Protracted elevation of neuronal nitric oxide synthase immunoreactivity in axotomised adult pudendal motor neurons

Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles

The urethral rhabdosphincter and pelvic floor muscles are important in maintenance of urinary continence and in preventing descent of pelvic organs [i.e., pelvic organ prolapse (POP)]. Despite its clinical importance and complexity, a comprehensive review of neural control of the rhabdosphincter and pelvic floor muscles is lacking. The present review places historical and recent basic science findings on neural control into the context of functional anatomy of the pelvic muscles and their coordination with visceral function and correlates basic science findings with clinical findings when possible. This review briefly describes the striated muscles of the pelvis and then provides details on the peripheral innervation and, in particular, the contributions of the pudendal and levator ani nerves to the function of the various pelvic muscles. The locations and unique phenotypic characteristics of rhabdosphincter motor neurons located in Onuf's nucleus, and levator ani motor neurons located diffusely in the sacral ventral horn, are provided along with the locations and phenotypes of primary afferent neurons that convey sensory information from these muscles. Spinal and supraspinal pathways mediating excitatory and inhibitory inputs to the motor neurons are described; the relative contributions of the nerves to urethral function and their involvement in POP and incontinence are discussed. Finally, a detailed summary of the neurochemical anatomy of Onuf's nucleus and the pharmacological control of the rhabdosphincter are provided.

Nitric oxide system alteration at spinal cord as a result of perinatal asphyxia is involved in behavioral disabilities: hypothermia as preventive treatment

Perinatal asphyxia (PA) is able to induce sequelae such as spinal spasticity. Previously, we demonstrated hypothermia as a neuroprotective treatment against cell degeneration triggered by increased nitric oxide (NO) release. Because spinal motoneurons are implicated in spasticity, our aim was to analyze the involvement of NO system at cervical and lumbar motoneurons after PA as well as the application of hypothermia as treatment. PA was performed by immersion of both uterine horns containing full-term fetuses in a water bath at 37 degrees C for 19 or 20 min (PA19 or PA20) or at 15 degrees C for 20 min (hypothermia during PA-HYP). Some randomly chosen PA20 rats were immediately exposed for 5 min over grain ice (hypothermia after PA-HPA). Full-term vaginally delivered rats were used as control (CTL). We analyzed NO synthase (NOS) activity, expression and localization by nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) reactivity, inducible and neuronal NOS (iNOS and nNOS) by immunohistochemistry, and protein nitrotyrosilation state. We observed an increased NOS activity at cervical spinal cord of 60-day-old PA20 rats, with increased NADPH-d, iNOS, and nitrotyrosine expression in cervical motoneurons and increased NADPH-d in neurons of layer X. Lumbar neurons were not altered. Hypothermia was able to maintain CTL values. Also, we observed decreased forelimb motor potency in the PA20 group, which could be attributed to changes at cervical motoneurons. This study shows that PA can induce spasticity produced by alterations in the NO system of the cervical spinal cord. Moreover, this situation can be prevented by perinatal hypothermia.

Changes of NADPH-diaphorase reactivity in lumbar spinal cord of short-term streptozotocin induced diabetic rats

Diabetes is an endocrine and metabolic disorder often associated with erectile dysfunction and peripheral neuropathy. Among other factors, penile erection is induced by activation of nitric oxide synthase (NOS). Hypothalamic paraventricular nuclei neurons produce NO and project to spinal cord areas implicated in penile reflexes. These nuclei have shown an increase of NOS in streptozotocin-induced diabetic rats. NOS-containing neurons are identical to the populations of neurons selectively stained for NADPH-diaphorase activity. Using this technique, we have evaluated changes of NOS in the lumbar spinal cord of diabetic rats with or without insulin treatment. Positive staining was found in motoneurons, dorsal horn neurons (layer II), neurons surrounding the ependimus (layer X) and neurons at the intermediolateral cell column (ILCC). Diabetic animals showed significant decrease in reactive area and increase of the histochemical reaction in motoneurons from the sexual dimorphic nuclei and in neurons of the ILCC. A marked decrease of the number of reactive neurons was also observed in layer II. Morphologic alterations were observed in neurons of layer X as an increase in the percentage of multipolar neurons and a decrease in the number and length of secondary processes. The alterations observed in these animals were absent in the insulin treated diabetic animals. These results show the plasticity of lumbar spinal cord neurons, suggesting a direct participation of NO synthesis in the physiopathology of the erection dysfunction in diabetes.

