Electrophysiological characteristics of renorenal reflexes in the cat

Impact of anesthesia, sex, and circadian cycle on renal afferent nerve sensitivity

Elevated renal afferent nerve (ARNA) activity or dysfunctional reno-renal reflexes via altered ARNA sensitivity contribute to hypertension and chronic kidney disease. These nerves contain mechano- and chemosensitive fibers that respond to ischemia, changes in intrarenal pressures, and chemokines. Most studies have utilized various anesthetized preparations and exclusively male animals to characterize ARNA responses. Therefore, this study assessed the impact of anesthesia, sex, and circadian period on ARNA responses and sensitivity. Multifiber ARNA recordings were performed in male and female Sprague-Dawley rats (250-400 g) and compared across decerebrate versus Inactin, isoflurane, and urethane anesthesia groups. Intrarenal artery infusion of capsaicin (0.1-50.0 μM, 0.05 mL) produced concentration-dependent increases in ARNA; however, the ARNA sensitivity was significantly greater in decerebrate versus Inactin, isoflurane, and urethane groups. Increases in renal pelvic pressure (0-30 mmHg, 30 s) produced pressure-dependent increases in ARNA; however, ARNA sensitivity was again greater in decerebrate and Inactin groups versus isoflurane and urethane. Acute renal artery occlusion (30 s) increased ARNA, but responses did not differ across groups. Analysis of ARNA responses to increased pelvic pressure between male and female rats revealed significant sex differences only in isoflurane and urethane groups. ARNA responses to intrarenal capsaicin infusion were significantly blunted at nighttime versus daytime; however, ARNA responses to increased pelvic pressure or renal artery occlusion were not different between daytime and nighttime. These results demonstrate that ARNA sensitivity is greatest in decerebrate and Inactin-anesthetized groups but was not consistently influenced by sex.NEW & NOTEWORTHY We determined the impact of anesthesia, sex, and circadian cycle on renal afferent nerve (ARNA) sensitivity to chemical and mechanical stimuli. ARNA sensitivity to renal capsaicin infusion was greatest in decerebrate > Inactin > urethane or isoflurane groups. Elevated renal pelvic pressure significantly increased ARNA; decerebrate and Inactin groups exhibited the greatest ARNA sensitivity. Sex differences in renal afferent responses were not consistently observed. Circadian cycle altered chemosensory but not mechanosensory responses.

Renal Denervation Improves Exaggerated Sympathoexcitation in Rats With Heart Failure: A Role for Neuronal Nitric Oxide Synthase in the Paraventricular Nucleus

Renal denervation (RDN) has been postulated to reduce sympathetic drive during heart failure (HF), but the central mechanisms are not completely understood. The purpose of the present study was to assess the contribution of neuronal nitric oxide synthase (nNOS) within the paraventricular nucleus (PVN) in modulating sympathetic outflow in rats with HF that underwent RDN. HF was induced in rats by ligation of the left coronary artery. Four weeks after surgery, bilateral RDN was performed. Rats with HF had an increase in FosB-positive cells in the PVN with a concomitant increase in urinary excretion of norepinephrine, and both of these parameters were ameliorated after RDN. nNOS-positive cells immunostaining, diaphorase staining, and nNOS protein expression were significantly decreased in the PVN of HF rats, findings that were ameliorated by RDN. Microinjection of nNOS inhibitor N(G)-monomethyl l-arginine into the PVN resulted in a blunted increase in lumbar sympathetic nerve activity (11±2% versus 24±2%) in HF than in sham group. This response was normalized after RDN. Stimulation of afferent renal nerves produced a greater activation of PVN neurons in rats with HF. Afferent renal nerve stimulation elicited a greater increase in lumbar sympathetic nerve activity in rats with HF than in sham rats (45±5% versus 22±2%). These results suggest that intact renal nerves contribute to the reduction of nNOS in the PVN, resulting in the activation of the neurons in the PVN of rats with HF. RDN restores nNOS and thus attenuates the sympathoexcitation commonly observed in HF.

Sympathetic renal innervation and resistant hypertension

Hypertension in chronic renal disease and renovascular disease is often resistant to therapy. Understanding the pathogenic mechanisms responsible for hypertension in these conditions may lead to improved and more targeted therapeutic interventions. Several factors have been implicated in the pathogenesis of hypertension associated with renal disease and/or renal failure. Although the role of sodium retention, total body volume expansion, and hyperactivity of the renin-angiotensin-aldosterone system (RAAS) are well recognized, increasing evidence suggests that afferent impulses from the injured kidney may increase sympathetic nervous system activity in areas of the brain involved in noradrenergic regulation of blood pressure and contribute to the development and maintenance of hypertension associated with kidney disease. Recognition of this important pathogenic factor suggests that antiadrenergic drugs should be an essential component to the management of hypertension in patients with kidney disease, particularly those who are resistant to other modalities of therapy.

Propagation of the electrical impulse in reversible unilateral ureteral obstruction as determined at high electrophysiological resolution

PURPOSE

We investigated the propagation of electrical impulses in a reversible, complete or partial unilateral ureteral obstruction model in vivo.

MATERIALS AND METHODS

In Wistar rats the left mid ureter was completely (8) or partially (7) occluded and released after 24 hours. We recorded electrical activity of the left and right ureter before, during and after obstruction at different stages up to 2 weeks after obstruction using a high resolution, 64 extracellular electrode probe.

RESULTS

Complete obstruction in the left proximal ureter caused an immediate increase in frequency from a mean ± SEM of 14.8 ± 1.3 to 18.6 ± 1.7 per minute (p <0.05), followed by a 1.4 ± 0.9 per minute decrease (p <0.001). Within the first 2 days after reversal velocity gradually decreased from 1.82 ± 0.12 to 0.79 ± 0.17 cm per second (p <0.001). Release of obstruction gradually restored frequency and velocity, which returned to baseline at 2 weeks. Generally the alterations in rats with complete and partial obstruction were similar but they were less marked in those with partial obstruction. Distal to the obstruction site the impulses disappeared (38%) or propagated retrograde (43%) at some stage in the post-obstruction period. These abnormal impulse propagations also gradually disappeared in the post-obstruction stage.

CONCLUSIONS

After complete or partial ureteral obstruction there were immediate, significant changes in the propagation of electrical impulses in the proximal and distal left ureter, which were generally less marked after partial than after complete obstruction. Reversal of obstruction resulted in the gradual disappearance of this abnormality in 2 weeks.

The viscerosympathetic response in rabbits is mediated by GABAergic and glutamatergic inputs into the sympathetic premotor neurons of the rostral ventrolateral medulla

Neurons in the rostral ventrolateral medulla (RVLM) receive inputs from various sources, including baroreceptors, and then regulate the activity of sympathetic preganglionic neurons in the spinal cord. Whether RVLM neurons mediate the viscerosympathetic reflex has yet to be clarified. In the present study, we investigated the role of RVLM neurons in the viscerosympathetic reflex in anaesthetized and vagotomized rabbits. Electrical stimulation of the greater splanchnic nerve (SplN) evoked reflex responses in renal sympathetic activity that were composed of inhibitory and/or excitatory components. Bilateral microinjection of muscimol, a GABA(A) receptor agonist, into the RVLM blocked the reflex responses. Bilateral microinjection of bicuculline, a GABA(A) receptor antagonist, largely attenuated the inhibitory component, whereas kynurenic acid, a glutamate receptor antagonist, eliminated the excitatory component. The activities of 21 RVLM barosensitive bulbospinal neurons were recorded. Twenty of the neurons responded to the SplN stimulation. The responses also consisted of inhibitory and/or excitatory components. The excitatory component of these neurons preceded that of the renal sympathetic nerve activity by about 100 ms. This latency difference was almost the same as that of the inhibitory responses evoked by aortic nerve stimulation. Therefore, the renal sympathetic reflex responses evoked by SplN stimulation are mediated by RVLM neurons, and GABAergic and glutamatergic transmission in the RVLM are related to this reflex.

