Intra-cerebroventricular captopril reduces plasma ACTH and vasopressin responses to hemorrhagic stress

Brain angiotensin AT1 receptors as specific regulators of cardiovascular reactivity to acute psychoemotional stress

1. Cardiovascular reactivity, an abrupt rise in blood pressure (BP) and heart rate in response to psychoemotional stress, is a risk factor for heart disease. Pharmacological and molecular genetic studies suggest that brain angiotensin (Ang) II and AT(1) receptors are required for the normal expression of sympathetic cardiovascular responses to various psychological stressors. Moreover, overactivity of the brain AngII system may contribute to enhanced cardiovascular reactivity in hypertension. 2. Conversely, brain AT(1) receptors appear to be less important for the regulation of sympathetic cardiovascular responses to a range of stressors involving an immediate physiological threat (physical stressors) in animal models. 3. Apart from threatening events, appetitive stimuli can induce a distinct, central nervous system-mediated rise in BP. However, evidence indicates that brain AT(1) receptors are not essential for the regulation of cardiovascular arousal associated with positively motivated behaviour, such as anticipation and the consumption of palatable food. The role of central AT(1) receptors in regulating cardiovascular activation elicited by other types of appetitive stimuli remains to be determined. 4. Emerging evidence also indicates that brain AT(1) receptors play a limited role in the regulation of cardiovascular responses to non-emotional natural daily activities, sleep and exercise. 5. Collectively, these findings suggest that, with respect to cardiovascular arousal, central AT(1) receptors may be involved primarily in the regulation of the defence response. Therefore, these receptors could be a potential therapeutic target for selective attenuation of BP hyperreactivity to aversive stressors, without altering physiologically important cardiovascular adjustments to normal daily activities, sleep and exercise.

Angiotensin II inhibition reduces stress sensitivity of hypothalamo-pituitary-adrenal axis in spontaneously hypertensive rats

Angiotensin II type 1 (AT(1)) receptors are expressed within organs of the hypothalamo-pituitary-adrenal (HPA) axis and seem to be important for its stress responsiveness. Secretion of CRH, ACTH, and corticosterone (CORT) is increased by stimulation of AT(1) receptors. In the present study, we tested whether a blockade of the angiotensin II system attenuates the HPA axis reactivity in spontaneously hypertensive rats. Spontaneously hypertensive rats were treated with candesartan (2 mg/kg), ramipril (1 mg/kg), or mibefradil (12 mg/kg) for 5 wk. In addition to baseline levels, CORT and ACTH responses to injection of CRH (100 microg/kg) were monitored over 4 h. mRNA of CRH, proopiomelanocortin, AT(1A), AT(1B), and AT(2) receptors was quantified by real-time PCR. All treatments induced equivalent reductions of blood pressure and had no effect on baseline levels of CORT and ACTH. However, both candesartan and ramipril significantly reduced CRH-stimulated plasma levels of ACTH (-26 and -15%) and CORT (-36 and -18%) and lowered hypothalamic CRH mRNA (-25 and -29%). Mibefradil did not affect any of these parameters. Gene expression of AT(1A), AT(1B), and AT(2) receptors within the HPA axis was not altered by any drug. We show for the first time that antihypertensive treatment by inhibition of AT(1) receptors or angiotensin-converting enzyme attenuates HPA axis reactivity independently of blood pressure reduction. This action is solely evident after CRH stimulation but not under baseline conditions. Both a reduced pituitary sensitivity to CRH and a down-regulation of hypothalamic CRH expression have the potential to reduce HPA axis activity during chronic AT(1) blockade or angiotensin-converting enzyme inhibition.

A central link between angiotensinergic and cholinergic systems; role of vasopressin

Participation of central cholinergic system in the effects of intracerebroventricular (i.c.v.) injection of angiotensin II (Ang II) on blood pressure and heart rate was studied in conscious, freely moving rats. Ang II dose-dependently increased blood pressure and decreased heart rate. Both atropine and mecamylamine (i.c.v.) pretreatments prevented the cardiovascular effects of Ang II. Pretreatment with a vasopressin V1 antagonist also prevented the cardiovascular responses to Ang II. Our data suggest that the central pressor effect of Ang II is mediated in part by central acetylcholine via both muscarinic and nicotinic receptors, and vasopressin participates in this effect through V1 receptors.

