Substance P increases cochlear blood flow without changing cochlear electrophysiology in rats

Physiopathology of the cochlear microcirculation

Normal blood supply to the cochlea is critically important for establishing the endocochlear potential and sustaining production of endolymph. Abnormal cochlear microcirculation has long been considered an etiologic factor in noise-induced hearing loss, age-related hearing loss (presbycusis), sudden hearing loss or vestibular function, and Meniere's disease. Knowledge of the mechanisms underlying the pathophysiology of cochlear microcirculation is of fundamental clinical importance. A better understanding of cochlear blood flow (CoBF) will enable more effective management of hearing disorders resulting from aberrant blood flow. This review focuses on recent discoveries and findings related to the physiopathology of the cochlear microvasculature.

Substance P inhibits potassium and calcium currents in inner ear spiral ganglion neurons

Substance P (SP), a member of the tachykinin family of neurotransmitters and neuromodulators, has been identified on spiral ganglion neurons (SGNs) in the inner ear; however, its high affinity receptor, neurokinin-1 (NK1), has not been identified and the physiological effects of SP on SGNs are not well understood. To address these issues, immunolabeling, RT-PCR, Western blots and whole-cell patch-clamp recordings were made from SGNs in P0-P5 mouse cochlear organotypic cultures. The NK1 receptor was detected on SGNs by immunocytochemistry, the protein was detected in cochlear tissues by Western blots, and the mRNA for the NK1 receptor was also found in cochlear tissues of postnatal mice (P2) by RT-PCR. Application of SP (1 to 25 microM) significantly increased the latency of SGN action potentials (APs) (mean increase 7.8 +/- 4 ms; 25 microM of SP), prolonged the duration of the action potential and made the resting potential (RP) more positive (mean 9.0 +/- 7 mV) relative to normal values (-54 +/- 6 mV). SP (1 to 25 microM) also suppressed voltage-activated potassium currents (IK+) and calcium currents (ICa2+). Puffing 25 microM of SP onto SGNs suppressed IK+ by 43 +/- 9% (n = 7) and ICa2+ by 40.6 +/- 5.6% (n = 7); both currents recovered when SP was washed out. A SP antagonist blocked the SP-induced suppression of IK+ and ICa2+. These results indicate that SP acting through NK1 receptors can have direct neuromodulatory effects on SGNs.

Substance P mobilizes intracellular calcium and activates a nonselective cation conductance in rat spiral ganglion neurons

We demonstrate the expression of functional tachykinin receptors in rat spiral ganglion neurons (SGNs) using calcium signal measurement and whole-cell patch clamp recording. Substance P (SP; 10 microm, 1 s application) induced a transient increase in intracellular calcium. The SP dose-response study showed an EC50 of 18.8 microm and a Hill slope of 0.77. Comparison between specific agonists for the three tachykinin receptor (NKR) types showed the potency NKR3 > NKR1 > NKR2 at 10 microm. The Ca2+ response could be evoked in Ca2+-free medium and was blocked by N-ethylmaleimide and U-73122, indicating that Ca2+ was released from intracellular stores via a G-protein and phospholipase C pathway. Under whole-cell voltage clamp recording at a holding potential of -50 mV, SP (10 microm, 1 s) evoked a slowly developing transient inward current. The current reversed near to 0 mV and ionic permeability experiments revealed a cation nonselective conductance also permeable to large organic cations such as N-methyl-D-glucamine and tetraethylammonium. Neither removing extracellular calcium nor chelating intracellular calcium with 10 mm BAPTA could block the SP-evoked current. This conductance appeared coupled to G-protein activation as intracellular GDP-betaS blocked the SP-evoked current. Mutual desensitization and occlusion studies with acetylcholine and ATP showed that the SP-evoked conductance share effector channels and/or intracellular processes with the purinergic/cholinergic conductance. In SGNs, SP could have both a trophic action, via a calcium response, and a neuromodulatory role, by a depolarizing action through the activation of nonselective cation channels.

