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Iturriaga R, Alcayaga J, Chapleau MW, Somers VK. Carotid body chemoreceptors: physiology, pathology, and implications for health and disease. Physiol Rev 2021; 101:1177-1235. [PMID: 33570461 PMCID: PMC8526340 DOI: 10.1152/physrev.00039.2019] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The carotid body (CB) is the main peripheral chemoreceptor for arterial respiratory gases O2 and CO2 and pH, eliciting reflex ventilatory, cardiovascular, and humoral responses to maintain homeostasis. This review examines the fundamental biology underlying CB chemoreceptor function, its contribution to integrated physiological responses, and its role in maintaining health and potentiating disease. Emphasis is placed on 1) transduction mechanisms in chemoreceptor (type I) cells, highlighting the role played by the hypoxic inhibition of O2-dependent K+ channels and mitochondrial oxidative metabolism, and their modification by intracellular molecules and other ion channels; 2) synaptic mechanisms linking type I cells and petrosal nerve terminals, focusing on the role played by the main proposed transmitters and modulatory gases, and the participation of glial cells in regulation of the chemosensory process; 3) integrated reflex responses to CB activation, emphasizing that the responses differ dramatically depending on the nature of the physiological, pathological, or environmental challenges, and the interactions of the chemoreceptor reflex with other reflexes in optimizing oxygen delivery to the tissues; and 4) the contribution of enhanced CB chemosensory discharge to autonomic and cardiorespiratory pathophysiology in obstructive sleep apnea, congestive heart failure, resistant hypertension, and metabolic diseases and how modulation of enhanced CB reactivity in disease conditions may attenuate pathophysiology.
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Affiliation(s)
- Rodrigo Iturriaga
- Laboratorio de Neurobiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile, and Centro de Excelencia en Biomedicina de Magallanes, Universidad de Magallanes, Punta Arenas, Chile
| | - Julio Alcayaga
- Laboratorio de Fisiología Celular, Facultad de Ciencias, Universidad de Chile, Santiago, Chile
| | - Mark W Chapleau
- Department of Internal Medicine, University of Iowa and Department of Veterans Affairs Medical Center, Iowa City, Iowa
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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Honing M, Martini C, van Velzen M, Niesters M, Dahan A, Boon M. Cholinergic Chemotransmission and Anesthetic Drug Effects at the Carotid Bodies. Molecules 2020; 25:molecules25245974. [PMID: 33348537 PMCID: PMC7765955 DOI: 10.3390/molecules25245974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022] Open
Abstract
General anesthesia is obtained by administration of potent hypnotics, analgesics and muscle relaxants. Apart from their intended effects (loss of consciousness, pain relief and muscle relaxation), these agents profoundly affect the control of breathing, in part by an effect within the peripheral chemoreflex loop that originates at the carotid bodies. This review assesses the role of cholinergic chemotransmission in the peripheral chemoreflex loop and the mechanisms through which muscle relaxants and hypnotics interfere with peripheral chemosensitivity. Additionally, consequences for clinical practice are discussed.
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Abstract
The discovery of the sensory nature of the carotid body dates back to the beginning of the 20th century. Following these seminal discoveries, research into carotid body mechanisms moved forward progressively through the 20th century, with many descriptions of the ultrastructure of the organ and stimulus-response measurements at the level of the whole organ. The later part of 20th century witnessed the first descriptions of the cellular responses and electrophysiology of isolated and cultured type I and type II cells, and there now exist a number of testable hypotheses of chemotransduction. The goal of this article is to provide a comprehensive review of current concepts on sensory transduction and transmission of the hypoxic stimulus at the carotid body with an emphasis on integrating cellular mechanisms with the whole organ responses and highlighting the gaps or discrepancies in our knowledge. It is increasingly evident that in addition to hypoxia, the carotid body responds to a wide variety of blood-borne stimuli, including reduced glucose and immune-related cytokines and we therefore also consider the evidence for a polymodal function of the carotid body and its implications. It is clear that the sensory function of the carotid body exhibits considerable plasticity in response to the chronic perturbations in environmental O2 that is associated with many physiological and pathological conditions. The mechanisms and consequences of carotid body plasticity in health and disease are discussed in the final sections of this article.
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Affiliation(s)
- Prem Kumar
- School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, United Kingdom.
