Neuronal control of airways smooth muscle

A review of the relaxant effect of various medicinal plants on tracheal smooth muscle, their possible mechanism(s) and potency

ETHNOPHARMACOLOGICAL RELEVANCE

The therapeutic effects of the medicinal plants described in the current review on obstructive pulmonary diseases have found mention in ancient Iranian medical texts and in traditional folk medicine. These effects are attributed to their bronchodilatory activity, which relaxes the smooth muscles of the airway. Therefore, in the present review, the relaxant effects of various extracts, fractions and constituents of medicinal plants on tracheal smooth muscle are reviewed in light of their therapeutic effects on obstructive pulmonary diseases.

MATERIALS AND METHODS

The online literature was searched using Medline, PubMed, ScienceDirect, Scopus, Google Scholar, Web of Science and SID (for articles written in Persian). Moreover, local books on ethnopharmacology from 1918 to 2014 were searched with keywords such as tracheal smooth muscle, airway smooth muscle, relaxant effect, bronchodilatory effect and related mechanisms to identify studies on the relaxant effects of medicinal plants on tracheal smooth muscle and the possible mechanism(s) of these effects.

RESULTS

All studied plants showed significant relaxant effects on tracheal smooth muscle, which were similar or superior to the effect of theophylline at the used concentrations. According to the results, most of these plants also showed an inhibitory effect on muscarinic and histamine (H1) receptors, whereas some plants showed more pronounced stimulatory effects on the beta-adrenergic receptor. Some of the studied plants also showed inhibitory effects on calcium and potassium channels.

CONCLUSION

The present article reviewed the relaxant effects of several medicinal plants on tracheal smooth muscle, which were comparable or superior to the effect of theophylline at the studied concentration. The possible mechanisms of the relaxant effects of the studied medicinal plants and a comparison of these effects were also reviewed. This review presents the fractions and constituents of plants with potent relaxant effects on tracheal smooth muscle, which can be used to treat obstructive pulmonary disease.

The effect of L-ascorbic acid and/or tocopherol supplementation on electrophysiological parameters of the colon of rats chronically exposed to lead

Background

The aim of this study was to assess the effect of diet supplementation with L-ascorbic acid (500 mg/L), tocopherol (3 mg/kg b.w.), and/or a water soluble analog of tocopherol (Trolox) (48 mg/L) on ion transport in the colon of rats subjected to a chronic exposure (9 months) to 0.1% lead acetate in drinking water.

Material/Methods

The electrophysiological parameters of the colon wall were measured with Ussing methods. Lead content in the whole blood was analyzed by graphite furnace atomic absorption spectrometry (GFAAS) using Zeeman correction. L-ascorbic acid and tocopherol in plasma was measured by high performance liquid chromatography. Immunohistochemical reaction was carried out for visualization of occludin, the intracellular tight junction protein.

Results

We showed a strong inhibitory effect of lead on the electrophysiological parameters, changes in intestinal permeability, disappearance of junctional occludin, decreased amount of mucus covering the colon surface, and the accumulation of PAS-positive substance in the apical region of the cytoplasm in the absorptive cells.

Conclusions

Supplementation with tocopherol or Trolox did not exert a beneficial influence on the studied parameters. L-ascorbic acid positively influenced the examined electrophysiological parameters, as it cancelled the inhibitory influence of lead on ion transport in the rat colon. L-ascorbic acid also protected against tight junction disruption of epithelial cells in the colon of the lead-treated rats. A similar effect was observed in the group of rats receiving lead and supplemented with L-ascorbic acid plus Trolox.