Central injection of captopril inhibits the blood pressure response to intracerebroventricular choline

In the present study, we investigated the involvement of the brain renin-angiotensin system in the effects of central cholinergic stimulation on blood pressure in conscious, freely moving normotensive rats. In the first step, we determined the effects of intracerebroventricular (icv) choline (50, 100 and 150 microg) on blood pressure. Choline increased blood pressure in a dose-dependent manner. In order to investigate the effects of brain renin-angiotensin system blockade on blood pressure increase induced by choline (150 microg, icv), an angiotensin-converting enzyme inhibitor, captopril (25 and 50 microg, icv), was administered 3 min before choline. Twenty-five microg captopril did not block the pressor effect of choline, while 50 microg captopril blocked it significantly. Our results suggest that the central renin-angiotensin system may participate in the increase in blood pressure induced by icv choline in normotensive rats.

Effect of adrenocorticotrophic hormone on sodium appetite in mice

A main vector of the effects of stress is secretion of corticotrophin releasing factor (CRF), adrenocorticotrophin (ACTH), and adrenal steroids. Systemic administration of ACTH (2.8 microgram/day sc) for 7 days in BALB/c mice caused a very large increase of voluntary intake of 0.3 M NaCl equivalent to turnover of total body sodium content each day. Intracerebroventricular infusion of ACTH (20 ng/day) had no effect. Intracerebroventricular infusion of ovine CRF (10 ng/h for 7 days) caused an increase of sodium intake. The large sodium appetite-stimulating effect of systemic ACTH was not influenced by concurrent systemic infusion of captopril (2 mg/day). Induction of stress by immobilization of mice on a running wheel caused an increase in Na appetite associated with a 50% decrease of thymus weight, indicative of corticosteroid effects. The present data suggest that stress and the hormone cascade initiated by stress evoke a large sodium appetite in mice, which may be an important survival mechanism in environmental conditions causing stress.

Forebrain pathways mediating stress-induced hormone secretion

Exposure to hostile conditions initiates the secretion of several hormones, including corticosterone/cortisol, catecholamines, prolactin, oxytocin, and renin, as part of the survival mechanism. Such conditions are often referred to as "stressors" and can be divided into three categories: external conditions resulting in pain or discomfort, internal homeostatic disturbances, and learned or associative responses to the perception of impending endangerment, pain, or discomfort ("psychological stress"). The hormones released in response to stressors often are referred to as "stress hormones" and their secretion is regulated by neural circuits impinging on hypothalamic neurons that are the final output toward the pituitary gland and the kidneys. This review discusses the forebrain circuits that mediate the neuroendocrine responses to stressors and emphasizes those neuroendocrine systems that have previously received little attention as stress-sensitive hormones: renin, oxytocin, and prolactin. Anxiolytic drugs of the benzodiazepine class and other drugs that affect catecholamine, GABAA, histamine, and serotonin receptors alter the neuroendocrine stress response. The effects of these drugs are discussed in relation to their effects on forebrain neural circuits that regulate stress hormone secretion. For psychological stressors such as conditioned fear, the neural circuits mediating neuroendocrine responses involve cortical activation of the basolateral amygdala, which in turn activates the central nucleus of the amygdala. The central amygdala then activates hypothalamic neurons directly, indirectly through the bed nucleus of the stria terminalis, and/or possibly via circuits involving brainstem serotonergic and catecholaminergic neurons. The renin response to psychological stress, in contrast to those of ACTH and prolactin, is not mediated by the bed nucleus of the stria terminalis and is not suppressed by benzodiazepine anxiolytics. Stressors that challenge cardiovascular homeostasis, such as hemorrhage, trigger a pattern of neuroendocrine responses that is similar to that observed in response to psychological stressors. These neuroendocrine responses are initiated by afferent signals from cardiovascular receptors which synapse in the medulla oblongata and are relayed either directly or indirectly to hypothalamic neurons controlling ACTH, prolactin, and oxytocin release. In contrast, forebrain pathways may not be essential for the renin response to hemorrhage. Thus current evidence indicates that although a diverse group of stressors initiate similar increases in ACTH, renin, prolactin, and oxytocin, the specific neural circuits and neurotransmitter systems involved in these responses differ for each neuroendocrine system and stressor category.

