Inhibition of baroreflex following microinjection of GABA or morphine into the nucleus tractus solitarii in rabbits

Endomorphin-2 is released from newborn rat primary sensory neurons in a frequency- and calcium-dependent manner

Recent evidence indicates that endomorphins, endogenous mu-opioid receptor (MOR) agonists, modulate synaptic transmission in both somatic and visceral sensory pathways. Here we show that endomorphin-2 (END-2) is expressed in newborn rat dorsal root ganglion (DRG) and nodose-petrosal ganglion complex (NPG) neurons, and rarely co-localizes with brain-derived neurotrophic factor (BDNF). In order to examine activity-dependent release of END-2 from neurons, we established a model using dispersed cultures of DRG and NPG cells activated by patterned electrical field stimulation. To detect release of END-2, we developed a novel rapid capture enzyme-linked immunosorbent assay (ELISA), in which END-2 capture antibody was added to neuronal cultures shortly before their electrical stimulation. The conventional assay was effective at reliably detecting END-2 only when the cells were stimulated in the presence of CTAP, a MOR-selective antagonist. This suggests that the strength of the novel assay is related primarily to rapid capture of released END-2 before it binds to endogenous MORs. Using the rapid capture ELISA, we found that stimulation protocols known to induce plastic changes at sensory synapses were highly effective at releasing END-2. Removal of extracellular calcium or blocking voltage-activated calcium channels significantly reduced the release. Together, our data provide the first evidence that END-2 is expressed by newborn DRG neurons of all sizes found in this age group, and can be released from these, as well as from NPG neurons, in an activity-dependent manner. These results point to END-2 as a likely mediator of activity-dependent plasticity in sensory pathways.

Endomorphin-2 in the medial NTS attenuates the responses to baroreflex activation

We have previously reported that microinjections of endomorphin-2 (E-2; an endogenous mu-receptor agonist) into the medial subnucleus of the NTS (mNTS) elicit depressor and bradycardic responses via activation of ionotropic glutamate receptors located on secondary mNTS-neurons. Based on this report, it was hypothesized that activation of secondary mNTS neurons by E-2 may result in an exaggeration of baroreflex responses. In order to test this hypothesis, baroreflex responses were studied in adult, urethane-anesthetized, artificially ventilated, male Wistar rats before and after the microinjections of E-2 into the mNTS. Baroreceptors were stimulated by applying pressure increments (80-100 mm Hg) in the carotid sinus and by electrical stimulation (stimulus intensity: 0.5 V, frequencies 5, 10, and 25 pulses/s, pulse duration: 1 ms) of the aortic nerve for 30-s periods. Baroreceptor stimulation elicited depressor and bradycardic responses. Microinjections (100 nl) of E-2 (0.4 mmol/l) into the mNTS attenuated the baroreflex responses. Microinjections of naloxone (an opioid receptor antagonist) into the mNTS (0.5 mmol/l) did not alter baroreflex responses. Based on these results, it was concluded that activation of mu-opioid receptors in the mNTS attenuates baroreflex responses. Possible mechanisms for excitatory effects of E-2 in the mNTS resulting in depressor and bradycardic responses, on one hand, and inhibitory effects resulting in attenuation of baroreflex responses, on the other, are discussed.

Attenuation of aortic baroreflex responses by microinjections of endomorphin-2 into the rostral ventrolateral medullary pressor area of the rat

The presence of μ-opioid receptors and endomorphins has been demonstrated in the general area encompassing the rostral ventrolateral medullary pressor area (RVLM). This investigation was carried out to test the hypothesis that endomorphins in the RVLM may have a modulatory role in regulating cardiovascular function. Blood pressure and heart rate (HR) were recorded in urethane-anesthetized male Wistar rats. Unilateral microinjections of endomorphin-2 (0.0125–0.5 mmol/l) into the RVLM elicited decreases in mean arterial pressure (16–30 mmHg) and HR (12–36 beats/min), which lasted for 2–4 min. Bradycardia was not vagally mediated. The effects of endomorphin-2 were mediated via μ-opioid receptors because prior microinjections of naloxonazine (1 mmol/l) abolished these responses; the blocking effect of naloxonazine lasted for 15–20 min. Unilateral stimulations of aortic nerve for 30 s (at frequencies of 5, 10, and 25 pulses/s; each pulse 0.5 V and 1-ms duration) elicited depressor and bradycardic responses. These responses were significantly attenuated by microinjections of endomorphin-2 (0.2 and 0.4 mmol/l). The inhibitory effect of endomorphin-2 on baroreflex responses was prevented by prior microinjections of naloxonazine. Microinjections of naloxonazine alone did not affect either baseline blood pressure and HR or baroreflex responses. These results indicate that endomorphin-2 elicits depressor and bradycardic responses and inhibits baroreflex function when injected into the RVLM. These effects are consistent with the known hyperpolarizing effect of opioid peptides on RVLM neurons.

