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Yang D, Almanzar N, Xia J, Udit S, Yeung ST, Khairallah C, Hoagland DA, Umans BD, Sarden N, Erdogan O, Baalbaki N, Beekmayer-Dhillon A, Lee J, Meerschaert KA, Liberles SD, Yipp BG, Franklin RA, Khanna KM, Baral P, Haber AL, Chiu IM. Vagal TRPV1 + sensory neurons regulate myeloid cell dynamics and protect against influenza virus infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.21.609013. [PMID: 39229208 PMCID: PMC11370462 DOI: 10.1101/2024.08.21.609013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Influenza viruses are a major global cause of morbidity and mortality. Vagal TRPV1 + nociceptive sensory neurons, which innervate the airways, are known to mediate defenses against harmful agents. However, their function in lung antiviral defenses remains unclear. Our study reveals that both systemic and vagal-specific ablation of TRPV1 + nociceptors reduced survival in mice infected with influenza A virus (IAV), despite no significant changes in viral burden or weight loss. Mice lacking nociceptors showed exacerbated lung pathology and elevated levels of pro-inflammatory cytokines. The increased mortality was not attributable to the loss of the TRPV1 ion channel or neuropeptides CGRP or substance P. Immune profiling through flow cytometry and single-cell RNA sequencing identified significant nociceptor deficiency-mediated changes in the lung immune landscape, including an expansion of neutrophils and monocyte-derived macrophages. Transcriptional analysis revealed impaired interferon signaling in these myeloid cells and an imbalance in distinct neutrophil sub-populations in the absence of nociceptors. Furthermore, anti-GR1-mediated depletion of myeloid cells during IAV infection significantly improved survival, underscoring a role of nociceptors in preventing pathogenic myeloid cell states that contribute to IAV-induced mortality. One Sentence Summary : TRPV1 + neurons facilitate host survival from influenza A virus infection by controlling myeloid cell responses and immunopathology.
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2
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Pollard KJ, Traina-Dorge V, Medearis SM, Bosak A, Bix GJ, Moore MJ, Piedimonte G. Respiratory Syncytial Virus Infects Peripheral and Spinal Nerves and Induces Chemokine-Mediated Neuropathy. J Infect Dis 2024; 230:467-479. [PMID: 38135285 PMCID: PMC11326824 DOI: 10.1093/infdis/jiad596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 12/24/2023] Open
Abstract
Respiratory syncytial virus (RSV) primarily infects the respiratory epithelium, but growing evidence suggests that it may also be responsible for neurologic sequelae. In 3-dimensional microphysiologic peripheral nerve cultures, RSV infected neurons, macrophages, and dendritic cells along 2 distinct trajectories depending on the initial viral load. Low-level infection was transient, primarily involved macrophages, and induced moderate chemokine release with transient neural hypersensitivity. Infection with higher viral loads was persistent, infected neuronal cells in addition to monocytes, and induced robust chemokine release followed by progressive neurotoxicity. In spinal cord cultures, RSV infected microglia and dendritic cells but not neurons, producing a moderate chemokine expression pattern. The persistence of infection was variable but could be identified in dendritic cells as long as 30 days postinoculation. This study suggests that RSV can disrupt neuronal function directly through infection of peripheral neurons and indirectly through infection of resident monocytes and that inflammatory chemokines likely mediate both mechanisms.