Brain angiotensin II modulates sympathoadrenal and hypothalamic pituitary adrenocortical activation during stress

Angiotensin II (Ang II) type-1 (AT1) receptors are present in areas of the brain controlling autonomic nervous activity and the hypothalamic-pituitary-adrenal (HPA) axis, including CRH cells in the hypothalamic paraventricular nucleus (PVN). To determine whether brain AT1 receptors are involved in the activation of the HPA axis and sympathetic system during stress, we studied the effects of acute immobilization stress on plasma catecholamines, ACTH and corticosterone, and mRNA levels of CRH and CRH receptors (CRH-R) in the PVN in rats under central AT1 receptor blockade by the selective antagonist, Losartan. While basal levels of epinephrine, norepinephrine and dopamine in plasma were unaffected 30 min after i.c.v. injection of Losartan (10 microg), the increases after 5 and 20 min stress were blunted in Losartan treated rats (P < 0.05 for norepinephrine, and P < 0.01 for epinephrine and dopamine, vs controls). Basal or stress-stimulated plasma ACTH and corticosterone levels were unaffected by i.c.v. Losartan treatment. Using in situ hybridization studies, basal levels of CRH mRNA and CRH-R mRNA in the PVN were unchanged after i.c.v. Losartan. While Losartan had no effect on the increases in CRH-R mRNA levels 2 or 3 h after 1 h immobilization, it prevented the increases in CRH mRNA. The blunted plasma catecholamine responses after central AT1 receptor blockade indicate that endogenous Ang II in the brain is required for sympathoadrenal activation during immobilization stress. While Ang II appears not to be involved in the acute secretory response of the HPA axis, it may play a role in regulating CRH expression in the PVN.

Effects of chronic central administration of losartan on the cardiovascular and hormonal responses to hemorrhage in conscious rats

Our objective was to assess the effects of chronic central angiotensin II (Ang II) blockade on the basal regulation of blood pressure, heart rate (HR), arginine vasopressin (AVP), renin, epinephrine (EPI), norepinephrine (NE) and on cardiovascular and hormonal responses to hemorrhage in conscious rats. Losartan (4 micrograms/h), or artificial cerebrospinal fluid (aCSF), was chronically infused into a lateral ventricle by using an osmotic minipump for 6 days at a rate of 1 microliter/h. Compared with aCSF controls, chronic losartan treatment significantly decreased the basal level of blood pressure (from 117 +/- 2.3 to 106 +/- 2.2 mmHg, P < 0.01) and increased the HR (from 357 +/- 3.7 to 410 +/- 6.6 beats/min, P < 0.01). Plasma renin concentration increased 3-fold (from 6.1 +/- 0.6 to 19.2 +/- 1.6 ng.ml(-1).h(-1), P < 0.01). Basal levels of AVP, EPI and NE were not different between two groups. Blood pressure immediately after hemorrhage and its compensatory recovery following hemorrhage was not different in both groups. Immediately after hemorrhage, however, in the losartan-treated rats, the HR was distinctly lower than that of aCSF controls, even at 10 min after hemorrhage. Hemorrhage produced a significant increase in the plasma concentrations of AVP, renin, EPI and NE. Chronic losartan treatment markedly augmented the AVP, renin and EPI responses to hemorrhage. These results strongly suggest that Ang II acting through AT1 receptors in the brain plays a significant physiological role in the regulation of basal blood pressure, HR and renin release. In addition, centrally acting Ang II may be one of the important mediators for cardiovascular regulations and hormone releases in response to hemorrhage.