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4
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Kåhlin J, Eriksson LI, Ebberyd A, Fagerlund MJ. Presence of nicotinic, purinergic and dopaminergic receptors and the TASK-1 K+-channel in the mouse carotid body. Respir Physiol Neurobiol 2010; 172:122-8. [PMID: 20452469 DOI: 10.1016/j.resp.2010.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 03/11/2010] [Accepted: 05/02/2010] [Indexed: 10/19/2022]
Abstract
We have characterized the mouse carotid body (CB) with special attention to nicotinic, purinergic and dopaminergic receptors as well as the TASK-1 K(+)-channel. Mouse CB sections were stained immunohistochemically and visualized using fluorescent and confocal microscopy. The CB type 1 cells contained the alpha3 (n=8), alpha4 (n=7), alpha7 (n=4) and beta2 (n=3) nicotinic acetylcholine receptor (nAChR) subunits, the ATP-receptors P2X(2) (n=15) and P2X(3) (n=9), the dopamine D(2) receptor (n=9) and the TASK-1 K(+)-channel (n=7). Here we report the presence of alpha3, alpha4, alpha7 and beta2 nAChR subunits, the D(2) receptor and the TASK-1 K(+)-channel in the mouse CB. Also, we confirm the presence of the P2X(2) and P2X(3) receptors in mouse CB. Thus, we have localized nicotinergic, purinergic and dopaminergic receptors and the TASK-1 K(+)-channel on a protein level in one species. Our data are in line with the theory that the CB chemoreceptor cell hosts an orchestra of receptor systems that ultimately modulate the response to hypoxia.
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Affiliation(s)
- Jessica Kåhlin
- Department of Anesthesiology and Intensive Care Medicine, Karolinska University Hospital, Stockholm, Sweden.
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Soto CR, Ortiz FC, Vargas RV, Arroyo J, Alcayaga J. Responses induced by acetylcholine and ATP in the rabbit petrosal ganglion. Respir Physiol Neurobiol 2010; 172:114-21. [PMID: 20452470 DOI: 10.1016/j.resp.2010.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 04/12/2010] [Accepted: 05/02/2010] [Indexed: 11/28/2022]
Abstract
Acetylcholine and ATP appear to mediate excitatory transmission between receptor (glomus) cells and the petrosal ganglion (PG) neuron terminals in the carotid body. In most species these putative transmitters are excitatory, while inhibitory effects had been reported in the rabbit. We studied the effects of the application of acetylcholine and ATP to the PG on the carotid nerve activity in vitro. Acetylcholine and ATP applied to the PG increased the carotid nerve activity in a dose-dependent manner. Acetylcholine-induced responses were mimicked by nicotine, antagonized by hexamethonium, and enhanced by atropine. Bethanechol had no effect on basal activity, but reduced acetylcholine-induced responses. Suramin antagonized ATP-induced responses, and AMP had little effect on the carotid nerve activity. Our results suggest that rabbit PG neurons projecting through the carotid nerve are endowed with nicotinic acetylcholine and purinergic P2 receptors that increase the carotid nerve activity, while simultaneous activation of muscarinic cholinergic receptors reduce the maximal response evoked by nicotinic cholinergic receptor activation.
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Affiliation(s)
- Carolina R Soto
- Departamento de Biología, Facultad de Ciencias, Universidad de Chile, Santiago, Chile.
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Niane L, Joseph V, Bairam A. Role of cholinergic-nicotinic receptors on hypoxic chemoreflex during postnatal development in rats. Respir Physiol Neurobiol 2009; 169:323-32. [DOI: 10.1016/j.resp.2009.09.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 09/28/2009] [Accepted: 09/29/2009] [Indexed: 11/28/2022]
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Bairam A, Joseph V, Lajeunesse Y, Kinkead R. Developmental profile of cholinergic and purinergic traits and receptors in peripheral chemoreflex pathway in cats. Neuroscience 2007; 146:1841-53. [PMID: 17478045 DOI: 10.1016/j.neuroscience.2007.03.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2006] [Revised: 03/23/2007] [Accepted: 03/23/2007] [Indexed: 10/23/2022]
Abstract
This study describes the developmental profile of specific aspects of cholinergic and purinergic neurotransmission in key organs of the peripheral chemoreflex: the carotid body (CB), petrosal ganglion (PG) and superior cervical ganglion (SCG). Using real time RT-PCR and Western blot analyses, we assessed both mRNA and protein expression levels for choline-acetyl-transferase (ChAT), nicotinic receptor (subunits alpha3, alpha4, alpha7, and beta2), ATP and purinergic receptors (P2X2 and P2X3). These analyses were performed on tissue from 1- and 15-day-old, 2-month-old, and adult cats. During development, ChAT protein expression level increased slightly in CB; however, this increase was more important in PG and SCG. In CB, mRNA level for alpha4 nicotinic receptor subunit decreased during development (90% higher in 1-day-old cats than in adults). In the PG, mRNA level for beta2 nicotinic receptor subunit increased during development (80% higher in adults than in 1-day-old cats). In SCG, mRNA for alpha7 nicotinic receptor levels increased (400% higher in adults vs. 1-day-old cats). Conversely, P2X2 receptor protein level was not altered during development in CB and decreased slightly in PG; a similar pattern was observed for the P2X3 receptor. Our findings suggest that in cats, age-related changes in cholinergic and purinergic systems (such as physiological expression of receptor function) are significant within the afferent chemoreceptor pathway and likely contribute to the temporal changes of O2-chemosensitivity during development.