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Affiliation(s)
| | - Vicki Traina-Dorge
- Department of Microbiology and Immunology, School of Medicine, Tulane University, New Orleans
- Division of Microbiology, Tulane National Primate Research Center, Covington
| | - Stephen M Medearis
- Department of Pediatrics
- Department of Biochemistry and Molecular Biology
| | | | - Gregory J Bix
- Clinical Neuroscience Research Center
- Department of Neurosurgery
- Department of Neurology, School of Medicine
- Tulane Brain Institute, Tulane University
| | - Michael J Moore
- Department of Biomedical Engineering
- Tulane Brain Institute, Tulane University
- Axosim, Inc, New Orleans, Louisiana
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3
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Seeholzer LF, Julius D. Neuroendocrine cells initiate protective upper airway reflexes. Science 2024; 384:295-301. [PMID: 38669574 DOI: 10.1126/science.adh5483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 02/21/2024] [Indexed: 04/28/2024]
Abstract
Airway neuroendocrine (NE) cells have been proposed to serve as specialized sensory epithelial cells that modulate respiratory behavior by communicating with nearby nerve endings. However, their functional properties and physiological roles in the healthy lung, trachea, and larynx remain largely unknown. In this work, we show that murine NE cells in these compartments have distinct biophysical properties but share sensitivity to two commonly aspirated noxious stimuli, water and acid. Moreover, we found that tracheal and laryngeal NE cells protect the airways by releasing adenosine 5'-triphosphate (ATP) to activate purinoreceptive sensory neurons that initiate swallowing and expiratory reflexes. Our work uncovers the broad molecular and biophysical diversity of NE cells across the airways and reveals mechanisms by which these specialized excitable cells serve as sentinels for activating protective responses.
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Affiliation(s)
- Laura F Seeholzer
- Department of Physiology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - David Julius
- Department of Physiology, University of California, San Francisco, San Francisco, CA 94143, USA
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4
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Kim B, Rothenberg ME, Sun X, Bachert C, Artis D, Zaheer R, Deniz Y, Rowe P, Cyr S. Neuroimmune interplay during type 2 inflammation: Symptoms, mechanisms, and therapeutic targets in atopic diseases. J Allergy Clin Immunol 2024; 153:879-893. [PMID: 37634890 PMCID: PMC11215634 DOI: 10.1016/j.jaci.2023.08.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/17/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
Type 2 inflammation is characterized by overexpression and heightened activity of type 2 cytokines, mediators, and cells that drive neuroimmune activation and sensitization to previously subthreshold stimuli. The consequences of altered neuroimmune activity differ by tissue type and disease; they include skin inflammation, sensitization to pruritogens, and itch amplification in atopic dermatitis and prurigo nodularis; airway inflammation and/or hyperresponsiveness, loss of expiratory volume, airflow obstruction and increased mucus production in asthma; loss of sense of smell in chronic rhinosinusitis with nasal polyps; and dysphagia in eosinophilic esophagitis. We describe the neuroimmune interactions that underlie the various sensory and autonomic pathologies in type 2 inflammatory diseases and present recent advances in targeted treatment approaches to reduce type 2 inflammation and its associated symptoms in these diseases. Further research is needed to better understand the neuroimmune mechanisms that underlie chronic, sustained inflammation and its related sensory pathologies in diseases associated with type 2 inflammation.
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Affiliation(s)
- Brian Kim
- Kimberly and Eric J. Waldman Department of Dermatology, Mark Lebwohl Center for Neuroinflammation and Sensation, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Marc E Rothenberg
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Xin Sun
- Department of Pediatrics, University of California, San Diego, Calif
| | - Claus Bachert
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Muenster, Muenster, Germany; First Affiliated Hospital, Sun Yat-Sen University, International Airway Research Center, Guangzhou, China
| | - David Artis
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Friedman Center for Nutrition and Inflammation, Joan and Sanford I. Weill Department of Medicine, Department of Microbiology and Immunology, Weill Cornell Medicine, Cornell University, New York, NY
| | | | - Yamo Deniz
- Regeneron Pharmaceuticals, Tarrytown, NY
| | | | - Sonya Cyr
- Regeneron Pharmaceuticals, Tarrytown, NY
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5
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Moe AAK, Bautista TG, Trewella MW, Korim WS, Yao ST, Behrens R, Driessen AK, McGovern AE, Mazzone SB. Investigation of vagal sensory neurons in mice using optical vagal stimulation and tracheal neuroanatomy. iScience 2024; 27:109182. [PMID: 38414860 PMCID: PMC10897902 DOI: 10.1016/j.isci.2024.109182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/28/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
In rats and guinea pigs, sensory innervation of the airways is derived largely from the vagus nerve, with the extrapulmonary airways innervated by Wnt1+ jugular neurons and the intrapulmonary airways and lungs by Phox2b+ nodose neurons; however, our knowledge of airway innervation in mice is limited. We used genetically targeted expression of enhanced yellow fluorescent protein-channelrhodopsin-2 (EYFP-ChR2) in Wnt1+ or Phox2b+ tissues to characterize jugular and nodose-mediated physiological responses and airway innervation in mice. With optical stimulation, Phox2b+ vagal fibers modulated cardiorespiratory function in a frequency-dependent manner while right Wnt1+ vagal fibers induced a small increase in respiratory rate. Mouse tracheae contained sparse Phox2b-EYFP fibers but dense networks of Wnt1-EYFP fibers. Retrograde tracing from the airways showed limited tracheal innervation by the jugular sensory neurons, distinct from other species. These differences in physiology and vagal sensory distribution have important implications when using mice for studying airway neurobiology.