Increased expression of type 1 angiotensin II receptors in the hypothalamic paraventricular nucleus following stress and glucocorticoid administration

Double staining in situ hybridization studies have shown that angiotensin II (AII) type 1 receptors (AT1) in the hypothalamic paraventricular nucleus (PVN) are located primarily in corticotropin releasing hormone (CRH) neurons of the parvicellular subdivision. The purpose of these studies was to investigate the role of AII regulating the hypothalamic-pituitary adrenal (HPA) axis, by correlating AT1 receptor expression levels in the PVN with the known changes in activity of the HPA axis under different stress paradigms, and manipulation of circulating glucocorticoids. AT1 receptor mRNA was measured by in situ hybridization using 35S-labelled cRNA probes and AII binding by autoradiography using 125I[Sar1,Ile8]AII in slide mounted hypothalamic sections. AT1 receptor mRNA levels and AII binding in the PVN were reduced by about 20% 18 h after adrenalectomy remaining at these levels up to 6 days after. This effect was prevented by corticosterone administration in the drinking water, or dexamethasone injection (100 mg, s.c., daily). Conversely, dexamethasone injection in intact rats caused a 20% increase in AT1 receptor mRNA in the PVN. AT1 receptor mRNA and binding in the PVN increased 4 h after exposure to stress paradigms associated with activation of the HPA axis (immobilization for 1 h, or i.p. injection of 1.5 M NaCl), and remained elevated after repeated daily stress for 14 days. Unexpectedly, two osmotic stress models associated with inhibition of the HPA axis (60 h water deprivation or 12 days of 2% saline intake) also resulted in increased AT1 receptor mRNA levels and AII binding in the parvicellular PVN. In intact rats, the stimulatory effect of acute stress on AT1 receptor mRNA in the PVN was significantly enhanced by dexamethasone administration (100 micrograms, s.c., 14 h and 1 h prior to stress), while in adrenalectomized rats, with or without glucocorticoid replacement, stress reduced rather than increased, AT1 receptor mRNA. Dexamethasone, 100 micrograms, injected sc within 1 min the beginning of immobilization in adrenalectomized rats, increased AT1 receptor mRNA in the PVN to levels significantly higher than those after dexamethasone alone, indicating that the stress induced glucocorticoid surge is required for the stimulatory effect of stress on AT1 receptor mRNA. The data suggest that AT1 receptor expression in the PVN is under dual control during stress: stress-activated inhibitory pathways and the stimulatory effect of glucocorticoids. The lack of specificity of the changes in AT1 receptor expression in the PVN following stressors with opposite effects on ACTH secretion (osmotic and physical-psychological stress) does not support a role for AII as a major determinant of the response of the HPA axis during stress.

Brain content and plasma concentrations of arginine vasopressin in an Australian marsupial, the brushtail possum Trichosurus vulpecula

Arginine vasopressin (AVP) has been identified and quantified in the brain and plasma of the possum using a highly specific radioimmunoassay and high-performance liquid chromatography. Large amounts of AVP were found in the pituitary (16.3 +/- 0.56 micrograms/pituitary, n = 5) and hypothalamus (398 +/- 82.5 ng/hypothalamus), and significant amounts of AVP were also present in the cerebral cortex (26.8 +/- 11.5 ng/cortex). Plasma AVP concentrations were significantly lower (2.2 +/- 0.45 pg/ml, n = 10) during anesthesia compared to concentrations while conscious (4.5 +/- 1.19 pg/ml). Severe hemorrhage markedly increased plasma concentrations to 1091 +/- 225 pg/ml (n = 8). It was concluded that AVP is present in the possum brain, pituitary, and plasma, and that its secretion is stimulated by hypovolemia and inhibited by surgical stress.

