Presence and physiological role of presynaptic inhibitory alpha 2-adrenoreceptors in guinea pig atria

The role of the endogenous neurotransmitters associated with neuropathic pain and in the opioid crisis: The innate pain-relieving system

Neuropathic pain is a chronic pain caused by central and peripheral nerve injury, long-term diabetes or treatment with chemotherapy drugs, and it is dissimilar to other chronic pain conditions. Chronic pain usually seriously affects the quality of life, and its drug treatment may result in increased costs of social and medical care. As in the USA and Canada, in Europe, the demand for pain-relieving medicines used in chronic pain has also significantly increased, but most European countries are not experiencing an opioid crisis. In this review, the role of various endogenous transmitters (noradrenaline, dopamine, serotonin, met- and leu-enkephalins, β-endorphin, dynorphins, cannabinoids, ATP) and various receptors (α₂, μ, etc.) in the innate pain-relieving system will be discussed. Furthermore, the modulation of pain processing pathways by transmitters, focusing on neuropathic pain and the role of the sympathetic nervous system in the side effects of excessive opioid treatment, will be explained.

Noradrenergic terminals are the primary source of α2-adrenoceptor mediated dopamine release in the medial prefrontal cortex

In various psychiatric disorders, deficits in dopaminergic activity in the prefrontal cortex (PFC) are implicated. Treatments involving selective augmentation of dopaminergic activity in the PFC primarily depend on the inhibition of α₂-adrenoreceptors singly or in combination with the inhibition of the norepinephrine transporter (NET). We aimed to clarify the relative contribution of dopamine (DA) release from noradrenergic and dopaminergic terminals to DA output induced by blockade of α₂-adrenoreceptors and NET. To this end, we assessed whether central noradrenergic denervation modified catecholamine output in the medial PFC (mPFC) of rats elicited by atipamezole (an α₂-adrenoreceptor antagonist), nisoxetine (an NET inhibitor), or their combination. Intraventricular administration of anti-dopamine-beta-hydroxylase-saporin (aDBH) caused a loss of DBH-positive fibers in the mPFC and almost total depletion of tissue and extracellular NE level; however, it did not reduce tissue DA level but increased extracellular DA level by 70% in the mPFC. Because noradrenergic denervation should have caused a loss of NET and reduced NE level at α₂-adrenoceptors, the actual effect of an aDBH-induced lesion on DA output elicited by blockade of α₂-adrenoceptors and NET was evaluated by comparing denervated and control rats following blockade of α₂-adrenoceptors and NET with atipamezole and nisoxetine, respectively. In the control rats, extracellular NE and DA levels increased by approximately 150% each with 3 mg/kg atipamezole; 450% and 230%, respectively, with 3 mg/kg nisoxetine; and 2100% and 600%, respectively, with combined atipamezole and nisoxetine. In the denervated rats, consistent with the loss of NET, nisoxetine failed to modify extracellular DA level, whereas atipamezole, despite the lack of NE-induced stimulation of α₂-adrenoceptors, increased extracellular DA level by approximately 30%. Overall, these results suggest that atipamezole-induced DA release mainly originated from noradrenergic terminals, possibly through the inhibition of α₂-autoreceptors. Furthermore, while systemic and local administration of the α₂-adrenoceptor agonist clonidine into the mPFC of the controls rats reduced extracellular NE level by 80% and 60%, respectively, and extracellular DA level by 50% and 60%, respectively, it failed to reduce DA output in the denervated rats, consistent with the loss of α₂-autoreceptors. To eliminate the possibility that denervation reduced DA release potential via the effects at dopaminergic terminals in the mPFC, the effect of systemic administration of the D₂-DA antagonist raclopride (0.5 mg/kg IP) on DA output was analyzed. In the control rats, raclopride was found to be ineffective when administered alone, but it increased extracellular DA level by 380% following NET inhibition with nisoxetine. In the denervated rats, as expected due to the loss of NET, raclopride-alone or with nisoxetine-increased DA release to approximately the same level as that observed in the control rats after NET inhibition. Overall, these results suggest that noradrenergic terminals in the mPFC are the primary source of DA released by blockade of α₂-adrenoreceptors and NET and that α₂-autoreceptors, and not α₂-heteroreceptors, mediate DA output induced by α₂-adrenoceptor blockade.

