline release from sympathetic nerves in human dental pulp

This study was undertaken to test for the presence of presynaptic beta-adrenoceptors on sympathetic nerves in human dental pulp and, if present, to investigate the subtype. Pulp was excised from freshly extracted teeth, incubated with [3H]-noradrenaline (0.6 micromol/l) and subsequently superfused with Krebs solution. Sympathetic nerves were stimulated at 5 Hz for 100 sec. The non-specific beta-adrenoceptor agonist isoprenaline (1.0 micromol/l), and the selective beta2-agonist salbutamol (10 micromol/l) facilitated the release of [3H]-noradrenaline; isoprenaline, but not salbutamol, also facilitated this release in the presence of desipramine (DMI, 0.3 micromol/l), corticosterone (10 micromol/l) and rauwolscine (0.1 micromol/l). BRL 37344 (1.0 micromol/l), a beta3-agonist, had no effect on [3H]-noradrenaline release. The facilitatory effects of isoprenaline and salbutamol were inhibited by the non-specific beta-antagonist propranolol (1.0 micromol/l), while that of salbutamol was inhibited in the presence of ICI-188,551 (1.0 micromol/l), a selective beta2-antagonist, as well. The beta1-antagonist atenolol (1.0 micromol/l) potentiated the facilitatory effects of isoprenaline in the presence of DMI and corticosterone. Neither propranolol nor ICI-188,551 alone affected the release of [3H]-noradrenaline. These results establish the presence of presynaptic beta-adrenoceptors on sympathetic nerves in human dental pulp. It is suggested that they are of the beta2-subtype, although a greater range of agonists and antagonists needs to be used to clarify the nature of the the beta-adrenoceptors.

Evidence for presynaptic cholinergic receptors in sympathetic nerves in human dental pulp

The purpose of this study was to determine whether presynaptic cholinergic receptors are present in sympathetic nerves in human dental pulp. Pulp was incubated with [3H]noradrenaline (0.6 mumol/l) for 30 min and then superfused with Krebs' solution at 1.0 ml/min. Electrical stimulation (100 sec, 5 Hz) increased the overflow of [3H]noradrenaline into the superfusate. Carbachol (10 and 100 mumol/l), an agonist of muscarinic receptors, decreased the stimulation-induced (SI) overflow of 3H, an effect blocked by atropine but not hexamethonium. Carbachol, atropine and hexamethonium had no effect on the resting overflow. Nicotine (10 mumol/l) increased the resting overflow and inhibited the SI overflow, although the inhibition was variable. Cytisine, another agonist of nicotinic receptors, also increased the resting overflow, but did not affect the SI overflow. To ascertain whether the actions of nicotine and electrical stimulation were influenced by the release of nitric oxide (NO), the effects of an NO donor and two NO-synthase inhibitors were examined. With the exception of one of the NO-synthase inhibitors (L-NAME), the agents were without effect on the overflow of 3H in the absence or presence of nicotine. It was concluded that sympathetic nerves in human dental pulp possess (a) presynaptic muscarinic receptors that inhibit the SI release of noradrenaline, and (b) nicotinic receptors that evoke the release of noradrenaline and that inhibit the SI release of the transmitter. The results do not point to a significant role for NO in the effects of stimulation or nicotine on the overflow of 3H.

Metabolism of [3H]-noradrenaline in human dental pulp in vitro

Slices of pulp from human maxillary and mandibular molar and promolar teeth were incubated with [3H]-noradrenaline (0.2 mumol/l) for 30 min after which the [3H]-noradrenaline and [3H]-metabolites in the tissue and medium were assayed by column chromatography. The deaminated metabolites 3,4-dihydroxy phenyl glycol (DOPEG) and 3,4-dihydroxy mandelic acid (DOMA) constituted 81% of the metabolites formed. Cocaine, an inhibitor of uptake1, decreased the formation of DOPEG and DOMA as well as the accumulation of [3H]-noradrenaline. In contrast to findings in rabbit pulp, when the disposition of exogenous noradrenaline in human pulp was examined by monoamine fluorescence histochemistry there was no evidence of extraneuronal accumulation of noradrenaline by connective tissue cells. In further experiments, pulp that had been incubated in [3H]-noradrenaline (0.6 mumol/l) for 30 min and superfused for 200 min contained [3H]-noradrenaline (183 pmol/g) and [3H]-DOMA (89 pmol/g). The 3H that overflowed into the perfusate between 85 and 90 min consisted mainly of metabolites. Stimulation of the sympathetic nerves through field electrodes increased the overflow of [3H]-noradrenaline into the perfusate threefold without affecting the overflow of metabolites. The increase was much greater (eightfold) in the presence of an alpha-adrenoceptor antagonist (rauwolscine; 0.1 mumol/l), plus inhibitors of uptake1 (desipramine; 0.3 mumol/l) and uptake 2 (corticosterone; 10 mumol/l). The results are interpreted as evidence that in human dental pulp the disposition of exogenous noradrenaline is determined largely by uptake by sympathetic nerves. After uptake, noradrenaline is deaminated by intraneuronal monoamine oxidase to DOPEG and DOMA.(ABSTRACT TRUNCATED AT 250 WORDS)