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Affiliation(s)
- Aung Aung Kywe Moe
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Monash University, Clayton Campus, Clayton, VIC 3800, Australia
| | - Tara G Bautista
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Matthew W Trewella
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Willian S Korim
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Song T Yao
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Robert Behrens
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Alexandria K Driessen
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Alice E McGovern
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Stuart B Mazzone
- Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
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6
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De Falco E, Solcà M, Bernasconi F, Babo-Rebelo M, Young N, Sammartino F, Tallon-Baudry C, Navarro V, Rezai AR, Krishna V, Blanke O. Single neurons in the thalamus and subthalamic nucleus process cardiac and respiratory signals in humans. Proc Natl Acad Sci U S A 2024; 121:e2316365121. [PMID: 38451949 PMCID: PMC10945861 DOI: 10.1073/pnas.2316365121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/16/2024] [Indexed: 03/09/2024] Open
Abstract
Visceral signals are constantly processed by our central nervous system, enable homeostatic regulation, and influence perception, emotion, and cognition. While visceral processes at the cortical level have been extensively studied using non-invasive imaging techniques, very few studies have investigated how this information is processed at the single neuron level, both in humans and animals. Subcortical regions, relaying signals from peripheral interoceptors to cortical structures, are particularly understudied and how visceral information is processed in thalamic and subthalamic structures remains largely unknown. Here, we took advantage of intraoperative microelectrode recordings in patients undergoing surgery for deep brain stimulation (DBS) to investigate the activity of single neurons related to cardiac and respiratory functions in three subcortical regions: ventral intermedius nucleus (Vim) and ventral caudalis nucleus (Vc) of the thalamus, and subthalamic nucleus (STN). We report that the activity of a large portion of the recorded neurons (about 70%) was modulated by either the heartbeat, the cardiac inter-beat interval, or the respiration. These cardiac and respiratory response patterns varied largely across neurons both in terms of timing and their kind of modulation. A substantial proportion of these visceral neurons (30%) was responsive to more than one of the tested signals, underlining specialization and integration of cardiac and respiratory signals in STN and thalamic neurons. By extensively describing single unit activity related to cardiorespiratory function in thalamic and subthalamic neurons, our results highlight the major role of these subcortical regions in the processing of visceral signals.