Selective antagonism of the postsynaptic alpha(1)-adrenoceptor is protective against ischemic acute renal failure in rats

We investigated the effects of prazosin, an alpha(1)-adrenoceptor antagonist, on the pathogenesis of ischemic acute renal failure in rats. Ischemic acute renal failure was induced by occlusion of the left renal artery and vein for 45 min followed by reperfusion, 2 weeks after contralateral nephrectomy. An in vivo microdialysis study revealed that renal interstitial norepinephrine levels were increased with the ischemia/reperfusion (n=3). Renal function in vehicle-treated acute renal failure rats markedly decreased 1 day after reperfusion (n=6), compared with those in sham-operated control animals (n=6). Pre-ischemic treatment with prazosin (100 microg/kg, i.v.) markedly and significantly attenuated the ischemia/reperfusion-induced renal dysfunction (n=6). Histopathological examination of the kidney of vehicle-treated acute renal failure rats revealed severe renal damage, which was also significantly suppressed by pre-ischemic treatment with 100 microg/kg prazosin. The same dose of prazosin given after reperfusion failed to improve the ischemia/reperfusion-induced renal dysfunction (n=6), in contrast to cases of the pre-ischemic treatment with this agent. The administration of prazosin before ischemia did not influence the elevation of renal venous plasma norepinephrine levels (n=6), which were observed both immediately and 1 day after reperfusion. From these findings, we suggest that norepinephrine released excessively from the post-ischemic kidney is involved in the pathogenesis of ischemic acute renal failure, probably acting at the postsynaptic alpha(1)-adrenoceptors.

Renal denervation attenuates long-term hypertensive effects of Angiotensin ii in the rat

1. It is well accepted that some of the long-term effects of angiotensin (Ang) II are mediated via the central nervous system. Some of these actions that are mediated by the circumventricular organs and the baroreceptor reflex are thought to then alter sympathetic nervous system activity. In particular, there is some debate as to the role of renal nerves in the chronic effects of AngII. The aim of the present study was to assess the contribution of the renal nerves in a long-term model of progressive AngII-induced hypertension. 2. Male Sprague-Dawley rats were subjected to either bilateral renal denervation (RDX; n = 7) or sham surgery (SHAM; n = 8). Rats were instrumented with radiotelemetric transducers and venous catheters for the measurement of blood pressure and AngII infusion, respectively. A 4.0% NaCl diet and distilled water were provided ad libitum. The first 3 days served as the control period (7 mL/day, 0.9% NaCl, i.v.). This was followed by an infusion of AngII for 16 days (10 ng/kg per min, i.v.) and a 3 day recovery period identical to control. 3. Baseline arterial pressure between RDX and SHAM rats did not differ. Following AngII treatment, the arterial pressure of SHAM rats increased more rapidly than that of RDX rats. By Day 10 of treatment, the mean arterial pressure was significantly different between groups, having increased to 166 +/- 4 mmHg in SHAM rats and 135 +/- 11 mmHg in RDX rats. This trend continued for the remainder of AngII treatment. 4. The present results indicate that the renal nerves are necessary for the full expression of AngII-induced hypertension.

The role of renal sympathetic nervous system in the pathogenesis of ischemic acute renal failure

We investigated the role of renal sympathetic nervous system in the progression of ischemia/reperfusion-induced acute renal failure in rats. Acute renal failure was induced by clamping the left renal artery and vein for 45 min followed by reperfusion, 2 weeks after the contralateral nephrectomy. Renal venous plasma norepinephrine concentrations markedly and significantly increased immediately after reperfusion, thereafter, the increased level declined but remained higher even at 24 h after reperfusion. Renal sympathetic nerve activity was significantly augmented during the renal ischemia. Renal denervation or the administration of pentolinium, a ganglion blocking agent, (5 mg/kg i.v.) at 5 min before ischemia attenuated the ischemia/reperfusion-induced renal dysfunction and histological damage, such as proteinaceous casts in tubuli and tubular necrosis. The elevation of renal venous norepinephrine levels after reperfusion was suppressed by renal denervation or pentolinium treatment. Thus, a surgical or pharmacological blockade of renal sympathetic nerve prevents the progression of ischemia/reperfusion-induced acute renal failure, thereby suggesting that renal sympathetic nervous system plays an important role in the development of the ischemic acute renal failure.

Neurogenic factors in renal hypertension

Hypertension is very common in patients with chronic renal failure and contributes to cardiovascular morbidity and mortality. Several mechanisms may contribute to hypertension in these patients, but recently a large body of evidence supports the notion that activation of the sympathetic nervous system (SNS) may play a very important role. In rats with 5/6 nephrectomy, the turnover rate of norepinephrine was increased in brain nuclei involved in the noradrenergic control of blood pressure, and dorsal rhizotomy prevented hypertension. Studies in human subjects with chronic renal failure and hypertension have also shown increased peripheral SNS activity measured my microneurography in the peroneal nerve and normalization with nephrectomy. In all, these studies indicate that renal injuries may activate renal afferent pathways that connect with integrative brain structures in SNS activity and blood pressure. We have also shown that central SNS activity is modulated by local expression of nitric oxide, which, in turn, is regulated by interleukin-1b.

Distribution of sympathetic preganglionic neurons innervating the kidney in the rat: PRV transneuronal tracing and serial reconstruction

The organization of spinal motor circuitry to the kidney is not well-characterized and changes in renal innervation have been associated with disease states such as hypertension found in the spontaneously hypertensive rat or renal hypertension. Here, we describe the segmental and intra-segmental organization of the spinal motor circuitry that was resolved after neurotropic viral injection into the kidney and retrograde transneuronal transport to the spinal cord. In the first experiment, the serial reconstruction of infected neurons in the thoracolumbar spinal cord from T8-L1 was performed following injection of pseudorabies virus (PRV, Bartha strain) into either the cranial pole, the caudal pole or both the cranial and caudal poles of the left kidney in male rats. In the second experiment, rats received injections of two different PRV strains that were genetically engineered to express unique reporter molecules; one of the engineered strains was injected into the cranial pole and the other was injected into the caudal pole. Either 3- or 4-day post-infection, the animals were anesthetized and sacrificed by transcardial perfusion. PRV-infected neurons were located by immunocytochemistry against either PRV itself (experiment 1) or the unique marker proteins (experiment 2). After injection of both poles of the kidney, the majority of the infected neurons were found in the ipsilateral intermediolateral cell column (IML) from T10 to T12 with the mode at T11. Infected neurons were found in discrete neuron clusters in the intermediolateral cell column along the longitudinal axis in a repeating pattern of high and low density that has been called "beading". Three observations indicated a topographic distribution of renal sympathetic preganglionic neurons (SPN). First, after injection into either the cranial or caudal poles of the kidney, the mode of infected cells was located in segments T11 and T12, respectively. The one spinal segment shift in the mode suggested a topographic distribution. Second, in spinal segments T8-L1, comparison of the distributions of the neurons innervating each pole of the left kidney revealed an overlap in the distribution, except in the T11 segment. In the T11 segment, the neurons projecting to each pole tended to segregate into separate populations. Third, in rats that received injections of two PRV strains that were genetically engineered to express unique markers into opposite poles of the kidney, a segregation of neurons projecting to the cranial and caudal poles of the kidney was noted again in the T11 spinal segment and the segregation at adjacent spinal levels was obvious. The analysis of the distribution of infected neurons within each spinal cord segment (intra-segmental distribution) revealed three different patterns along the cranial-caudal dimension. In segments T8-T10, >60% of the infected neurons were located in the caudal half of the spinal segment. In segments T12-L1, >60% of the infected neurons were located in the cranial half of the spinal segment. In segment T11, the neurons were more evenly distributed throughout the segment. These intra-segmental distribution patterns were found after both 3- or 4-day survival periods post-infection and were found in most animals. The distribution of clusters of neurons revealed a similar intra-segmental pattern. Thus, as was described previously for the sympathetic postganglionic neurons that innervate the kidney, the present work indicates a topographic organization in the second-order neurons in the renal sympathetic efferent pathway. The physiological significance of this anatomical organization remains to be determined.