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Affiliation(s)
- A Bairam
- Unité de recherche en périnatologie, Centre Hospitalier Universitaire de Québec, Hôpital Saint-François d'Assise, Département de Pédiatrie, Université Laval, Québec, Canada.
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Zapata P. Is ATP a suitable co-transmitter in carotid body arterial chemoreceptors? Respir Physiol Neurobiol 2007; 157:106-15. [PMID: 17276149 DOI: 10.1016/j.resp.2007.01.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2006] [Revised: 01/04/2007] [Accepted: 01/04/2007] [Indexed: 11/29/2022]
Abstract
A review is presented on carotid body ATP content, effects and release, receptors involved and results of their block by purinergic antagonists, and the possibility of cholinergic-purinergic co-transmission in the carotid body. Glomus cells release ACh and ATP upon physiological stimulation. Both agents and their agonists have chemo-excitatory actions and their combined effects disappear upon blocking n-ACh and P2X receptors. Both ACh and ATP also are capable of exciting the somata of chemosensory neurons of petrosal ganglia. Although a combined cholinergic-purinergic block suppresses the chemosensory activity in neurons co-cultured with glomus cells and some carotid body preparations in vitro, basal chemosensory activity and chemosensory responses to hypoxic stimuli persist in cat carotid body preparations in situ and in vitro. Therefore, ATP is an effective excitatory agent for carotid body chemosensory activity, although less potent than ACh; their joint participation may contribute to -- but does not entirely explain -- the transfer of chemoreceptor excitation from glomus cells to sensory endings in carotid body.
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Affiliation(s)
- P Zapata
- Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
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Shirahata M, Balbir A, Otsubo T, Fitzgerald RS. Role of acetylcholine in neurotransmission of the carotid body. Respir Physiol Neurobiol 2007; 157:93-105. [PMID: 17284361 DOI: 10.1016/j.resp.2006.12.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2006] [Revised: 12/11/2006] [Accepted: 12/27/2006] [Indexed: 01/19/2023]
Abstract
Acetylcholine (ACh) has been considered an important excitatory neurotransmitter in the carotid body (CB). Its physiological and pharmacological effects, metabolism, release, and receptors have been well documented in several species. Various nicotinic and muscarinic ACh receptors are present in both afferent nerve endings and glomus cells. Therefore, ACh can depolarize or hyperpolarize the cell membrane depending on the available receptor type in the vicinity. Binding of ACh to its receptor can create a wide variety of cellular responses including opening cation channels (nicotinic ACh receptor activation), releasing Ca(2+) from intracellular storage sites (via muscarinic ACh receptors), and modulating activities of K(+) and Ca(2+) channels. Interactions between ACh and other neurotransmitters (dopamine, adenosine, nitric oxide) have been known, and they may induce complicated responses. Cholinergic biology in the CB differs among species and even within the same species due to different genetic composition. Development and environment influence cholinergic biology. We discuss these issues in light of current knowledge of neuroscience.
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Affiliation(s)
- Machiko Shirahata
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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Reyes EP, Fernández R, Larraín C, Zapata P. Carotid body chemosensory activity and ventilatory chemoreflexes in cats persist after combined cholinergic-purinergic block. Respir Physiol Neurobiol 2006; 156:23-32. [PMID: 16956797 DOI: 10.1016/j.resp.2006.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2006] [Revised: 06/23/2006] [Accepted: 07/24/2006] [Indexed: 11/24/2022]
Abstract
Acetylcholine (ACh) and ATP have been proposed as excitatory co-transmitters operating at synapses between glomus cells and sensory nerve endings of the carotid body (CB). To test such hypothesis, we performed experiments on cats under pentobarbitone anesthesia and breathing spontaneously. Cholinergic and purinergic agonists and antagonists were given into one common carotid artery. Chemoreflex ventilatory changes initiated from the ipsilateral CB or chemosensory activity from the ipsilateral carotid nerve were recorded. Agonists ACh, nicotine, epibatidine, ATP, betagamma-methylene-ATP and gammaS-ATP induced transient chemoreflex enhancements of ventilation or increased chemosensory activity. When given in combination, mecamylamine and suramin suppressed both nicotine- and ATP-induced ventilatory chemoreflexes or chemosensory responses. However, neither chemoreflex hyperventilation induced by brief hypoxic exposures or steady-state hypoxic levels, nor chemosensory excitation elicited by these maneuvers were eliminated. Asphyxia-induced chemosensory excitation was not reduced by combined blockade of ACh and ATP receptors. Furthermore, ventilatory or chemosensory depression evoked by 100% O2 tests was unmodified, thus evidencing that basal chemosensory drive in normoxia was not suppressed by combined cholinergic-purinergic blockade. Therefore, although ACh and ATP may participate in chemoexcitation of the CB, their involvement fails to explain the origin of chemosensory discharges from synaptic transmission between glomus cells and chemosensory nerve endings of the CB.