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Affiliation(s)
- Emanuela De Falco
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Neuroscience, Rockefeller Neuroscience Institute–West Virginia University, Morgantown, WV26505
| | - Marco Solcà
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Psychiatry, University Hospital Geneva, Geneva1205, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
| | - Mariana Babo-Rebelo
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
| | - Nicole Young
- Medical Department, SpecialtyCare, Brentwood, TN37027
| | - Francesco Sammartino
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH43210
| | - Catherine Tallon-Baudry
- Laboratoire de Neurosciences Cognitives et Computationnelles, Département d’Etudes Cognitives, École normale supérieure-Paris Sciences et Lettres University, Inserm, Paris75005, France
| | - Vincent Navarro
- Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm, CNRS, Assistance Publique - Hôpitaux de Paris, Epilepsy Unit, Hôpital de la Pitié-Salpêtrière, Paris75013, France
| | - Ali R. Rezai
- Department of Neurosurgery, Rockefeller Neuroscience Institute—West Virginia University, Morgantown, WV26505
| | - Vibhor Krishna
- Department of Neurosurgery, University of North Carolina at Chapel Hill, Durham, NC27516
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Clinical Neurosciences, University Hospital Geneva, Geneva1205, Switzerland
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7
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Wang RL, Chang RB. The Coding Logic of Interoception. Annu Rev Physiol 2024; 86:301-327. [PMID: 38061018 PMCID: PMC11103614 DOI: 10.1146/annurev-physiol-042222-023455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024]
Abstract
Interoception, the ability to precisely and timely sense internal body signals, is critical for life. The interoceptive system monitors a large variety of mechanical, chemical, hormonal, and pathological cues using specialized organ cells, organ innervating neurons, and brain sensory neurons. It is important for maintaining body homeostasis, providing motivational drives, and regulating autonomic, cognitive, and behavioral functions. However, compared to external sensory systems, our knowledge about how diverse body signals are coded at a system level is quite limited. In this review, we focus on the unique features of interoceptive signals and the organization of the interoceptive system, with the goal of better understanding the coding logic of interoception.
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Affiliation(s)
- Ruiqi L Wang
- Department of Neuroscience and Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut, USA;
| | - Rui B Chang
- Department of Neuroscience and Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut, USA;
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8
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Aguilar D, Zhu F, Millet A, Millet N, Germano P, Pisegna J, Doherty TA, Swidergall M, Jendzjowsky N. Sensory neurons regulate stimulus-dependent humoral immunity. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.04.574231. [PMID: 38260709 PMCID: PMC10802321 DOI: 10.1101/2024.01.04.574231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Sensory neurons sense pathogenic infiltration, serving to inform immune coordination of host defense. However, sensory neuron-immune interactions have been predominantly shown to drive innate immune responses. Humoral memory, whether protective or destructive, is acquired early in life - as demonstrated by both early exposure to streptococci and allergic disease onset. Our study further defines the role of sensory neuron influence on humoral immunity in the lung. Using a murine model of Streptococcus pneumonia pre-exposure and infection and a model of allergic asthma, we show that sensory neurons are required for B-cell and plasma cell recruitment and antibody production. In response to S. pneumoniae , sensory neuron depletion resulted in a larger bacterial burden, reduced B-cell populations, IgG release and neutrophil stimulation. Conversely, sensory neuron depletion reduced B-cell populations, IgE and asthmatic characteristics during allergen-induced airway inflammation. The sensory neuron neuropeptide released within each model differed. With bacterial infection, vasoactive intestinal polypeptide (VIP) was preferentially released, whereas substance P was released in response to asthma. Administration of VIP into sensory neuron-depleted mice suppressed bacterial burden and increased IgG levels, while VIP1R deficiency increased susceptibility to bacterial infection. Sensory neuron-depleted mice treated with substance P increased IgE and asthma, while substance P genetic ablation resulted in blunted IgE, similar to sensory neuron-depleted asthmatic mice. These data demonstrate that the immunogen differentially stimulates sensory neurons to release specific neuropeptides which specifically target B-cells. Targeting sensory neurons may provide an alternate treatment pathway for diseases involved with insufficient and/or aggravated humoral immunity.
