Neural input and the development of adrenergic intracellular signaling: neonatal denervation evokes neither receptor upregulation nor persistent supersensitivity of adenylate cyclase

Glucagon, cyclic AMP, and hepatic glucose mobilization: A half‐century of uncertainty

For at least 50 years, the prevailing view has been that the adenylate cyclase (AC)/cyclic AMP (cAMP)/protein kinase A pathway is the predominant signal mediating the hepatic glucose‐mobilizing actions of glucagon. A wealth of evidence, however, supports the alternative, that the operative signal most of the time is the phospholipase C (PLC)/inositol‐phosphate (IP3)/calcium/calmodulin pathway. The evidence can be summarized as follows: (1) The consensus threshold glucagon concentration for activating AC ex vivo is 100 pM, but the statistical hepatic portal plasma glucagon concentration range, measured by RIA, is between 28 and 60 pM; (2) Within that physiological concentration range, glucagon stimulates the PLC/IP3 pathway and robustly increases glucose output without affecting the AC/cAMP pathway; (3) Activation of a latent, amplified AC/cAMP pathway at concentrations below 60 pM is very unlikely; and (4) Activation of the PLC/IP3 pathway at physiological concentrations produces intracellular effects that are similar to those produced by activation of the AC/cAMP pathway at concentrations above 100 pM, including elevated intracellular calcium and altered activities and expressions of key enzymes involved in glycogenolysis, gluconeogenesis, and glycogen synthesis. Under metabolically stressful conditions, as in the early neonate or exercising adult, plasma glucagon concentrations often exceed 100 pM, recruiting the AC/cAMP pathway and enhancing the activation of PLC/IP3 pathway to boost glucose output, adaptively meeting the elevated systemic glucose demand. Whether the AC/cAMP pathway is consistently activated in starvation or diabetes is not clear. Because the importance of glucagon in the pathogenesis of diabetes is becoming increasingly evident, it is even more urgent now to resolve lingering uncertainties and definitively establish glucagon’s true mechanism of glycemia regulation in health and disease.

Terbutaline impairs the development of peripheral noradrenergic projections: potential implications for autism spectrum disorders and pharmacotherapy of preterm labor

Terbutaline, a β2-adrenoceptor agonist, is used off-label for long-term management of preterm labor; such use is associated with increased risk of neurodevelopmental disorders, including autism spectrum disorders. We explored the mechanisms underlying terbutaline's effects on development of peripheral sympathetic projections in developing rats. Terbutaline administration on postnatal days 2-5 led to immediate and persistent deficiencies in cardiac norepinephrine levels, with greater effects in males than in females. The liver showed a lesser effect; we reasoned that the tissue differences could represent participation of retrograde trophic signaling from the postsynaptic site to the developing neuronal projection, since hepatic β2-adrenoceptors decline in the perinatal period. Accordingly, when we gave terbutaline earlier, on gestational days 17-20, we saw the same deficiencies in hepatic norepinephrine that had been seen in the heart with the later administration paradigm. Administration of isoproterenol, which stimulates both β1- and β2-subtypes, also had trophic effects that differed in direction and critical period from those elicited by terbutaline; methoxamine, which stimulates α1-adrenoceptors, was without effect. Thus, terbutaline, operating through trophic interactions with β2-adrenoceptors, impairs development of noradrenergic projections in a manner similar to that previously reported for its effects on the same neurotransmitter systems in the immature cerebellum. Our results point to the likelihood of autonomic dysfunction in individuals exposed prenatally to terbutaline; in light of the connection between terbutaline and autism, these results could also contribute to autonomic dysregulation seen in children with this disorder.

Sleep architecture and attenuated heart rate response to arousal from sleep in patients with autonomic failure

OBJECTIVE

To determine if patients with autonomic failure have increased sleep disturbances and if multiple system atrophy (MSA) and pure autonomic failure (PAF) patients have frequent arousals from sleep associated with an attenuated heart rate (HR) response compared to healthy volunteers.

METHODS

With informed consent, 10 autonomic failure patients and 10 healthy volunteers were studied. Sleep disturbances were scored using standard criteria. Arousals were identified from stage 2 sleep and differences in the R-R interval between groups were tested using a mixed-model regression analysis.

