Development of pulmonary reflexes and pattern of breathing in Virginia opossum

Respiratory characteristics of the tammar wallaby pouch young and functional limitations in a newborn with skin gas exchange

A short gestation, low birth weight and presence of cutaneous exchange of O₂ and CO₂ comprise altricial features of newborn marsupials and that collectively implies a highly immature respiratory system. In the present study, we investigated various respiratory characteristics of the neonatal/postnatal tammar wallaby, a species of marsupial in which > 30% of the newborn's total O₂ demands are supported by cutaneous rather than pulmonary gas exchange. The ventilatory response (HVR) to acute hypoxia (10% inspired O₂) was absent in the newborn (1 day old) pouch young; a hypoxic hypometabolism contributed entirely to the hyperventilation (increased pulmonary convection requirement). A high (compared to older animals) resting metabolic cost to breathe and an inefficient respiratory system suggest the lack of a HVR might be due to an energetic constraint that impinges on their ability to sustain an increase in ventilation. The latter was supported by the inability of the newborn to tolerate metabolic-ventilatory stimulation following administration of the metabolic uncoupler, 2,4-dinitrophenol (2,4-DNP). At 1 week of age, the cost of breathing was reduced, which coincided with the expression of a significant ventilatory response to hypoxia, a more energetically efficient respiratory system, and tolerance to 2,4-DNP. These data suggest this species of marsupial is born with major respiratory insufficiency, and that their pronounced dependence on the skin for metabolic gas exchange is of critical importance for survival.

Phase contrast imaging reveals low lung volumes and surface areas in the developing marsupial

Marsupials are born with immature lungs when compared to eutherian mammals and rely, to various extents, on cutaneous gas exchange in order to meet metabolic requirements. Indeed, the fat-tailed dunnart is born with lungs in the canalicular stage of development and relies almost entirely on the skin for gas exchange at birth; consequently undergoing the majority of lung development in air. Plane radiographs and computed tomography data sets were acquired using phase contrast imaging with a synchrotron radiation source for two marsupial species, the fat-tailed dunnart and the larger tammar wallaby, during the first weeks of postnatal life. Phase contrast imaging revealed that only two lung sacs contain air after the first hour of life in the fat-tailed dunnart. While the lung of the tammar wallaby was comparatively more developed, both species demonstrated massive increases in air sac number and architectural complexity during the postnatal period. In addition, both the tammar wallaby and fat-tailed dunnart had lower lung volumes and parenchymal surface areas than were expected from morphometrically determined allometric equations relating these variables to body mass during the neonatal period. However, lung volume is predicted to scale with mass as expected after the neonatal marsupial reaches a body mass of ∼1 g and no longer relies on the skin for gas exchange. Decreased lung volume in the marsupial neonate further supports the maxim that cutaneous gas exchange occurs in the marsupial neonate because the respiratory apparatus is not yet capable of meeting the gas exchange requirements of the newborn.

The ventilatory response to hypoxia and hypercapnia is absent in the neonatal fat-tailed dunnart

At birth, the newborn fat-tailed dunnart relies on cutaneous gas exchange to meet metabolic demands, with continuous lung ventilation emerging several days later. We hypothesized that the delayed expression of lung ventilation (VE) in these animals is in part owing to a low responsiveness of the respiratory control system to blood gas perturbations. To address this hypothesis we assessed the ventilatory and metabolic response to hypoxia (10% O2) and hypercapnia (5% CO2) using closed-system respirometry from birth to 23 days postpartum (P). Neonatal fat-tailed dunnarts displayed no significant hypoxic or hypercapnic ventilatory responses at any age. Regardless, significant hyperventilation through a suppression of metabolic rate (Vo2) was observed at birth in response to hypercapnia and in response to hypoxia at all ages, except P12. Therefore, reliance on cutaneous gas exchange during early life may be partially attributed to reduced chemosensitivity or a lack of central integration of chemosensitive afferent information. This may be in part due to the relative immaturity of this species at birth, compared to other mammals.

