Internalization of adenovirus by alveolar macrophages initiates early proinflammatory signaling during acute respiratory tract infection

Adenovirus is a common respiratory pathogen which causes a broad range of distinct clinical syndromes and has recently received attention for its potential for in vivo gene delivery. Although adenovirus respiratory tract infection (ARTI) results in dose-dependent, local inflammation, the pathogenesis of this remains unclear. We hypothesized that alveolar macrophages (AMphi) rapidly internalize adenovirus following in vivo pulmonary administration and then initiate inflammatory signaling within the lung. To evaluate the role of AMphi in the induction of lung inflammation during ARTI in vivo, we directly assessed adenovirus uptake by murine AMphi and correlated uptake with the initiation of proinflammatory gene expression. Stimulation of cytokine (tumor necrosis factor alpha [TNF-alpha], interleukin-6 [IL-6], macrophage inflammatory protein-2 [MIP-2], and MIP-1alpha) expression in the lung was evaluated at the level of mRNA (by reverse transcription-PCR [RT-PCR]) and protein (by enzyme-linked immunosorbent assay) and by identification of cells expressing TNF-alpha and IL-6 mRNA in lung tissues (by in situ hybridization) and isolated lung lavage cells (by RT-PCR). Adenovirus, labeled with the fluorescent dye (Cy3), was rapidly and widely distributed on epithelial surfaces of airways and alveoli and was very rapidly ( approximately 1 min) localized within AMphi. At 30 min after infection AMphi but not airway epithelial or vascular endothelial cells expressed mRNA for TNF-alpha and IL-6, thus identifying AMphi as the cell source of initial cytokine signaling. IL-6, TNF-alpha, MIP-2, and MIP-1alpha levels progressively increased in bronchoalveolar lavage fluid after pulmonary adenovirus infection, and all were significantly elevated at 6 h (P < 0.05). To begin to define the molecular mechanism(s) by which adenovirus initiates the inflammatory signaling in macrophages, TNF-alpha expression from adenovirus-infected RAW264.7 macrophages was evaluated in vitro. TNF-alpha expression was readily detected in adenovirus-infected RAW cell supernatant with kinetics similar to AMphi during in vivo infection. Blockage of virus uptake at specific cellular sites, including internalization (by wortmannin), endosome acidification and/or lysis (by chloroquine) or by Ca(2+) chelation (by BAPTA) completely blocked TNF-alpha expression. In conclusion, results showed that during ARTI, (i) AMphi rapidly internalized adenovirus, (ii) expression of inflammatory mediators was initiated within AMphi and not airway epithelial or other cells, and (iii) the initiation of inflammatory signaling was linked to virion uptake by macrophages occurring at a point after vesicle acidification. These results have implications for our understanding of the role of the AMphi in the initiation of inflammation following adenovirus infection and adenovirus-mediated gene transfer to the lung.

Nonspecific inflammation inhibits adenovirus-mediated pulmonary gene transfer and expression independent of specific acquired immune responses

Replication-deficient adenovirus vectors (Avs) have shown high-efficiency gene transfer in a variety of animal models, but demonstrated lower than expected efficiency in the intensely inflammatory milieu of the respiratory tract of individuals with cystic fibrosis (CF). Specific acquired immune responses directed at adenovirus capsid proteins are known to limit the duration of transgene expression and the effectiveness of vector readministration. In these models, however, nonspecific inflammation is also frequently noted to accompany specific immune responses. Because inflammation can occur early after Av administration, we hypothesized that inflammation may block Av-mediated gene transfer in the lung independent of specific immune responses. To evaluate this hypothesis, we measured pulmonary gene transfer and expression in the absence or presence of the potent antiinflammatory agent dexamethasone. To address and eliminate concerns over the potentially confounding effects of systemic, vector-specific acquired immune responses, evaluations were confined to a 3-day period following Av administration and were carried out, in parallel, in normal and immunodeficient (athymic) mice. Dexamethasone significantly reduced Av-associated inflammation in all animals as measured by a significant reduction of blinded, quantitative lung histopathology scores and by reduced proinflammatory cytokine release. Concomitant with reduced inflammation, gene transfer efficiency was significantly increased in both normal and immunodeficient animals as measured by transgene product activity (beta-galactosidase) in total lung homogenates 3 days after vector administration. This finding could not be explained by a direct effect of dexamethasone on transgene specific activity. To begin to understand the molecular mechanisms of Av-induced inflammatory responses, lung levels of the chemoattractive chemokines MIP-2, MIP-1alpha, and MCP-1 were quantified. All were elevated significantly in Av-exposed animals. Dexamethasone reduced levels of MCP-1 and MIP-1alpha, but not MIP-2, consistent with the observed pattern of inflammatory cell changes. Expression of several proinflammatory cytokines including TNF-alpha, IL-6, IL-1beta, and IFN-gamma were also elevated in Av-exposed animals and modulated by dexamethasone. These observations demonstrate that nonspecific inflammation is an important determinant of the efficiency of in vivo pulmonary gene transfer and expression independent of specific immune responses and may have important implications for human gene therapy for diseases of the lung.