Vasopressin Release Following Microinjection of Angiotensin II into the Caudal Ventrolateral Medulla Oblongata in the Anaesthetized Rabbit

Abstract Stimulation of the caudal ventrolateral medulla in rats and rabbits elicits secretion of vasopressin from the neurohypophysis. Inhibition of the area attenuates baroreceptor-initiated vasopressin secretion. Angiotensin II receptor binding sites and angiotensin-like immunoreactive nerve terminals are localized in the caudal ventrolateral medulla, in the region of the A1 noradrenaline-synthesizing neurons. To examine the possible functional role of angiotensin II in this region, we have microinjected angiotensin II into the A1 area in the urethane-anaesthetized rabbit. Microinjection of angiotensin II (0.1 to 100 pmol in 100 nl) stimulated vasopressin secretion (plasma vasopressin concentration increased from 24 +/- 8 pg/ml to 104 +/- 8 pg/ml following microinjection of 10 pmol angiotensin II) and produced a depressor response with bradycardia. The responsive area was confined to the region of the A1 cell group. AII responses were blocked by prior intramedullary injection of an angiotensin II receptor antagonist, [Sar(1), Thr(8)] angiotensin II (2 nmol in 200 nl), which had no effect on the response to the excitatory amino-acid N-methyl-D-aspartate. Following spinal blockade of efferent sympathetic activity, microinjections of angiotensin II into the caudal ventrolateral medulla caused a similar increase in plasma vasopressin concentration without a depressor response, demonstrating that the stimulation of vasopressin release by angiotensin II was not secondary to hypotension. Microinjection of [Sar(1), Thr(8)] angiotensin II dramatically attenuated the normal secretion of vasopressin in response to systemic haemorrhage. Following injection of vehicle into the caudal ventrolateral medulla, haemorrhage stimulated an increase in plasma vasopressin concentration from 3 +/- 1 pg/ml to 335 +/- 75 pg/ ml (n = 5). After microinjection of [Sar(1), Thr(8)] angiotensin II the haemorrhage-induced change in vasopressin concentration was only 17 +/- 6 pg/ml to 35 +/- 7 pg/ml (n = 4). Microinjection of the N-methyl-D-aspartate receptor antagonist, DL-amino-5-phosphonovaleric acid (5 nmol, n = 4), did not alter the secretion of vasopressin in response to haemorrhage. These results in the anaesthetized rabbit suggest that angiotensin II in the caudal ventrolateral medulla may have a physiological role in baroreceptor control of vasopressin release.

Role of central angiotensinergic mechanism in shaking stress-induced ACTH and catecholamine secretion

The role of central angiotensin II (AII) in the shaking stress-induced adrenocorticotropic hormone (ACTH), plasma catecholamine secretion and pressor response were investigated using conscious rats. We also studied whether or not vasopressin (VP) is involved in the shaking stress-induced pressor response. The shaking stress caused significant elevations in plasma ACTH, catecholamine, and systolic blood pressure. Intra-third ventricular administration of the AII antagonist, Sar1, Ile8-angiotensin II (saralasin) significantly attenuated pressor response and plasma noradrenaline elevation but not plasma ACTH elevation. Pretreatment with the vascular-type VP receptor (V1) antagonist, d(CH2)5Tyr(Me)AVP, did not attenuate pressor response nor plasma catecholamine elevation. These results indicate that the central angiotensinergic pathway at least partly mediates the shaking stress-induced activation of the sympathetic nervous system without VP involvement, and that central AII does not mediate the ACTH secretion evoked by shaking stress.

Neuroendocrine responses to emotional stress: possible interactions between circulating factors and anterior pituitary hormone release

We have shown that a psychological stressor can elicit increases in plasma AVP levels in normal human subjects. Since AVP can enhance the release of ACTH, and the pituitary gland is outside the blood-brain barrier, AVP present in the general circulation might extend the time course of stress-induced, CRF-mediated release of ACTH from the anterior lobe. Since PRA is involved in the synthesis of angiotensin I, the precursor of AII, and AII is known to enhance CRF-mediated release of ACTH from pituitary cells and to stimulate release of AVP, it is possible that the increase in PRA also contributed to the release of AVP and ACTH in this study. Reports differ as to whether circulating catecholamines can release ACTH in vivo by direct action on the pituitary. Finally, it has been reported that beta-EP enhances the release of PRL, and inhibits release of AVP. Since the increase in beta-EP in the present study was quite robust, it might have extended the PRL release, and truncated the AVP response.

