Tachykinins in autonomic control systems. The company they keep

Effect of Restraint Stress on the Progression of Experimental Periodontitis in Rats

BACKGROUND

A hypothesis of an increased risk for destructive periodontal diseases due to psychological stress has long been promoted. However, the research on stress and periodontal disease is still in its infancy. One of the reasons is thought to be that there is no suitable animal model for investigating the relationship.

METHODS

One hundred male Wistar rats were included. A nylon ligature was placed around the second right maxillary molars. The animals were then divided into group S, exposed to a restraint stress for 12 hours/day for up to 10 days, and group N, controls. Ten animals were sacrificed on days 2, 4, 6, 8, and 10. Blood samples were taken, and the blood glucose level and the concentrations of adrenocorticotropic hormone, corticosterone, and adrenaline were measured as the markers of stress. The atrophies of the thymus and the spleen were measured. The furcation area of the second maxillary molars was examined histologically and histometrically.

RESULTS

In group S, all values of stress markers were increased, and the thymus and the spleen were atrophied. Whereas group N showed only slight alveolar bone resorption, a marked alveolar bone resorption occurred in group S between days 8 and 10. An increase in beaded nerve terminals occurred around the vessels in the furcation area of group S.

CONCLUSION

The results of the present study suggest that the restraint stress modulates the progression of periodontal inflammation and that this rat model is suitable for investigating the association between stress and periodontal disease.

NEUROPEPTIDES AND NEUROGENIC MECHANISMS IN ORAL AND PERIODONTAL INFLAMMATION

It is generally accepted that the nervous system contributes to the pathophysiology of peripheral inflammation, and a neurogenic component has been implicated in many inflammatory diseases, including periodontitis. Neurogenic inflammation should be regarded as a protective mechanism, which forms the first line of defense and protects tissue integrity. However, severe or prolonged noxious stimulation may result in the inflammatory response mediating injury rather than facilitating repair. This review focuses on the accumulating evidence suggesting that neuropeptides have a pivotal role in the complex cascade of chemical activity associated with periodontal inflammation. An overview of neuropeptide synthesis and release introduces the role of neuropeptides and their interactions with other inflammatory factors, which ultimately lead to neurogenic inflammation. The biological effects of the neuropeptides substance P (SP), calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP), and neuropeptide Y (NPY) are summarized, and evidence for their involvement in the localized inflammatory lesions which characterize periodontitis is presented. In this context, the role of CGRP in bone metabolism is described in more detail. Recent research highlighting the role of the nervous system in suppressing pain and inflammation is also discussed.

Modulation of the carotid baroreceptor reflex by substance P in the nucleus tractus solitarius

Previous studies have shown that administration of substance P (SP) into the nucleus tractus solitarius (NTS) can evoke a depressor response similar to that produced by activation of the arterial baroreceptors. In addition, some studies have suggested that SP increases the reflex responses to activation of baroreceptor input. The present study was performed to determine the effects of SP on the carotid sinus baroreceptor reflex at the level of the NTS by examining the effects of both exogenous SP microinjected into different rostrocaudal locations in the NTS and blockade of the effects of endogenous SP, through the microinjection of a substance P antagonist (SPa; [D-Pro, D-Trp]-substance P). Changes in pressure in an isolated carotid sinus in anesthetized dogs were used to evoke baroreflex changes in arterial blood pressure (BP) before and after microinjection of SP (0.5 microM) or SPa (10 microM) into barosensitive regions of the NTS. Microinjection of SP or its antagonist did not alter baseline, resting BP but did produce significant changes in baroreflex sensitivity. Microinjection of SP into different rostrocaudal regions of the NTS produced different responses, with rostral and caudal NTS microinjections producing significant increases in sensitivity. No effects on baroreflex sensitivity were obtained in response to SP microinjections into the intermediate NTS. Unlike SP, microinjection of the SPa significantly decreased baroreflex sensitivity at all rostrocaudal levels of the NTS. These data demonstrated that SP has the capability to modulate the carotid baroreflex at the level of the NTS and support a physiological role for endogenously released SP.