Somatic nociception activates NK1 receptors in the nucleus tractus solitarii to attenuate the baroreceptor cardiac reflex

There is limited information regarding the integration of visceral and somatic afferents within the nucleus of the solitary tract (NTS). We studied the interaction of nociceptive and baroreceptive inputs in this nucleus in an in situ arterially perfused, un-anaesthetized decerebrate preparation of rat. At the systemic level, the gain of the cardiac component of the baroreceptor reflex was attenuated significantly by noxious mechanical stimulation of a forepaw. This baroreceptor reflex depression was mimicked by NTS microinjection of substance P and antagonized by microinjection of either bicuculline (a GABAA receptor antagonist) or a neurokinin type 1 (NK1) receptor antagonist (CP-99994). The substance P effect was also blocked by a bilateral microinjection of bicuculline, at a dose that was without effect on basal baroreceptor reflex gain. Baroreceptive NTS neurons were defined by their excitatory response following increases in pressure within the ipsilateral carotid sinus. In 27 of 34 neurons the number of evoked spikes from baroreceptor stimulation was reduced significantly by concomitant electrical stimulation of the brachial nerve (P < 0.01). Furthermore, the attenuation of baroreceptor inputs to NTS neurons by brachial nerve stimulation was prevented by pressure-ejection of bicuculline from a multi-barrelled microelectrode (n = 8). In a separate population of 17 of 45 cells tested, brachial nerve stimulation evoked an excitatory response that was antagonized by blockade of NK1 receptors. We conclude that nociceptive afferents activate NK1 receptors, which in turn excite GABAergic interneurons impinging on cells mediating the cardiac component of the baroreceptor reflex.

Chronic mu-opioid receptor stimulation alters cardiovascular regulation in humans: differential effects on muscle sympathetic and heart rate responses to arterial hypotension

In opioid addicted patients, respiratory regulation adapts allowing intake of otherwise lethal dosages of opioids. In contrast, little is known about cardiovascular regulation during chronic opioid receptor stimulation. We previously demonstrated that chronic mu-opioid receptor stimulation by methadone decreases resting muscle sympathetic activity (MSA). However, for short-term control of arterial blood pressure autonomic responses to arterial hypotension may be of greater importance. Accordingly, we tested the hypothesis that chronic opioid receptor stimulation attenuates muscle sympathetic and heart rate responses to arterial hypotension. Ten young patients (mean +/- SD, 30 years +/- 6) with a long history of mono-opioid addiction and under oral methadone substitution therapy (54 mg d(-1) +/- 31) for 12 months (+/-20) were studied. Peroneal MSA (microneurography) and heart rate responses to hypotensive challenges (sodium nitroprusside) were assessed in the awake state and compared with those of 10 matched healthy subjects. Effects of mu-opioid receptor blockade by naloxone (12.4 mg i.v.) were determined during propofol anesthesia. Chronic mu-opioid receptor stimulation markedly decreased the MSA response to hypotension (-0.5 units mm Hg(-1) +/- 0.2 vs. -2.0 +/- 1.8; p = 0.01) compared with healthy subjects despite similar arterial blood pressure and heart rate at rest. In contrast, the heart rate response to hypotension did not differ between addicted patients (6 ms mm Hg(-1) +/- 2) and healthy subjects (7 ms mm Hg(-1) +/-4). Opioid receptor blockade during propofol anesthesia markedly increased the MSA response to hypotension even beyond awake values (-1.2 units mm Hg(-1) +/- 1.1; p = 0.02 vs. awake) while the heart rate response remained unchanged. Thus, chronic mu-opioid receptor stimulation 1) results in uncompensated depression of cardiovascular sympathetic neural regulation, and 2) exerts differential effects on efferent sympathetic nerve activity to muscle and on heart rate control in response to arterial hypotension.

