Distribution of SP- and CGRP-immunoreactivity in the cat's larynx

Laryngeal Chemoreflex in Health and Disease: A Review

The larynx plays a key role in airway protection via the laryngeal chemoreflex (LCR). This involuntary reflex can be evoked when hazardous substances activate mucosal receptors, which send signals to be processed within the brainstem. Although the LCR is meant to be protective, the reflex can become hyperstimulated, even to benign stimuli, which can result in pathological disorders, such as chronic cough and inducible laryngeal obstruction. In this review, we will outline the mechanism of the LCR and its associated pathological disorders.

Sensory Innervation of the Larynx and the Search for Mucosal Mechanoreceptors

Purpose The larynx is a uniquely situated organ, juxtaposed between the gastrointestinal and respiratory tracts, and endures considerable immunological challenges while providing reflexogenic responses via putative mucosal mechanoreceptor afferents. Laryngeal afferents mediate precise monitoring of sensory events by relay to the internal branch of the superior laryngeal nerve (iSLN). Exposure to a variety of stimuli (e.g., mechanical, chemical, thermal) at the mucosa-airway interface has likely evolved a diverse array of specialized sensory afferents for rapid laryngeal control. Accordingly, mucosal mechanoreceptors in demarcated laryngeal territories have been hypothesized as primary sources of sensory input. The purpose of this article is to provide a tutorial on current evidence for laryngeal afferent receptors in mucosa, the role of mechano-gated ion channels within airway epithelia and mechanisms for mechanoreceptors implicated in laryngeal health and disease. Method An overview was conducted on the distribution and identity of iSLN-mediated afferent receptors in the larynx, with specific focus on mechanoreceptors and their functional roles in airway mucosa. Results/Conclusions Laryngeal somatosensation at the cell and molecular level is still largely unexplored. This tutorial consolidates various animal and human researches, with translational emphasis provided for the importance of mucosal mechanoreceptors to normal and abnormal laryngeal function. Information presented in this tutorial has relevance to both clinical and research arenas. Improved understanding of iSLN innervation and corresponding mechanotransduction events will help shed light upon a variety of pathological reflex responses, including persistent cough, dysphonia, and laryngospasm.

Glycoconjugate residues in a subpopulation of feline taste cells

There have been a number of studies which have categorized cells of feline taste buds: Types I, II, III and IV; however, few studies have examined whether feline taste bud cell types differ from each other histochemically. The goal of the present study is to figure out what kinds of glycoconjugates correspond to the four different types of cells in the taste bud. We have detected glycochains by lectin histochemistry. We have also identified Types II and III by immunohistochemistry. Then, we combined lectin histochemistry and immunohistochemistry to determine which types of cells have which glycochains. In addition, we have compared these reactions in different papillae in the oral cavity: circumvallate papillae, fungiform papillae and epiglottises. Our results demonstrated that glycoconjugates showed a variety of distributions among cells in these papillae, although immunopositive reactions of the proteins involved in the taste transduction showed similar distributions in the taste buds in these papillae. Amongst all, N-acetyllactosamine was the most prominently detected glycoconjugate residue in a subpopulation of Type II (receptor) cells and Type III (pre-synaptic) cells. Our findings suggest that 1) Different localization of glycol-residues in taste buds might be owing to the possibility that different types of cells need different types of glycoconjugates, possibly for the function of cells in the taste buds, and 2) N-acetyllactosamine might play some roles in taste sensation perception and their transfer by Type II and III cells.

Intraepithelial Nerve Fibers Project Into the Lumen of the Larynx

OBJECTIVES/HYPOTHESIS

Studies on the morphology and location of the sensory receptors in the laryngeal mucosa have resulted in insufficient and sometimes conflicting data. In the present study the authors analyzed the distribution and morphology of sensory nerve plexuses and terminal fibers in the laryngeal mucosa of the rat.

STUDY DESIGN

Two groups of Male Wistar rats were used in this laboratory study; the larynx of the first group were used to analyse the sensitive innervation of its epithelium, whereas the larynx of the second group (controls) were tested for the specificity of the antibodies used.

