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Luijerink LLM, Vivekanandarajah A, Waters KA, Machaalani R. The α7 and β2 nicotinic acetylcholine receptor subunits regulate apoptosis in the infant hippocampus, and in sudden infant death syndrome (SIDS). Apoptosis 2021; 25:574-589. [PMID: 32577853 DOI: 10.1007/s10495-020-01618-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Apoptosis is increased in the hippocampus of infants who died of sudden infant death syndrome (SIDS), yet it is not known via which mechanism this has occurred. Following existing support for a role of the α7 and β2 nicotinic acetylcholine receptor (nAChR) subunits in apoptotic regulation, we aimed to determine whether these subunits are altered in the SIDS hippocampus and if they are correlated with cell death markers of active caspase-3 (Casp-3) and TUNEL. Further analyses were run according to the presence of major SIDS risk factors related to hypoxia (bed-sharing and prone sleeping), infection (presence of an upper respiratory tract infection (URTI)), cigarette smoke exposure and gender. Immunohistochemical expression of the markers was studied in 4 regions of the hippocampus (Cornu Ammonis (CA)1, CA2, CA3, CA4) and subiculum amongst 52 infants (aged 1-7 months) who died suddenly and unexpectedly (SUDI) and for whom the cause of death was explained (eSUDI; n = 9), or not and characterised as SIDS I (n = 8) and SIDS II (n = 35) according to the San Diego diagnostic criteria. Results showed that SIDS II infants had widespread increases in TUNEL compared with eSUDI and SIDS I infants, as well as increased α7 and Casp-3 in CA2 compared to eSUDI infants, although these changes were predominant amongst infants who did not bed-share. Cigarette smoke exposure had minimal effects on the markers, while an URTI was associated with changes in all markers (after accounting for bed-sharing). Our findings support the role of nAChRs in regulating apoptosis in the SIDS hippocampus, and highlight the need for separate analysis according to risk factors.
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Affiliation(s)
- L L M Luijerink
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Medical Foundation Building K25, Sydney, NSW, 2006, Australia
| | - A Vivekanandarajah
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Medical Foundation Building K25, Sydney, NSW, 2006, Australia
| | - K A Waters
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Medical Foundation Building K25, Sydney, NSW, 2006, Australia.,The Children's Hospital at Westmead, Westmead, NSW, 2146, Australia
| | - R Machaalani
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Medical Foundation Building K25, Sydney, NSW, 2006, Australia. .,The Children's Hospital at Westmead, Westmead, NSW, 2146, Australia.
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Vivekanandarajah A, Nelson ME, Kinney HC, Elliott AJ, Folkerth RD, Tran H, Cotton J, Jacobs P, Minter M, McMillan K, Duncan JR, Broadbelt KG, Schissler K, Odendaal HJ, Angal J, Brink L, Burger EH, Coldrey JA, Dempers J, Boyd TK, Fifer WP, Geldenhuys E, Groenewald C, Holm IA, Myers MM, Randall B, Schubert P, Sens MA, Wright CA, Roberts DJ, Nelsen L, Wadee S, Zaharie D, Haynes RL. Nicotinic Receptors in the Brainstem Ascending Arousal System in SIDS With Analysis of Pre-natal Exposures to Maternal Smoking and Alcohol in High-Risk Populations of the Safe Passage Study. Front Neurol 2021; 12:636668. [PMID: 33776893 PMCID: PMC7988476 DOI: 10.3389/fneur.2021.636668] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/29/2021] [Indexed: 11/13/2022] Open
Abstract
Pre-natal exposures to nicotine and alcohol are known risk factors for sudden infant death syndrome (SIDS), the leading cause of post-neonatal infant mortality. Here, we present data on nicotinic receptor binding, as determined by 125I-epibatidine receptor autoradiography, in the brainstems of infants dying of SIDS and of other known causes of death collected from the Safe Passage Study, a prospective, multicenter study with clinical sites in Cape Town, South Africa and 5 United States sites, including 2 American Indian Reservations. We examined 15 pons and medulla regions related to cardiovascular control and arousal in infants dying of SIDS (n = 12) and infants dying from known causes (n = 20, 10 pre-discharge from time of birth, 10 post-discharge). Overall, there was a developmental decrease in 125I-epibatidine binding with increasing postconceptional age in 5 medullary sites [raphe obscurus, gigantocellularis, paragigantocellularis, centralis, and dorsal accessory olive (p = 0.0002-0.03)], three of which are nuclei containing serotonin cells. Comparing SIDS with post-discharge known cause of death (post-KCOD) controls, we found significant decreased binding in SIDS in the nucleus pontis oralis (p = 0.02), a critical component of the cholinergic ascending arousal system of the rostral pons (post-KCOD, 12.1 ± 0.9 fmol/mg and SIDS, 9.1 ± 0.78 fmol/mg). In addition, we found an effect of maternal smoking in SIDS (n = 11) combined with post-KCOD controls (n = 8) on the raphe obscurus (p = 0.01), gigantocellularis (p = 0.02), and the paragigantocellularis (p = 0.002), three medullary sites found in this study to have decreased binding with age and found in previous studies to have abnormal indices of serotonin neurotransmission in SIDS infants. At these sites, 125I-epibatidine binding increased with increasing cigarettes per week. We found no effect of maternal drinking on 125I-epibatidine binding at any site measured. Taken together, these data support changes in nicotinic receptor binding related to development, cause of death, and exposure to maternal cigarette smoking. These data present new evidence in a prospective study supporting the roles of developmental factors, as well as adverse exposure on nicotinic receptors, in serotonergic nuclei of the rostral medulla-a finding that highlights the interwoven and complex relationship between acetylcholine (via nicotinic receptors) and serotonergic neurotransmission in the medulla.