A peripheral site of action for the attenuation of baroflex-mediated bradycardia by intravenous mu-opioid agonists

We previously reported that i.v. DAMGO (Tyr-D-Ala-Gly-NMePhe-Gly-ol), a selective mu-opioid agonist, causes an increase in blood pressure with no change in heart rate in unanesthetized sheep and subsequently demonstrated that DAMGO attenuates baroreflex-mediated bradycardia. To determine the site and mechanism by which mu-agonists inhibit baroreflex sensitivity, we have carried out further investigations by using DAMGO and another mu-agonist, DALDA (Tyr-D-Arg-Phe-Lys-NH2). The bradycardic response to norepinephrine (NE) was significantly blunted after i.v. DAMGO or DALDA in both nonpregnant and pregnant sheep. In contrast, the tachycardic response to sodium nitroprusside (SNP) remained unchanged in the presence of DAMGO or DALDA. In view of the highly restricted distribution of DALDA across the blood-brain barrier (BBB), we hypothesized that the blunting of reflex-mediated bradycardia by mu-opioid agonists can occur peripherally. Pretreatment with the quaternary opioid antagonist, naloxone methiodide (NM), completely blocked the attenuation of baroreflex sensitivity by DAMGO and DALDA in both nonpregnant and pregnant animals. These data suggest that in addition to central mechanisms, mu-opioid agonists can inhibit baroreflex sensitivity at a peripheral site, most likely by inhibiting vagal influence on heart-rate control rather than by acting directly at baroreceptors.

Presence of mu-opioid receptors in targets of efferent projections from the central nucleus of the amygdala to the nucleus of the solitary tract

Opioids acting at mu-opioid receptors (MORs) within the nucleus of the solitary tract (NTS) potently modulate autonomic functions that are also known to be influenced by inputs from the central nucleus of the amygdala (CEA). In addition, many of the physiological effects of MOR agonists have been attributed to interactions with neurons that contain gamma-aminobutyric acid (GABA), one of the neurotransmitters present in CEA-derived terminals and their targets in the medial NTS. Together, these observations suggest that MORs are present at pre- or postsynaptic sites within the CEA to NTS circuitry. To test this hypothesis, we combined anterograde transport of biotinylated dextran amine (BDA) with immunogold-silver localization of an antipeptide antiserum against the MOR in the NTS of adult rats. In animals receiving bilateral CEA injections of BDA, anterogradely labeled axons were seen throughout the rostrocaudal NTS. Electron microscopy of the medial NTS at rostral and intermediate levels showed anterograde BDA-labeling in many small unmyelinated axons and axon terminals, none of which contained detectable MOR. The BDA-labeled axon terminals formed mainly symmetric, inhibitory-type synapses with somata and dendrites. Over half of the somatic and approximately 10% of the dendritic targets showed nonsynaptic plasmalemmal immunogold labeling for MOR. The BDA-labeled axon terminals were also frequently apposed by other small axons that contained MORs. These results suggest that within the medial NTS, MOR agonists modulate the postsynaptic inhibition produced by CEA afferents and also play a role in the presynaptic release of other neurotransmitters.

Baroreflex-mediated bradycardia is blunted by intravenous mu- but not kappa-opioid agonists

To assess the cardiovascular effects of systemically administered opioid agonists, changes in blood pressure and heart rate were observed after intravenous (i.v.) administration of U50,488H (trans-3,4-dichloro-N-[2-(1-pyrrolidinyl) cyclohexyl]benzeneacetamide), a selective kappa-opioid receptor agonist, and DAMGO (D-Ala2, N-Me-Phe4, Gly5-ol), a selective mu-opioid-receptor agonist. Intravenous administration of U50,488H (1.2 mg/kg) and DAMGO (0.3 mg/kg) to the awake sheep resulted in an immediate increase in blood pressure. The pressor response to U50,488H was accompanied by an increase in heart rate. In contrast, there was no accompanying change in heart rate in response to DAMGO. We hypothesized that the lack of a reflex bradycardia to the pressor responses of both the mu- and kappa-opioid-receptor agonists was due to a blunting of baroreflex-mediated bradycardia. The reflex bradycardia to norepinephrine (0.6 microg/kg/min) was significantly reduced in the presence of DAMGO but not U50,488H. In view of the lack of effect of U50,488H on the baroreflex, we further hypothesized that the tachycardia it elicited was due to an increase in sympathetic activity. Pretreatment with propranolol (0.1 mg/kg) completely blocked the tachycardia elicited by U50,488H. These data suggest that the lack of a reflex bradycardia to the pressor response of DAMGO is due to a blunting of baroreflex-mediated bradycardia. In contrast, the increase in heart rate caused by U50,488H is mediated by sympathetic activation of the heart.