Antiasthmatic effect of Nigella sativa in airways of asthmatic patients

In the present study, the antiasthmatic (bronchodilatory) effect of the boiled extract of Nigella sativa in the airways of asthmatic patients was examined. The bronchodilatory effects of 50 and 100 mg/kg of boiled extract in comparison with 6 mg/kg theophylline were studied on 15 asthmatic patients. Pulmonary function tests (PFTs) including forced expiratory volume in one second (FEV(1)), peak expiratory flow (PEF), maximal mid expiratory flow (MMEF), maximal expiratory flow at 75, 50 and 25% of the FVC (MEF(75), MEF(50), and MEF(25,) respectively) and specific airway conductance (sGaw) were measured before administration and repeated , 30, 60, 90 120, 150, and 180 min after administration of the oral extract and theophylline. The results showed that the extract caused significant increases in all measured pulmonary function tests (PFTs), in most time intervals, (p<0.05 to p<0.001). However, the increase in FEV(1), MMEF and MEF(50) due to both doses of boiled extract and increase in MEF(75) and MEF(25) due to its lower doses were significantly lower than those of theophylline (p<0.05 to p<0.001). The onset of brochodilatory effect of extract was similar to that of theophylline beginning 30 min, and the effect of extract decline after 150 min following administration similar to the effect of theophylline. The effect of both doses of the extract was also significantly less than that of salbutamol at 30 minutes post administration (p<0.001 for all cases). The results of the present study showed that Nigella sativa has a relatively potent antiasthmatic effect on asthmatic airways. However, the effects of boiled extract of this plant on most measured PFTs was less than those of theophylline at concentrations used.

Increased vagal airway tone in fatal asthma

Slow-onset asthma deaths are characterized by eosinophilic airway infiltrates and thickening of the basal membrane, while rapid-onset asthma deaths are associated with fewer airway inflammatory changes, suggesting that bronchospasm may be responsible for the latter events. Airway tone is primarily controlled by the autonomous nervous system and can be pharmacologically modified. Therapies that stimulate the sympathetic beta(2) adrenoreceptor or inhibit the muscarinic receptor signal transduction induce bronchodilation. Parasympathetic (vagal) airway tone is enhanced in some asthmatics due to a number of stimuli, while in others it is constitutively heightened. Mainstream asthma therapy, however, only consists of corticosteroids and beta(2) agonists, not addressing this aspect. In this publication, I propose that increased vagal airway tone resulting in overwhelming bronchoconstriction and mucus plugging could be responsible for the near-fatal or fatal events observed in a number of asthmatics, in spite of their adequate treatment with standard therapies. On the basis of this hypothesis, I recommend that vagal airway tone be assessed in all patients with asthma, particularly in those with a history of near-fatal events. If the airway tone is increased, individuals should be treated with a triple combination of long-acting beta(2) agonists, inhaled steroids, and inhaled anticholinergics to prevent vagally mediated fatal events.

Bronchodilatory effect of Carum copticum in airways of asthmatic patients

BACKGROUND

Several therapeutic effects including anti-asthma and dyspnea have been described for the seeds of Carum copticum. In previous studies the relaxant and anticholinergic (functional antagonism) effects, histamine H(1) inhibitory and beta(2) stimulatory effects of Carum copticum have been demonstrated on guinea pig tracheal chains. In the present study, the bronchodilatory effect of boiled extract from Carum copticum in the airways of asthmatic patients was examined.

MATERIALS AND METHODS

The bronchodilatory effects of 0.125 and 0.25 ml/kg of 10 g% boiled extract in comparison with 6 mg/kg theophylline and placebo were studied by measuring pulmonary function tests (PFTs) and specific airway conductance (sGaw). Pulmonary function tests were measured before administration and repeated 30, 60, 90, 120, 150 and 180 min after administration of the oral extract and theophylline.

RESULTS

The results showed that the boiled extract of Carum copticum caused significant increases in all PFT values, in most time intervals, (p<0.05 to p<0.001). However, the increase in most PFT values due to the both doses of boiled extract were significantly lower than those of theophylline in most time intervals (p<0.05 to p<0.001). The onset of brochodilatory effect of extract was similar to that of theophylline beginning 30 min, its maximum effect on PFTs (23 to 32% increase) was seen in 90-120 min and the effect of extract decline after 150 min following administration similar to the effect of theophylline. In addition the placebo did not cause any significant increase in PFT values.

CONCLUSION

In conclusion, the results of the present study showed that Carum copticum has a relatively bronchodilatory effect on asthmatic airways which was comparable with the effect of theophylline at concentrations used.