Acute desipramine restores presynaptic cortical defects in murine experimental autoimmune encephalomyelitis by suppressing central CCL5 overproduction

BACKGROUND AND PURPOSE

Altered glutamate exocytosis and cAMP production in cortical terminals of experimental autoimmune encephalomyelitis (EAE) mice occur at the early stage of disease (13 days post-immunization, d.p.i.). Neuronal defects were paralleled by overexpression of the central chemokine CCL5 (also known as RANTES), suggesting it has a role in presynaptic impairments. We propose that drugs able to restore CCL5 content to physiological levels could also restore presynaptic defects. Because of its efficacy in controlling CCL5 overexpression, desipramine (DMI) appeared to be a suitable candidate to test our hypothesis.

EXPERIMENTAL APPROACH

Control and EAE mice at 13 d.p.i. were acutely or chronically administered DMI and monitored for behaviour and clinical scores. Noradrenaline and glutamate release, cAMP, CCL5 and TNF-α production were quantified in cortical synaptosomes and homogenates. Peripheral cytokine production was also determined.

KEY RESULTS

Noradrenaline exocytosis and α₂ -adrenoeceptor-mediated activity were unmodified in EAE mice at 13 d.p.i. when compared with control. Acute, but not chronic, DMI reduced CCL5 levels in cortical homogenates of EAE mice at 13 d.p.i., but did not affect peripheral IL-17 and TNF-α contents or CCL5 plasma levels. Acute DMI caused a long-lasting restoration of glutamate exocytosis, restored endogenous cAMP production and impeded the shift from inhibition to facilitation of the CCL5-mediated control of glutamate exocytosis. Finally, DMI ameliorated anxiety-related behaviour but not motor activity or severity of clinical signs.

CONCLUSIONS

We propose DMI as an add-on therapy to normalize neuropsychiatric symptoms in multiple sclerosis patients at the early stage of the disease.

The amygdala and emotional modulation of competition between cognitive and habit memory

The basolateral amygdala (BLA) is implicated in the neurobiology of emotion, and can also modulate the cognitive and habit memory processes mediated by the hippocampus and dorsal striatum, respectively. In a dual-solution task that can be acquired using either hippocampus-dependent or dorsal striatal-dependent learning, peripheral or intra-BLA infusion of the anxiogenic alpha(2)-adrenoreceptor antagonist RS 79948 biases rats towards the use of habit learning. In view of evidence that anxiety can promote relapse into habitual and maladaptive human behaviors, understanding the mechanism(s) by which emotional arousal can influence the relative use of multiple memory systems may prove clinically relevant. Therefore, the present experiments examined whether intra-BLA infusions of RS 79948 bias rats towards the use of habit learning directly by enhancing dorsal striatal function, or indirectly by impairing hippocampal function. Adult male Long-Evans rats were trained in one of two single-solution water plus-maze tasks. One version required the use of hippocampus-dependent "place" learning. A second version required the use of dorsal striatal-dependent "response" learning, and hippocampal mnemonic processes have been shown to interfere with acquisition of this task. Post-training intra-BLA infusions of RS 79948 (1.0 microg/0.5 microl) impaired acquisition of place learning. In contrast, intra-BLA infusions of RS 79948 enhanced response learning. Intra-BLA infusion of RS 79948 also produced an anxiogenic behavioral profile in an elevated plus-maze at the same dose (1.0 microg) that differentially influenced place and response learning. The findings suggest that intra-BLA infusion of an anxiogenic drug can influence the use of multiple memory systems by impairing hippocampus-dependent learning, thereby releasing habit memory from competing and/or inhibitory influences of cognitive memory.