Immunolabeling of Mu opioid receptors in the rat nucleus of the solitary tract: extrasynaptic plasmalemmal localization and association with Leu5-enkephalin

Activation of the mu opioid receptor (MOR) by morphine within the caudal nucleus of the solitary tract (NTS) is known to mediate both cardiorespiratory and gastrointestinal responses. Leu5-enkephalin (LE), a potential endogenous ligand for MOR, is also present within neurons in this region. To determine the cellular sites for the visceral effects of MOR ligands, including LE, we used immunogold-silver and immunoperoxidase methods for light and electron microscopic localization of antisera against MOR (carboxyl terminal domain) and LE in the caudal NTS of rat brain. Light microscopy of coronal sections through the NTS at the level of the area postrema showed MOR-like immunoreactivity (MOR-LI) and LE labeling in punctate processes located within the subpostremal, dorsomedial and medial subnuclei. Electron microscopy of sections through the medial NTS at this level showed gold-silver particles identifying MOR-LI prominently distributed to the cytoplasmic side of the plasma membranes of axons and terminals. MOR labeled terminals formed mostly symmetric (inhibitory-type) synapses but sometimes showed multiple asymmetric junctions, characteristic of excitatory visceral afferents. MOR-LI was also present along extrasynaptic plasma membranes of dendrites receiving afferent input from unlabeled and LE-labeled terminals. We conclude that MOR ligands, possibly including LE, can act at extrasynaptic MORs on the plasma membranes of axons and dendrites in the caudal NTS to modulate the presynaptic release and postsynaptic responses of neurons. These are likely to include local inhibitory neurons and both gastric and cardiorespiratory afferents known to terminate in the subnuclei with the most intense MOR-LI.

GABAergic neurons in rat nuclei of solitary tracts receive inhibitory-type synapses from amygdaloid efferents lacking detectable GABA-immunoreactivity

Gamma-aminobutyric acid (GABA) is a prominent inhibitory transmitter in both the central nucleus of the amygdala (Ce) and the medial nuclei of the solitary tracts (mNTS). These regions are reciprocally connected by anatomical pathways mediating the coordinated visceral responses to emotional stress. To further determine whether GABA is present in the amygdaloid efferents or their targets in the mNTS, we combined peroxidase labeling of Phaseolus vulgaris leucoagglutinin (PHA-L) or biotinylated dextran amine (BDA) anterogradely transported from the Ce with immunogold-silver detection of antibodies against GABA in the rat mNTS. By light microscopy, peroxidase labeling for either PHA-L or BDA was seen in varicose processes, whereas immunogold-silver labeling for GABA was detected in perikarya and processes throughout the rostrocaudal mNTS. The intermediate mNTS at the level of the area postrema, a region receiving mainly cardiorespiratory and gastric visceral afferents, were examined by electron microscopy. In this region, anterograde labeling was observed exclusively in unmyelinated axons and axon terminals. These terminals lacked detectable GABA-immunoreactivity, but formed symmetric synapses that are associated with inhibition. The targets of the anterogradely labeled terminals were medium-sized dendrites both with and without GABA-labeling. These dendrites often also received convergent input from terminals that were intensely GABA-immunoreactive. We conclude that visceral activation accompanying emotional response to stress is likely to involve inhibition of GABAergic neurons in the mNTS by non-GABA-containing amygdaloid efferents. Furthermore, our results indicate that the inhibition of these GABAergic neurons may be further augmented by release of GABA from other converging terminals in the mNTS.