METHODS

The larynges of the animals were entirely removed after perfusion, and coronal or horizontal sections were immunoprocessed for further randomized analysis of the mucosa. Primary afferents were detected by immunoreaction to two widely recognized markers of sensory nerves, calcitonin gene-related peptide and substance P, and visualized using diaminobenzidine as a chromogen.

RESULTS

The nerve plexuses were more densely distributed in the dorsal half of the vocal folds and in the laryngeal aspect of the epiglottis. Dense networks of fine fibers with many varicosities en passant, immunoreactive for both calcitonin gene-related peptide and substance P, occurred in the lamina propria and along the epithelial thickness. Calcitonin gene-related peptide-immunoreactive and substance P-immunoreactive fibers extended across the epithelium and projected to the laryngeal lumen itself, reaching the space between the cilia.

CONCLUSION

The projection of intraepithelial nerve fibers into the lumen of the larynx indicates that in the absence of mucus, nerve endings may be exposed and thus receive direct stimulation from airborne substances. Furthermore, it suggests that the laryngeal mucosa of the rat may constitute an experimental model for studying the direct activation or manipulation of primary afferents at the periphery and neurogenic inflammation.

Contribution of free nerve endings in the laryngeal epithelium to CO2 reception in rats

The superior laryngeal nerve (SLN) contains CO2-sensitive fibers. In the laryngeal epithelium, two candidates for CO2 reception have been identified, namely the intraepithelial free nerve endings and the taste buds. To elucidate the contribution of free nerve endings to CO2 reception, electrophysiological activities were recorded during various stages of regeneration of nerve endings following SLN-crush in rats. The left SLN was crushed surgically and maintained from 4 to 40 days for regeneration of nerve endings. Laryngeal sections were processed for immunohistochemical staining of protein gene product 9.5 to observe regeneration of free nerve endings and taste buds in the epithelium. By day 4 after SLN-crush, both the free nerve endings and taste buds had disappeared. Regeneration of the free nerve endings was recognized from day 8, while that of the taste buds started at day 16. On day 40, the number of taste buds on SLN-crush side was similar to that on the untreated side. Electrophysiological recording of SLN throughout the regeneration period (excluding day 4), showed response to intralaryngeal 9% CO2 (stimulation or inhibition) whether or not taste buds were present. Our results showed intralaryngeal CO2 reception without taste bud involvement, indicating that the free nerve endings in the laryngeal epithelium are receptive to intralaryngeal CO2.

Taste buds and nerve fibers in the rat larynx: an ultrastructural and immunohistochemical study

We investigated the rat laryngeal taste buds and their innervation by electron microscopy and immunohistochemical methods. Taste buds were densely arranged in the surface facing the laryngeal cavity of the epiglottis, the aryepiglottic fold, and the cuneiform process of the arytenoid cartilages. The cells of the buds were classified into types I, II, III, and basal cells, the ultrastucture of which was almost the same as that previously reported in lingual taste buds. The type III cells that had synaptic contacts with nerve fibers were considered to be sensory cells. Immunohistochemical analysis revealed thick calbindin D28k-immunoreactive fibers and thin varicose fibers immunoreactive for calcitonin gene-related peptide or substance P in and around the taste bud. Serotonin-immunoreactive cells were also observed here. The results revealed the innervation pattern of laryngeal taste buds to be the same as that in lingual taste buds. Carbonic anhydrase (CA) is known to catalyze the hydration of CO2 and dehydration of H2CO3, and seems to be essential in CO2 reception. Immunoreactivity for CAI was detected in slender cells and that for CAIII was observed in barrel-like cells in the laryngeal taste buds. The pH-sensitive inward rectifier K+ (Kir) channel in the cell membrane may be involved in CO2 reception as well. CAII-reactive cells were also reactive to Kir4.1, PGP 9.5 and serotonin. Our results indicated that CAII and Kir4.1 are located in type III cells of the laryngeal taste buds, and supported the idea that the buds may be involved in the recognition of CO2.