Electrogenic Na+/Ca2+-exchange of nerve and muscle cells

The plasma membrane Na(+)/Ca(2+)-exchanger is a bi-directional electrogenic (3Na(+):1Ca(2+)) and voltage-sensitive ion transport mechanism, which is mainly responsible for Ca(2+)-extrusion. The Na(+)-gradient, required for normal mode operation, is created by the Na(+)-pump, which is also electrogenic (3Na(+):2K(+)) and voltage-sensitive. The Na(+)/Ca(2+)-exchanger operational modes are very similar to those of the Na(+)-pump, except that the uncoupled flux (Na(+)-influx or -efflux?) is missing. The reversal potential of the exchanger is around -40 mV; therefore, during the upstroke of the AP it is probably transiently activated, leading to Ca(2+)-influx. The Na(+)/Ca(2+)-exchange is regulated by transported and non-transported external and internal cations, and shows ATP(i)-, pH- and temperature-dependence. The main problem in determining the role of Na(+)/Ca(2+)-exchange in excitation-secretion/contraction coupling is the lack of specific (mode-selective) blockers. During recent years, evidence has been accumulated for co-localisation of the Na(+)-pump, and the Na(+)/Ca(2+)-exchanger and their possible functional interaction in the "restricted" or "fuzzy space." In cardiac failure, the Na(+)-pump is down-regulated, while the exchanger is up-regulated. If the exchanger is working in normal mode (Ca(2+)-extrusion) during most of the cardiac cycle, upregulation of the exchanger may result in SR Ca(2+)-store depletion and further impairment in contractility. If so, a normal mode selective Na(+)/Ca(2+)-exchange inhibitor would be useful therapy for decompensation, and unlike CGs would not increase internal Na(+). In peripheral sympathetic nerves, pre-synaptic alpha(2)-receptors may regulate not only the VSCCs but possibly the reverse Na(+)/Ca(2+)-exchange as well.

Non-adrenergic non-cholinergic (NANC) neural control of the atrial myocardium

1. Current concepts in the regulation of atrial contractility by non-adrenergic non-cholinergic (NANC) sensory nerves are reviewed. 2. There is now evidence that in addition to sympathetic and parasympathetic innervation capsaicin-sensitive sensory nerves contribute to the local control of atrial contractility by releasing NANC transmitters, such as calcitonin gene-related peptide (CGRP). 3. Certain chemical and physical stimuli affect atrial contractility by inducing the release of CGRP from sensory nerves. In addition, as widely recognized for the sympathetic and vagal atrial innervation, NANC neurotransmission is under the inhibitory control of several endogenous modulators. 4. Cardioexcitatory actions of NANC neurotransmission on the atrial myocardium are considered. 5. Pharmacological modulation of NANC neurotransmission and functional evidence for cross-talk between NANC and sympathetic neurones are also discussed.

Differences between the prejunctional effects of phenylephrine and clonidine in guinea-pig isolated atria

The prejunctional effects of clonidine and phenylephrine were studied in guinea-pig isolated atria by means of field stimulation of the sympathetic nerve terminals during the cardiac refractory period, in the presence of 1 microM atropine. Clonidine (10-100 nM) produced a dose-dependent decrease in the stimulus-inotropic response curve; the IC50 for clonidine was increased about 70 times by the pretreatment of the preparations with 1 microM yohimbine. The effect of clonidine was not modified by 0.5 microM prazosin. Unlike clonidine, phenylephrine (1-10 microM) induced a statistically insignificant increase in the contractile force of preparations stimulated at 4 Hz. The inhibitory effect of phenylephrine (1-10 microM) was partially prevented by either 1 microM yohimbine or 0.5 microM prazosin. However, it was antagonized, to about the same degree as that observed with clonidine, by the pretreatment of the preparations with both 1 microM yohimbine and 0.5 microM prazosin. The results seem to indicate that one component of the prejunctional effects of phenylephrine may be mediated by presynaptic alpha-adrenoceptors belonging to the alpha 1-subtype.

Effect of age on the prejunctional alpha-adrenoceptor-mediated feedback in the heart of spontaneously hypertensive rats and normotensive Wistar Kyoto rats. Evidence for a physiological role of prejunctional alpha 2-adrenoceptors

The prejunctional alpha 2-adrenoceptor-mediated feedback in the heart of pithed young and adult spontaneously hypertensive rats (SHR) and corresponding normotensive Wistar Kyoto rats (WKY) was studied. After electrical stimulation of the sympathetic outflow from the spinal cord to the heart, B-HT 920 induced an inhibition of the cardiac response, which was significant at stimulation frequencies up to 1 Hz in young SHR and WKY and up to 2 Hz in the adult animals. Rauwolscine produced a potentiation of the cardiac response to electrical stimulation in SHR, which was significant from 0.2-10 Hz in young SHR and from 0.1-10 Hz in adult SHR. In young WKY, rauwolscine did not potentiate the increase in heart rate to sympathetic nerve stimulation, whereas in adult WKY alpha 2-adrenoceptor blockade by rauwolscine significantly potentiated the cardiac response to electrical stimulation at frequencies in the range of 0.2-10 Hz. In SHR the potentiation of the cardiac response to sympathetic nerve stimulation by rauwolscine was much stronger than in WKY. These results suggest that in adult animals the prejunctional alpha 2-adrenoceptor mediated feedback is more developed than in young rats. In contrast with young WKY, a significant endogenous feedback can be demonstrated in adult WKY. In SHR, however, the physiological role of prejunctional alpha 2-adrenoceptors is much more important.

