Fever: reciprocal shift in brain sodium to calcium ratio as the set-point temperature rises

The antipyretic effect of the famous classical formula Qingwanzi Pills on a rabbit model and its serum metabolomic study

Qingwanzi Pills (QP) were first mentioned in the "Puji Fang" of the Ming Dynasty, with a history of approximately 600 years. The formula consisted of Gypsum Fibrosum and Indigo Naturalis. It is a famous classical formula with antipyretic effects frequently utilized in ancient China, although our knowledge about the overall antipyretic mechanism of QP remains limited. Therefore, we replicated the fever model in New Zealand rabbits induced by lipopolysaccharide, performed the pharmacodynamic evaluation of QP, identified the differential metabolites among QP groups, and performed pathway enrichment analysis to comparatively analyze the effects of QP on fever-related metabolic pathways by ultra-performance liquid chromatography-mass spectrometry. The results showed that the antipyretic effect of QP was superior to that of each disassembled prescription, with Gypsum Fibrosum primarily contributing to the efficacy, followed by Indigo Naturalis and Junci Medulla. QP had an effective antipyretic effect, which was related to lowering the levels of TNF-α, IL-6, IL-1β, and calcium in rabbit serum, lowering the levels of PGE2 and cAMP in rabbit cerebrospinal fluid, and increasing the level of calcium in rabbit cerebrospinal fluid. A total of 27 endogenous biomarkers were screened by serum metabolomics for the treatment of fever with QP. It is hypothesized that the antipyretic mechanism of QP may be related to regulating α-linolenic acid, sphingolipid, tryptophan, and bile acid metabolism. In summary, QP exhibited a significant antipyretic effect in rabbits with lipopolysaccharide-induced fever.

Role of the nitric oxide/cyclic GMP/Ca2+ signaling pathway in the pyrogenic effect of interleukin-1beta

Interleukin-1beta (IL-1beta) has a wide spectrum of inflammatory, metabolic, haemopoietic, and immunological properties. Because it produces fever when injected into animals and humans, it is considered an endogenous pyrogen. There is evidence to suggest that Ca2+ plays a critical role in the central mechanisms of thermoregulation, and in the intracellular signaling pathways controlling fever induced by IL-1beta and other pyrogens. Data from different labs indicate that Ca2+ and Na+ determine the temperature set point in the posterior hypothalamus (PH) of various mammals and that changes in Ca2+ and PGE2 concentrations in the cerebrospinal fluid (CSF) of these animals are associated with IL-1beta-induced fever. Antipyretic drugs such as acetylsalicylic acid, dexamethasone, and lipocortin 5-(204-212) peptide counteract IL-1beta-induced fever and abolish changes in Ca2+ and PGE2 concentrations in CSF. In vitro studies have established that activation of the nitric oxide (NO)/cyclic GMP (cGMP) pathway is part of the signaling cascade transducing Ca2+ mobilization in response to IL-1beta and that the ryanodine (RY)- and inositol-(1,4,5)-trisphosphate (IP3)-sensitive pools are the main source of the mobilized Ca2+. It is concluded that the NO/cGMP/Ca2+ pathway is part of the signaling cascade subserving some of the multiple functions of IL-1beta.

Changes in extracellular Ca2+ can affect the pattern of discharge in rat thalamic neurons

1. The aim of this study was to investigate some of the cellular mechanisms involved in the effects caused by changes in extracellular Ca2+ concentration ([Ca2+](o)). 2. Current- and voltage-clamp experiments were carried out on acutely isolated thalamic neurons of rats. 3. Increasing [Ca2+](o) alone induced a transition of the discharge from single spike to burst mode in isolated current-clamped neurons. 4. Increasing [Ca(2+)](o) caused the voltage-dependent characteristics of the low voltage-activated (LVA) transient Ca2+ currents to shift towards positive values on the voltage axis. Changing [Ca2+](o) from 0.5 to 5 mM caused the inactivation curve to shift by 21 mV. 5. Extracellular Ca2+ blocked a steady cationic current. This current reversed at -35 mV, was scarcely affected by Mg2+ and was completely blocked by the non-selective cation channel inhibitor gadolinium (10 microM). The effect of [Ca2+](o) was mimicked by 500 microM spermine, a polyamine which acts as an agonist for the Ca(2+)-sensing receptor, and was modulated by intracellular GTP-gamma-S. 6. At the resting potential, both the voltage shift and the block of the inward current removed the inactivation of LVA calcium channels and, together with the increase in the Ca2+ driving force, favoured a rise in the low threshold Ca2+ spikes, causing the thalamic firing to change to the oscillatory mode. 7. Our data indicate that [Ca2+](o) is involved in multiple mechanisms of control of the thalamic relay and pacemaker activity. These findings shed light on the correlation between hypercalcaemia, low frequency EEG activity and symptoms such as sleepiness and lethargy described in many clinical papers.