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Patil MJ, Kim SH, Bahia PK, Nair SS, Darcey TS, Fiallo J, Zhu XX, Frisina RD, Hadley SH, Taylor-Clark TE. A Novel Flp Reporter Mouse Shows That TRPA1 Expression Is Largely Limited to Sensory Neuron Subsets. eNeuro 2023; 10:ENEURO.0350-23.2023. [PMID: 37989590 PMCID: PMC10698635 DOI: 10.1523/eneuro.0350-23.2023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 11/23/2023] Open
Abstract
Transient receptor potential ankyrin 1 (TRPA1) is a polymodal cation channel that is activated by electrophilic irritants, oxidative stress, cold temperature, and GPCR signaling. TRPA1 expression has been primarily identified in subsets of nociceptive sensory afferents and is considered a target for future analgesics. Nevertheless, TRPA1 has been implicated in other cell types including keratinocytes, epithelium, enterochromaffin cells, endothelium, astrocytes, and CNS neurons. Here, we developed a knock-in mouse that expresses the recombinase FlpO in TRPA1-expressing cells. We crossed the TRPA1Flp mouse with the R26ai65f mouse that expresses tdTomato in a Flp-sensitive manner. We found tdTomato expression correlated well with TRPA1 mRNA expression and sensitivity to TRPA1 agonists in subsets of TRPV1 (transient receptor potential vanilloid receptor type 1)-expressing neurons in the vagal ganglia and dorsal root ganglia (DRGs), although tdTomato expression efficiency was limited in DRG. We observed tdTomato-expressing afferent fibers centrally (in the medulla and spinal cord) and peripherally in the esophagus, gut, airways, bladder, and skin. Furthermore, chemogenetic activation of TRPA1-expressing nerves in the paw evoked flinching behavior. tdTomato expression was very limited in other cell types. We found tdTomato in subepithelial cells in the gut mucosa but not in enterochromaffin cells. tdTomato was also observed in supporting cells within the cochlea, but not in hair cells. Lastly, tdTomato was occasionally observed in neurons in the somatomotor cortex and the piriform area, but not in astrocytes or vascular endothelium. Thus, this novel mouse strain may be useful for mapping and manipulating TRPA1-expressing cells and deciphering the role of TRPA1 in physiological and pathophysiological processes.
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Affiliation(s)
- Mayur J Patil
- Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612
| | - Seol-Hee Kim
- Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612
| | - Parmvir K Bahia
- Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612
| | - Sanjay S Nair
- Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612
| | - Teresa S Darcey
- Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612
| | - Jailene Fiallo
- Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612
| | - Xiao Xia Zhu
- Medical Engineering, College of Engineering, University of South Florida, Tampa, Florida 33620
| | - Robert D Frisina
- Medical Engineering, College of Engineering, University of South Florida, Tampa, Florida 33620
| | - Stephen H Hadley
- Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612
| | - Thomas E Taylor-Clark
- Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida 33612
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10
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Kornfield J, De La Torre U, Mize E, Drake MG. Illuminating Airway Nerve Structure and Function in Chronic Cough. Lung 2023; 201:499-509. [PMID: 37985513 PMCID: PMC10673771 DOI: 10.1007/s00408-023-00659-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
Airway nerves regulate vital airway functions including bronchoconstriction, cough, and control of respiration. Dysregulation of airway nerves underlies the development and manifestations of airway diseases such as chronic cough, where sensitization of neural pathways leads to excessive cough triggering. Nerves are heterogeneous in both expression and function. Recent advances in confocal imaging and in targeted genetic manipulation of airway nerves have expanded our ability to visualize neural organization, study neuro-immune interactions, and selectively modulate nerve activation. As a result, we have an unprecedented ability to quantitatively assess neural remodeling and its role in the development of airway disease. This review highlights our existing understanding of neural heterogeneity and how advances in methodology have illuminated airway nerve morphology and function in health and disease.
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Affiliation(s)
- James Kornfield
- OHSU Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code UHN67, Portland, OR, 97239, USA
| | - Ubaldo De La Torre
- OHSU Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code UHN67, Portland, OR, 97239, USA
| | - Emily Mize
- OHSU Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code UHN67, Portland, OR, 97239, USA
| | - Matthew G Drake
- OHSU Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code UHN67, Portland, OR, 97239, USA.
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11
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Engelen T, Solcà M, Tallon-Baudry C. Interoceptive rhythms in the brain. Nat Neurosci 2023; 26:1670-1684. [PMID: 37697110 DOI: 10.1038/s41593-023-01425-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/08/2023] [Indexed: 09/13/2023]
Abstract
Sensing internal bodily signals, or interoception, is fundamental to maintain life. However, interoception should not be viewed as an isolated domain, as it interacts with exteroception, cognition and action to ensure the integrity of the organism. Focusing on cardiac, respiratory and gastric rhythms, we review evidence that interoception is anatomically and functionally intertwined with the processing of signals from the external environment. Interactions arise at all stages, from the peripheral transduction of interoceptive signals to sensory processing and cortical integration, in a network that extends beyond core interoceptive regions. Interoceptive rhythms contribute to functions ranging from perceptual detection up to sense of self, or conversely compete with external inputs. Renewed interest in interoception revives long-standing issues on how the brain integrates and coordinates information in distributed regions, by means of oscillatory synchrony, predictive coding or multisensory integration. Considering interoception and exteroception in the same framework paves the way for biological modes of information processing specific to living organisms.