RESULTS

Three MSA and one PAF patient had obstructive sleep apnoea compared to one volunteer. One MSA and three PAF patients had periodic limb movements. One MSA patient had REM behaviour disorder. The autonomic patients had significantly reduced total sleep time (p=0.007) and sleep efficiency (p=0.003). The HR response to arousal was smaller in autonomic failure patients compared to volunteers during the early phase of the arousal (p=0.047), but not the later phase (p=0.67).

CONCLUSION

Autonomic failure patients have increased sleep disturbances compared to healthy volunteers. The smaller HR response in autonomic failure patients suggests that an intact sympathetic nervous system is a key component of the HR response associated with arousal from sleep.

β-Adrenoceptor modulation of transiently overexpressed α2-adrenoceptors in brain and peripheral tissues: cellular mechanisms underlying the developmental toxicity of terbutaline

Terbutaline, a selective beta(2)-adrenoceptor (beta(2)AR) agonist, is widely used as a tocolytic to arrest preterm labor but recent studies indicate that excessive betaAR stimulation can alter the expression and function of other neurotransmitter receptors that are essential to fetal/neonatal development. In many immature tissues, alpha(2)-adrenergic receptors (alpha(2)ARs) are overexpressed and the receptors are thought to play a role in cell proliferation and architectural assembly. We evaluated whether betaAR agonists perturb the expression of alpha(2)ARs in central and peripheral tissues during various developmental stages in the fetal and neonatal rat. In peripheral tissues (heart, liver, kidney) administration of terbutaline (10mg/kg s.c. for 4 days) elicited decrements in alpha(2)AR expression only during a critical developmental window that differed for each tissue; terbutaline was more effective than isoproterenol, a mixed beta(1)/beta(2) agonist. Neonatal destruction of sympathetic nerves with 6-hydroxydopamine (6-OHDA) had a biphasic effect, initially reducing alpha(2)ARs but subsequently elevating receptor expression. In contrast to the effects in the periphery, terbutaline administration promoted alpha(2)AR expression in neonatal brain regions with effects preferential to males. As the rat is an altricial species, these results during late gestation and the early neonatal period indicate that betaAR input modulates alpha(2)AR expression during developmental stages in which betaAR tocolytics are likely to be used. Disruption of alpha(2)AR expression and function may therefore contribute to adverse effects that have been noted in the offspring of pregnant women treated with terbutaline.

The importance of the prolonged postnatal period in determination of heart atrial muscarinic receptor and β-adrenoceptor densities

Our previous work indicated that hyperstimulation of muscarinic receptors brought about profound changes not only in the density of the muscarinic receptors, but also of the beta-adrenoceptors both in vivo and in vitro. Now we try to identify the changes in receptor densities when the neuronal input from the autonomic nerves is disrupted, i.e. when neonatal rats were injected with 6-hydroxydopamine (6-OHDA; able to destroy sympathetic nerves). Although the interruption of neuronal input was successful as indicated by norepinephrine uptake, there was no change in receptor densities in the rat heart atria when 6-OHDA was applied in the first postnatal week only. When we repeated the 6-OHDA treatment consequently (on 14th, 21st and 28th postnatal day) there were clear increases of both receptor types (muscarinic receptors rise to 139% of control, beta-adrenoceptors to 134% of control). The atrial muscarinic receptor number was increased (to 146% of control) also when we combined the first week 6-OHDA application with another factor (when the pups abide with mother till the 56th day). The simple non-weaning of animals has no effect on the receptor densities. We can therefore conclude that the first week application of 6-OHDA was insufficient in changing the receptor number and that only repeated 6-OHDA administration was able to change them. Similarly, combination with other factor: non-weaning led to the muscarinic receptors increase. Our results can indicate the importance of the prolonged postnatal period for the heart muscarinic and beta-adrenergic receptor number determination.