Airway responsiveness to beta-adrenergic agonist (salbutamol) in asthma

Despite the controversy of airway responsiveness to beta2-agonist drugs in asthma, in a previous study we showed increased responsiveness of asthmatic airways to isoprenaline. Therefore, in the present study of airway sensitivity to other beta2-agonists, salbutamol and its relationship to histamine responsiveness was reexamined. The threshold bronchodilator concentrations of inhaled salbutamol required for a 20% increase in forced expiratory flow in 1 sec (FEV1), (PC20) was measured in 20 normal and 19 asthmatic adults. Airway responsiveness to histamine, as the concentration that caused a 20% decrease in FEV1, was also measured in 11 normal and 12 asthmatic subjects; and the correlation between PC20 salbutamol and PC20 histamine was evaluated. Sensitivity to salbutamol was greater in asthmatics (PC20 = 7.24 mg/L) than in non-asthmatics (PC20 = 124.25 mg/L, p < 0.001). Airway responsiveness to histamine in asthmatics (PC20 = 0.18 g/L) was also significantly greater than in normal subjects (PC20 = 19.46 g/L, p < 0.001). There was a significant correlation between PC20 salbutamol and histamine (Rs = 0.6052, p < 0.005). Maximum response to both salbutamol and histamine and slope of concentration-response curves of both agents were significantly greater in patients with asthma than in normal subjects (p < 0.001 and p < 0.005 for maximum response and slope, respectively). The increased sensitivity of asthmatics to inhaled salbutamol suggests that they also may be more sensitive to their endogenous adrenaline, which may thus dilate and stabilize their airways.

Bronchial responsiveness to beta-adrenergic stimulation and enhanced beta-blockade in asthma

OBJECTIVE

Beta-adrenergic blocking drugs have no effect on the airways of normal subjects but in asthma even small doses may cause severe deterioration. A seemingly obvious explanation for this abnormal sensitivity is that asthmatic airways, but not normal airways, are tonically dilated by the sympatho-adrenal system. However, studies suggest that sympatho-adrenal activity is normal in asthma, as is bronchial sensitivity to beta-agonists. The present study re-examines bronchial beta-adrenergic sensitivity in asthma and also measures antagonism produced in normal and asthmatic bronchi by a beta-blocking drug.

METHODOLOGY

The threshold bronchodilator doses of inhaled isoprenaline (dose required for a 35% increase in specific airway conductance 'PD35') was measured in 11 normal and 14 asthmatic adults on two separate occasions. After administering propranolol (inhaled or intravenously) PD35 was remeasured.

RESULTS

Sensitivity to isoprenaline was greater in symptomatic asthmatics (PD35 = 0.003 micromol) than in asymptomatic asthmatics (PD35 = 0.021 micromol) and in non-asthmatics (PD35 = 0.123 micromol; P < 0.001 in each case). Symptomatic asthmatics also showed 66-fold more antagonism than non-asthmatics when they were given propranolol by inhalation (P < 0.001) and sixfold more with intravenous propranolol (P = 0.005).

CONCLUSIONS

The increased sensitivity of asthmatics to inhaled isoprenaline suggests that they may also be more sensitive to their endogenous adrenaline, which may thus dilate and stabilize their airways. Taken with enhanced antagonism by propranolol, this provides insight into the aggravation of asthma by beta-blocking drugs.

Physiological oxygen concentration gives an oscillating spontaneous tone in guinea-pig tracheal preparations

The spontaneous tone in isolated six-segment preparations of guinea-pig trachea was examined. In 12% oxygen (corresponding to normal systemic arterial oxygen pressure) the preparations developed a spontaneous tone with regular oscillations (6.6 min(-1)), usually grouped in so-called complexes (7.5 h(-1)). The average tone during an entire complex amounted to 12% of a maximum KCl-induced contraction. The complex tone was highly stable during observation periods of at least 4 h, and was reversibly transformed to the 'classical', smooth type when exposed to 94% oxygen. Stretch of preparations in low oxygen resulted in a fast, stable change of tone, while preparations in traditionally high oxygen reacted slower, and lost 40% of the active tension during the hour following stretch. Indomethacin (10 microM) did not eliminate the oscillating behaviour, but reduced the average size of the tone by 44%. Exposure to the C-fibre blocking agent capsaicin (50 microM) and the local anaesthetic lidocaine (1 mM) completely eliminated the oscillations and complexes, although the preparations retained a smooth tone. Atropine, propranolol and tetrodotoxin did not affect the complex tone. This study demonstrates for the first time that guinea-pig tracheal preparations that are exposed to near-physiological oxygen concentrations develop a new type of oscillating spontaneous tone, which is largely prostaglandin-independent, but appears to require transmitter release from sensory C-fibres. We argue that the complex tone is physiological, and that traditionally high oxygen (95%) probably results in non-physiological hyperoxic changes in this preparation.