Structural and functional development of the respiratory system in a newborn marsupial with cutaneous gas exchange

Marsupials are born with structurally immature lungs and rely, to varying degrees, on cutaneous gas exchange. With a gestation of 13 d and a birth weight of 13 mg, the fat-tailed dunnart (Sminthopsis crassicaudata) is one of the smallest and most immature marsupial newborns. We determined that the skin is almost solely responsible for gas exchange in the early neonatal period. Indeed, fewer than 35% of newborn dunnarts were observed to make any respiratory effort on the day of birth, with pulmonary ventilation alone not meeting the demand for oxygen until approximately 35 d postpartum. Despite the lack of pulmonary ventilation, the phrenic nerve had made contact with the diaphragm, and the respiratory epithelium was sufficiently developed to support gas exchange on the day of birth. Both type I and type II (surfactant-producing) alveolar epithelial cells were present, with fewer than 7% of the cells resembling undifferentiated alveolar epithelial precursor cells. The type I epithelial cells did, however, display thickened cytoplasmic extensions, leading to a high diffusion distance for oxygen. In addition, the architecture of the lung was immature, resembling the early canalicular stage, with alveolarization not commencing until 45 d postpartum. The pulmonary vasculature was also immature, with a centrally positioned single-capillary layer not evident until 100 d postbirth. These structural limitations may impede efficient pulmonary gas exchange, forcing the neonatal fat-tailed dunnart to rely predominately on its skin, a phenomenon supported by a low metabolic rate and small size.

Arrest of 5HT neuron differentiation delays respiratory maturation and impairs neonatal homeostatic responses to environmental challenges

Serotonin (5HT) is a powerful modulator of respiratory circuitry in vitro but its role in the development of breathing behavior in vivo is poorly understood. Here we show, using 5HT neuron-deficient Pet-1 (Pet-1(-/-)) neonates, that serotonergic function is required for the normal timing of postnatal respiratory maturation. Plethysmographic recordings reveal that Pet-1(-/-) mice are born with a depressed breathing frequency and a higher incidence of spontaneous and prolonged respiratory pauses relative to wild type littermates. The wild type breathing pattern stabilizes by postnatal day 4.5, while breathing remains depressed, highly irregular and interrupted more frequently by respiratory pauses in Pet-1(-/-) mice. Analysis of in vitro hypoglossal nerve discharge indicates that instabilities in the central respiratory rhythm generator contribute to the abnormal Pet-1(-/-) breathing behavior. In addition, the breathing pattern in Pet-1(-/-) neonates is susceptible to environmental conditions, and can be further destabilized by brief exposure to hypoxia. By postnatal day 9.5, however, breathing frequency in Pet-1(-/-) animals is only slightly depressed compared to wild type, and prolonged respiratory pauses are rare, indicating that the abnormalities seen earlier in the Pet-1(-/-) mice are transient. Our findings provide unexpected insight into the development of breathing behavior by demonstrating that defects in 5HT neuron development can extend and exacerbate the period of breathing instability that occurs immediately after birth during which respiratory homeostasis is vulnerable to environmental challenges.

Development of the respiratory system in marsupials

Marsupials at birth are small and relatively undeveloped. At birth, the lung in some species is at the canalicular stage of development and though lung diffusion and metabolic rate are strongly correlated, the allometric exponent suggests that smaller newborns have relatively smaller diffusing capacity with respect to their demand for oxygen. Without improvement in functional or structural parameters newborn marsupials are reliant to varying degrees on skin gas exchange to compensate for the immaturity of the lung. Indeed, in some species there is complete reliance on the skin for gas exchange at birth. Nevertheless, with an early dependence on ventilation, the CNS would appear already to contain neurons with properties and connections that permit rhythmic motor output at birth and pulmonary reflexes mature soon after. Despite appropriate neural control and the presence of surfactant, the highly compliant nature of the newborn chest wall results in substantial chest wall distortion during inspiratory effort which reduce the efficacy of the lung for ventilation. This review explores the morpho-functional development of the respiratory system, including oxygen transport and cardiac shunts, and the establishment of convective requirement in marsupials, a group that places emphasis on extended postnatal development.

Upper airways and neonatal respiration

The upper airways exert an important influence on breathing from the fetal period onward. This review focuses on recent results obtained in the newborn, particularly on laryngeal function in the lamb. Cumulated data can be summarized as follows. Firstly, upper airway closure, either at the pharyngeal or laryngeal level, is now known to occur during central apneas. By maintaining a high apneic lung volume throughout central apneas, active laryngeal closure decreases the magnitude of post-apneic desaturation. Secondly, reflexes originating from laryngeal mucosal receptors, such as laryngeal chemoreflexes and non-nutritive swallowing, are of crucial importance within the context of preterm birth, postnatal maturation, neonatal apneas and apparent life-threatening events/sudden infant death syndrome. While laryngeal chemoreflexes appear to be mature and confer an efficient protection against aspiration in the full-term healthy newborn, they can be responsible for prolonged apneas and bradycardias in the immature preterm newborn. In regard to non-nutritive swallowing, the absence of swallowing activity during apneas in periodic breathing during quiet sleep as well as the presence of bursts of swallows with apneas in active sleep remain to be explained. Forthcoming studies will have to further delineate the impact of common clinical conditions, such as cigarette smoke exposure and/or viral respiratory infection on laryngeal chemoreflexes and non-nutritive swallowing. Better knowledge on the importance of the upper airways in neonatal respiration will ultimately aid in designing clinical applications for the understanding and treatment of severe, pathological respiratory conditions of the newborn.