Selective blockade of substance P or neurokinin A receptors reduces the expression of c-fos in trigeminal subnucleus caudalis after corneal stimulation in the rat

Stimulation of the cornea activates neurons in two distinct regions of the spinal trigeminal nucleus: at the transition between trigeminal subnucleus interpolaris and subnucleus caudalis and at the transition between trigeminal subnucleus caudalis and the upper cervical spinal cord as estimated by expression of the immediate early gene, c-fos. To determine if receptors for substance P or neurokinin A, neurokinin 1 and neurokinin 2 receptors, respectively, contribute to the production of Fos-positive neurons in these brainstem regions, receptor-selective antagonists were given intracerebroventricularly 15 min prior to stimulation of the cornea in anesthetized rats. The number of Fos-positive neurons produced in superficial laminae at the trigeminal subnucleus caudalis/cervical cord transition by application of the selective small fiber excitant, mustard oil, to the corneal surface was reduced by the neurokinin 1 receptor antagonist, CP99,994 (5-100 nmol, i.c.v.) and the neurokinin 2 receptor antagonist, MEN10,376 (0.01-1.0 nmol, i.c.v.). Combined pretreatment with CP99,994 and the competitive N-methyl-D-aspartate receptor antagonist, CPP, caused a greater reduction in c-fos expression at the subnucleus caudalis/cervical cord transition than after either drug alone suggesting interaction between receptors for glutamate and substance P. Tachykinin receptor antagonists did not reduce the number of Fos-positive neurons produced at the subnucleus interpolaris/subnucleus caudalis transition. The elevation in plasma concentration of adrenocorticotropin, but not the increases in arterial pressure or heart rate, evoked by corneal stimulation was prevented by pretreatment with CP99,994 or MEN10,376 at doses lower than those needed to reduce c-fos expression. The results indicate that receptors for substance P and neurokinin A contribute to the transmission of sensory input from corneal nociceptors to brainstem neurons in trigeminal subnucleus caudalis and to increased activity of the hypothalamo-pituitary axis that accompanies acute stimulation of the cornea.

Emotional stress effects on immunity, gingivitis and periodontitis

Gingivitis and periodontitis are thought to result from an imbalance between those oral microorganisms which normally colonize tooth surfaces in close contact with the gingival margin, and the nature and efficiency of the host response. The bacteria are the triggering agents, but host defence mechanisms within the gingival/periodontal tissues seem to be responsible for most of the tissue damage and for the outcome and progression of the diseases. It has recently been shown that emotional or psychological load (stress) may influence immune activities directly via nerve messenger substances (neurotransmitters and neuropeptides) and/or indirectly via neuroendocrine (hormone) substances. This review discusses how emotional stressors and nervous and neuroendocrine responses to psychological stressors may modulate the immune response to bacteria, and thus be expected to influence the progression and course of gingivitis and periodontitis.

Neuropeptides in the sympathetic system: presence, plasticity, modulation, and implications

Neuropeptides are ubiquitous in the sympathetic system and modulate transmission at the levels of the intermediolateral cell column, sympathetic ganglia, and neuroeffector junctions. Several neuropeptide-containing pathways from the hypothalamus and medulla modulate excitability of preganglionic neurons. Neuropeptides coexist with norepinephrine or acetylcholine in subpopulations of chemically coded, target-specific sympathetic ganglion neurons. Neuropeptide Y is colocalized in adrenergic vasoconstrictor neurons, whereas vasoactive intestinal polypeptide is colocalized in cholinergic sudomotor neurons. Neuropeptide expression is plastic; during development, neurons that switch from a noradrenergic to a cholinergic phenotype increase expression of vasoactive intestinal polypeptide, somatostatin, and substance P. Preganglionic inputs increase neuropeptide Y and inhibit substance P expression. Sympathetic denervation produces sprouting of sensory fibers containing substance P and calcitonin gene-related peptide in target tissues. Neuropeptides from preganglionic fibers (e.g., enkephalin) and primary afferents (e.g., substance P, vasoactive intestinal polypeptide) modulate transmission in sympathetic ganglia. Neuropeptide Y produces vasoconstriction, prejunctional inhibition of norepinephrine release, and postjunctional potentiation of norepinephrine effects. Plasma neuropeptide Y increases during intense sympathoexcitation, hypertension, and pheochromocytoma. Dystrophic neurites containing neuropeptide Y occur in human sympathetic ganglia during aging, diabetes, and dysautonomia. Sympathetic neuropeptides may thus have important clinical implications.