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Affiliation(s)
- Tahnée Engelen
- Cognitive and Computational Neuroscience Laboratory, Inserm, Ecole Normale Supérieure PSL University, Paris, France
| | - Marco Solcà
- Cognitive and Computational Neuroscience Laboratory, Inserm, Ecole Normale Supérieure PSL University, Paris, France
| | - Catherine Tallon-Baudry
- Cognitive and Computational Neuroscience Laboratory, Inserm, Ecole Normale Supérieure PSL University, Paris, France.
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12
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Kunovac F, Cicvaric A, Robba C, Turk T, Muzevic D, Kralik K, Kvolik S. Gastrointestinal Motility Disorders Correlate with Intracranial Bleeding, Opioid Use, and Brainstem Edema in Neurosurgical Patients. Neurocrit Care 2023; 39:368-377. [PMID: 36788178 DOI: 10.1007/s12028-023-01678-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/12/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Gastrointestinal (GI) motility disorders may be directly associated with the intensity of acute brain injury, edema of the brainstem, and opioid use in neurosurgical patients. METHODS In this retrospective study, patient demographic characteristics, computed tomography (CT) scans, the occurrence of gastroparesis, constipation, and opioid use were registered during the intensive care unit (ICU) stay and correlated with days of mechanical ventilation, length of ICU stay, and survival. Gastroparesis was defined as residual gastric volume > 250 mL per day, and constipation was defined as the absence of stool for 3 days or more during the ICU stay. RESULTS Of 207 neurosurgical patients screened, 69 adult patients who spent more than 4 days in the ICU were included in the study. Gastroparesis was observed in 48 (69.6%) patients, constipation was observed in 67 (97.1%) patients, and stress ulcers were observed in 4 (5.8%) patients. Patients with brainstem edema (n = 57, 82.6%) had the first stool evacuation later compared with patients with no edema (8 [interquartile range (IQR) 5.25-9.75] vs. 3.5 [IQR 2.25-4] days; P < 0.001). In the logistic regression analysis, factors that were associated with GI dysmotility were central nervous system (CNS) bleeding (odds ratio [OR] 5.1, 95% confidence interval [CI] 1.26-20.8, P = 0.02), opioid use > 19.3 morphine equivalents (ME) per day (OR 5.37, 95% CI 1.1-27.1, P = 0.04), and brainstem edema (OR 4.9, 95% CI 1.1-21.6, P = 0.04). A receiver operating characteristic curve analysis confirmed that the cutoff value of > 6.78 ME per day was a good predictor determining GI dysmotility, with 89.5% sensitivity and 72.7% specificity (95% CI 0.67-0.88, area under the curve 0.784, Youden index 0.62, P = 0.001). Poor survival correlated with lower Glasgow Coma Score values (ρ = - 520, P < 0.001), CNS bleeding (ρ = 0.393, P < 0.001), associated cardiac diseases (ρ = 0.279, P < 0.001), and cardiorespiratory arrest on admission (ρ = 0.315, P < 0.001), but not with GI dysmotility (ρ = 0.175, P = 0.402). CONCLUSIONS Significant correlation was registered between brainstem edema, gastrointestinal dysmotility, and opioids. CNS bleeding was the most important single factor influencing GI dysmotility. Further studies with opioid and nonopioid sedation may distinguish the influence of acute brain lesions versus drugs on GI dysmotility.