A morphogenetic role for acetylcholine in mouse cerebral neocortex

Recently, cholinergic afferents to cerebral cortex have met renewed attention regarding the regulation of plasticity as well as cognitive processing. My laboratory has developed a mouse neonatal basal forebrain lesion paradigm that has contributed considerably to the understanding of cholinergic mechanisms in cortical development. We have shown that transient cholinergic deafferentation, beginning at birth, precipitates alterations in neuronal differentiation and synaptic connectivity that persist into maturity, and contribute to altered cognitive behavior. These data are in general agreement with studies in rats in which the cholinergic basal forebrain is lesioned very early in development but contrast with effects of later developmental lesions. Moreover, in mouse, both morphological and behavioral consequences of the lesion are sex dependent. Studies of receptors and secondary messengers that are instrumental in morphogenesis and plasticity suggest that sex dependent molecular alterations occur within days if not hours following cortical cholinergic deafferentation.

beta-Adrenergic modulation of muscarinic cholinergic receptor expression and function in developing heart

Imbalances of beta-adrenoceptor (beta-AR) and muscarinic ACh receptor (mAChR) input are thought to underlie perinatal cardiovascular abnormalities in conditions such as sudden infant death syndrome. Administration of isoproterenol, a beta(1)/beta(2)-AR agonist, to neonatal rats on postnatal days (PN) 2-5 caused downregulation of cardiac m(2)AChRs and a corresponding decrement in their control of adenylyl cyclase activity. Terbutaline, a beta(2)-selective agonist that crosses the placenta and the blood-brain barrier, was also effective when given either on PN 2-5 or during gestational days 17-20. Terbutaline failed to downregulate brain m(2)AChRs, even though it downregulated beta-ARs; beta-ARs and m(2)AChRs are located on different cell populations in the brain, but they are on the same cells in the heart. Destruction of catecholaminergic neurons with neonatal 6-hydroxydopamine upregulated cardiac but not brain m(2)AChRs. These results suggest that perinatal beta-AR stimulation shifts cardiac receptor production away from the generation of m(2)AChRs so that the development of sympathetic innervation acts as a negative modulator of cholinergic function. Accordingly, tocolytic therapy with beta-AR agonists may compromise the perinatal balance of adrenergic and cholinergic inputs.

Regulation of Pit-1 expression by ghrelin and GHRP-6 through the GH secretagogue receptor

GH secretagogues are an expanding class of synthetic peptide and nonpeptide molecules that stimulate the pituitary gland to secrete GH through their own specific receptor, the GH-secretagogue receptor. The cloning of the receptor for these nonclassical GH releasing molecules, together with the more recent characterization of an endogenous ligand, named ghrelin, have unambiguously demonstrated the existence of a physiological system that regulates GH secretion. Somatotroph cell-specific expression of the GH gene is dependent on a pituitary-specific transcription factor (Pit-1). This factor is transcribed in a highly restricted manner in the anterior pituitary gland. The present experiments sought to determine whether the synthetic hexapeptide GHRP-6, a reference GH secretagogue compound, as well as an endogenous ligand, ghrelin, regulate pit-1 expression. By a combination of Northern and Western blot analysis we found that GHRP-6 elicits a time- and dose-dependent activation of pit-1 expression in monolayer cultures of infant rat anterior pituitary cells. This effect was blocked by pretreatment with actinomycin D, but not by cycloheximide, suggesting that this action was due to direct transcriptional activation of pit-1. Using an established cell line (HEK293-GHS-R) that overexpresses the GH secretagogue receptor, we showed a marked stimulatory effect of GHRP-6 on the pit-1 -2,500 bp 5'-region driving luciferase expression. We truncated the responsive region to -231 bp, a sequence that contains two CREs, and found that both CREs are needed for GHRP-6-induced transcriptional activation in both HEK293-GHS-R cells and infant rat anterior pituitary primary cultures. The effect was dependent on PKC, MAPK kinase, and PKA activation. Increasing Pit-1 by coexpression of pCMV-pit-1 potentiated the GHRP-6 effect on the pit-1 promoter. Similarly, we showed that the endogenous GH secretagogue receptor ligand ghrelin exerts a similar effect on the pit-1 promoter. These data provide the first evidence that ghrelin, in addition to its previously reported GH-releasing activities, is also capable of regulating pit-1 transcription through the GH secretagogue receptor in the pituitary, thus giving new insights into the physiological role of the GH secretagogue receptor on somatotroph cell differentiation and function.