Development of mechanics and pulmonary reflexes

The mechanical properties of the respiratory system are paramount in converting neural output into ventilation. The highly compliant chest wall of the newborn results in chest distortion and volume loss during inspiration and, as the chest is also unable to resist the inward recoil of the lung, there is a reduction in lung volume at end expiration (functional residual capacity) and a tendency for alveoli to collapse. Vagal innervation of the lungs and airways is responsible for eliciting various reflexes that result in the dynamic modification of respiratory mechanics and an improvement in ventilation. From the first breath, the newborn increases the frequency of augmented breaths to improve lung compliance and prolongs the expiratory time constant in order to increase the amount of air remaining in the lung at end expiration and help prevent lung collapse. This review examines the respiratory mechanics of the mammalian neonate at birth and during early development together with the vagal reflexes that are responsible for the dynamic modification of respiratory mechanics in order to ensure that effective gas exchange occurs from birth.

Hypothermia and hypoxia inhibit the Hering-Breüer reflex in the marsupial newborn

The effects of lowering body temperature (Tb) on metabolic rate, ventilation, and the strength of the Hering-Breüer expiratory promoting reflex (HB reflex; determined from an inhibitory ratio calculated from volumetric measurements of the respiratory rhythm) were examined in 18-day-old ectothermic pouch young of the tammar wallaby during normoxia or hypoxia (10% O2). Hypoxia and hypothermia, either singularly or combined, depressed metabolic rate. At all Tb, the hypoxic hyperventilation was associated with a significant hyperpnea. At pouch Tb (36.5°C) during normoxia, inflation of the lungs with -5 or -10 cmH2O extrathoracic pressure induced a significant HB reflex. Exposure to cold reduced the strength of the reflex, almost abolishing it at 28°C. For Tb above 28°C, the reflex in hypoxia was always less than the corresponding normoxic value. Taken in context with the changes in metabolic state that occurred, these data in the ectothermic marsupial newborn suggest that the decline in the HB reflex during moderate hypothermia is the result of a direct effect of Tb on vagal mechanisms rather than a temperature-driven decline in metabolic rate that should have acted to strengthen the HB reflex. Therefore, it seems that inputs inhibitory to breathing are more negatively affected during cold than those inputs that are excitatory.

The Larynx and Neonatal Apneas

OBJECTIVE: We sought to review the current literature on the role of the larynx in neonatal apneas. STUDY DESIGN: We conducted a literature search and analysis of the published and other available information on the topic.

RESULTS: Publications on this topic in otolaryngology journals are rare, although more basic sciences-oriented journals have published interesting results from animal studies during the past 20 years. The scarce data on human neonates are also presented.

CONCLUSIONS: The authors follow the phylogenetic and oncogenetic pathways to explain the active role of the larynx in neonatal apneas. Although most of these results are derived from animal studies, they certainly improve our understanding of human neonatal apneas.

Convection requirement is established by total metabolic rate in the newborn tammar wallaby

Ventilation (VE) and metabolic rate, determined from both pulmonary and cutaneous gas exchange, were measured in 39 newborn tammar wallabies, Macropus eugenii, aged between 0 and 3 days. In 1-day-old animals both total metabolic rate (skin+lung exchange) and ventilation were approximately 50% of the values predicted for eutherian newborns of equivalent body mass. Hence, the convection requirement (VE/total metabolic rate) of the newborn tammar is close to predicted values for newborns and adult mammals in general. Metabolic rate in the newborn tammar is supported to some extent by cutaneous gas exchange, approximately 30% of the total in the 1-day-old animal. This ratio diminishes with increasing age as the lung takes on an increasingly more important role for respiratory exchange. The early establishment of the convection requirement in the newborn tammar, despite significant cutaneous gas exchange, provides supporting evidence that metabolic rate per se is important in establishing the level of ventilation.

