Ultrastructural and histochemical study of the neuromuscular junctions in the denervated intrinsic laryngeal muscle of the cat

Neuromuscular junctions of the posterior cricoarytenoid muscle in multiple system atrophy: a case study

CONCLUSION

The present study showed a variety of stages of neurogenic degeneration of the muscle fibers and the neuromuscular junctions (NMJs) of the posterior cricoarytenoid (PCA) muscle in multiple system atrophy (MSA). These findings coincide with abductor paralysis of vocal cords. Ultrastructural features of the NMJs of the PCA muscle in MSA were different from those of previous studies on experimental resection of recurrent nerve and amyotrophic lateral sclerosis (ALS).

OBJECTIVES

MSA may influence various respiratory functions. Upper airway tracts including larynx are affected without exception during its clinical course. Morphological changes of NMJs of the intrinsic laryngeal muscle in MSA were examined ultrastructurally.

PATIENT AND METHODS

The patient was a 68-year-old male complaining of recurrent aspiration pneumonia, dysphagia, respiratory disturbance, and abductor paralysis of vocal cords. The motor nerve terminals of the PCA muscle in a patient with MSA were investigated electron microscopically.

RESULTS

The NMJs showed varying degrees of ultrastructural changes by motor nerve degeneration. They were seen in the pre- and post-synaptic regions. Muscle fibers losing nerve terminals showed severe damage in their cytoplasm.

Ganglion cells in the posterior cricoarytenoid muscle of the rat following experimental denervation

OBJECTIVE

To investigate morphological changes of the i.m. ganglion cells in the posterior cricoarytenoid (PCA) muscle of the rat following denervation of the recurrent laryngeal nerve.

MATERIAL AND METHODS

The recurrent laryngeal nerve on the left side of the rat was resected. Three weeks after transection, the PCA muscle was removed for morphological study using light and electron microscopy.

RESULTS

No morphological changes were found in the i.m. ganglion cells in the PCA muscle, even though the myelinated nerve fibers were destroyed and had disappeared in ramified i.m. bundles. Around the cell body, numerous non-myelinated nerve fibers were found; these contained a large number of clear, spherical synaptic vesicles approximately 50 nm in diameter and several dense-cored vesicles approximately 100 nm in diameter. In contrast, neuromuscular junctions in most muscle fibers with partially disoriented and/or disintegrated myofibrils showed degenerative figures. In some instances, however, multiple nerve terminals were detected in contact with the postsynaptic membrane. Like the varicose swellings of non-myelinated nerve fibers around the ganglion cell body, these nerve terminals contained, in addition to clear synaptic vesicles (50 nm in diameter), several dense-cored vesicles (100 nm in diameter).

CONCLUSION

We suggest that i.m. ganglion cells in the rat PCA muscle may supply postganglionic nerve fibers to the denervated neuromuscular junctions after transection of the nerve.

Mitochondria-filled nerve endings around the terminal arteriole in the rat posterior cricoarytenoid muscle

We employed light and electron microscopy to examine the innervation of terminal arterioles in the rat posterior cricoarytenoid (PCA) muscle over a three-week period before and after unilateral denervation of the recurrent nerve. Observations showed an occasional single small-sized myelinated nerve fiber around the terminal arteriole in both normal and denervated PCA muscles. One axon after the last node of Ranvier of the small-sized myelinated nerve fiber, together with some nonmyelinated nerve fibers, was enwrapped by the Schwann cell and ran along the terminal arteriole, forming varicose swellings with numerous mitochondria along its course. In one instance, a small-sized myelinated nerve fiber in the denervated PCA muscle ramified into several branches containing numerous mitochondria. These nerve endings mainly existed in the adventitia, consisting of some layers of fibroblasts and collagen fibrils, and some of them were close to the vascular smooth muscle cells with only an intervening basal lamina. These findings suggest that the mitochondria-filled nerve endings may be sensory in nature, and function in response to the expansion and contraction of blood vessels caused by increased and/or decreased blood flow or intravascular pressure.

The distribution of ganglion cells in the posterior cricoarytenoid muscle of the normal adult rat. A light and electron microscopic study

We employed by light and electron microscopy to examine the innervation of the posterior cricoarytenoid muscle of the adult rat. The laryngeal nerve was found to often bifurcate into two different bundles. One contained large myelinated (motor) nerve fibers, which were located along the frontal (ventral) muscle surface and entered the muscle at its middle portion to form neuromuscular contacts with individual muscle fibers. The other nerve bundle consisting of clustered ganglion cells (20-30 microm in diameter) and their associated nonmyelinated and small-sized myelinated nerve fibers were mainly found on the dorsal side of the muscle and often ran along the peripheral clefts or depressions of the muscle surface. The nerve bundle often extended side branches, which entered the muscle to be distributed among muscle fibers and near arterioles. Some ganglion cells are considered to enter the muscle, accompanied by branched nerves. Intramuscular ganglion cells and their associated nerve fibers examined by electron microscopy were similar in fine structure to perimuscular ganglion cells and their associated nerve fibers. Nerve fibers contained abundant clear synaptic vesicles which were cholinergic in nature, and often formed synapses with both neighboring axons and the cell body of the ganglion cells. These findings suggest that, in the rat posterior cricoarytenoid muscle, perimuscular and intramuscular ganglion cells exist and may be involved in innervating and contracting smooth muscle cells of the arterioles, thus regulating the blood flow or intravascular pressure.