Thyroarytenoid muscle: functional subunits based on morphology and muscle fiber typing in cats

Using parvalbumin immunohistochemistry to determine the distribution of muscle fiber types in the feline thyroarytenoid muscle (TA), we clearly distinguished the vocalis (with predominance of "slow" type 1 fibers) from the external TA (in which "fast" type 2 fibers predominated, especially in its rostral part). Reconstruction of serial frontal sections of the TA allowed the stereoscopic study of each division. The existence of a rudimentary laryngeal ventricle separating the true and false vocal folds in cats was demonstrated anatomically and histologically, and its relationships to each division of the TA were established. Our results suggest that the vocalis, fitted for enduring activities, is suited for voice control. The fast, rostral part of the external TA seems suited to laryngeal sphincteric demands, while its caudal counterpart may act in both functions. The anatomic individualization of the divisions of the TA may suggest that they play distinct physiological roles and may imply that they should not be considered a single functional unit.

Sensory innervation of the pharynx and larynx

To shed light on supraesophageal complications of reflux disease, sensory innervation--particularly, distinct distribution, area, and density of sensory fibers--of the feline pharyngolaryngeal mucosa was reported. The investigations were performed by means of histochemistry (tracer techniques) and immunohistochemistry. The pharyngeal mucosa from the Eustachian cushion to the middle level of aryepiglottic fold, except the laryngeal surface of epiglottis, was supplied by the glossopharyngeal sensory fibers, whereas the laryngeal sensory fibers innervated between the apex of epiglottis and the level of the first tracheal ring in the larynx and between the middle level of aryepiglottic fold and the caudal end of piriform sinus in the pharynx. Most areas of the mucosa, except the subglottis, had unilateral innervation. The subglottis, including the caudal aspect of vocal fold and the posterior glottis, had bilateral supply with ipsilateral predominance. The density of sensory fibers in the vestibule of larynx involving the posterolateral aspect of arytenoid eminence was much heavier than the other parts. Sensory nerve fibers around the caudal pole of palatine tonsil, and in the root of tongue and the hypopharyngeal wall also were dense. Regional distribution and density of substance P and calcitonin gene-related peptide immunoreactive fibers showed almost the same pattern as did the sensory fibers.

The distribution of nerve fibres immunoreactive for vasoactive intestinal peptide, calcitonin gene-related peptide, substance P and dopamine beta-hydroxylase in the normal equine larynx

The autonomic innervation of the mammalian respiratory system is complex, and involves a wide variety of peptide and non-peptide neurotransmitters which will have an important role in normal laryngeal function and the response to disease. This innervation has been partially described in the horse airway and lung, but there is no information on the equine larynx. This paper describes the expression and distribution of nerve fibres immunoreactive for vasoactive intestinal peptide (VIP), calcitonin gene-related peptide (CGRP), substance P (SP) and the adrenergic enzymatic marker dopamine beta-hydroxylase (DBetaH) in the mucosa of the equine larynx. The overall relative density of nerve fibres immunoreactive for the different antigens was VIP>>CGRP>SP>>DBetaH. There were differences in the distribution of nerve fibre types, although each antigen was found in nerve fibres adjacent to blood vessels and mucous glands. VIP -like immunoreactivity (VIP -Li) was particularly extensive in association with mucous glands. SP - and CGRP -like immunoreactivity (SP -Li, CGRP -Li) were also seen close to the epithelium, with occasional nerve fibres coursing beneath and between the epithelial cells. Fragments of SP -Li and CGRP -Li fibres were also present in large nerve fibre bundles and ganglionic cell clusters, but not in the neurons themselves. The density of nerve fibres immunoreactive for DBetaH was very low and restricted to blood vessels and mucous glands. There was marked variation in the density of nerve fibres at the different sites, with the greatest density, particularly for VIP, over the arytenoid cartilage. Immunoreactive nerve fibres were less plentiful over the epiglottis, and the density of all types of nerve fibres was low over the cricoid cartilage. Overall VIP -Li nerve fibres were the most plentiful.