Physiological and pharmacological aspects of adrenergic receptor classification

The questions raised are: what is the physiological or pharmacological basis for the differentiation into beta 1- and beta 2-, and alpha 1- and alpha 2-adrenergic receptors?; and do the neurotransmitter norepinephrine and the hormone epinephrine differ in their receptors? On the basis of a preference of beta 2- and alpha 2-adrenergic receptors for epinephrine, the hormone, and of beta 1-and alpha 1-receptors for norepinephrine, the neurotransmitter, it was postulated that the alpha 2- and beta 2-receptors are predominantly epinephrinergic in nature and located extrajunctionally and presynaptically whereas the alpha 1- and beta 1-receptors are predominantly norepinephrinergic in nature and located postsynaptically in the sympathetic terminal junction. The alpha 2- and beta 2-character of the presynaptic receptors matches that of the corresponding extrajunctional receptors. This indicates that a circulating catecholamine, namely epinephrine, is involved in the regulation of adrenergic transmitter release.

Characterization of the clonidine receptor site

At the cardiac sympathetic nerve terminal the alpha 2-adrenoceptor is presynaptic and appears to be located at an extrasynaptic site. This is suggested by (1) absence of evidence of autoinhibitory feedback at physiologic stimulus levels up to about 50 percent of the maximum chronotropic response in the isolated guinea pig right atrium, and (2) absence of significant competition between clonidine and synaptically released noradrenaline (NA) for the presynaptic site. In the central nervous system (CNS) cardiovascular alpha 2-receptors are probably located at a postsynaptic site in bulbospinal regions of the brain, since they produce effects identical to those of synaptic release of NA. Experiments with the clonidine analog alinidine (ST 567) suggest that there are differences in central receptor type subserving clonidine-mediated baroreflex heart rate and blood pressure changes.

Hemodynamic and neuroendocrine responses to acute and chronic alpha-adrenergic blockade with prazosin and phenoxybenzamine

We investigated the relevance of the selective alpha 1-adrenergic receptor blockade produced by prazosin to its blood pressure-lowering efficacy in man. The hemodynamic and neuroendocrine responses to the acute and chronic oral administration of prazosin and phenoxybenzamine were compared in a randomized, double-blind, placebo-controlled, crossover study of 11 patients with essential hypertension. These responses were also evaluated during lower body negative pressure and dynamic bicycle exercise, which produce potent but diversified activation of the sympathetic nervous system. In the acute studies, arterial blood pressure decreased to similar levels with prazosin or phenoxybenzamine; however, hemodynamic and neuroendocrine responses differed both before and during sympathetic nervous system activation. Prazosin lowered arterial blood pressure by reducing total peripheral resistance (p less than 0.05). In contrast, phenoxybenzamine produced a modest reduction in cardiac output (8%, p less than 0.05) with little change in total peripheral resistance, forearm vascular resistance or forearm blood flow. Additionally, plasma norepinephrine concentration and heart rate rose to significantly higher levels with prazosin (p less than 0.02) than with phenoxybenzamine, a difference that was most evident with lower body negative pressure or dynamic exercise. Baroreceptor control of arterial pressure homeostasis was preserved with both agents, except during marked degrees of cardiovascular stress. With chronic therapy, the circulatory responses adapted to the alpha-adrenergic antagonists, and both drugs produced similar hemodynamic and neuroendocrine profiles. The differences with acute administration may be the result of a more rapid onset of action and a more marked degree of alpha-adrenergic blockage with prazosin than with phenoxybenzamine therapy, rather than to any difference in their alpha 1- and alpha 2-adrenergic receptor blocking properties. Moreover, the findings of the present study suggest that the prejunctional alpha 2-receptor, autoinhibitory to sympathetic neuronal norepinephrine release, is of no functional significance in patients with essential hypertension.