Neurotransmitters and neuromodulators involved in laryngeal innervation

The distribution and role of neurotransmitters and neuromodulators in laryngeal innervation are reviewed, and our recent findings regarding the nitrergic innervation of the larynx are demonstrated for the better understanding of the complexity of the laryngeal innervation system. Noradrenergic innervation of the larynx was studied with fluorescence histochemistry and electron microscopy after application of 5-hydroxydopamine. These studies confirmed the existence of noradrenergic innervation for the submucosal glands and blood vessels, and the origin and course of noradrenergic nerve fibers contained in the laryngeal nerves and their destinations in the larynx. Cholinergic innervation of the larynx has not been clarified in detail. Many kinds of neuropeptides have been demonstrated to be involved in laryngeal innervation. Vasoactive intestinal polypeptide originating from intralaryngeal ganglionic neurons participates in laryngeal vasodilation and reduction of laryngeal seromucous secretion. Neuropeptide Y nerve fibers are few in the larynx, and most originate from the superior cervical ganglion. They are distributed around the large or medium-sized blood vessels, especially arteries. They are also associated with excretory structures. Substance P was the first neuropeptide found to be a sensory neurotransmitter in the laryngeal afferent system. It is also involved in regulation of laryngeal blood flow and secretion. Calcitonin gene-related peptide is associated with the sensory, autonomic, and motor innervation of the larynx. The majority of enkephalin nerve fibers are located close to excretory structures, although no information on the physiological significance of enkephalin is available. In addition to the above neuropeptides, the peptides histidine isoleucine, histidine methionine, and helospectin have been shown to exist in the larynx. The nitrergic innervation of the larynx has been recently studied with NADPH-diaphorase histochemistry and immunohistochemistry using antiserum against nitric oxide synthase. Nitric oxide originates from the neurons in the intralaryngeal ganglia and is believed to modulate blood flow and secretion of the larynx. It controls the laryngeal exocrine secretion in cooperation with intrinsic vasoactive intestinal polypeptide and/or extrinsic calcitonin gene-related peptide. Nitric oxide from the nodose ganglion may modulate nociception of the larynx. The existence of nitrergic neurons located in the intrinsic laryngeal muscles has been demonstrated. Many of them are bipolar or pseudounipolar, so they might be sensory in nature. The effect of injury of the recurrent laryngeal nerve on the induction of nitric oxide synthase in the laryngeal motoneurons is also discussed.

Ultrastructural and histochemical study of the motor end plates of the intrinsic laryngeal muscles in amyotrophic lateral sclerosis

Motor end plates of the intrinsic laryngeal muscles in amyotrophic lateral sclerosis (ALS) were examined light and electron microscopically. Light microscopically, typical neurogenic changes such as small angulated fibers and grouped atrophy were found in the intrinsic laryngeal muscles. Acetylcholinesterase (AchE) activities of the neuromuscular junctions (NMJ) of many fibers in ALS were decreased as compared with those of the controls. Some end-plate areas on each fiber detected by AchE histochemistry were larger than those of the controls. Ultrastructurally, muscle fibers in ALS specimens showed several changes; increased number of lipofuscin granules and/or nuclei, numerous mitochondria, and disappearance of the myofilaments. The NMJ also showed various degrees of structural changes. Some NMJ appeared almost normal. Others showed the absence of nerve terminals and Schwann cells covering the former junctional sites. Their primary synaptic clefts were flattened, and the secondary synaptic clefts were relatively well preserved. On occasion, several small nerve terminals were seen on the severely distorted postsynaptic folds, suggesting regenerative findings. In severely degenerated muscle fibers, the NMJ could not be found.

Calcitonin gene-related peptide in nucleus ambiguus motoneurons in rat: viscerotopic organization

Calcitonin gene-related peptide has been reported in the rat nucleus ambiguus. This nucleus comprises a dorsal division that is the source of special visceral efferents innervating the striated muscle of the upper alimentary tract and a ventral division supplying general visceral efferents primarily to the heart. The distribution of calcitonin gene-related peptide immunoreactive neurons in the two divisions was determined by using a combination of immunocytochemical techniques and fluorescent retrograde tracing. In 22 rats, injections of Fluoro-Gold were made into either the supranodosal vagus nerve, palatopharynx, larynx, esophagus, or heart. Following colchicine injection, medullary sections were processed immunocytochemically for calcitonin gene-related peptide. Injection of Fluoro-Gold into the supranodosal vagus resulted in prominent labeling of neurons in the dorsal and ventral divisions of the nucleus ambiguus. The majority of fluorescent labeled neurons in the dorsal division were found to be immunoreactive for calcitonin gene-related peptide, while those labeled neurons in the ventral division were unreactive for the peptide. With esophageal, and palatopharyngeal and cricothyroid injections, many fluorescent labeled neurons that were immunoreactive for calcitonin gene-related peptide were found respectively in the compact and semicompact formations of the dorsal division. In contrast, injections of the heart resulted in fluorescent labeled neurons, which were unreactive for calcitonin gene-related peptide, localized to the external formation. The results demonstrate that calcitonin gene-related peptide immunoreactive neurons are localized entirely to the dorsal division of the nucleus ambiguus and that all striated muscular areas of the alimentary tract are innervated by calcitonin gene-related peptide containing motoneurons. The localization of calcitonin gene-related peptide to vagal motoneurons also known to contain acetylcholine and the increase in acetylcholine receptor synthesis caused by this peptide suggest that calcitonin gene-related peptide acts as a cotransmitter with acetylcholine in special visceral efferent vagal motoneurons.