Neurogenic factors and hypertension in renal disease

Hypertension in chronic renal failure (CRF) is very common and contributes to morbidity and mortality and to the progression of renal disease. The pathogenesis of hypertension in CRF has been attributed mostly to sodium retention and to activation of the renin-angiotensin-aldosterone system. More recently an abundance of evidence has accumulated to support a role for increased sympathetic nervous system (SNS) activity in the genesis of hypertension associated with CRF. Evidence from our laboratory has also demonstrated that the rise in central SNS activity is mitigated by increased local expression of nitric oxide synthase (NOS)-mRNA and nitric oxide (NO) production, and that the upregulation of NO production in the brain is mediated by IL-1beta.

The renal afferent pathways in the rat: a pseudorabies virus study

Retrograde tract tracing studies have indicated that dorsal root ganglion cells from T8 to L2 innervate the rat's left kidney. Electrophysiology studies have indicated that putative second-order sympathetic afferents are found in the dorsal horn at spinal segments T10 to L1 in laminae V-VII. Here, the spread of pseudorabies virus through renal sensory pathways was examined following 2-5 days post-infection (PI) and the virus was located immunocytochemically using a rabbit polyclonal antibody. Two days PI, dorsal root ganglion neurons (first-order sympathetic afferents) were infected with PRV. An average of 1.2, 0.8, 2.1 and 4.4% of the infected dorsal root ganglion neurons were contralateral to the injected kidney at spinal segments T10, T11, T12 and T13, respectively. Four days PI, infected neurons were detected within laminae I and II of the dorsal horn of the caudal thoracic and upper lumbar spinal cord segments. The labeling patterns in the spinal cord are consistent with previous work indicating the location of renal sympathetic sensory pathways. The nodose ganglia were labeled starting 4 days PI, suggesting the involvement of parasympathetic sensory pathways. Five days PI, infected neurons were found in the nucleus tractus solitarius. In the present study, it was unclear whether the infected neurons in the nucleus tractus solitarius are part of sympathetic or parasympathetic afferent pathways or represent a convergence of sensory information. Renal denervation prevented the spread of the virus into the dorsal root ganglia and spinal cord. Sectioning the dorsal roots from T10-L3 blocked viral spread into the spinal cord dorsal horn, but did not prevent infection of neurons in dorsal root ganglion nor did it prevent infection of putative preganglionic neurons in the intermediolateral cell column. The present results indicated that renal afferent pathways can be identified after pseudorabies virus infection of the kidney. Our results suggest that renal afferents travel in sympathetic and parasympathetic nerves and that this information may converge at the NTS.

Renal denervation prevents and reverses hyperinsulinemia-induced hypertension in rats

Experiments were performed to evaluate the role of the renal nerves in hyperinsulinemia-induced hypertension. Male Sprague-Dawley rats were made hyperinsulinemic by insulin infusion via osmotic minipumps implanted subcutaneously (3.0 mU/kg per minute for 6 weeks). Rats with vehicle infusion served as controls. Bilateral renal denervation was performed either at the beginning of or 4 weeks after insulin infusion. The systolic blood pressure was measured by the tail-cuff method twice a week. Food and water intake and urine flow were measured daily. The results showed that sustained insulin infusion significantly increased plasma insulin concentrations from 277.7+/-25.8 pmol/L to 609.9+/-22.2 and 696.7+/-23.0 pmol/L by the end of weeks 4 and 6, respectively (P<0.05). Systolic blood pressure was significantly increased from 135+/-3 to 157+/-3 and 159+/-2 mm Hg (P<0.05) at the corresponding time points. There was a significant increase in the plasma norepinephrine concentration after insulin infusion, whereas no significant changes in plasma triglyceride and glucose concentrations, water intake, urine flow, sodium excretion, sodium gain, and body weight gain were observed. Bilateral renal denervation depleted renal norepinephrine stores and prevented the development of hyperinsulinemia-induced hypertension. After hyperinsulinemia-induced hypertension had been fully established (from 134+/-2 to 157+/-2 mm Hg), bilateral renal denervation reversed the elevated systolic blood pressure to normotensive levels within 2 weeks. Transient denervated diuresis and natriuresis were observed. These results indicate that chronic hyperinsulinemia-induced hypertension requires the presence of intact renal nerves in rats.

Electrophysiological evidence of ipsilateral reno-renal reflexes in the cat

To verify the existence of ipsilateral reno-renal reflexes we studied the effect of surgical denervation of one kidney on the ipsilateral efferent renal nerve activity (ERNA), in the absence of contralateral afferent renal nerve activity. Thus the ipsilateral renal denervation was performed 1 h later than the contralateral renal denervation. The experiments were done on 9 anesthetized cats. Arterial pressure, urine flow rate (UFR) of both kidneys and ERNA to the ipsilateral kidney were measured. All variables were monitored during a 3 min control period and for 13 min after either contralateral and ipsilateral renal denervations. ERNA significantly increased (+20 +/- 9%) and UFR concomitantly decreased (-11 +/- 10%) after the surgical denervation of the contralateral kidney which showed an increase (+91 +/- 19%) in UFR. The subsequent ipsilateral denervation caused a significant increase in UFR (+117 +/- 25%) and ERNA (79 +/- 23%) of the same kidney, while on the opposite side UFR did not change. During the two procedures, arterial pressure did not change. Our data demonstrate the existence of ipsilateral reno-renal reflexes that exert a tonic inhibitory effect on ipsilateral ERNA.