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Affiliation(s)
- Franka Kunovac
- Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Ana Cicvaric
- Faculty of Medicine, University of Osijek, Osijek, Croatia
- Department of Anesthesiology, Resuscitation and Intensive Care Unit, University Hospital Osijek, Osijek, Croatia
| | - Chiara Robba
- Anesthesia and Intensive Care, Policlinico San Martino, IRCCS for Oncology and Neuroscience, Genoa, Italy
| | - Tajana Turk
- Faculty of Medicine, University of Osijek, Osijek, Croatia
- Department of Radiology, University Hospital Osijek, J. Huttlera 4, Osijek, 31000, Croatia
| | - Dario Muzevic
- Faculty of Medicine, University of Osijek, Osijek, Croatia
- Department of Neurosurgery, University Hospital Osijek, J. Huttlera 4, Osijek, Croatia
| | | | - Slavica Kvolik
- Faculty of Medicine, University of Osijek, Osijek, Croatia.
- Department of Anesthesiology, Resuscitation and Intensive Care Unit, University Hospital Osijek, Osijek, Croatia.
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Hooper JS, Taylor-Clark TE. Irritant-evoked reflex tachyarrhythmia in spontaneously hypertensive rats is reduced by inhalation of TRPM8 agonists l-menthol and WS-12. J Appl Physiol (1985) 2023; 134:307-315. [PMID: 36603045 PMCID: PMC9886351 DOI: 10.1152/japplphysiol.00495.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/06/2022] [Accepted: 12/24/2022] [Indexed: 01/06/2023] Open
Abstract
Inhalation of noxious irritants activates nociceptive sensory afferent nerves innervating the airways, inducing reflex regulation of autonomic networks and the modulation of respiratory drive and cardiovascular (CV) parameters such as heart rate and blood pressure. In healthy mammals, irritant-evoked pulmonary-cardiac reflexes cause parasympathetic-mediated bradycardia. However, in spontaneously hypertensive (SH) rats, irritant inhalation also increases sympathetic drive to the heart. This remodeled pulmonary-cardiac reflex may contribute to cardiovascular risk caused by inhalation of air pollutants/irritants in susceptible individuals with cardiovascular disease (CVD). Previous studies have shown that the cooling mimic l-menthol, an agonist for the cold-sensitive transient receptor potential melastatin 8 (TRPM8), can alleviate nasal inflammatory symptoms and respiratory reflexes evoked by irritants. Here, we investigated the impact of inhalation of TRPM8 agonists l-menthol and WS-12 on pulmonary-cardiac reflexes evoked by inhalation of the irritant allyl isothiocyanate (AITC) using radiotelemetry. l-Menthol, but not its inactive analog d-menthol, significantly reduced the AITC-evoked reflex tachycardia and premature ventricular contractions (PVCs) in SH rats but had no effect on the AITC-evoked bradycardia in either SH or normotensive Wistar-Kyoto (WKY) rats. WS-12 reduced AITC-evoked tachycardia and PVCs in SH rats, but this more potent TRPM8 agonist also reduced AITC-evoked bradycardia. l-Menthol had no effect on heart rate when given alone, whereas WS-12 evoked a minor bradycardia in WKY rats. We conclude that stimulation of TRPM8-expressing afferents within the airways reduces irritant-evoked pulmonary-cardiac reflexes, especially the aberrant reflex tachyarrhythmia in SH rats. Airway menthol treatment may be an effective therapy for reducing pollution-associated CV exacerbations.NEW & NOTEWORTHY Irritant-evoked pulmonary-cardiac reflexes are remodeled in spontaneously hypertensive (SH) rats-causing de novo sympathetic reflexes that drive tachyarrhythmia. This remodeling may contribute to air pollution-associated risk in susceptible individuals with cardiovascular disease. We found that inhalation of TRPM8 agonists, l-menthol and WS-12, but not the inactive analog d-menthol, selectively reduces the reflex tachyarrhythmia evoked by allyl isothiocyanate (AITC) inhalation in SH rats. Use of menthol may protect susceptible individuals from pollution-associated CV exacerbations.
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Affiliation(s)
- J Shane Hooper
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Thomas E Taylor-Clark
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida
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