Neurotransmitters and neuromodulators involved in laryngeal innervation

The distribution and role of neurotransmitters and neuromodulators in laryngeal innervation are reviewed, and our recent findings regarding the nitrergic innervation of the larynx are demonstrated for the better understanding of the complexity of the laryngeal innervation system. Noradrenergic innervation of the larynx was studied with fluorescence histochemistry and electron microscopy after application of 5-hydroxydopamine. These studies confirmed the existence of noradrenergic innervation for the submucosal glands and blood vessels, and the origin and course of noradrenergic nerve fibers contained in the laryngeal nerves and their destinations in the larynx. Cholinergic innervation of the larynx has not been clarified in detail. Many kinds of neuropeptides have been demonstrated to be involved in laryngeal innervation. Vasoactive intestinal polypeptide originating from intralaryngeal ganglionic neurons participates in laryngeal vasodilation and reduction of laryngeal seromucous secretion. Neuropeptide Y nerve fibers are few in the larynx, and most originate from the superior cervical ganglion. They are distributed around the large or medium-sized blood vessels, especially arteries. They are also associated with excretory structures. Substance P was the first neuropeptide found to be a sensory neurotransmitter in the laryngeal afferent system. It is also involved in regulation of laryngeal blood flow and secretion. Calcitonin gene-related peptide is associated with the sensory, autonomic, and motor innervation of the larynx. The majority of enkephalin nerve fibers are located close to excretory structures, although no information on the physiological significance of enkephalin is available. In addition to the above neuropeptides, the peptides histidine isoleucine, histidine methionine, and helospectin have been shown to exist in the larynx. The nitrergic innervation of the larynx has been recently studied with NADPH-diaphorase histochemistry and immunohistochemistry using antiserum against nitric oxide synthase. Nitric oxide originates from the neurons in the intralaryngeal ganglia and is believed to modulate blood flow and secretion of the larynx. It controls the laryngeal exocrine secretion in cooperation with intrinsic vasoactive intestinal polypeptide and/or extrinsic calcitonin gene-related peptide. Nitric oxide from the nodose ganglion may modulate nociception of the larynx. The existence of nitrergic neurons located in the intrinsic laryngeal muscles has been demonstrated. Many of them are bipolar or pseudounipolar, so they might be sensory in nature. The effect of injury of the recurrent laryngeal nerve on the induction of nitric oxide synthase in the laryngeal motoneurons is also discussed.

Parvalbumin distribution in the musculature of the pharyngo-oesophageal segment

The composition and size of muscle fibre types in the hyopharyngeus (HP), thyropharyngeus (TP), cricopharyngeus (CP) and cervical oesophageal muscle (CE) from 6 normal adult cats were investigated using parvalbumin (PA) immunohistochemistry. Fibre types I, IIA and IIB were identified in all muscles. HP and TP revealed predominance of type II fibres (74.8% and 75.2%, respectively), whilst CP and CE showed predominance of type I fibres (72.6% and 82.2%, respectively). The mean diameter of narrow fibres was greater in type II (23.9 microm) than in type I fibres (21.7 microm). The results seem to reflect the physiological features of each muscle, i.e. short rapid contractions of HP and TP, sustained contraction of CP and slow peristaltic movements of CE.

Does botulinum toxin alter laryngeal secretions and mucociliary transport?

Localized botulinum toxin injection disrupts cholinergic transmission and has potential to cause focal dysautonomia. Mucociliary transport and laryngeal secretions are thought to be mediated in part by autonomic, cholinergic transmission. We questioned whether patients who receive Botox injection for adductor spasmodic dysphonia (ADSD) report postinjection symptoms possibly related to altered mucociliary clearance or laryngeal secretions. Medical histories, audiotaped interviews, and symptom ratings were retrospectively examined for 29 patients with ADSD who were followed after one or more Botox injections. Patients had received bilateral, percutaneous Botox injections of 2.5 units using an EMG-guided approach. One or more weeks after injection, four patients reported either burning, tickling, or irritation of the larynx/throat, excessive thick secretions, or dryness. Symptoms recurred with subsequent injections in two patients and were not associated with swallowing difficulty. These symptoms are consistent with, but not diagnostic of, the known effects of botulinum toxin on cholinergic, autonomic transmission.