Hypercalciuria in children with febrile convulsions

BACKGROUND

The purpose of the present study was to investigate whether idiopathic hypercalciuria may be implicated in the pathogenesis of febrile convulsions.

METHODS

We studied 38 children (22 boys) with febrile convulsions (mean (+/- SD) age 3.25 +/- 1.09 years) and 45 healthy children (28 boys) of similar age who served as controls. Twenty-four hour urine calcium and phosphate, as well as serum calcium, phosphate, alkaline phosphatase and intact parathyroid hormone (PTH) concentrations were determined.

RESULTS

Hypercalciuria (urine Ca >4.0 mg/kg bodyweight per 24 h) was found in nine children with febrile convulsions (23.7%) and in three controls (6.7%). Hypercalciuric children excreted significantly more phosphate in their urine (37.0 +/- 11.6 mg/kg bodyweight per 24 h) than normocalciuric children (18.7 +/- 8.7 mg/kg bodyweight per 24 h) and controls (20.2 +/- 7.6 mg/kg bodyweight per 24 h). They also had higher serum intact PTH concentrations (49.87 +/- 15.36 pg/mL) than normocalciuric (35.39 +/- 15.67 pg/mL) and control children (28.21 +/- 14.00 pg/mL). According to the calcium-loading test, eight of nine children with hypercalciuria had the renal type of the disorder. Furthermore, hypercalciuric children had significantly more convulsive episodes (2.77 +/- 1.98) than normocalciuric children (1.86 +/- 1.24).

CONCLUSIONS

Our results suggest that renal hypercalciuria may be implicated in the pathogenesis of febrile convulsions.

A chelate theory for the mechanism of action of aspirin-like drugs

Two hundred years after the discovery of the pharmaceutical usefulness of aspirin, it and aspirin-like drugs, a family with an ever-increasing number of members, are an indispensable part of modern life. However, the question as to how these drugs work in the body has remained unsettled. It is postulated here that this group of drugs may exert their therapeutic (and adverse) effects by chelating various physiologically important metallic cations in the body. The chelate theory is supported by the vast majority, if not all, of the observations on these drugs made in the past.

Cholecystokinin octapeptide (CCK-8) injected into a cerebral ventricle induces a fever-like thermoregulatory response mediated by type B CCK-receptors in the rat

In conscious female Wistar rats with chronic lateral cerebroventricular cannula, the thermoregulatory effects of CCK-8, ceruletide and prostaglandin E1 (PGE1) were studied. In addition, the possible involvement of type A or type B receptors of CCK-8 in thermoregulatory effects of PGE1 and CCK-8 was also investigated. In the normothermic rat an intracerebroventricular (i.c.v.) injection of CCK-8 or ceruletide induced a thermogenic response with tail-skin vasoconstriction and a resulting rise in colonic temperature (Tc). There was a significant negative correlation between the starting level of Tc and the extent of rise in Tc following an i.c.v. administration of PGE1, CCK-8 or ceruletide. Subcutaneously injected CCK-8 caused decreases in Tc in a cool ambient temperature as also described by others. The fever-like response to i.c.v. injected CCK-8 was attenuated by a CCK type B receptor blocker, but not by a CCK type A receptor blocker. Conversely, the hypothermic response to peripherally administered CCK-8 was attenuated by a type A receptor blocker, but not by a type B receptor blocker. Neither of these CCK-receptor blockers influenced the fever caused by an i.c.v. injection of PGE1. It is concluded that in normothermic rats the thermogenic response observed after i.c.v. injection of CCK-8 and ceruletide is the most likely central thermoregulatory change mediated by CCK type B receptors, while the well-known hypothermic response observed after peripheral injection of these peptides might also be explained by their direct effect on variables influencing some of the thermoregulatory effector mechanisms at the periphery.

Cadmium induced hypothermia in mice: dose dependent tolerance development

The i.p. injection of Cd in mice will produce a dose related hypothermic response. The Cd appears to make the animals poikilothermic and their body temperature will approach the ambient temperature at which they are housed. The cause for this hypothermic action of Cd is not known, but we have demonstrated in our experiments that the effect may be partially related to a direct effect within the brain. In addition, the repeated injection of a low Cd dose (0.62 mg/kg) i.p. once daily for 3 days results in a profound tolerance to the Cd. A high dose (1.25 mg/kg i.p. once daily X 3 days) of Cd did not result in a similar tolerance phenomenon and a single injection of the high Cd dose 120 hr prior to the repeated low Cd dose regimen resulted in an obtunded tolerance response to the low dose. We propose that the higher Cd dose may have damaged the blood-brain barrier and this could account for the results we have observed.