Effect of renal denervation on renin gene expression, concentration, and secretion in mature ovine fetus

To determine the role of the renal nerves on renin secretion and expression in the mature ovine fetus, we performed bilateral renal denervation on eight fetuses of time-dated pregnant ewes (126.8 +/- 0.6 days gestation) and compared renin in them to seven fetuses that underwent sham denervation (126.7 +/- 0.6 days gestation). Fetal arterial and venous catheters were implanted, and after 5-7 days of recovery isoproterenol was infused. Plasma active renin was lower in denervated animals than in intact animals under basal conditions and at each dose of isoproterenol. Plasma prorenin levels were lower in denervated fetuses but unaffected by isoproterenol. Denervation did not change renal renin, prorenin, or renin mRNA, but it did block isoproterenol-induced increases in renin mRNA in renocortical cells in vitro. We conclude that the renal nerves are required for renin secretory mechanisms and responsiveness of renin mRNA to beta-adrenergic stimulation but not for the expression of renin in the fetal kidney. We propose that one or more of the factors that maintain renin expression in the perinatal period may be absent or may be replaced by the renal nerves in the adult.

Ontogeny of G-protein expression: control by beta-adrenoceptors

Cardiac cell homeostasis is maintained in the face of excessive beta-adrenoceptor stimulation through the process of desensitization. Desensitization is not an inherent property of these cells but rather is acquired during development; neonates given beta-agonists actually show heterologous sensitization, involving changes in the expression and catalytic activity of adenylyl cyclase (AC) as well as an increased receptor/G-protein coupling. The current study examines the role of specific G-protein components, G(s)alpha and G(i)alpha, in the ontogeny of beta-adrenoceptor responses and in the transition from agonist-induced sensitization to desensitization. Between postnatal days (PN) 6 and 15 there was a significant decrease in the 52 kDa isoform of G(s)alpha with no accompanying change of the 45 kDa form; over the same period, G(i)alpha3 also declined substantially. In contrast, the 45 kDa isoform of G(s)alpha and G(i)alpha1,2 remained fairly constant over the same period and fluoride-stimulated AC activity increased. Treatment with isoproterenol on PN2-5 did not result in any significant changes in G(s)alpha expression but robustly decreased G(i)alpha1,2. These changes were accompanied by heterologous sensitization of AC activity at the level of AC itself, evidenced by equivalent increases in the enzymatic response to fluoride and forskolin-Mn2+. Isoproterenol given to older animals (PN11-14) also caused specific loss of G(i) protein, in this case targeting G(i)alpha3, whereas G(s)alpha again was unchanged; in contrast to the younger group, the older animals displayed heterologous desensitization of AC at the level of G-protein function (specific loss of the fluoride response). These results indicate that the normal ontogenetic increase of cardiac beta-adrenoceptor coupling to AC is not dependent on the absolute amount of G-proteins, nor on the relative balance of stimulatory (G(s)) and inhibitory (G(i)) subunits. However, the ability of receptor stimulation to downregulate G(i)alpha1,2, an event which is specific to immature cardiac cells, is likely to be an important component of the resistance of the fetal/neonatal heart to agonist-induced desensitization and hypertrophy. The maintenance of cardiac beta-adrenoceptor signaling in the face of intense stimulation is likely to play an important role in the physiologic adaptations necessary to the perinatal transition.

Cardiac sympathetic denervation in early stages of amyotrophic lateral sclerosis demonstrated by 123I-MIBG-SPECT

Involvement of the autonomic cardiac nervous system in early stages of amyotrophic lateral sclerosis (ALS) was evaluated in 40 patients. I-123-metaiodobenzylguanidine-single photon emission computed tomography (MIBG-SPECT) and heart rate variability (HRV) yielded information about sympathetic and parasympathetic innervation of the heart. MIBG-SPECT is a sensitive diagnostic method for demonstration of early cardiac sympathetic denervation. Both sympathetic and parasympathetic dysfunction was observed in 16 (40%) out of 40 patients. Mean cardiac MIBG uptake as demonstrated by the heart/mediastinum ratio was significantly reduced in all ALS patients in comparison with controls (P<0.01). The global MIBG-SPECT score was clearly abnormal in 29% and slightly abnormal in 22% of patients. HRV was diminished in 6 of 38 patients, 4 of whom having an abnormal MIBG-SPECT score as well. The presented results indicate that ALS patients with mild to moderate impairment may have evidence of postganglionic sympathetic adrenergic cardiac or cardiovagal denervation. To our knowledge, this is the first study indicating possible postganglionic sympathetic denervation in ALS. The original concept of ALS as an isolated degeneration of motor neurons seems to extend to a more widespread understanding of the disease which possibly represents different entities.