Distribution of ectonucleoside triphosphate diphosphohydrolases 1 and 2 in rat cochlea

Extracellular ATP and other extracellular nucleotides acting via P2 receptors in the inner ear initiate a wide variety of signalling pathways important for regulation of hearing and balance. Ectonucleotidases are extracellular nucleotide-metabolising enzymes that modulate purinergic signalling in most tissues. Major ectonucleotidases in the cochlea are likely members of the ectonucleoside triphosphate diphosphohydrolase (E-NTPDase) family. In this study, we provide a detailed description of NTPDase1 and NTPDase2 distribution in cochlear tissues using immunocytochemistry. E-NTPDase immunoreactivity was not equally distributed in the tissues bordering scala media. It was observed in the organ of Corti, including sensory and supporting cells, but was notably absent from Reissner's membrane and most of the marginal cells of the stria vascularis. NTPDase1 expression was most prominent in the cochlear vasculature and cell bodies of the spiral ganglion neurones, whereas considerable NTPDase2 immunoreactivity was detected in the stria vascularis. Both E-NTPDases were expressed in the cuticular plates of the sensory hair cells and nerve fibres projecting from the synaptic area underneath the inner and outer hair cells. E-NTPDase localisation corresponds to the reported distribution of some P2X receptor subunits (P2X(2) in particular) in sensory, supporting and neural cells and also P2Y receptor distribution in the vasculature and secretory tissues of the lateral wall. The role for E-NTPDases in purinergic signalling is most likely to regulate extracellular nucleoside triphosphate and diphosphate levels and thus provide termination for extracellular ATP signalling that has been linked to control of cochlear blood flow, electrochemical regulation of sound transduction and to neurotransmission in the cochlea.

Co-existence of tyrosine hydroxylase and calcitonin gene-related peptide in cochlear spiral modiolar artery of guinea pigs

The distribution of tyrosine hydroxylase (TH) and calcitonin gene-related peptide (CGRP) on the cochlear spiral modiolar artery (SMA) was investigated in the guinea pig. The SMA was dissected from the modiolus so that the entire length of the vessel and many of its branches could be observed. Immunohistochemical labeling and double immunofluorescence were employed to localize each compound and to determine whether the TH and CGRP co-exist in neurons of the SMA. Microscopic examination of whole vessel preparations revealed numerous TH- and CGRP-positive neural networks innervating the SMA and its branches. The labeled neurons showed distinct arborization, varicosities and overlap, and were of different diameters. Confocal immunofluorescence microscopy of double-labeled TH and CGRP neurons showed that a number of the TH- and CGRP-positive neurons were co-labeled. Thus, TH and CGRP partially co-exist within the neuronal innervation of SMA. These findings support a hypothesis that specific neuropeptide and adrenergic neurons regulate cochlear blood flow.

Comparison of the vascular innervation of the rat cochlea and vestibular system

In order to gain a better understanding of the neuronal and local control of inner ear blood flow, the vascular innervation to the rat cochlea and vestibular system was examined. Specimens were removed in toto beginning at the basilar artery extending to the anterior inferior cerebellar artery, labyrinthine artery, common cochlear artery, modiolar artery and anterior vestibular artery. When possible the vessels were dissected in continuity through the cribrose area. The vestibular endorgans were also removed. Specimens were examined using immunohistochemical techniques for the presence of vasoactive intestinal peptide, neuronal nitric oxide synthase, neuropeptide-Y, substance P and calcitonin gene related peptide. Results show that the vasculature to the cochlea and vestibular portion of the inner ear receive similar types of nonadrenergic innervation, that within the vestibular endorgans, only CGRP and SP were found in the neuroepithelium or in association with vessels, and that within the vestibular system, the majority of the vascular innervation appears to stop at or near the cribrose area. In the cochlea however, it extends to include the radiating arterioles. These findings suggest that cochlear blood flow is under finer control and that neuronally induced changes in blood flow may have a more global effect in the vestibular periphery.