Non-adrenergic, non-cholinergic neurons innervating the guinea-pig trachea are located in the oesophagus: evidence from retrograde neuronal tracing

The possibility that non-adrenergic, non-cholinergic (NANC) neurons innervating the guinea-pig trachea may be located within the oesophagus has been investigated using an in vitro retrograde tracing technique. The cervical trachea and oesophagus were excised from guinea-pigs and Dil was applied to a 5 mm region of the trachealis muscle. These preparations were maintained in organotypic culture for 3 days and processed for immunohistochemistry. A mean of 44 (4 neural cell bodies in the oesophageal myenteric plexus were found to be labelled by Dil. The vast majority of these neurons contained nitric oxide synthase, vasoactive intestinal polypeptide and neuropeptide Y. It is suggested that the population of neurons identified in this study are postganglionic parasympathetic neurons mediating NANC relaxation of the trachealis muscle in this species.

Capsaicin can abolish spontaneous tone in guinea-pig trachealis

The properties of spontaneous tone in isolated preparations of guinea-pig tracheal smooth muscle were examined. Experiments with control preparations revealed that 5-15 min after stretching the muscle with 0.15 mN, the spontaneous tone assumed a plateau value from which it declined gradually during the following hour. During the plateau, the force amounted to approximately 35% and 1 h later to approximately 20% of a maximum KC1 contraction. The tone was independent of tetrodotoxin, atropine and propranolol. Indomethacin quickly and completely relaxed the tone in 15 of 21 preparations. However, four preparations retained some tone even after 1 h of treatment. Exposure to the C-fibre influencing drug capsaicin resulted in a dose-dependent, reversible suppression of spontaneous tone, normally preceded by a transient increase in force. No spontaneous tone at all remained after 1 h of 10 microM capsaicin. This effect was also found in preparations pretreated with tetrodotoxin, atropine and propranolol. Preparations, deprived of spontaneous tone by capsaicin-treatment, contracted distinctly when exposed to 10 microM arachidonic acid. This contraction was almost completely abolished by indomethacin, which indicates that the prostaglandin synthesis is functioning after capsaicin treatment and, thus, that inhibition of this synthesis is not responsible for the capsaicin effect. Exposure to phosphoramidon increased the spontaneous tone almost threefold. Addition of 3 nM neurokinin A in the permanent presence of capsaicin gave weaker contractions in preparations where prostaglandin synthesis had been abolished by indomethacin, as compared to contractions in preparations with intact prostaglandin synthesis. The data indicate that a continuous release of tachykinins from sensory C-fibres is essential for the generation of spontaneous tone and that a combination of tachykinins and prostaglandins determine the size of the tone in this preparation.

Evidence for adrenergic and tachykinin activity in venom of the stonefish (Synanceja trachynis)

The aim of the present study was to investigate previously suggested adrenergic and tachykinin activity, as well as the cardiovascular effects, of venom from the stonefish (Synanceja trachynis). Stonefish venom (60-120 micrograms/kg, i.v.) produced dose-dependent bronchoconstriction in anaesthetised guinea-pigs. This response (100 micrograms/kg, i.v.) was significantly reduced by the neurokinin 1 (NK1) receptor antagonist CP-99,994 (1 mg/kg, i.v.). Contractile responses to venom (4 micrograms/ml) of guinea-pig isolated ileum (GPI) were significantly inhibited by a combination of the sodium channel blocking drug tetrodotoxin (1 microM) and the ganglion blocking drug mecamylamine (10 microM). However, subsequent administration of CP-99,994 (0.1 microM) did not produce further inhibition. Endogenous tachykinin depletion with capsaicin (1 microM) also significantly attenuated responses to venom (4 micrograms/ml) in GPI. Venom (4 micrograms/ml) produced increases in rate and force of contraction of rat spontaneously beating isolated atria which were significantly inhibited by the beta-adrenoceptor antagonist propranolol (5 microM) but not by noradrenergic transmitter depletion with reserpine (4.5 mg/kg, i.p.). In the presence of the alpha 1-adrenoceptor antagonist prazosin (0.3 microM), venom (6 micrograms/ml) significantly inhibited electrically evoked twitches of prostatic segments of rat vas deferens. The inhibitory effect of venom was significantly reduced by the alpha 2-adrenoceptor antagonist idazoxan (1 microM) but not by propranolol (5 microM) or the neurokinin 2 (NK2) receptor antagonist SR-48,968 (0.1 microM). Venom (60-120 micrograms/kg, i.v.) produced dose-dependent increases in mean arterial blood pressure in anaesthetised rats. This pressor response (60 micrograms/kg, i.v.) was significantly reduced by prazosin (10-50 micrograms/kg, i.v.) and the leukotriene receptor antagonist SB205312 (1 mg/kg, i.v.), significantly increased by propranolol (2 mg/kg, i.v.), but not significantly affected by the cyclo-oxygenase inhibitor indomethacin (10 mg/kg, i.v.) or the thromboxane A2/prostaglandin H2 (TP) receptor antagonist GR32191B (1 mg/kg, i.v.). Pressor responses to venom (100 micrograms/kg, i.v.) were also observed in anaesthetised rabbits. These results suggest that stonefish venom contains a component capable of stimulating the release of endogenous tachykinins with subsequent activity at NK1 receptors. The venom also appears to act via stimulation of sodium channels on sensory nerves. The venom also has activity at alpha 2-adrenoceptors and a direct action at beta-adrenoceptors. The effect of venom on blood pressure of anaesthetised rats appears to include a pressor component that is mediated, in part,by alpha-adrenoceptors and leukotriene receptors, and a depressor component that is mediated by beta-adrenoceptors. However, the pressor response does not involve action at TP receptors, or require the production of cyclo-oxygenase metabolites.

