Neurotransmission in the sheep middle cerebral artery: modulation of responses by 5-HT and haemolysate

Subarachnoid hemorrhage-induced upregulation of the 5-HT1B receptor in cerebral arteries in rats

OBJECT

Cerebral vasospasm following subarachnoid hemorrhage (SAH) leads to reduced blood flow in the brain. Inspired by organ culture-induced changes in the receptor phenotype of cerebral arteries, the authors investigated possible changes in the 5-hydroxytryptamine (HT) receptor phenotype after experimental SAH.

METHODS

Experimental SAH was induced in rats by using an autologous prechiasmatic injection of arterial blood. Two days later, the middle cerebral artery (MCA), posterior communicating artery (PCoA), and basilar artery (BA) were harvested and examined functionally with the aid of a sensitive in vitro pharmacological method molecularly by performing quantitative real-time reverse transcription-polymerase chain reaction (PCR). In the MCA and BA the 5-HT1B receptor was upregulated, as determined through both functional and molecular analysis. In response to selective 5-HT1 receptor agonists both the negative logarithm of the 50% effective concentration was increased (one log unit in the MCA and one half unit in the BA), as was the agonist's potency (increased by 50% in the MCA and doubled in the BA). In addition, the authors found an approximately fourfold increase in the number of copies of messenger RNA coding for the 5-HT1B receptor as determined by quantitative real-time PCR. In the PCoA no upregulation of the 5-HT1B receptor was observed.

CONCLUSIONS

Changes in the receptor phenotype in favor of contractile receptors may well represent the end stage in a sequence of events leading from SAH to the actual development of cerebral vasospasm. Insight into the mechanism of upregulation may provide new targets for developing specific treatment against cerebral vasospasm.

Signal transduction pathways in cerebral vasospasm

Cerebral vasospasm is a deadly complication following the rupture of intracranial aneurysms. The time course of cerebral vasospasm is unique in that it is slow developing, usually takes 4-7 days to peak, but lasts up to 2-3 weeks, and is resistant to most known vasodilators. These special features make cerebral vasospasm the most important determinant in the outcome of patients suffering subarachnoid hemorrhage. The available treatment strategies include mechanical dilation of spastic cerebral arteries (angioplasty) and non-selective vasodilatation such as by Ca(2+) channel blockers. One new development in the experimental treatment of cerebral vasospasm is the looming target of signaling pathways. Understanding vasospastic signals in cerebral arteries might offer a new avenue for selective treatment of cerebral vasospasm in the future.

The role of nitric oxide in inhibitory neurotransmission in the middle cerebral artery of the sheep

1. The involvement of nitric oxide (NO) as a mediator of inhibitory neurotransmission and its potential release mechanism in sheep isolated middle cerebral artery rings was investigated using NO synthase inhibitors, haemolysate, superoxide dismutase (SOD) and omega-conotoxin GVIA. In the presence of guanethidine (5 microM) and atropine (2 microM), transmural nerve stimulation of precontracted artery rings elicited an endothelium-independent vasodilator response that could be abolished by tetrodotoxin. 2. The magnitude of the vasodilator response was virtually abolished by NG-nitro-L-arginine-p-nitroanilide (L-NAPNA; 100-500 microM) and significantly reduced by NG-nitro-L-arginine (50 microM) or haemolysate (1 microliter ml-1). NG-nitro-D-arginine (50 microM) had no effect. In the presence of the NO synthase inhibitors, addition of L-arginine (300 microM) produced either no effect or a partial, transient restoration of inhibitor responses following electrical field stimulation (EFS). L-NAPNA (100 microM) did not affect the relaxant response to the NO donor SIN-1. These results suggest that NO is involved in the relaxation elicited by transmural nerve stimulation. 3. Superoxide dismutase (SOD; 150 Uml-1) did not produce any significant changes in the magnitude of the EFS-induced vasodilation. Thus, superoxide anions appear not to be a limiting factor for NO-mediated neurogenic vasodilation in sheep MCA. 4. omega-Conotoxin GVIA (100 nM) caused an almost immediate abolition of the EFS-induced vasoconstrictor response at resting tension, but had no effect on the vasodilator response at all frequencies of stimulation (0.5-8 Hz) tested. Thus, the neurotransmission process mediating this vasodilator response does not appear to involve Ca2+ entry via N-type Ca2+ channels.

Relaxation of sheep cerebral arteries by vasoactive intestinal polypeptide and neurogenic stimulation: inhibition by L-NG-monomethyl arginine in endothelium-denuded vessels