Modulation of cochlear blood flow by extracellular purines

Humoral adenosine 5'-triphosphate (ATP), adenosine and uridine 5'-triphosphate (UTP) have been shown to have a role in controlling local blood flow in a variety of tissues. The presence of P1 and P2 receptors in the cochlea, and particularly the highly vascular region, the stria vascularis, implies a vasoactive role for these compounds in the inner ear. To test the effect of extracellular purines and pyrimidines on cochlear blood flow, cochleae from anaesthetised guinea-pigs were perfused with ATP (1 microM-10 mM), adenosine (1 microM-10 mM) and UTP (1 mM) in artificial perilymph while blood flow through the cochlea was measured. An acute perilymphatic perfusion technique was established via tubing placed through a hole in the bone overlying scala tympani of the first cochlear turn, with an outlet hole in scala vestibuli of the fourth turn. Blood flow was measured by placing the probe of a laser Doppler blood perfusion monitor on the bone overlying the stria vascularis in the third cochlear turn. ATP and adenosine produced a significant dose dependent increase in cochlear blood flow (28.8-229.0% and 35.8-258.1%, respectively). The effect of ATP (100 microM) on cochlear blood flow was reduced in the presence of reactive blue 2 (1 mM) and pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (1 mM). The blood flow response to adenosine (10 microM) was reduced in the presence of 1,3-dimethylxanthine (theophylline, 100 microM), but not with either 3,7-dimethyl-1-propargylxanthine (10 microM) or 8-cyclopentyl-1,3-dipropylxanthine (10 microM). UTP did not produce any change in the cochlear blood flow. To determine if the ATP effect was also mediated by adenosine derived from ectonucleotidase activity, the perilymphatic compartment was perfused with either ATP plus theophylline (100 microM) or with the non-metabolisable form of ATP, adenosine 5'-O-(3-thiophosphate) (ATPgammaS, 100 microM). The effect of ATP on cochlear blood flow was unaffected with the inclusion of theophylline while ATPgammaS produced an increase in cochlear blood flow similar to the one observed with ATP. These findings indicate that extracellular ATP and its metabolite adenosine have a modulatory role in cochlear blood flow possibly mediated by both P1 and P2 receptors.

Endolymphatic hydrops reduces retrograde labeling of trigeminal innervation to the cochlea

This paper reports that endolymphatic hydrops causes a significant reduction of retrogradely labeled cell bodies of the ipsilateral trigeminal ganglion following application of horseradish peroxidase in the cochlea. We previously showed that the trigeminal ganglion is a source of primary sensory innervation to the cochlear blood vessels. The innervation of the cochlea from the trigeminal ganglion may provide the basis of an alternative mechanism for Ménière's syndrome (imbalance, hearing loss, tinnitus, and a sensation of fullness in the ear) for which a central neural basis has been speculated. Innervation patterns of sensory nerves from the trigeminal ganglion to the cochlear blood vessels were studied using retrograde transport of wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP). Healthy and hydropic guinea pigs were unilaterally implanted with an osmotic pump and a cannula for cochlear delivery of 2% WGA-HRP or vehicle alone. In other guinea pigs the cochlea was pretreated with 100 micromol capsaicin before administering 2% WGA-HRP. Histological sections of the ipsi- and contralateral trigeminal ganglia were obtained 48 h after WGA-HRP infusion. In the hydropic guinea pig, the number of labeled nerve cell bodies observed in the anteriomedial portion of the trigeminal ganglion at the origin of the ophthalmic nerve was reduced by 70% relative to normal animals. Capsaicin pretreatment nearly eliminated the labeled sensory fibers as expected. These data indicate that the trigeminal innervation to the cochlea could be involved in inner ear homeostatic disturbances, including the hydrops that is symptomatic of Ménière's disease.

Changes in cochlear blood flow due to intra-arterial infusions of angiotensin II (3-8) (angiotensin IV) in guinea pigs

The effects of a newly discovered form of angiotensin, angiotensin IV (ANGIV), on cochlear blood flow (CBF) have been investigated utilizing the laser Doppler flowmetry (LDF) technique. Two specific questions were addressed: What are the effects of anterior inferior cerebellar artery infusions (AICA) of ANGIV on CBF and do angiotensin fragments other than ANGIV influence CBF in mature male and female guinea pigs. Infusions of ANGIV, and C-terminal shortened fragments were accomplished via micropipette into the AICA and changes in CBF were observed using LDF. The results demonstrated that 10 and 100 pmol/min doses of ANGIV increased CBF 22% and 75% (n = 6; P < 0.01) from baseline, respectively, with little change in mean arterial blood pressure (MAP). Pretreatment with the ANGIV antagonist divalanal-ANGIV (1 nmole/min) blocked increases in CBF due to infusions of 100 pmol/min of ANGIV. The infusion of the C-terminal shortened fragment ANGIV(1-5) and saline had no significant effect on either CBF or MAP. These results provide the evidence for a new subtype of the angiotensin receptor and indicate the likely role of circulating hormones in blood flow regulation in the inner ear.