Brain peptides: what, where, and why?

Within the past decade, a large number of peptides have been described within the vertebrate central nervous system. Some of these peptides were previously known to be present in nonneural vertebrate tissues, as well as in lower species, in which they may serve as primitive elements of intercellular communication prior to the development of neuronal or endocrine systems. In vertebrates, these peptides are thought to have neurotransmitter or neuromodulatory roles and appear to be involved in the regulation of a number of homeostatic systems, although the mechanisms of their actions are still unclear.

Peripherally administered cations do not modify febrile responses induced in chickens by Escherichia coli

Two experiments were conducted to investigate the effects on intramuscular injections of Escherichia coli strains B and W on rectal temperature in broiler chicks and to investigate the effects of various cations on the temperature response. In Experiment 1, 4 birds were randomly assigned to each of three treatments. Control birds received a dextrose (50 mg/100 ml) solution and treated birds received a suspension of either E. coli B or E. coli W lyophilized cells (100 mg/kg) in a volume of 2 ml/kg. Rectal temperatures were recorded before injection and thereafter every 4 hr for a period of 24 hr. In Experiment 2, 10 birds were assigned randomly to each of two treatments. Birds received intramuscularly 2 ml/kg body weight injections of either dextrose (50 mg/100 ml) solution or a suspension of E. coli B lyophilized cells (100 mg/kg) in a volume of 2 ml/kg. At 16 hr after injection, rectal temperatures were recorded and birds were divided into the following treatments with 5 birds per group. Birds previously receiving dextrose (50 mg/100 ml) were given intramuscular injections (2 ml/kg body weight) of demineralized distilled water or a 2 ml/kg injection of .5 M solution of either Na+, K+, Ca+2, or Mg+2 made from their chloride salts. Birds previously receiving E. coli B were given intramuscular injections (2 ml/kg body weight) of demineralized distilled water or an injection of a .5 M solution of either Na+, K+, Ca+2, or Mg+2. Five birds served as uninjected controls. Rectal temperatures were taken every 30 min for 90 min thereafter. In Experiment 1, intramuscular injections of E. coli B and E. coli W resulted in an initial fall in rectal temperatures of chickens followed by a rise after 4 hr that peaked at 16 hr postinjection and at 24 hr remained significantly above preinjection values. The injection of the cations Na+, K+, Ca+2, or Mg+2 in Experiment 2 did not significantly affect the febrile response produced by E. coli B.

Radiation and brain calcium: a review and critique

Serious controversy pervades the scientific study of radio-frequency (RF) radiation and its biological effects. The issues range broadly from international differences in safe exposure standards to questions pertaining to the neurological symptoms purportedly induced by electromagnetic radiation. In a more specialized vein, there is great concern in the discipline about the influence of different sources of radiation on the activity of calcium in the brain. A principal and very realistic reason for this concern stems from the pivotal importance of calcium ions in the normal functioning of the brain in all of its myriad complexity. The purpose of the review is to critically evaluate from an unbiased and "non-involved" viewpoint the major findings on the possible interaction between calcium ions and various radiation sources. Background information is also considered as it relates even indirectly to hypothetical mechanisms that might be used to explain any possible shift in Ca++ ion kinetics. Finally, an inclusive critique is presented which deals with the bench-top methods and strategy used in the conduct of calcium-radiation experiments.

Hypothalamic Na+ and Ca++ ions and temperature set-point: new mechanisms of action of a central or peripheral thermal challenge and intrahypothalamic 5-HT, NE, PGEi and pyrogen