Static and dynamic responses of renal chemoreceptor neurons to intrapelvic pressure increases in the rat

Multiunit afferent renal nerve activity (ARNA) and single unit activity from R2 chemoreceptors were recorded in anesthetized male Sprague Dawley rats during rapid and graded increases in intrapelvic pressure. Multiunit ARNA in 9 rats was excited by rapid intrapelvic pressure increases to 20 mmHg with non-diuretic urine (285.5 +/- 76.2% above control) but not when isotonic saline was used to fill the pelvis (13.0 +/- 9.0%). Similar responses were recorded from 27 single R2 chemoreceptors. Multiunit ARNA showed a direct, linear relationship with ramp increases in intrapelvic pressure between 0 and 20 mmHg at rates of 0.05, 0.15 and 0.3 mmHg/s. The responses were dynamically linked to intrapelvic pressure and maximum activations showed a positive linear relationship with the rate of pressure increase. Individual R2 chemoreceptor activity showed a similar dynamic relationship with intrapelvic pressure. ARNA was also excited by intrapelvic backflow of diuretic urine (10% expansion of extracellular volume) but the response in impulses/s was depressed by 58.6 +/- 9% in multiunit preparations and 30.1 +/- 10.8% for R2 chemoreceptors. Basal activities were also reduced during diuresis by 49.0 +/- 16% and 36.7 +/- 12.3% for multiunit and single unit preparations, respectively, and the percent increases over background during urine backflow were not different in non-diuresis and diuresis. Both multiunit ARNA and R2 chemoreceptors were also activated by ramp increases in intrapelvic pressure during diuresis, but the dynamic component was lost and responses to each pressure ramp were not different. The similarity in responses between multiunit ARNA and individual R2 chemoreceptors indicates that the multiunit ARNA activation during intrapelvic pressure increases is largely composed of activity from R2 chemoreceptors.

Fos induction in central structures after afferent renal nerve stimulation

Experiments were done in the conscious and unrestrained rat to identify central structures activated by electrical stimulation of afferent renal nerves (ARN) using the immunohistochemical detection of Fos-like proteins. Fos-labelled neurons were found in a number of forebrain and brainstem structures bilaterally, but with a contralateral predominance. Additionally, Fos-labelled neurons were found in the lower thoracolumbar spinal cord predominantly ipsilateral to the side of ARN stimulation. Within the forebrain, neurons containing Fos-like immunoreactivity after ARN stimulation were primarily found along the outer edge of the rostral organum vasculosum of the laminae terminalis, in the medial regions of the subfornical organ, in the median preoptic nucleus, in the ventral subdivision of the bed nucleus of the stria terminalis, along the lateral part of the central nucleus of the amygdala, throughout the deeper layers of the dysgranular insular cortex, in the parvocellular component of the paraventricular nucleus of the hypothalamus (PVH), and in the paraventricular nucleus of the thalamus. Additionally, a smaller number of Fos-labelled neurons was observed in the supraoptic nucleus, in the magnocellular component of the PVH and along the lateral border of the arcuate nucleus. Within the brainstem, Fos-labelled neurons were found predominantly in the commissural and medial subnuclei of the nucleus of the solitary tract and in the external subnucleus of the lateral parabrachial nucleus. A smaller number were observed near the caudal pole of the locus coeruleus, and scattered throughout the ventrolateral medullary and pontine reticular formation in the regions known to contain the A1, C1 and A5 catecholamine cell groups. The final area observed to contain Fos-labelled neurons in the central nervous system was the thoracolumbar spinal cord (T9-L1) which contained cells in laminae I-V of the dorsal horn ipsilateral to side of stimulation and in the intermediolateral cell column at the same levels bilaterally, but with an ipsilateral predominance. Few, if any Fos-labelled neurons were observed in the same structures of control animals in which the ARN were stimulated, but the renal nerves proximal to the site of stimulation were transected, or in the sham operated animals. These data indicate that ARN information originating in renal receptors is conveyed to a number of central areas known to be involved in the regulation of body fluid balance and arterial pressure, and suggest that this afferent information is an important component of central mechanisms regulating these homeostatic functions.

Aging and the hypothalamus: research perspectives

There are several hypothalamic theories of aging, none of which has been validated. An approach to validation is to search for consequences of anatomic ablations of hypothalamic regions that are functional hallmarks of aging, or consequences of ablation that postpone the appearance of hallmarks of aging or extend longevity. Ablation of the hypothalamic ventromedial nucleus (VMN) in the weanling rat is associated with subsequent increased body fat, glucose intolerance, hyperlipidemia, and decreased renal function. Each of these consequences is characteristic of aging in humans and in several animal models of aging. Ablation of the hypothalamic dorsomedial nucleus (DMN) in the weanling rat leads to a symmetrically smaller animal with normal glucose and lipid metabolism, decreased body fat for size, and reduced risk of decreased renal function and circulating IGF-I levels. These are findings consistent with calorie restriction models in rodents that significantly extend life span. This review compares outcomes of lesions in the VMN, DMN, and lateral hypothalamic area (LHA) for relevance to aging. To establish a relationship between these anatomic areas of the hypothalamus and aging, it is concluded that the VMN, DMN, and LHA lesions should be examined for impact on longevity and compared with data obtained from simultaneously studied intact ad-lib-fed and 40% calorie-restricted animals. Lesioned animals also should be rigorously studied for neurotransmitters (e.g., neuropeptide Y, beta-endorphin, serotonin, corticotropin-releasing factor, and galanin), and for behavioral changes consistent with aging, for accumulation of specific tissue lipofuscin and amyloid that are associated with normal aging and for other age-dependent findings, such as incidence of tumors and cataract.

Clinical significance of urinary enzymes and beta 2-microglobulin following ESWL

To examine the renal damage caused by shock waves, urinary excretion of enzymes and beta 2-microglobulin were determined before and after ESWL. Urine samples were obtained from 35 patients with renal stone and 26 patients with ureteric stone treated with ESWL. Urinary lactate dehydrogenase (LDH) levels significantly increased on day 0, just after ESWL, in both groups. In the ureteric stone group the kidneys received less shock waves than in the renal stone group. Increased urinary lactate dehydrogenase was considered to have derived from erythrocytes in urine. Elevated urinary N-acetyl-beta-D-glucosaminidase (NAG) levels were also observed on day 0 after ESWL in both groups, due to unknown reasons. Indirect effect of ESWL through the sympathetic nervous system or humoral factors may contribute to increases in the urinary excretion of NAG. No significant increase was found in urinary gamma-glutamyl-transpeptidase (GGTP) levels for 5 days after ESWL. Urinary beta 2-microglobulin (BMG) levels increased on day 0 in the renal stone group alone. In our present study, the clinical significance of urinary enzymes and BMG was not well evaluated, because urinary excretion of these indicators following ESWL were transient and mild.