Guinea pig vestibular blood flow in response to calcitonin-gene related peptide

Little is known about the physiologic regulation of the vestibular end organ blood flow. The purpose of the current study was to examine posterior semicircular canal ampulla blood flow in addition to systemic factors during intravenous infusions of calcitonin-gene related peptide (CGRP), a factor involved in the tonic regulation of blood flow. Receptors for this factor are known to be available to the vascular supply of the vestibular organs. Local blood flow using laser Doppler flowmetry and systemic parameters were monitored during infusion of CGRP. CGRP antagonists and control vehicle. The results show relatively stable vestibular blood flow (VBF), concentration-dependent decreases in systemic blood pressure, and elevations in heart rate. Pretreatment with CGRP(8-37), a specific receptor antagonist, attenuated these responses to subsequent CGRP infusions. These findings suggest a rigid regulation of VBF in the presence of a systemically active vasodilator.

Trigeminal ganglion innervation of the cochlea--a retrograde transport study

Innervation patterns of sensory nerves from the trigeminal ganglion to the cochlear blood vessels were studied using retrograde transport of wheat germ agglutinin conjugated to horseradish peroxidase. Guinea-pigs (n=7) were unilaterally implanted with an osmotic pump and a cannula for cochlear delivery of 2% or 20% wheat germ agglutinin horseradish peroxidase (Group 1), 2% wheat germ agglutinin-horseradish peroxidase followed by 100 micromol capsaicin (Group 2), or vehicle alone. Histological sections of the trigeminal ganglia, the C1 and C2 dorsal ganglia, the superior and inferior ganglia of the glossopharyngeal nerve bilaterally, the midbrain and the brainstem were obtained after 48 h of infusion. In Group 1, a large number of labeled nerve cell bodies were observed in the anteromedial portion of the trigeminal ganglion and at the origin of the ophthalmic nerve. Some labeled cells were also found on the lateral side of the ophthalmic nerve, as well as on the medial side of the maxillary nerve root. Capsaicin pretreatment significantly reduced the density of labeled neurons in the trigeminal ganglion. A few labeled neurons were also found in the trigeminal brainstem nucleus complex and in certain auditory brainstem nuclei. No wheat germ agglutinin horseradish peroxidase-positive cells were observed in the spinal C1 or C2 cervical ganglia or in the superior or inferior glossopharyngeal ganglia. In contrast, wheat germ agglutinin-horseradish peroxidase application to the middle ear resulted in labeled cells in the middle posterolateral portion of the trigeminal ganglia and in the superior ganglia of the glossopharyngeal nerve. These results provide the first direct evidence that the trigeminal ganglion sends projections to the cochlea.

Nitric oxide mediates capsaicin-induced increase in cochlear blood flow

Capsaicin has been previously shown to increase cochlear blood flow (CBF) in a dose-dependent manner. The aim of this study was to define the role of nitric oxide (NO) in capsaicin-induced changes in CBF. This was investigated in the anesthetized guinea pig, utilizing laser Doppler flowmetry. Application of capsaicin (64.8 and 6.48 nmol in 2 microliters of saline) to the round window membrane (RWM) caused increases in CBF (34 +/- 2.8% of baseline (BL) and 28 +/- 2.3% BL, respectively (P < 0.001)). Application of the NO synthase inhibitor, NG-nitro-L-arginine methyl ester (L-NAME) (10 mg/kg intravenously or topically to the RWM) reduced blood flow in the cochlea, as previously reported. After pretreatment with i.v. L-NAME, the effect of capsaicin on CBF was significantly decreased. With the dose of capsaicin at 64.8 nmol, the increase in CBF fell from 34 +/- 2.8% BL to 6.9 +/- 1.5% BL (P < 0.001), and at 6.48 nmol it fell from 28 +/- 2.3% BL to 4.8 +/- 1.6% BL (P < 0.001). RWM L-NAME application also decreased the capsaicin vasodilatation effect. A capsaicin dose of 64.8 nmol resulted in only a 10 +/- 2.5% BL increase in CBF, and with 6.48 nmol capsaicin the increase was 7.8 +/- 2.2% of BL (P < 0.001). Capsaicin-sensitive sensory neurons in other systems are generally known to release substance P (SP), which in turn elicits release of endothelium derived relaxing factor (NO). The results of this study indicate that NO is a mediator of capsaicin-sensitive sensory neuronal function in CBF regulation.