Control of respiration in the isolated central nervous system of the neonatal opossum, Monodelphis domestica

Respiration represents an unusual motor activity with respect to its development. As newly born mammals enter the world, their limb movements are not coordinated; time and experience are required for effective performance to be achieved. Yet the rhythm of respiration is of necessity functionally perfected and unfailing at birth. Inspiratory and expiratory motor neurons are already able to fire at appropriate rates, under the command of rhythmically active neurons in the medulla. In this review, we discuss refinements of control present in the newborn opossum, particularly with respect to mechanisms that allow adaptation of respiration to changes in the level of activity or in the outside environment. Our own studies have been aimed at analyzing respiration at the earliest stages, and at establishing the way in which important variables influence inspiration and expiration. To this end, we have used the central nervous system (CNS) of a neonatal opossum, isolated in its entirety and maintained in culture. Although the opossum is unable to walk and highly immature at birth, its respiration is regular and unfailing. The isolated CNS survives, undergoes development, and maintains its neural activity and fine structure in vitro. Moreover, fictive respiration persists for over a day or longer at rates similar to those of the intact pup. The effects of altered pH, of increased temperature, and of drugs known to alter respiratory rhythm in intact animals can be measured directly, by electrical recordings made from medullary neurons or ventral roots. As in a slice, fluids of different composition can be applied focally, through micropipettes to the surface of the ventral medulla, or diffusely to the brainstem, With highly localized application of procaine hydrochloride (2%) to selected areas of the ventral medulla, the respiratory rhythm is reduced or abolished. As in adult mammals, both the rate and the amplitude of respiration simultaneously increase in response to lowered pH (6.5-.7.1) or to topical application of 1.0 microM carbachol. Conversely, as expected, the rate and amplitude decrease in response to increased pH (pH 7.5-7.7), or 100 microM scopolamine. Two characteristic features of the control of respiration in the neonatal opossum are evident from such tests. First, changes in rate are achieved by changes in the duration of the expiratory phase of respiration. This result suggests that the timing of the respiratory cycle in the neonatal opossum is controlled by an expiratory instead of an inspiratory "off-switch". Second, the rate and the amplitude of the respiratory excursions can be controlled independently, depending on the stimulus. For example, an increase in temperature increases the rate of fictive respiration without changing its amplitude, whereas noradrenaline decreases the rate while increasing the amplitude. Thus, changes of timing and amplitude need not go hand in hand. The opossum CNS offers a favorable preparation for the analysis of neural mechanisms that generate and modulate a motor rhythm, as the animal develops from embryonic to adult stages.

Thyroarytenoid muscle electrical activity during spontaneous apneas in preterm lambs

Laryngeal dynamics plays a major role during perinatal life, a period of respiratory control immaturity. Continuous electromyographic (EMG) activity of a laryngeal adductor muscle (thyroarytenoid [TA] muscle), was recently observed throughout provoked central apneas, either isolated or during induced periodic breathing, in full-term lambs. The aim of the present study was to test if continuous TA EMG activity was also present during spontaneous apneas in nonsedated preterm lambs. We studied 7 premature lambs (term 131 +/- 1 d of postconceptional age). Premature birth was induced after acceleration of fetal lung maturation. Electrodes for diaphragm, inferior pharyngeal constrictor (IPC), and TA electromyograms, electrocardiogram, electroencephalogram, eye movement, and airflow recordings were implanted. Radiotelemetry recordings were repeated from 135 to 149 +/- 8 d of postconceptional age. A total of 2,088 apneas (2,020 central and 68 mixed) >/= 3 s were recorded in the lambs, including 57 epochs of periodic breathing. Continuous TA EMG activity was present throughout 88.4% of all apneas and 98.4% of apneas during periodic breathing, regardless of the sleep stage. These results suggest that active glottic closure is frequent during spontaneous central apneas in this model of prematurity. This unique model will allow us to study controlling mechanisms and consequences of glottic closure during neonatal apneas.