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Affiliation(s)
- Arunnjah Vivekanandarajah
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Morgan E. Nelson
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Hannah C. Kinney
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Rebecca D. Folkerth
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Forensic Medicine, New York University School of Medicine, New York City, NY, United States
| | - Hoa Tran
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Jacob Cotton
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Perri Jacobs
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Megan Minter
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Kristin McMillan
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Jhodie R. Duncan
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Kevin G. Broadbelt
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Kathryn Schissler
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Hein J. Odendaal
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Jyoti Angal
- Avera Research Institute, Sioux Falls, SD, United States
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Lucy Brink
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Elsie H. Burger
- Division of Forensic Pathology, Department of Pathology, Faculty of Health Sciences, Stellenbosch University & Western Cape Forensic Pathology Service, Tygerberg, South Africa
| | - Jean A. Coldrey
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Johan Dempers
- Division of Forensic Pathology, Department of Pathology, Faculty of Health Sciences, Stellenbosch University & Western Cape Forensic Pathology Service, Tygerberg, South Africa
| | - Theonia K. Boyd
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
| | - William P. Fifer
- Department of Psychiatry and Pediatrics, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY, United States
| | - Elaine Geldenhuys
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Coen Groenewald
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Ingrid A. Holm
- Division of Genetics and Genomics and the Manton Center for Orphan Diseases Research, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Michael M. Myers
- Department of Psychiatry and Pediatrics, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY, United States
| | - Bradley Randall
- Department of Pathology, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States
| | - Pawel Schubert
- Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Mary Ann Sens
- Department of Pathology, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Colleen A. Wright
- Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
- Lancet Laboratories, Johannesburg, South Africa
| | - Drucilla J. Roberts
- Department of Pathology, Massachusetts General Hospital, Boston, MA, United States
| | | | - Shabbir Wadee
- Division of Forensic Pathology, Department of Pathology, Faculty of Health Sciences, Stellenbosch University & Western Cape Forensic Pathology Service, Tygerberg, South Africa
| | - Dan Zaharie
- Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Robin L. Haynes
- Department of Pathology, Harvard School of Medicine, Boston Children's Hospital, Boston, MA, United States
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Aishah A, Hinton T, Waters KA, Machaalani R. The α3 and α4 nicotinic acetylcholine receptor (nAChR) subunits in the brainstem medulla of sudden infant death syndrome (SIDS). Neurobiol Dis 2019; 125:23-30. [PMID: 30665006 DOI: 10.1016/j.nbd.2019.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 12/17/2022] Open
Abstract
SIDS occurs in early infancy and predominantly during a sleep period. Abnormalities in nicotine receptor binding and in the expression of the nicotinic acetylcholine receptor (nAChR) subunits α7 and β2 have been reported in the brainstem of SIDS infants. This study focuses on the α3 and α4 nAChR subunits as α3 is important for early postnatal survival while α4 is crucial for nicotine-elicited antinociception and sleep-wake cycle regulation. Tissue from the rostral medulla of infants who died with a known cause of death (eSUDI, n = 7), and from SIDS classified as SIDS I (n = 8) and SIDS II (n = 27), was immunohistochemically stained for the α3 and α4 nAChR subunits and quantified in 9 nuclei comparing amongst these groups. The association with risk factors of sex, cigarette smoke exposure, upper respiratory tract infection (URTI), prone sleeping and bedsharing was also evaluated. Results showed that only α4 changes (increase) were evident in SIDS, occurring in the hypoglossal and cuneate nuclei of SIDS II infants and the nucleus of the spinal trigeminal tract of SIDS I infants. Amongst the SIDS infants, cigarette smoke exposure was only associated with decreased α4 in cribriform fibre tracts, while sex and bedsharing were associated with increases in α3 in the dorsal motor nucleus of the vagus and solitary nucleus, respectively. Combined, these findings suggest that abnormalities in endogenous acetylcholine synthesis and regulation may underlie the altered α3 and α4 nAChR subunit expressions in the SIDS brainstem medulla since the changes were not related to cigarette smoke exposure.
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Affiliation(s)
- Atqiya Aishah
- Discipline of Pharmacology, Faculty of Health and Medicine, The University of Sydney, NSW 2006, Australia; The Bosch Institute, Faculty of Health and Medicine, The University of Sydney, NSW 2006, Australia
| | - Tina Hinton
- Discipline of Pharmacology, Faculty of Health and Medicine, The University of Sydney, NSW 2006, Australia; The Bosch Institute, Faculty of Health and Medicine, The University of Sydney, NSW 2006, Australia
| | - Karen A Waters
- Central Clinical School of Medicine, Faculty of Health and Medicine, The University of Sydney, NSW 2006, Australia
| | - Rita Machaalani
- The Bosch Institute, Faculty of Health and Medicine, The University of Sydney, NSW 2006, Australia; Central Clinical School of Medicine, Faculty of Health and Medicine, The University of Sydney, NSW 2006, Australia.
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