Regulation of melanophore responsiveness in the background-adapted medaka, Oryzias latipes: change in the intracellular signaling system

The responsiveness of melanophores of the medaka fish (wild type, Oryzias latipes) to a neurotransmitter and hormones is changed differentially after long-term adaptation to a black or white background. In the present study, we further examined whether this phenomenon involved some change in the intracellular signaling system. Using a permeabilized melanophore model, in which pigment granules could be dispersed by exogenously applied cAMP, the requirement of cAMP for pigment-dispersing reaction was revealed to be higher in melanophores of fish adapted to a black background (B cells) than in those of white background-adapted fish (W cells). Specific inhibitors of cAMP-dependent protein kinase (PKA) and cyclic nucleotide phosphodiesterase did not reduce the difference in the pigment dispersion level between B and W cells. A similar result was obtained with the free catalytic subunit of PKA. In contrast, the inhibition of protein phosphatase activity by okadaic acid diminished the difference in the responsiveness between B and W cells. These results suggest that the activity of protein phosphatase in B cell is higher than that in W cells, and that the change in the melanophore responsiveness by long-term chromatic adaptation to a background involves the change in the enzyme activity in the intracellular signaling system.

Neuronal control of cardiac and hepatic macromolecule synthesis in the neonatal rat: effects of sympathectomy

Neurotransmitters are thought to influence cell development in their target tissues. In the current study, neonatal rats were given 6-hydroxydopamine to produce permanent sympathetic denervation, and the effects on cardiac and hepatic DNA and protein synthesis were assessed. Lesioned animals showed deficits in cardiac DNA synthesis over the first 8 d postpartum, a period in which sympathetic innervation is sparse and synaptic norepinephrine concentrations are low; the effect of lesioning was also evident for protein synthesis. Subsequently, DNA synthesis in control animals declined precipitously during the second to third postnatal week, the phase associated with ingrowth of the majority of sympathetic terminals and sympathetic hyperactivity. Neonatal lesioning delayed the ontogenetic decline in DNA synthesis: this effect was not shared by protein synthesis. In the liver, a tissue whose cells, unlike the heart, maintain the ability to divide into adulthood, there was no effect of 6-hydroxydopamine on DNA synthesis and only minor changes in protein synthesis. These results suggest that neural input provides two distinct trophic signals to the developing heart: an early promotion of cell replication associated with low levels of stimulation, and a subsequent promotion of the switchover from cell replication, to cell differentiation and enlargement, associated with high levels of stimulation. In light of the precipitous rise in circulating catecholamines at parturition, and of the subsequent development of sympathetic innervation, catecholamines are likely to play a trophic role in the establishment of the proper pattern of cardiac cell development.

Ontogeny of beta-adrenoceptor/adenylyl cyclase desensitization mechanisms: the role of neonatal innervation

The ability of adrenergic stimulation to elicit desensitization of the beta-receptor/adenylyl cyclase signaling cascade is not an inherent property of cells but rather is acquired during the period in which sympathetic innervation develops. This study examines whether innervation provides the signal that enables target cardiac and hepatic cells to learn to desensitize their responses. Neonatal rats were sympathectomized with 6-OHDA on postnatal day 1 and were treated at various ages with a regimen of isoproterenol known to elicit desensitization in adults. In control rats, desensitization first appeared between days 6 and 15. Desensitization was heterologous, involving changes in the efficiency of G-protein coupling, as there were parallel decreases in isoproterenol-stimulated adenylyl cyclase activity, basal activity and fluoride-stimulated activity (maximal G-protein activation) without changes in forskolin-Mn2+-stimulated activity (total cyclase catalytic activity). The lesioned animals showed a delay in the onset of desensitization as isoproterenol did not evoke decreased responsiveness until day 25 in the heart; the liver did not display agonist-induced desensitization even at day 25. The effects of lesioning on development of desensitization were entirely separable from those on regulation of beta-receptors themselves: agonist-induced decreases in receptor binding appeared by day 15 in both control and lesioned animals. Uniquely in the youngest animals (6 days old), isoproterenol treatment produced heterologous sensitization of adenylyl cyclase responses rather than desensitization, with a parallel increase in basal, isoproterenol-, fluoride- and forskolin-Mn2+-stimulated activity; the latter indicates induction of total catalytic activity as the primary mechanism of sensitization. The lesioned neonates did not show sensitization, despite the fact that during this period, sympathetic pathways are not functionally competent. Our results indicate that innervation provides a timing signal for the onset of desensitization capabilities of sympathetic target cells, but is not absolutely required for the cells to learn how to desensitize. Prior to the onset of desensitization, agonists induce sensitization that may be important in preserving physiological responsiveness during ontogenetic surges of adrenergic activity. The absence of sensitization in lesioned animals implies that, before physiological function is completely established, early pioneer synapses provide a trophic signal that enables cells to increase their sensitivity to stimulation during the perinatal transition period.