Spatial and temporal correlation of nitric oxide synthase expression with CuZn-superoxide dismutase reduction in motor neurons following axotomy

Axotomized neurons expressing neuronal nitric oxide synthase (nNOS) may use nitric oxide (NO), known for its antioxidant activities and ability to scavenge free radicals, to protect against oxidative stress. This hypothesis was tested by immunohistochemical examination of superoxide dismutase (SOD) in neurons of the hypoglossal nucleus (HGN) and dorsal motor nucleus of the vagus nerve (DMV) one day to ten weeks after unilateral hypoglossal nerve crush or avulsion combined with vagus nerve crush in adult rats, and also in neurons of the anterior horn (AH) one week after unilateral sciatic nerve crush or avulsion. In the HGN, emergence of nNOS coincided temporally with reduction of CuZn-SOD immunoreactivity (ir), and the level of reduction correlated with that of nNOS induction, differing only in magnitude between nerve crush and nerve avulsion. The two nerve lesion models further revealed the concurrence of nNOS abatement with recovery of CuZn-SOD ir, and absence of nNOS abatement with persistent low CuZn-SOD ir. In the AH, reduced CuZn-SOD ir was localized in the segments containing nNOS positive neurons as a result of sciatic nerve avulsion. CuZn-SOD ir was unchanged in the absence of nNOS induction following sciatic nerve crush. DMV neurons were devoid of CuZn-SOD ir. However, increased Mn-SOD ir one and two weeks post crush was similar to that in HGN neurons. DMV neurons lacked both nNOS abatement and CuZn-SOD ir, which may explain their particular vulnerability to cell death from axotomy in comparison with other peripheral neurons. These data suggest that axotomy-induced nNOS expression is causally linked to oxidative stress, and that NO is neuroprotective, but can become neurodestructive when produced in excess.

Gene and protein expressions of nitric oxide synthases in ischemia-reperfused peripheral nerve of the rat

This study examined mRNA and protein expressions of neuronal (nNOS), inducible (iNOS), and endothelial nitric oxide synthases (eNOS) in peripheral nerve after ischemia-reperfusion (I/R). Sixty-six rats were divided into the ischemia only and I/R groups. One sciatic nerve of each animal was used as the experimental side and the opposite untreated nerve as the control. mRNA levels in the nerve were quantitatively measured by competitive PCR, and protein was determined by Western blotting and immunohistochemical staining. The results showed that, after ischemia (2 h), both nNOS and eNOS protein expressions decreased. After I/R (2 h of ischemia followed by 3 h of reperfusion), expression of both nNOS and eNOS mRNA and protein decreased further. In contrast, iNOS mRNA significantly increased after ischemia and was further upregulated (14-fold) after I/R, while iNOS protein was not detected. The results reveal the dynamic expression of individual NOS isoforms during the course of I/R injury. An understanding of this modulation on a cellular and molecular level may lead to understanding the mechanisms of I/R injury and to methods of ameliorating peripheral nerve injury.

Time-dependent alterations in NOS1 immunoreactivity in feline pudendal motoneurons following retrograde axonal transport of diphtheria toxin

Neuronal nitric oxide synthase immunoreactivity (NOS1-ir) in sacral somatic motor neurons of normal adult cats was compared with NOS1-ir in cats surviving 1 to 10 weeks after injection of the ADP-ribosylating protein diphtheria toxin (DTX) into one-half of the external anal sphincter. Levels of immunostaining were measured by microdensitometry. In non-operated cats, 60% of motor neurons in the ventrolateral (VL) and Onuf's nucleus (ON) showed high levels of NOS1-ir with lower NOS1-ir in 40%. Intramuscular injection of DTX caused cytopathology in motoneurons in ON, but not in VL with onset at 1 week, and regression by 10 weeks. Immunocytochemistry and microdensitometry disclosed an associated rise in levels of NOS1-ir in both the ipsilateral and contralateral ON at 1 week, which persisted up to 4 weeks, but reduced to normality by 10 weeks. Simultaneous neuronal swelling in ON precluded raised staining intensity being an artifact of neuronal atrophy. Despite restriction of cytopathology to ON, motoneurons in VL also exhibited acute elevation with subsequent normalisation of NOS1-ir over an identical time-course. Conclusions. Since DTX inhibits protein synthesis, (i) activation of NOS1 in acute toxicity probably reflects raised intracellular calcium due to loss of calcium homeostasis; (ii) the bilateral response in ON may indicate uptake of DTX by contralateral pudendal axons crossing the sphincter midline; and (iii) raised NOS1-ir in VL indicates a wider response in nuclei synaptically coupled to ON. Recovery of neuronal morphology and normalisation of NOS1-ir in sublethal toxicity contrast with the protracted elevation of NOS1-ir reported by others following axonal lesions associated with neuronal death and muscle target deprivation.