Atrial natriuretic peptide participates in the regulation of vestibular blood flow

Atrial natriuretic peptide (ANP) is a cardiac hormone which exerts natriuretic, diuretic and vasorelaxant effects. Among the many organs and vascular beds populated with ANP receptors (Genest and Cantin, 1988) are the vestibular and auditory organs of the inner ear (Lamprecht and Meyer zum Gottesberge, 1988). The purpose of the current study was to assess the potential influence of ANP on vestibular blood flow in the guinea pig. The inner ear was exposed with a posterior-lateral approach medially through the mastoid cortex. The laser Doppler probe was placed adjacent to the ampulla of the posterior semicircular canal. Baseline measurements of mean blood pressure (BP), heart rate (HR) and vestibular blood flow were established. ANP dissolved in physiologic saline was infused intravenously at concentrations of 15, 150 or 300 ng/kg/min at 10 microliters/min for 30 min. Measurements were recorded during the infusion and for a recovery period of 65 min. The control group was treated equivalently and infused with 0.15 M NaCl. Baseline BP and HR for all animals were 40.1 +/- 6.67 and 190 +/- 15.7, respectively. BP, HR and vestibular blood flow remained stable during the baseline, control and recovery conditions of saline infused subjects. Infusion of ANP (15 ng/kg/min) induced a mild elevation of BP followed by a small decrease in pressure during the post-infusion period. Vestibular blood flow showed a decrease to approximately 20% below baseline during infusion and stabilized at this level during the recovery period. Infusion of higher concentrations of ANP (150 and 300 ng/kg/min) induced a similar pattern of BP change in a dose-dependent manner. Vestibular blood flow, however, evidenced significant elevations during the post-infusion periods for both concentrations. These increases (22% and 26%, for 150 and 300 ng/kg/min, respectively) were significantly different from vestibular blood flow changes in the saline and low dose groups. The HR remained stable for baseline, infusion and recovery periods for each of the ANP infused subjects. This investigation demonstrates the systemic and local effects of ANP suggest a possible role for ANP in local regulation of vestibular blood flow.

Neuronal regulation of cochlear blood flow in the guinea-pig

1. Previous studies have shown that electrical stimulation (ES) of the guinea-pig cochlea causes a neurally mediated increase in cochlear blood flow (CBF). It is known that the centrifugal neuronal input to the cochlea comes through the perivascular sympathetic plexus from the cervical sympathetic chain and along the vestibular nerve (VN) from the periolivary area of the brainstem. Both of these neuronal systems are distributed topographically in the cochlea. 2. In order to study the neural origins of ES-evoked CBF increase, laser Doppler flowmetry was used to test the following hypotheses. (a) The response is regional, that is, limited to the area of the cochlea stimulated. To test this we performed differential ES of the cochlear turns. CBF was measured from either the third or the first turn. (b) The response is mediated via autonomic receptors within the cochlea. To study this, we applied atropine, succinylcholine and idazoxan locally to the cochlea. (c) The response is influenced by neuronal input via the sympathetic cervical chain (SC) and components of the VN. We stimulated and sectioned the SC, and sectioned the VN, to test this hypothesis. 3. We observed that the CBF response was topographically restricted to the stimulated region. Locally applied muscarinic or nicotinic antagonists (atropine and succinylcholine respectively) did not affect the response. However, local idazoxan (an alpha 2-blocker) eliminated the response. Locally applied adrenaline and SC stimulation modified the dynamic range of the response. SC sectioning enhanced the responsiveness of the cochlear vasculature to ES. The VN section caused a temporary decrease in CBF and elimination of the ES-evoked CBF response. 4. We conclude that the release of dilating agents is topographical with respect to ES current flow, the ES-evoked CBF increase is peripherally mediated via alpha 2-receptors, and the response is influenced by input via the SC. The elimination of the response by VN sectioning proximal to the brainstem indicated that fibres of the VN mediate the CBF increase during direct cochlear ES. The data suggest that these fibres may be the efferent limb of a neural loop involved with the regulation of CBF. Such a system could provide a mechanism for the rapid increase in CBF with organ stress.