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Affiliation(s)
- E P Reyes
- Laboratorio de Neurobiología, P. Universidad Católica de Chile, Santiago, Chile
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Conde SV, Monteiro EC. Activation of nicotinic ACh receptors with alpha4 subunits induces adenosine release at the rat carotid body. Br J Pharmacol 2006; 147:783-9. [PMID: 16444287 PMCID: PMC1751505 DOI: 10.1038/sj.bjp.0706676] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The effect of ACh on the release of adenosine was studied in rat whole carotid bodies, and the nicotinic ACh receptors involved in the stimulation of this release were characterized. ACh and nicotinic ACh receptor agonists, cytisine, DMPP and nicotine, caused a concentration-dependent increase in adenosine production during normoxia, with nicotine being more potent and efficient in stimulating adenosine release from rat CB than cytisine and DMPP. D-Tubocurarine, mecamylamine, DHbetaE and alpha-bungarotoxin, nicotinic ACh receptor antagonists, caused a concentration-dependent reduction in the release of adenosine evoked by hypoxia. The rank order of potency for nicotinic ACh receptor antagonists that inhibit adenosine release was DHbetaE>mecamylamine>D-tubocurarine>alpha-bungarotoxin. The effect of the endogenous agonist, ACh, which was mimicked by nicotine, was antagonized by DHbetaE, a selective nicotinic receptor antagonist. The ecto-5'-nucleotidase inhibitor AOPCP produces a 72% inhibition in the release of adenosine from CB evoked by nicotine. Taken together, these data indicate that ACh induced the production of adenosine, mainly from extracellular ATP catabolism at the CB through a mechanism that involves the activation of nicotinic receptors with alpha4 and beta2 receptor subunits.
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Affiliation(s)
- Sílvia V Conde
- Department of Pharmacology, Faculty of Medical Sciences, New University of Lisbon, Campo Mártires da Pátria, 130, Lisbon 1169-056, Portugal
| | - Emília C Monteiro
- Department of Pharmacology, Faculty of Medical Sciences, New University of Lisbon, Campo Mártires da Pátria, 130, Lisbon 1169-056, Portugal
- Author for correspondence:
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Otsubo T, Yamaguchi S, Shirahata M. Voltage-dependent K channels in mouse glomus cells are modulated by acetylcholine. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2006; 580:319-24; discussion 351-9. [PMID: 16683738 DOI: 10.1007/0-387-31311-7_49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Affiliation(s)
- Toshiki Otsubo
- Departments of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Jonsson M, Wyon N, Lindahl SGE, Fredholm BB, Eriksson LI. Neuromuscular blocking agents block carotid body neuronal nicotinic acetylcholine receptors. Eur J Pharmacol 2004; 497:173-80. [PMID: 15306202 DOI: 10.1016/j.ejphar.2004.06.052] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2004] [Revised: 06/23/2004] [Accepted: 06/25/2004] [Indexed: 10/26/2022]
Abstract
Neuromuscular blocking agents predominantly block muscle type nicotinic acetylcholine receptors as opposed to the neuronal type. However, there is growing evidence that neuromuscular blocking agents have affinity to some neuronal nicotinic acetylcholine receptors. The carotid body chemoreceptor as the essential oxygen-sensing cell, relies on cholinergic signalling. Atracurium and vecuronium impair carotid body chemoreceptor activity during hypoxia. Here, we characterize atracurium and vecuronium as antagonists at nicotinic receptors of the carotid body chemoreceptor. Isolated rabbit carotid body preparations with carotid sinus nerve were used, and chemoreceptor activities were recorded. There was a concentration-dependent reduction in the chemoreceptor responses to nicotine, with an IC(50) to 50 microg nicotine of 3.64 and 1.64 microM and to 500 microg nicotine of 27.00 microM and 7.29 microM for atracurium and vecuronium, respectively. It is concluded that atracurium and vecuronium depress nicotine-induced chemoreceptor responses of the carotid body in a dose-dependent fashion.
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Affiliation(s)
- Malin Jonsson
- Department of Anesthesiology and Intensive Care Medicine, Karolinska Hospital and Institute, SE-171 76 Stockholm, Sweden.
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