Nitric oxide in the peripheral nervous system

Nitric oxide (NO) is a neurotransmitter and neuromodulator in the central nervous system, but this small labile substance also seems to serve as a peripheral neurotransmitter. Abundant evidence is now available that NO, synthesized from L-arginine by NO synthase (NOS), is a nonadrenergic noncholinergic relaxant transmitter of gastrointestinal smooth muscle. Electrically induced nonadrenergic noncholinergic relaxations are antagonized by NOS inhibitors in vitro and in vivo. In a bioassay superfusion system, the release of a substance with the pharmacological characteristics of NO from a gastrointestinal smooth muscle preparation was detected; also, indirect measurements (e.g. of the NO metabolite nitrite or of the co-product of its synthesis L-citrulline) suggest NO release. Immunohistochemistry with antibodies raised against the neuronal NOS showed immunoreactivity in cell bodies of neurones in the myenteric plexus and in nerve fibres in the muscular layer. These data suggest that nerve endings, innervating smooth muscle, are able to release NO that will penetrate the cells to induce relaxation (i.e. nitrergic neurotransmission). It is unlikely that NO as such is stored and it is generally accepted that it is synthesized on demand when the nerve endings are excited, although the possibility of the release of a NO-containing molecule protecting it from degradation in the junction has been proposed. Other sources than neurones (interstitial cells, smooth muscle cells) for the NO involved in nonadrenergic noncholinergic inhibitory transmission have also been proposed. Using NADPH diaphorase as a marker for neuronal NOS, deficiency of the nitrergic innervation has been shown in isolated tissue from patients with infantile hypertrophic pyloric stenosis, achalasia and Hirschsprung's disease, suggesting that a lack of NO release might be involved in these disorders. Evidence in favour of nitrergic neurotransmission to smooth muscle has also been obtained in the respiratory and lower urinary tract, the corpora cavernosa and some blood vessels.

Mechanosensitive modulation of myosin phosphorylation and phosphatidylinositol turnover in smooth muscle

Myosin light chain phosphorylation and phosphatidylinositol turnover were measured at different muscle lengths in bovine tracheal smooth muscle. The relationship between myosin phosphorylation and muscle length was linear between optimal length (Lo) and 0.1 Lo in both unstimulated and carbachol-activated tissues. However, myosin phosphorylation in carbachol-activated tissues was more sensitive to changes in muscle length. As a result, suprabasal myosin phosphorylation induced by carbachol was significant at Lo but became insignificant at 0.1 Lo. Phosphatidylinositol turnover was assayed by measuring the formation of myo-[3H]inositol phosphates in unstimulated and carbachol-activated tissues using the Li+ method. Pairs of time-matched and length-matched muscle strips were used for control (unstimulated) and activation by carbachol. Phosphatidylinositol turnover in carbachol-activated tissues was more sensitive than that in unstimulated tissues to changing length. As a result, suprabasal phosphatidylinositol turnover induced by carbachol was significant at Lo but became insignificant at 0.1 Lo. These results indicated that myosin phosphorylation and phosphatidylinositol turnover mediated by muscarinic receptor activation were modulated by the mechanical state of smooth muscle.