Stress and the pituitary-adrenal axis

The hypothalamo-pituitary-adrenal axis is controlled by complex regulatory mechanisms. Numerous factors such as CRF, vasopressin, oxytocin, angiotensin II and conceivably other hormones--all controlled by various substances acting on central locations--stimulate the release of the stress hormone ACTH. On the other hand, glucocorticoids inhibit the secretion of ACTH by acting at the hypothalamic and/or pituitary level. The release of ACTH is therefore the final outcome of the interactions between the hypothalamus, the adrenal gland and possibly other organs. The multimolecular nature of the factors responsible for the control of the pituitary-adrenal axis is an attractive hypothesis because of the great variety of stress stimuli. The various factors could have specific roles in various stress situations. They provide a highly sensitive mechanism regulating very finely the stress hormone in response to a whole variety of endogenous and exogenous stimuli. Depending on the type of stress, they may therefore singly or in combination affect the amount and duration of ACTH and steroid secretion. The released glucocorticoids may then produce their numerous effects on inflammatory and immunological processes, carbohydrate metabolism, shock and water balance. It has been postulated that these effects may be important in order to prevent host responses from over-reacting to stress and threatening homeostasis. However, proof of the necessity of the glucocorticoid hypersecretion in response to stress remains elusive.

The effects of stress on salt and water balance

The effect of 'stress' on salt and water balance is largely determined by intrinsic renal factors supported by a series of inter-related neuro-humoral mechanisms which serve to enhance salt and water reabsorption and to maintain arterial pressure. As shown by acute hypovolaemic stress, the hormone response is characterized by increased renin-angiotensin production and associated hyperaldosteronism, which is further augmented by states of Na+ depletion. As well as increasing aldosterone secretion, angiotensin II has a direct renal effect to increase Na+ retention, and may stimulate both thirst and arginine vasopressin secretion. Additional support to volume homeostasis is provided by increased secretion of hypothalamic hormones (arginine vasopressin and corticotrophin releasing factor) and activation of the sympathetic nervous system, which further enhances renin secretion. These mechanisms, in restoring extracellular fluid volume and renal perfusion pressure, eventually diminish the stimuli to renin once normovolaemia is achieved. A variety of other acute 'stressors', not associated with major changes in ECF volume or hypotension, also stimulate adrenocortical hormones (cortisol and aldosterone), renin and arginine vasopressin. The biological significance of these changes is uncertain, but their brief duration make it unlikely that the responses contribute significantly to changes in salt or water balance. Atrial peptide hormones could also be important in ECF volume regulation. However, recent studies show little if any change in basal plasma atrial natriuretic peptide levels during acute hypovolaemic stress, whereas severe treadmill exercise (but not surgical stress or acute hypoglycaemia) stimulates venous levels in man. The relevance of these findings to the regulation of salt and water balance during stress clearly requires further study.

Stress-induced activation of the sympathetic nervous system

Discrepancies between perceptions of internal or external circumstances and innate or acquired expectations lead to patterned stress responses involving several homeostatic systems, of which the sympathoadrenomedullary system (SAMS) is one. Severe, generalized threats such as hypoglycaemia, hypoxia, haemorrhage, circulatory collapse, and fight/flight situations elicit generalized SAMS activation, including cardiac stimulation, splanchnic, cutaneous, and renal vasoconstriction, and usually preserved skeletal muscle blood flow. Patterned sympathetic neural responses, resulting in redistribution of blood volume or changes in glandular activity, occur during orthostasis, exercise, altered environmental temperature, the postprandial state, and performance of attention-requiring tasks. In all these situations, SAMS activity is co-ordinated with that of the parasympathetic nervous system, the pituitary-adrenocortical system, and probably several neuropeptide systems. Although acute stress-induced SAMS activation can be a health hazard, the role of chronically repeated, stress-induced SAMS activation in the development of cardiovascular disease remains unclear. Benzodiazepines, beta-adrenoceptor blockers, and alpha 2-adrenoceptor agonists can attenuate effects of stress-induced SAMS activation, but pressor responses often are maintained.