Relationship of neuropeptides to nitrergic innervation of the canine laryngeal glands

The participation of vasoactive intestinal polypeptide (VIP) or calcitonin gene-related peptide (CGRP) in the nitrergic innervation of the canine laryngeal glands was investigated using a double-staining technique of NADPH-diaphorase (NADPHd) histochemistry and VIP or CGRP immunohistochemistry. NADPHd-positive nerve fibers with varicosities appeared to terminate in some acinar cells. Double staining revealed that NADPHd reactivity and VIP- or CGRP-like immunoreactivity were colocalized in some nerve fibers distributed around the acini. A cluster of NADPHd-positive cells were occasionally found in the larynx. Many NADPHd-positive cells had VIP-like immunoreactivity and no NADPHd-positive cells were CGRP-like immunoreactive. These findings suggest that nitric oxide participates in the neural control of the laryngeal exocrine secretion in cooperation with intrinsic VIP and/or extrinsic CGRP.

Precise localization of VIP-, NPY-, and TH-immunoreactivities of cat laryngeal glands

The precise distribution of vasoactive intestinal polypeptide (VIP)-, neuropeptide Y (NPY)-, and tyrosine hydroxylase (TH)-immunoreactive (ir) fibers in the cat's laryngeal glands was examined by immunoelectronmicroscopy. A relatively dense population of VIP-ir fibers was recognized close to the basal lamina of the glandular and myoepithelial cells. Some VIP-ir fibers contacted with the basal lamina and some of them pierced it and ran intercellularly in the adjoining glandular cells without making synaptic contacts with them. NPY- and TH-ir fibers were located in the vicinity of the basal lamina, but they were less abundant than VIP-ir fibers at this region. They never terminated or penetrated the basal lamina. Pattern of distribution of TH-ir fibers was similar to that of NPY-ir fibers. The estimated ratio of VIP-, TH-, and NPY-ir fibers was 20:4:1 from the density of fibers in the laryngeal glands. This value was equal between serous and mucous glandular cells, so both types of glandular cells may receive the same pattern of autonomic innervation.

Neuropeptide participation in canine laryngeal sensory innervation. Immunohistochemistry and retrograde labeling

We investigated the quantitative participation of calcitonin gene-related peptide (CGRP), substance P (SP), and leu-enkephalin (ENK) in canine laryngeal sensory innervation by immunohistochemistry in combination with retrograde labeling using the recently introduced retrograde tracer cholera toxin subunit B-conjugated gold (CTBG). In the nodose ganglion, neurons labeled from the internal branch of the superior laryngeal nerve with CTBG were investigated immunohistochemically by means of antisera against CGRP, SP, and ENK. The percentages of neurons immunoreactive to each neuropeptide were as follows: CGRP 81.5%, SP 24.5%, and ENK 7.0%. These results suggest that CGRP is the main sensory neurotransmitter in canine laryngeal sensory innervation.

CGRP-immunoreactive cells supplying laryngeal sensory nerve fibres in the cat's nodose ganglion

Through a combination of retrograde staining by wheat germ agglutinin (WGA) and immunohistochemistry, calcitonin gene-related peptide (CGRP)-reactive sensory neurons projecting from the laryngeal mucosa were detected in the feline nodose ganglion. The size of the CGRP-immunoreactive cell which was regarded as a laryngeal sensory neuron, was about 60 microns in diameter: the shape of the immunoreactive laryngeal sensory neuron was unipolar. CGRP-reacted laryngeal sensory cells were found in the rostral part of the nodose ganglion extending to the middle part. They aggregated in the most rostral part, were sparse in other parts and were approximately 50 per cent of WGA-reactive laryngeal sensory neurons in number. Our results suggest that this neurotransmitter might play an important role in laryngeal peripheral sensory innervation.