GABA receptor-mediated inhibition of reflex deglutition in the cat

In anesthetized cats, swallowing elicited by electrical stimulation of the superior laryngeal nerves (SLNs) was inhibited by the GABA-mimetic muscimol and by diazepam, an action that was reversed by picrotoxin and bicuculline. This inhibition supports the involvement of GABA receptors, specifically those of the GABAA subtype which both antagonists have been shown to block in various areas of the central nervous system. The inhibition of reflex swallowing and its reversal were unaltered by a transection of the brainstem at a midcollicular level. Stimulation of the SLNs also caused a bradycardia that was inhibited by both muscimol and diazepam and was restored by both GABA antagonists. Data from these experiments provide suggestive evidence for a role of GABA-ergic transmission in the central control of the deglutitory reflex.

The effects of butorphanol on baroreflex control of heart rate in man

The effects of butorphanol injection on baroreflex control of heart rate were investigated using both pressor and depressor tests in eighteen adult patients. Baroreflex sensitivity was attenuated after butorphanol injection in the pressor test using phenylephrine, whereas it was unchanged in the depressor test using nitroglycerine. No resetting of the baroreflex occurred after butorphanol injection. After the administration of butorphanol, plasma epinephrine and norepinephrine levels increased. These results suggest that it is safe to use butorphanol clinically even when a reduction in blood pressure due to hypovolemia or unclamping of the major artery is expected and that it is disadvantageous to administer the drug when an increase in blood pressure due to cross-clamping of the major artery is predicted.

Insulin resistance syndrome: defective GABA neuromodulation as a possible hereditary pathogenetic factor (the 'GABA hypothesis')

The origin of the insulin resistance syndrome which, mostly through its cardiovascular implications, is characterized by a high incidence of death, is still practically unknown. Energy and glucose homeostasis are under the control of CNS centers and the neurotransmitter GABA modulates the activity of these centers. Alteration of the biochemical structure of GABA receptors is suggested as an interpretation of the origin of the syndrome.

Difference in distribution of glutamate-immunoreactive neurons projecting into the subretrofacial nucleus in the rostral ventrolateral medulla of SHR and WKY: a double-labeling study

Glutamate immunoreactivity was found in 19% and 21% of the neurons of the central autonomic nuclei projecting into the subretrofacial nucleus (SRF) in the rostral ventrolateral medulla of Wistar-Kyoto rat (WKY) and spontaneously hypertensive rat (SHR), respectively, using a double-labeling technique in combination with glutamate immunocytochemistry. Double-labeled neurons were distributed in 22 nuclei or subnuclei in the limbic system, hypothalamus, midbrain, pons and medulla. The average number of glutamate-immunoreactive neurons per thousand in SHR was significantly higher in the ipsilateral lateral parabrachial nucleus (P less than 0.05) and Koelliker-Fuse nucleus (P less than 0.01) than in WKY, while it was significantly lower in the ipsilateral medial subnucleus (P less than 0.05) and the commissure subnucleus (P less than 0.05) of the nucleus tractus solitarii in SHR than in WKY. The results indicate that: (1) glutamate-immunoreactive neurons (possibly glutamatergic) in many central autonomic nuclei project into the sympathetic vasomotor control neurons in the SRF; (2) the large population of glutamate-immunoreactive neurons in the lateral parabrachial nucleus and the Koelliker-Fuse nucleus of SHR is likely to increase excitatory inputs to the SRF vasomotor control neurons, while the smaller population of glutamate-immunoreactive neurons in the medial and commissure subnuclei of the nucleus tractus solitarii is likely to decrease excitatory inputs to the GABAergic neurons intrinsic to the SRF.

Neural mechanisms of swallowing: neurophysiological and neurochemical studies on brain stem neurons in the solitary tract region

Neurophysiological studies of the nuclei of the tractus solitarius (NTS) and adjacent regions have provided a partial understanding of the integrative brainstem network underlying swallowing and related functions such as respiration. The NTS is also richly endowed with an abundance of neuropeptides and other neuroactive substances, but only limited information is available on their influences on neurons involved specifically in swallowing. Since dysfunction of these neurophysiological and neurochemical regulatory mechanisms in the NTS region may be important in pathophysiological conditions such as dysphagia, increased awareness of and focus on these mechanisms are warranted. This paper outlines recent neurophysiological and neurochemical data that provide information on the afferent inputs and neurophysiological properties of neurons in NTS and adjacent caudal brainstem regions implicated in swallowing, respiration, and respiratory-related reflexes.