1. Perivascular nerves of the sheep middle cerebral artery show immunoreactivity for both vasoactive intestinal polypeptide (VIP) and calcitonin gene-related peptide (CGRP). 2. Rings of endothelium-denuded sheep middle cerebral artery precontracted with 5-hydroxytryptamine were relaxed by CGRP (maximum relaxation = 87.8 +/- 8.1%, pD2 = 7.81 +/- 0.12, n = 12) and by VIP (maximum relaxation = 55.1 +/- 4.1%, pD2 = 7.65 +/- 0.04, n = 18). Rings of endothelium-denuded cat middle cerebral artery precontracted with U46619 were also relaxed by vasoactive intestinal polypeptide (maximum relaxation = 53.1 +/- 6.1%, pD2 = 7.82 +/- 0.11, n = 6). 3. Haemolysate (1 microliters ml-1) inhibited VIP-induced relaxation in endothelium-denuded sheep and cat middle cerebral artery (n = 6) but had no effect on the CGRP-induced relaxation of the sheep middle cerebral artery (n = 6). 4. The relaxant response to VIP in endothelium-denuded sheep middle cerebral artery was inhibited by methylene blue (10 microM) and augmented by either M&B 22948 (10 microM) or superoxide dismutase (150 units ml-1). Indomethacin (1 microM) had no effect. 5. The addition of L-NG-monomethyl arginine (100 microM) inhibited both neurogenic and VIP-induced relaxation of endothelium-denuded sheep MCA by 56 +/- 6% and 60 +/- 6% (n = 5) respectively. The CGRP-induced relaxation was unaffected. 6. It is concluded that neurally mediated vasodilatation in the sheep middle cerebral artery is mediated largely by VIP through a direct action on smooth muscle through a cyclic-GMP-mediated mechanism that appears to involve synthesis of nitric oxide from L-arginine. Vasodilatation by CGRP, which is also contained in perivascular nerves, does not utilize this pathway.

Innervation of cerebral arteries by nerves containing 5-hydroxytryptamine and noradrenaline

Noradrenaline (NA)-containing nerves, mainly originating in the sympathetic superior cervical ganglia, supply large and small cerebral arteries. In large cerebral arteries, nerves containing serotonin (5-hydroxytryptamine, 5-HT) may represent neuronal uptake of circulating 5-HT by sympathetic nerves. 5-HT-containing nerves supplying small pial vessels probably have a central origin in the dorsal raphe nucleus. In most species, NA is a weak vasoconstrictor (alpha 1- or alpha 2-adrenoceptors), while 5-HT is a potent vasoconstrictor (5-HT2 or 5-HT1-like receptors) of large cerebral arteries. In contrast, both NA and 5-HT tend to cause vasodilatation in small pial vessels and arterioles. Adrenergic and serotonergic transmission can be modulated by pH, a range of putative neurotransmitters and neuromodulators, and by the endothelium. Sumatriptan, a 5-HT1-like receptor agonist, has been shown to be effective in the treatment of migraine. Changes in NA- or 5-HT-containing nerves and/or in the responses of cerebral vessels to NA and 5-HT have been observed in a variety of vascular disorders, including cerebral vasospasm following subarachnoid haemorrhage, hypertension, and atherosclerosis.

Nitric oxide mediates, and acetylcholine modulates, neurally induced relaxation of bovine cerebral arteries

Helical strips of bovine basilar arteries denuded of the endothelium responded to transmural electrical stimulation with frequency-dependent relaxations that were abolished or markedly attenuated by treatment with tetrodotoxin, oxyhemoglobin and Methylene Blue. Relaxations induced by vasoactive intestinal polypeptide and calcitonin gene-related peptide were not affected by oxyhemoglobin and Methylene Blue. The neurally induced relaxation was not attenuated in the artery made unresponsive to these peptides by successive application. The relaxation caused by nerve stimulation was markedly inhibited by treatment with NG-nitro-L-arginine, a nitric oxide synthase inhibitor, which did not inhibit the relaxation caused by exogenously applied nitric oxide. The inhibition was reversed by L-arginine but not by the D-enantiomer. Exogenously applied acetylcholine did not alter the tone of endothelium-denuded arteries. Neurally induced relaxations were attenuated by treatment with acetylcholine and physostigmine and were significantly potentiated by atropine. It may be concluded that the relaxation induced by nerve stimulation is mediated by nitric oxide, but not by vasoactive intestinal polypeptide or calcitonin gene-related peptide, derived from vasodilator nerves innervating the bovine basilar artery, and the nerve function is inhibited prejunctionally via muscarinic receptor activation by acetylcholine released from cholinergic nerves but is not influenced by vasoactive intestinal polypeptide.

A review of hemoglobin and the pathogenesis of cerebral vasospasm

We believe that current experimental and clinical evidence can be most satisfactorily interpreted by assuming that oxyhemoglobin is the cause of cerebral vasospasm that follows subarachnoid hemorrhage. We review the pathogenetic mechanisms by which oxyhemoglobin affects cerebral arteries. The relative importance of each of these mechanisms in the genesis of vasospasm, the biochemical pathways of oxyhemoglobin-induced smooth muscle contraction, and the intracellular actions of oxyhemoglobin on smooth muscle and on other cells in arteries are still not definitely established.

Nitric oxide mediates the neurogenic vasodilation of bovine cerebral arteries

Nitric oxide (NO) is a mediator of the vasodilation induced by a variety of physiological and pharmacological stimuli. The possible role of NO in the relaxation elicited in cerebral arteries by perivascular nerve stimulation has been investigated. Electrical field stimulation of precontracted bovine cerebral arteries induced a relaxation that was blocked by tetrodotoxin, but not by adrenergic or muscarinic receptor antagonists, suggesting the existence of noradrenergic, noncholinergic dilator nerves, as has been shown in other species. The relaxation was significantly reduced by the inhibitors of NO synthesis, NG-monomethyl-L-arginine and nitro-L-arginine methyl ester, but not by the enantiomer, NG-monomethyl-D-arginine. Such a reduction was reversed by L-arginine. In addition, transmural nerve stimulation (TNS)-induced relaxation was potentiated by superoxide dismutase. No response to TNS was observed in arteries without endothelium. These results suggested that neurogenic relaxation of bovine cerebral arteries is mediated by endothelium-derived NO.