The effect of dorsomedial hypothalamic nucleus lesions on kidney function and structure after 1 and 12 months

According to the Dillman theory (17), aging results from a deterioration of metabolism that begins with an elevation of hypothalamic receptor thresholds for feedback signals from the periphery. Three hypothalamic areas are known to contain such receptors: the ventromedial and dorsomedial hypothalamic nuclei (DMN) and the lateral hypothalamic area. We have hypothesized that selective destruction of those hypothalamic areas might be followed by physiological changes associated with aging. Electrolytic bilateral DMN lesions were produced in male and female weanling rats. These rats were maintained for up to 13 months of age. Sham-operated rats served as controls. Food intake and body weight were monitored postoperatively and prior to sacrifice. Before sacrifice, tail blood and a 24-h urine samples were obtained. In accordance with previous findings, rats with DMN lesions showed dramatic reductions of ponderal growth and food intake but had normal body composition. Total protein and albumin excretion rates were significantly lower in rats with lesions. The fractional contribution of albumin to total urinary protein was also decreased in rats with lesions. Histological examination of the kidneys showed significantly less pathology in the kidneys of rats with DMN lesions; the severity of renal pathology was correlated directly with proteinuria. These changes were seen as early as 1 month after production of the lesion. The attenuation of age-related changes in kidney functions and structure in rats with lesions could be due to reduced food intake (dietary restriction is known to produce similar results), and/or a direct effect of the lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

Peripheral and central pathways regulating the kidney: a study using pseudorabies virus

We used the retrograde transneuronal transport of a neurotropic virus, pseudorabies virus (PRV), to identify the neurons in sympathetic ganglia, spinal cord and brain which regulate renal function and renal circulation. PRV was microinjected into the left kidney of 70, pentobarbital-anesthetized, male rats. After an incubation period of 1-4 days, rats were anesthetized and sacrificed. PRV-infected neurons were located immunocytochemically in pre- and paravertebral sympathetic ganglia, the intermediolateral cell column of the T10-T13 segments and several brainstem cell groups: the medullary raphe nuclei, rostral ventrolateral medulla, rostral ventromedial medulla, A5 cell group, and the paraventricular hypothalamic nucleus. In more heavily infected rats, additional labeling was found in the locus coeruleus, periaqueductal gray matter, lateral hypothalamic area, zona incerta, and anterior hypothalamic area. No infected propriospinal neurons were observed in the lateral spinal nucleus or gray matter of the caudal cervical, lumbosacral or thoracic spinal segments not containing infected putative sympathetic preganglionic neurons. The paucity of infected propriospinal neurons in the presence of infected brainstem neurons, even in lightly infected rats, is discussed in reference to the relative importance of descending vs spinal regulation of the sympathetic outflow to the kidney.

The lateral hypothalamic area revisited: neuroanatomy, body weight regulation, neuroendocrinology and metabolism

This article reviews findings that have accumulated since the original description of the syndrome that follows destruction of the lateral hypothalamic area (LHA). These data comprise the areas of neuroanatomy, body weight regulation, neuroendocrinology, neurochemistry, and intermediary metabolism. Neurons in the LHA are the largest in the hypothalamus, and are topographically well organized. The LHA belongs to the parasympathetic area of the hypothalamus, and connects with all major parts of the brain and the major hypothalamic nuclei. Rats with LHA lesions regulate their body weight set point in a primary manner and not because of destruction of a "feeding center". The lower body weight is not due to finickiness. In the early stages of the syndrome, catabolism and running activity are enhanced, and so is the activity of the sympathetic nervous system (SNS) as shown by increased norepinephrine excretion that normalizes one mo later. The LHA plays a role in the feedback control of body weight regulation different from ventromedial (VMN) and dorsomedial (DMN). Tissue preparations from the LHA promote glucose utilization and insulin release. Although it does not belong to the classical hypothysiotropic area of the hypothalamus, the LHA does affect neuroendocrine secretions. No plasma data on growth hormone are available following electrolytic lesions LHA but electrical stimulation fails to elicit GH secretion. Nevertheless, antiserum raised against the 1-37 fragment of human GHRF stains numerous perikarya in the dorsolateral LHA. The plasma circadian corticosterone rhythm is disrupted in LHA lesioned rats, but this is unlikely due to destruction of intrinsic oscillators. Stimulation studies show a profound role of the LHA in glucose metabolism (glycolysis, glycogenesis, gluconeogenesis), this mechanism being cholinergic. Its role in lipolysis appears not to be critical. In general, stimulation of the VMN elicits opposite effects. Lesion studies in rats show altered in vitro glucose carbon incorporation into several tissue fractions both a few days, and one mo after lesion production. Several of these changes may be due to the reduced food intake, others appear to be due to a "true" lesion effect.

Role of hypothalamic-renal noradrenergic systems in hypotensive action of potassium

To clarify the role of the renal and hypothalamic noradrenergic systems in the antihypertensive actions of dietary potassium supplementation in salt-loaded spontaneously hypertensive rats (SHR), we measured systolic blood pressure and norepinephrine turnover, which was determined from the rate of decline of tissue norepinephrine concentration after the administration of alpha-methyl-p-tyrosine, in 5-week-old SHR or age-matched Wistar-Kyoto (WKY) rats eating normal-NaCl (0.66%) or high-NaCl (8%) diet with supplementation of 8% KCl. In WKY rats, neither high-sodium nor high-potassium diets had an effect on blood pressure with no change in renal or hypothalamic norepinephrine turnover. In SHR, however, salt loading accelerated the development of hypertension. Potassium supplementation did not affect blood pressure in normal-sodium SHR but attenuated the rise in blood pressure with salt loads. Correspondingly, renal norepinephrine turnover in SHR was increased compared with that of WKY rats, and salt loading further potentiated the increased turnover in the kidney; however, no changes in hypothalamic turnover occurred. Potassium supplementation attenuated the rise in blood pressure with salt loads and the increased renal turnover. Stimulation of sympathetic discharge by cold exposure after the administration of alpha-methyl-p-tyrosine produced marked depletion of norepinephrine in most tissues. The loss of norepinephrine was significantly greater in both kidney and hypothalamus of salt-loaded SHR than in those of normal-sodium SHR, but potassium could normalize this. Thus, potassium not only diminished the increased renal norepinephrine turnover in the kidney under normal conditions but also attenuated the augmented renal and hypothalamic norepinephrine turnover by cold stress in salt-loaded SHR.(ABSTRACT TRUNCATED AT 250 WORDS)

Somatic versus vestibular gravity reception in man

In order to assess the effect of extravestibular gravity receptors on perception and control of body position against that of the otoliths, the subject (S) is exposed to gravitoinertial forces along the spinal (Z) axis on a tiltable board and on a sled centrifuge. It turns out that (1) both effects, on average, are equally strong, although with considerable variance between Ss; (2) the centroid of the mass(es) governing the somatic receptors lies near the centroid of the body; and (3) somatic gravity reception contains two distinctly different systems. Both appear unimpaired in paraplegic Ss with total bilateral sensory loss (TSL) from the 5th to the 1st lumbar spinal segment. One, the truncal system, is eliminated with TSL from the 11th thoracic segment upwards. Yet another is still functioning with TSL up to and including the 6th cervical segment, with the same effectiveness throughout this range. Hence it must be mediated by vagal or, less likely, sympathetic afference, that is, probably, by the influence of gravity on the cardiovascular system. That the afference of the truncal system appears to enter the cord at the last two thoracic segments supports earlier conjectures about a supererogatory static function of the kidneys. In fact, on the tiltable board, 7 bilaterally nephrectomized Ss behaved like paraplegics with TSL between T11 and C6, yet differed significantly in the predicted direction from the normal controls.