Effects of hypoxia on lung volume in the garter snake

Ventilation and lung volume were measured in unanesthetized garter snakes using a headout body plethysmograph. The breathing cycle consisted of expiration, inspiration and a prolonged post-inspiratory breath-holding period, which lasted until the onset of the next expiration. Hypoxia induced increases in VT and in the volume at which the breath was held between cycles. Hypercapnia usually elicited hyperpnea after an initial, transient inhibition of breathing movements, but was accompanied by little or no increase in breath-holding lung volume. Snakes with T-tube tracheostomies failed to maintain the normal positive intrapulmonary pressure during the breath-holding period and failed to increase breath-holding lung volume in hypoxia, despite increased inspiratory excursions. These studies demonstrate a pronounced increase in lung volume during hypoxia and indicate that this response requires an intact upper airway. These findings in a reptile may be related in evolutionary terms to the increase in lung volume and post-inspiratory laryngeal narrowing that occur in mammals during hypoxia.

CO2-sensitivity of stretch receptors in the marsupial lung

Discharge activity in single fibres of the vagus of the brush tailed possum was examined for evidence of pulmonary CO2 receptors by artificially ventilating the lungs with gas mixtures which preserved, abolished or reversed the normal tidal oscillation in FCO2. No specific CO2 receptors were observed. A quantitative study of the CO2 sensitivity of thirteen pulmonary stretch receptors was carried out after stabilizing FACO2 at high (6.4-7.8%), low (1.4-2.5%) as well as intermediate values. In addition receptor responses to a series of sustained augmenting inflations were examined at different intrapulmonary CO2 concentrations. All thirteen receptors showed CO2 sensitivity, their frequency of discharge being reduced by hypercapnia and increased by hypocapnia. Five were low threshold receptors which discharged throughout the ventilatory cycle while the remaining eight were only phasically active. High threshold receptors were more sensitive to FACO2 changes than were low threshold units. The results from the series of augmenting inflations suggest that it is the receptor's threshold, but not its sensitivity, to tracheal pressure that is modulated by the co2 signal.

Laryngeal effects and respiration in the suckling opossum

Electromyogram (EMG) activity of the posterior cricoarytenoid (PCA muscles were active, but was otherwise closed. Larynx closure may contribute to the end-inspiratory pauses often observed in the intact animal. During inhalation of an asphyxiant test gas in place of room air, PCA and diaphragm activity generally increased; and increases in anesthesia decreased the EMG activity of both muscles. Water on the larynx transiently abolished both PCA and diaphragm discharge; but EMG activity returned to the PCA muscles before the diaphragm. Further, reactivation of the diaphragm was not always accompanied by a synchronized burst of PCA activity. Therefore, it is possible under some conditions to dissociate the motor outputs from the PCA muscles and diaphragm in this immature mammal.

An obstructive apnea in the suckling opossum

Pressure plethysmographic measurement of ventilation and electromyographic measurement of diaphragm activation in unanesthetized suckling opossums revealed spontaneous episodes of obstructive apnea. To better understand this phenomenon, intact animals were tested under different conditions of respiratory drive and during activation of pulmonary reflexes. Results showed that obstructed breaths were usually initiated with the lungs at or near the end-inspiratory level, and they occurred more frequently during air or oxygen breathing as compared with inhalation of hypercapnic or asphyxiant test gases. The latter two gas mixtures caused increases in ventilation; but depression of breathing resulting from pentobarbital anesthesia was not accompanied by obstructed breaths. It was initially considered that a reflex laryngeal response with changes in lung volume or lung irritation might trigger obstructive apnea; but pulmonary inflation and deflation as well as ammonia inhalation did not typically produce such an effect. The results indicate that mechanisms for obstructive apnea in the suckling opossum must account for the limited incidence of obstructed breaths during both ventilatory chemostimulation and anesthetic respiratory depression.

Ventilatory effects accompanying spontaneous movement in the suckling opossum

To determine whether spontaneous movement was associated with an organized respiratory response during early stages of mammalian development, we studied immature suckling opossums (Didelphis virginiana) between 30 and 60 days of age. Rate and depth of breathing were measured using pressure plethysmography and movement was assessed using electromyography of neck muscles. During air-breathing as well as during ventilatory chemostimulation with hypoxic, hypercapnic, and asphyxiant test gases, the onset of spontaneous movement was often marked by an increase in minute-ventilation, dominated by an increase in breathing frequency. In the absence of respiratory irregularities, ventilation and breathing frequency remained elevated throughout an episode of movement. After decerebration at the midcollicular level, the onset of spontaneous movement was accompanied by respiratory effects similar to those found in the intact preparation. The ventilation response with spontaneous movement contrasted to results during venilatory chemostimulation at rest, where increases in breathing resulted primarily from increases in tidal volume. It is concluded that a hyperpnea with spontaneous movement is present in the suckling opossum, and that the effect is primarily organized in the lower brainstem.