Atypical regulation of hepatic adenylyl cyclase and adrenergic receptors during a critical developmental period: agonists evoke supersensitivity accompanied by failure of receptor down-regulation

Ordinarily, beta-adrenergic receptors and responses linked to the receptors increase with development but in the liver, beta-receptors are higher in the fetus and neonate than in adulthood. We examined how hepatic beta-receptor signaling mediated through adenylyl cyclase is regulated in rats of different ages. In each case, animals were pretreated with isoproterenol for 4 d, and on the 5th d, hepatic membrane preparations were examined for adenylyl cyclase activity and receptor binding capabilities. Uniquely in 6-d-old animals, the cyclase response to isoproterenol was enhanced by chronic pretreatment, caused by heterologous sensitization mediated through effects on total catalytic activity (increased response to forskolin-Mn2+) and on G-protein coupling (enhanced effect of fluoride and increased GTP dependence of basal activity). Isoproterenol pretreatment failed to cause beta-receptor down-regulation in 6-d-old animals, but by 15 d of age, down-regulation was detected along with slight desensitization of the cyclase response. However, at 25 d, neither effect was present. In adulthood, repeated isoproterenol administration failed to cause cyclase desensitization but did reduce beta-receptor numbers; the loss of receptors was still unusual in that beta-receptor down-regulation could be achieved with either isoproterenol or with methoxamine, an alpha-receptor agonist. The results indicate that, early in development, hepatic beta-receptor-mediated responses are enhanced, not desensitized, after chronic stimulation. These effects would foster responsiveness of hepatic gluconeogenesis in the face of the massive adrenergic stimulation associated with the transition from fetal to neonatal life. In adulthood, when receptor numbers are far lower than in the neonate, the inability to desensitize the signaling cascade despite receptor down-regulation would serve to maintain the response to catecholamines.

Beta-adrenoceptor control of cardiac adenylyl cyclase during development: agonist pretreatment in the neonate uniquely causes heterologous sensitization, not desensitization

In the adult, increased stimulation of postsynaptic receptor sites produces compensatory desensitization that reduces tissue responsiveness. During development, however, responses in most systems increase with age and with the maturation of neuronal inputs. In the current study, we examined whether agonist-induced desensitization of cardiac beta-adrenergic receptor signaling mediated through adenylyl cyclase could be elicited in 6-, 15- and 25-day-old rats, and in adults. In each case, animals were pretreated with isoproterenol daily for four days preceding the experiment, and on the fifth day, cardiac membrane preparations were examined. Fifteen and 25-day-old animals and adults all exhibited desensitization, as demonstrated by a diminished cyclase response to isoproterenol in vitro. However, in 6-day-old animals, the enzymatic response to isoproterenol was enhanced by chronic pretreatment. Measurements of the G-protein-sensitive component of cyclase (decrement in activity obtained with deletion of GTP from the reaction mixture, stimulatory response to fluoride) indicated heterologous desensitization in the older animals, evidenced by diminished dependence on GTP and reduced response to fluoride; the 6-day-old animals showed enhanced GTP dependence and augmentation of the fluoride response. Uniquely in 6-day-old animals, the total catalytic activity of adenylyl cyclase, measured with forskolin-Mn2+, was markedly elevated by chronic isoproterenol pretreatment, whereas it was unaffected in older animals. These data suggest that regulation of receptor signaling is completely different early in neonatal life. Instead of producing desensitization of responses, agonist exposure promotes receptor signaling by enhancing expression and/or catalytic efficiency of adenylyl cyclase. In older animals, the predominant effect is heterologous desensitization mediated at the level of G-proteins. These developmental differences are likely to be important in the maintenance of tissue responsiveness during the period in which innervation develops, as well as in the ability of neurotrophic input to 'program' the responsiveness of target tissues.