Tonic descending modulation of spinal neurons with renal input

Experiments were conducted to determine the influence of tonically active descending pathways on thoracolumbar spinal neurons that respond to renal nerve stimulation in anesthetized cats. We examined the effect of reversible blockade of spinal conduction on spontaneous activity, responses to renal nerve stimulation and responses to somatic stimuli of 71 spinal neurons. Mid-thoracic cold block resulted in enhanced responses (tonically inhibited neurons), reduced responses (tonically excited neurons), or did not affect neuronal responses. The spontaneous activity of 47 of 69 neurons (68%) increased from 7.3 +/- 2.0 spikes/s before cooling to 23.3 +/- 4.5 spikes/s during cooling. Activity of 8 neurons (12%) decreased while 14 (20%) had no change in activity. Cooling increased the responses of 51 of 71 neurons (72%) to renal nerve stimulation. Renal nerve stimulation evoked a two-fold increase in both short latency (early) and long latency (late) responses. Four neurons had a late response which was revealed by cold block. Cooling decreased responses of 8 of 71 neurons (11%) and 9 neurons (13%) were not affected. Cooling increased the early responses but decreased the late responses of 3 of 71 neurons (4%). All neurons had somatic receptive fields and 33 of 56 exhibited increased responses to somatic stimulation during cooling. In addition, receptive field sizes of 26 neurons increased. Four neurons had a decrease and 25 neurons had no change in receptive field size during cooling. These data indicate that tonically active descending pathways modulate the activity of most spinal neurons with renal input and the major effect of these pathways is inhibitory. This influence may be important in the modulation of spinal circuits that participate in reflexes evoked by renal afferent fibers.

Origins of the renal innervation in the primate, Macaca fascicularis

The origins of the renal efferent and afferent nerves in 5 cynomolgus monkeys (Macaca fascicularis) were studied by using the retrograde transport of horseradish peroxidase (HRP) and horseradish peroxidase-wheat germ agglutinin (HRP-WGA). The cut ends of the right renal nerves were soaked for 30-45 min in solutions consisting of 15% HRP and 1% HRP-WGA. Three or four days later the animals were killed and the tissues examined for the presence of retrogradely labeled neurons, HRP-filled cells were observed, with rare exceptions, only in ganglia ipsilateral to the side of tracer application. Renal efferent neurons (4648-14565 cells per animal) were found in relatively equal numbers in prevertebral and paravertebral (sympathetic chain) ganglia. Labeled prevertebral cells were distributed among the renal (52%), aorticorenal (32%) and superior mesenteric (16%) ganglia, whereas labeled paravertebral neurons were mainly located in chain ganglia T11-L3, with 94% of these located in L1-3. Labeled renal sensory neurons (31-543 per animal) constituted less than 5% of all labeled cells and were found in ipsilateral dorsal root ganglia T10-L3, with (80%) in T12 and L1. The labeled sensory neurons ranged from 18-64 microns in diameter (X = 32.4 microns). With the exception of a single cell in one animal, no labeled neurons were observed in the nodose ganglia. Many parallels were observed between the organization of the renal plexuses of macaques and humans, suggesting the utility of the non-human primate as an experimental model for functional studies of renal innervation in humans.

Renal and cardiovascular afferent inputs to hypothalamic paraventriculo-spinal neurons

Experiments were done in chloralose-anesthetized cats to identify single units in the paraventricular nucleus of the hypothalamus (PVH) that responded to stimulation of afferent renal nerves (ARN) and the buffer nerves (carotid sinus (CSN) and aortic depressor (ADN) nerves), and whose axons projected directly to thoracic spinal sympathetic areas. Of 426 single units tested in the PVH region, 20 were antidromically activated by stimulation of the spinal cord. Sixteen of these antidromic units (80%) responded orthodromically to stimulation of ARN and/or the buffer nerves; 6 units (30%) were excited by ARN stimulation only, 2 units (10%) were excited by both ARN and buffer nerve stimulation, and 6 units were excited and 2 inhibited by buffer nerve stimulation only. These data demonstrate that sensory information originating in renal and cardiovascular receptors alters the firing rate of PVH-spinal projecting neurons and suggest that this long renal-PVH reflex loop may contribute to the elevation of arterial pressure (AP) during conditions when ARN are activated.

Serial measurements of plasma renin activity, aldosterone and cortisol during percutaneous transluminal angioplasty of the renal artery in man

Fifteen patients (eight men, seven women) with hypertension and renal artery stenosis underwent dilation of the stenosis by percutaneous transluminal renal angioplasty (PTRA). During and shortly after this treatment the effects on the renin-angiotensin-aldosterone system and blood pressure were studied. Plasma renin activity (PRA) was measured in peripheral blood and in renal venous blood during the PTRA. PRA increased in peripheral blood during PTRA as a result of an immediate significant rise in renal venous plasma renin activity by 132 +/- 134% (P less than 0.01) on the dilated side. PRA in the contralateral renal vein was close to that in peripheral blood. Within 10 min after PTRA there was a significant increase in serum aldosterone from 439 +/- 343 to 774 +/- 635 pmol 1-1 (P less than 0.025), while serum cortisol remained unchanged. The aldosterone increase was most probably mediated by angiotensin II. Systolic and diastolic blood pressures were unchanged during PTRA in spite of renin and aldosterone increases, suggesting that antihypertensive factors counteract the pressor effects of a physiologically relevant increase in PRA.

The effect of sevoflurane on somatically induced sympathetic reflexes

The effects of various inspiratory concentrations of sevoflurane anesthetics on the sympathetic reflex responses evoked in the left inferior cardiac nerve branch following an electrical stimulation to the ipsilateral superficial peroneal nerve were investigated in cats. At a 2.0% inspiratory concentration of sevoflurane, two components of the somato-sympathetic reflexes with two different latencies were recorded. The early component was due to an activation of myelinated A afferent fibers (referred to as the A-reflex), while the late component was due to an activation of unmyelinated C afferent fibers (referred to as the C-reflex). The increase in the concentration of sevoflurane from 2.0% to 3.0% resulted in about 50% attenuation of both the A- and C-reflexes. A further increase in the concentration of sevoflurane to 4.0% resulted in further suppression of both reflexes.

Persistent firing of splenic and renal nerves after acute decentralization but failure to produce ganglionic reflexes

Experiments were done to evaluate the contribution of peripheral neural circuits to generation of ongoing splenic and renal sympathetic discharge as well as to the reflex alteration of this discharge by chemical stimulation of receptors of intestinal afferent nerves. After decentralization of the celiac and superior mesenteric ganglia, low amplitude spikes with low discharge rates still were observed in both nerves. Stimulation of intestinal receptors with bradykinin or capsaicin did not alter this residual firing. Cholinergic blockade eliminated most of this discharge. The source of the residual firing and its contribution to basal discharge of splenic and renal nerves remains to be determined.

The conduction velocities and spinal projections of single renal afferent fibers in the rat

This study was designed to examine the conduction velocities and spinal projections of renal afferent fibers in the rat using electrophysiological techniques. In chloralose-anesthetized rats, we electrically stimulated the peripheral ends of cut, lower thoracic and upper lumbar dorsal roots and recorded and averaged antidromically conducted action potentials in the renal nerves. Of 284 single axons responding to stimulation of ipsilateral dorsal roots T9-L1, the majority were activated by stimulating roots T11-T13. No antidromic responses could be elicited by stimulating the contralateral dorsal roots. Afferent fibers were divisible into two groups, distinguished by their conduction velocities: a population of slowly conducting axons, presumably composed of both unmyelinated (0.3-2 m/s, 76%) and thinly myelinated (2-9 m/s, 19%) fibers, and a population of more rapidly conducting, small myelinated axons (12-32 m/s, 5%). Slowly and more rapidly conducting fibers were not differentially distributed among dorsal roots. Postexperimental histological examination of nerves revealed small myelinated axons with diameters appropriate for some, but not for all, of the axons with conduction velocities in the myelinated range. These results indicate that single myelinated and unmyelinated primary afferent axons can be identified by antidromic stimulation in autonomic nerves of rat. They provide the first electrophysiological description of afferent renal nerve fibers in the rat, and they verify the predominantly unmyelinated nature of these fibers.