The effects of changes in ambient and central temperature, amines, PGEu and pyrogen were investigated with respect to the mechanism of Na+-Ca++ ratio in the posterior hypothalamus of the unrestrained cat. Guide tubes were implanted bilaterally above the posterior hypothalamic area of 23 cats so as to accommodate push-pull cannulae. After a Na+ or Ca++ sensitive site was identified by perfusion at 50 mul/min of an artificial CSF containing 10.4 mM excess Ca++ ions or 13.6 mM excess Na+ ions, several types of experiments were undertaken with the results summarized as follows: if the cat was exposed to a cold or warm environmental temperature as the posterior hypothalamus was perfused with excess cation, the typical hypothermia was produced by Ca++ and hyperthermia by Na+ ions. However, if the cat was exposed to peripheral cooling or warming 30 min prior to the perfusion, the fall or rise produced by Ca++ or Na+ was attenuated or prevented. In other experiments, 1.0 muCi 45Ca++ was injected in the ion sensitive site in the posterior hypothalamus to label stores of the cation. Raising of ambient temperature caused a retention of 45Ca++ in this hypothalmic area, whereas a cold environmental temperature enhanced the efflux of 45Ca++ at the same perfusion site. The magnitude of change in 45Ca++ efflux depended upon the intensity of the thermal challenge. Similarly, warming of the anterior hypothalmic, preoptic area by means of implanted thermodes caused an immediate diminution in 45Ca++ efflux in the posterior hypothalamus, whereas cooling of this anterior region augmented the extrusion of 45Ca++ ions from the posterior area. When substances which produce a temperature change were applied to the same thermosensitive zone, the direction of shift in 45Ca++ flux in the posterior area corresponded to the signal for heat production or heat loss. That is, the microinjection of 5-HT, PGE1 or Salmonella typhosa into the anterior hypothalamus enhanced the efflux of 45Ca++ in the posterior hypothalamus as hyperthermia developed, whereas a similar microinjection of norepinephrine reduced the 45Ca++ output from the same sites. Finally, locally anesthetizing the cells of the anterior hypothalamus by the nerve blocker, procaine, prevented the cold and heat-induced 45Ca++ eflux and retention, respectively. These results suggest that if the Na+-Ca++ ratio in the posterior hypothalamus establishes and maintains the set-point for body temperature of 37 degrees -38 degrees C, the mechanism of lability of Ca++ through changes in binding characteristics, transport, or metabolism of the cation serves two purposes: (1) the active defense of the set-point temperature through gradations in ion shifts; and (2) the upward or downward change in set-point value, pathological or normal, triggered by virtue of impulses relayed from the anterior hypothalamus.

Horizontal cell potentials: dependence on external sodium ion concentration

The membrane potential of the horizontal cell of the axolotl is highly dependent on the extracellular concentration of sodium. Experimental results reported here are consistent with the suggestion that in the dark the receptors release a synaptic transmitter which increases primarily the sodium conductance of the postsynaptic membrane. Externally applied aspartate or glutamate depolarizes the horizontal cell membrane and eliminates the light response of the horizontal cell. However, it appears to increase the conductances of the postsynaptic membrane to several ions rather than just to sodium ions.

Fever produced by endotoxin injected into the hypothalamus of the monkey and its antagonism by salicylate

1. A suspension of the killed cell bodies of either E. coli, S. dysenteriae or S. typhosa was micro-injected through cannulae implanted chronically at specific sites within the diencephalon and mid-brain of the unanaesthetized monkey. A biphasic, monophasic or an undifferentiated fever could be induced by each type of micro-organism, but the type of response depended solely upon the locus of injection.2. Although little difference in the potency of the three pyrogens was found, the rise in body temperature was in each instance dependent upon the concentration of the endotoxin. A more intense fever was accompanied by shivering, vasoconstriction of the ear vessels, piloerection and huddling behaviour. Tolerance to the pyrexic effect of repeated injections of endotoxin did not develop.3. The febrile response having the shortest latency, greatest maximum rise in temperature and largest 10-hr fever index was evoked by micro-injections into the anterior hypothalamic, preoptic area. The incidence of biphasic fevers was also greater after endotoxin was injected into this same region. Endotoxin given similarly in the posterior hypothalamus or in the mesencephalon had either no effect or produced a smaller elevation in temperature after a longer latency. The distance of an injection site from the coronal plane formed by the optic chiasm and anterior commissure correlated significantly with the latency and magnitude of the temperature change as well as the fever index.4. When given intravenously, endotoxin in a quantity at least 100 times greater was required to evoke a fever similar to that produced when the pyrogen was micro-injected into the anterior hypothalamic, preoptic region. However, a biphasic fever was evoked with a latency of from 3 to 15 min when a larger amount of endotoxin was injected intravenously. Tolerance developed rapidly to the febrile effect of endotoxin administered by this route although toxic reactions were not observed.5. After the fever evoked by the hypothalamic injection of endotoxin had reached a plateau, 300-1200 mg sodium salicylate administered intragastrically produced a dose-dependent fall in temperature, but had no effect on the body temperature of an afebrile monkey.6. It is concluded that in the rhesus monkey, a bacterial pyrogen can evoke a fever which is mediated entirely by an action on the central nervous system, the principal site being the anterior hypothalamic, preoptic area. The first phase of a biphasic fever caused by bacteria acting either by the central or peripheral route seems to be due either to a direct action of the pyrogen on the cells of the anterior hypothalamus, or to the secondary release within this region of an intermediary thermogenic substance such as 5-hydroxytryptamine or prostaglandin. The finding that sodium salicylate counteracts a centrally evoked fever is not compatible with the hypothesis that an antipyretic exerts its action by preventing a pyrogen that is circulating in the blood stream from entering the central nervous system.