A silver-impregnation and immunocytochemical study of innervation of the distal sesamoid bone and its suspensory ligaments in the horse

The innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments (ligamenta sesamoidea collateralia) (CSL) or proximal suspensory ligament and the ligamentum sesamoideum distale impar or the distal sesamoidean impar ligament (DS-impar ligament) was examined using combined anatomical techniques of silver impregnation and immunocytochemistry. Silver impregnation studies revealed an abundance of nerve fibres present in both the CSL and DS-impar ligament with the latter having relatively more nerve fibres. These silver-impregnated nerves coursed parallel to and were associated with the vasculature rather than appearing to innervate the vessels. Immunocytochemistry identified several sensory-related neuropeptides (calcitonin gene-related peptide (CGRP), substance P (SP) and neurokinin A (NKA)) in the nerves of the navicular bone and suspensory ligaments. More peptidergic nerves were evident within the synovial membrane and loose connective tissue in the dorsal part than in the palmar aspect of the CSL. In the CSL along the synovial membrane bordering the distal interphalangeal joint, the CGRP, SP and NKA were present in the nerves of vessels as well as the intimal layer of the distal interphalangeal joint. In the DS-impar ligament, there were many more nerves innervating vessels and the synovial membrane between the navicular bone and the third phalanx than were present in these structures in the CSL. Nerves with all 3 peptides entered the navicular bone via the proximal border and the distal groove to innervate the perichondrium, trabeculae and osteons. SP-like nerves also innervated the cortical bone underlying the articular cartilage. We suggest that these sensory nerve peptides contribute to the pathology of the navicular syndrome. The distribution of the nerves in the CSL and the DS-impar ligament could explain the clinical effects of local anaesthetics injected into the distal interphalangeal joint.

Neurokinin A coexists with substance P and serotonin in ventral medullary spinally projecting neurons of the rat

The coexistence of neurokinin A (NKA) with substance P (SP) and serotonin (5-HT) in ventral medullary neurons of the parapyramidal region and nucleus raphe pallidus of the rat was studied using multiple immunofluorescence labeling. Nearly all of the NKA-immunoreactive (IR) cells in the parapyramidal region and raphe pallidus were SP-IR nd 5-HT-IR, whereas about 70% of the SP-IR neurons and about 60% of the 5-HT-IR neurons contained NKA-IR. There were no apparent differences in the patterns of coexistence between parapyramidal and raphe pallidus neurons. NKA-IR neurons, which colocalized SP-IR and 5-HT-IR, were studied for projections to the lumbar and thoracic spinal cord by use of retrograde transport of fluorescent tracer. Whereas about 50% of the retrogradely labeled neurons of the parapyramidal region and raphe pallidus contained NKA-IR, nearly all of the NKA-IR neurons projected to the thoracic and lumbar spinal cord. In addition, some NKA-IR neurons in the ventral medulla were retrogradely labeled with tracer from localized injections into the thoracic intermediolateral cell column. In summary, this study demonstrated that NKA-IR is colocalized with SP-IR in bulbospinal serotonergic neurons of the parapyramidal region and raphe pallidus, which are known to regulate sensory, motor, and autonomic activities of the spinal cord.

Neurokinin B peptide-2 neurons project from the hypothalamus to the thoracolumbar spinal cord of the rat

The presence and location of CNS neurokinin B peptide-2-like immunoreactive neurons that project to the spinal cord were studied by a combination of retrograde transport of fluorescent dye (FluoroGold) and fluorescence immunocytochemistry. After injections of FluoroGold into the thoracic or lumbar segments of the rat spinal cord, serial sections of brain were stained with antisera directed against neurokinin B peptide-2. The results of the study showed that neurokinin B peptide-2-like immunoreactive neurons were located in the nucleus arcuate, median eminence, ventral and external bed nuclei of the stria terminalis, dorsal hypothalamic area, and medial habenula. Neurokinin B peptide-2 neurons that give rise to the long descending projections from the hypothalamus to thoracolumbar spinal cord were found only in the dorsal hypothalamic area. Approximately 36% of the neurokinin B peptide-2 neurons in the dorsal hypothalamic area projected to the spinal cord, whereas about 28% of the spinal projecting neurons in the dorsal hypothalamic area contained neurokinin B peptide-2-like immunoreactivity. Most of the spinal projecting neurokinin B peptide-2 neurons in the dorsal hypothalamic area had a cell size of 15 x 25 microns. In the spinal cord, immunoreactive neurokinin B peptide-2 fibers and terminals were distributed mainly in the superficial dorsal horn and the central autonomic area, with the highest density in laminae II and X, with less density in laminae IV and V. A few neurokinin peptide-2 fibers and terminals were also found in the ventral horn of the spinal cord. The results of the present study show that hypothalamic neurokinin B peptide-2 neurons are the main source of the spinal neurokinin B peptide-2.