Effects of lumbar sympathetic block on kidney function in cirrhotic patients with hepatorenal syndrome

We studied the effects of unilateral lumbar sympathetic block on kidney function in eight patients with cirrhosis and hepatorenal syndrome. In five patients with basal glomerular filtration rate (GFR) below 25 ml/min, sympathetic block induced a significant increase in GFR, osmolal clearance, urinary sodium excretion, fractional excretion of filtered sodium (FENa) and effective renal plasma flow (ERPF) and a decrease in plasma renin activity. In the three patients with basal GFR greater than 25 ml/min, sympathetic block produced no significant change in renal function. We conclude that sympathetic block might improve renal function in cirrhotics with hepatorenal syndrome, particularly those with more impaired GFR.

Functional identification of the central projections of afferent renal nerves

The central integration of cardiovascular reflexes produced by activation of renal sensory mechanisms was examined by studying arterial pressure and regional blood flow responses to electrical stimulation of the renal afferent nerves. Spinal transection, rostral to the entry into the cord of renal afferent projections, abolished the cardiovascular response consisting of an a fall in arterial pressure, mesenteric vasoconstriction and vasodilation in the hindquarters. Several supraspinal structures at medullary, midbrain and forebrain levels were identified by lesion studies to be important for the reflex responses. Lesion of NTS abolished the hindquarter vasodilator response but left the mesenteric vasoconstrictor response intact. Lesions of the parabrachial complex produce similar effects whereas lesions in the periventricular preoptic region of hypothalamus abolished mesenteric vasoconstriction and left hindquarter vasodilation unaffected. These studies demonstrate that cardiovascular reflexes elicited by activation of renal sensory nerves require integrity of spinal pathways and are differentially integrated at several levels of the neuraxis.

Electrophysiological characteristics of sensory mechanisms in the kidney

R2 chemoreceptors are excited by backflow of urine or isotonic KCl into the renal pelvis, they do not respond to backflow of isotonic saline at the same intrapelvic pressure but are excited during periods of renal ischemia. R1 chemoreceptors are excited during complete renal ischemia but otherwise exhibit no activity. The responses of multiunit afferent renal nerve activity (ARNA) to these stimuli in Sprague Dawley rats follow the same patterns exhibited by R2 chemoreceptors, and the data do not support the presence of mechanoreceptive nerves which are excited by increases in intrapelvic pressure in these animals. The responses of multiunit ARNA in SHR and WKY rats were not different from Sprague Dawley rats. In contrast, while the response of WKY rats during renal ischemia was not different from Sprague Dawley rats the excitation of SHR during ischemia was more than 10 fold greater than that of the normotensive animals.

Renorenal reflex responses to renal sensory receptor stimulation in normotension and hypertension

The renorenal reflex responses to renal mechano-(MR) and chemoreceptor (CR) stimulation have been examined in anesthetized dogs, cats, and rats. Renal MR were stimulated by increased ureteral pressure and renal CR by retrograde ureteropelvic perfusion with 0.9 M NaCl at unchanged ureteral pressure. In the dog, renal MR stimulation results in an increase in ipsilateral afferent renal nerve activity (ARNA) and contralateral efferent RNA (ERNA) and a contralateral renal vasoconstriction. Mean arterial pressure (MAP) is unchanged. Renal CR stimulation is without effect. In the cat, renal MR and CR stimulation increases MAP and either increases or decreases contralateral urine flow rate and urinary sodium excretion at unchanged renal perfusion pressure. In the rat, renal MR and CR stimulation increases ipsilateral ARNA, decreases contralateral ERNA and increases contralateral urine flow rate and urinary sodium excretion. The magnitude of the renorenal reflex responses is related to the magnitude of the stimulation. Furthermore the renorenal reflex responses are attenuated in spontaneously hypertensive rats (SHR). We conclude that there is a species difference in the nature of the renorenal reflex responses to renal MR and CR stimulation. The attenuated renorenal reflexes in SHR might contribute to their hypertension by promoting increased ERNA and sodium retention.

Central organization of afferent renal nerve pathways

Although afferent renal nerves have been studied for over a quarter of a century, their physiological role remains unclear. There is considerable experimental evidence indicating that afferent renal nerves convey sensory information from renal receptors to integrative circuits in the central nervous system which gives rise to command signals controlling the function of effector organs. In addition, it has been demonstrated that these integrative neural circuits are found at several different levels of the neuraxis; the spinal cord, the medulla and the hypothalamus. In this review, recent neuroanatomical and electrophysiological data on the central pathways of afferent renal nerves is discussed with reference to their possible role in homeostasis.

The sympathetic nervous system in clinical and experimental hypertension

In summary, many lines of evidence indicate that the sympathetic nervous system, via the renal nerves, plays an important role in the pathogenesis of renovascular hypertension in humans and laboratory animals. Patients with established renovascular hypertension have increased sympathetic nervous system activity, as evidenced by increased plasma and urinary norepinephrine levels, elevated excretion of catecholamine metabolites, and an exaggerated depressor response to centrally acting sympatholytic agents. The observation that converting enzyme inhibitors can cause both blood pressure and urinary norepinephrine excretion to return to normal in patients with renovascular hypertension is consistent with the interpretation that activation of the sympathetic nervous system in these subjects is, at least in part, angiotensin-induced. The sympathetic nervous system, via the efferent renal nerves, plays a role in the pathogenesis of hypertension in a number of experimental models. In the spontaneously hypertensive rat of the Okamoto strain (SHR) and in the DOCA/NaCl hypertensive model, increased renal efferent nerve activity contributes to the development of hypertension by causing increased renal sodium retention. In both of these experimental models, renal denervation delays the development and blunts the severity of hypertension. This delay is associated with increased urinary sodium excretion, suggesting a renal efferent mechanism. In contrast to the predominantly efferent renal nerve mechanisms observed in the DOCA-NaCl and SHR models, studies of the effects of renal denervation in one-kidney, one-clip and two-kidney, one-clip Goldblatt hypertensive rats suggest that renal afferent nerves are important in these models of hypertension. Total renal denervation in rats with established 1K, 1C and 2K, 1C hypertension attenuates the severity of the hypertension without altering sodium intake or excretion, renin activity, water intake, or renal function. Thus, efferent renal nerve activity does not appear to be involved in the development of maintenance of 1K, 1C or 2K, 1C hypertension. In contrast with the findings in SHR and DOCA-NaCl rats, these studies provide indirect evidence that the renal afferent nerves play a role in the pathogenesis of this form of experimental hypertension. The major effect of renal denervation in these models appears to be an interruption of renal afferent nerve activity, which by a direct feedback mechanism attenuates systemic sympathetic tone, thereby lowering blood pressure.(ABSTRACT TRUNCATED AT 400 WORDS)

Afferent renal nerve-dependent hypertension following acute renal artery stenosis in the conscious rat

Anatomical and electrophysiological evidence indicates that the kidneys contain both mechano- and chemoreceptor nerve endings. We conducted the present study to determine whether conditions of reduced renal blood flow elicit cardiovascular alterations that are dependent on afferent renal nerves. Removal of the renin-angiotensin system with the angiotensin I-converting enzyme inhibitor, captopril, and/or reduction in baroreflex gain by sinoaortic denervation, were combined in conscious rats with acute renal artery stenosis to prevent these systems from potentially obscuring any afferent renal nerve-dependent effects. One week after sinoaortic denervation or sham sinoaortic denervation, each rat was chronically instrumented with Doppler flow probes on the lower abdominal aorta and superior mesenteric and right renal arteries, as well as with intravascular catheters, and a perivascular balloon occluder on the right renal artery. After surgical recovery, sham sinoaortic-denervated animals responded to a 60-minute period of stenosis (50% reduction in renal blood flow) with increases in arterial pressure, regional resistance, and plasma renin activity. Captopril abolished the increases in arterial pressure, hindquarters, and left renal resistance, but both bradycardia and increased mesenteric resistance persisted, indicating that baroreflex activation might be buffering a non-renin-angiotensin system pro-hypertensive mechanism. In support of this, sinoaortic-denervated animals during captopril administration responded to stenosis with substantial increases in arterial pressure (25-30 mm Hg) and regional resistance (30-50%) that were unrelated to the renin-angiotensin system, but which were abolished after denervation of the stenotic kidney. The data suggest that acute reductions in renal blood flow activate an afferent renal nerve-dependent cardiovascular response that is strongly expressed under conditions of reduced gain of the renin-angiotensin and baroreflex systems. We speculate that this reflex may assume particular importance in chronic renal hypertension when baroreflexes become impaired and activation of the renin-angiotensin system is reduced.

Effect of paraventricular nucleus lesions on arterial pressure and heart rate after aortic baroreceptor denervation in the rat

Two series of experiments were done in male Wistar rats to investigate the effects of lesions of the paraventricular nucleus of the hypothalamus (PVH) on the maintenance and development of the elevated arterial pressure resulting from denervation of aortic baroreceptors. In the first series, after control recordings of arterial pressure (AP) and heart rate (HR), rats were subjected to either bilateral aortic depressor nerve (ADN) transection or sham-ADN transection. These animals were later subjected to either bilateral lesions of the PVH or sham-PVH lesions. AP (146 +/- 2 mm Hg) and HR (515 +/- 5 bpm) were significantly elevated in only the ADN-transected groups. Bilateral lesions of the PVH significantly reduced AP (119 +/- 3 mm Hg) and HR (440 +/- 8 bpm) in the ADN transected animals compared to ADN-transected sham-PVH-lesioned animals, to levels which were not significantly different from pre-ADN-transected levels (AP, 113 +/- 2 mm Hg; HR, 448 +/- 3 bpm), and from sham-ADN-transected PVH-lesioned (AP, 119 +/- 2 mm Hg; HR, 391 +/- 6 bpm) and sham-ADN-transected sham-PVH-lesioned animals (AP, 116 +/- 2 mm Hg; HR, 436 +/- 4 bpm). In the second series of experiments, after control AP and HR recordings rats were first subjected to either bilateral lesions of the PVH or sham-PVH lesions, and second to either bilateral ADN transection or sham-ADN transection. PVH lesions did not significantly alter the AP and HR from control levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Pathophysiology of experimental renovascular hypertension

The genesis of renovascular hypertension follows a continuum from an acute to a chronic phase. Reduction in renal perfusion initiates renin release and angiotensin-mediated systemic vasoconstriction. Aldosterone secretion, sodium and water retention, and expansion of the extracellular volume ensue. Sustained hypertension is further maintained by interacting physiologic mechanisms including increased angiotensin II sensitivity, vasopressin, ouabain-like substance, the sympathetic nervous system, CNS mechanisms, autoregulation, and structural changes.

Neural organization of the viscero-cardiac reflexes

The reflex responses evoked in the postganglionic nerves to the heart were tested in chloralose-anaesthetized cats. Electrical stimulation of the A delta afferent fibres from the left inferior cardiac nerve evoked spinal and supraspinal reflex responses with the onset latencies of 36 ms and 77 ms respectively. The most effective stimulus was a train of 3-4 electrical pulses with the intratrain frequency of 200-300 Hz. Electrical stimulation of the high threshold afferent fibres (C-fibres) from the left inferior cardiac nerve evoked the reflex response with the onset latency of 200 ms. The C-reflex was present in intact animals and disappeared after spinalization. The most effective stimulus to evoke this reflex was a train of electrical pulses delivered at a frequency of 1-2 Hz with an intratrain frequency of 20-30 Hz. The most prominent property of the C-reflex was its marked increase after prolonged repeated electrical stimulation. We conclude that: (1) viscero-cardiac sympathetic reflexes may be organized at the spinal and supraspinal level; (2) viscero-cardiac sympathetic reflexes evoked by stimulation of the A delta and C afferent fibres from the left inferior cardiac nerve have different central organization.

An anomalous vagorenal reflex pathway in the cat

Although physiological investigations support the view that the innervation to the kidney is primarily sympathetic in origin, there is anatomic evidence suggesting direct vagal projections to the kidney. We examined electrophysiologically the possibility that neural connections exist between the cervical vagus and renal nerves. Electrical stimulation of the peripheral segment of the cut cervical vagus evoked electrical activity in the central segment of cut renal nerve of chloralose-anesthetized, paralyzed cats. The evoked potentials (vagorenal responses) displayed components with peak latencies of about 50, 120, and 500 ms. Another peak at about 175 ms was also seen in some cases. In addition, a period of postexcitatory depression occurred between approximately 180 and 400 ms after delivery of the stimulus. Evoked responses were recorded in the contralateral as well as the ipsilateral renal nerves. In contrast, stimulation of the central cut end of renal nerves did not elicit responses in the cervical vagus. Vagorenal responses were not altered by cutting the subdiaphragmatic vagus indicating that the abdominal vagus was not involved in this response. Electrical activity in renal nerves elicited by vagal stimulation could be eliminated by either ganglionic blockade or by cutting or cooling the splanchnic nerves. Finally, supraspinal ischemia abolished the vagorenal response. These data suggest that a vagorenal reflex pathway exists and that the potentials recorded in renal nerves are due to activation of aberrant sensory fibers traveling from the peripheral segment of the cut cervical vagus to the central nervous system, where they excite a sympathetic efferent pathway to the kidney.

The reno-renal reflex; evaluation from renal blood flow measurements

Stimulation of the intact renal nerve bundle at a frequency of 5 Hz was found to affect not only the blood flow of the ipsilateral kidney, but also the contralateral kidney responded with a 15% reduction in its total and regional renal blood flow. If the nerves were cut proximal to the stimulation electrodes, the ipsilateral kidney, as before, responded with a reduction in its blood flow, but now the contralateral kidney remained almost unaffected. If, on the other hand, the nerves were cut distal to the stimulation electrode, meaning that only efferent nerve fibres will be activated, the contralateral kidney responded with the same 15% fall in its blood flow. If the afferent fibres of the ipsilateral kidney were stimulated as before, but the contralateral kidney was denervated, no reduction of the blood flow of the contralateral kidney could be established. It was furthermore noted that stimulation of afferent fibres resulted in a prompt rise in the systemic blood pressure with subsequent normalization after interruption of the stimulus. It is concluded that the general sympathetic tone is determined also by receptors within the kidneys. The signals reach the central nervous system via afferent fibres, and act to increase the sympathetic tone with concomitant rise in the systemic blood pressure and increased efferent renal nerve activity with subsequent reduction of the renal blood flow.