Regional localization of agmatine in the rat brain: an immunocytochemical study

The distribution of agmatine (decarboxylated arginine) was mapped in the central nervous system (CNS) in the rat. Agmatine-like immunoreactivity was identified by light microscopy, exclusively in the cytoplasm of neuronal perikarya. Immunoreactive neurons were present in the cerebral cortex, predominantly within laminae VI and V and, to a lesser extent, III and mainly in retrosplenial, cingulate, primary somatosensory and auditory cortices, and the subiculum. In the lower brainstem, immunoreactivity was selectively localized to visceral relay nuclei: the nucleus tractus solitarii and pontine parabrachial complex, and periventricular areas including the laterodorsal nucleus, locus coeruleus and dorsal raphe. In the midbrain, immunolabeled cells were concentrated in the ventral tegmental area and periaqueductal gray. In the forebrain, subcortical neurons were labeled predominantly in the preoptic area, amygdala, septum, bed nucleus of the stria terminalis, midline thalamus, and the hypothalamus. Ultrastructural analysis of layer V of the somatosensory cortex demonstrated agmatine-immunoreactivity in neurons, primarily in large dense-core vesicles located in the cytoplasm. Agmatine immunoreactivity was also affiliated with endoplasmic reticulum and the plasmalemma. Cortical neurons and the subiculum were labeled in animals not administered the axonal transport inhibitor, colchicine; thus, may normally contain higher concentrations of the amine than other brain regions. The central distribution of agmatine is consistent with the hypothesis that the amine may be a novel neurotransmitter of neurons involved in behavioral and visceral control.

Soluble Nef antigen of HIV-1 is cytotoxic for human CD4+ T cells

We have previously shown that Nef-gene 10 fusion protein induces marked growth arrest of human primary CD4+ T cells. Here, in vitro cytostatic and cytotoxic activities of human immunodeficiency virus type 1 (HIV-1) Nef against CD4+ T cells were extensively investigated. Growth of human CD4+ cells was inhibited significantly just by the addition of purified full-length Nef to cultures. When Nef was cross-linked by anti-Nef antibodies, it became very cytocidal for CD4+ T cells. A high percentage of sera from HIV-1-infected individuals contained soluble Nef. Thus, soluble Nef in vivo may play an important role in immunodysfunction of CD4+ T lymphocytes in HIV-1 infection.

Potassium-competitive acid blockers: Advanced therapeutic option for acid-related diseases

Acid-related diseases (ARDs), such as peptic ulcers and gastroesophageal reflux disease, represent a major health-care concern. Some major milestones in our understanding of gastric acid secretion and ARD treatment reached during the last 50years include 1) discovery of histamine H₂-receptors and development of H₂-receptor antagonists, 2) identification of H⁺,K⁺-ATPase as the parietal cell proton pump and development of proton pump inhibitors (PPIs), and 3) identification of Helicobacter pylori (H. pylori) as the major cause of peptic ulcers and development of effective eradication regimens. Although PPI treatments have been effective and successful, there are limitations to their efficacy and usage, i.e. short half-life, insufficient acid suppression, slow onset of action, and large variation in efficacy among patients due to CYP2C19 metabolism. Potassium-competitive acid blockers (P-CABs) inhibit H⁺,K⁺-ATPase in a reversible and K⁺-competitive manner, and exhibit almost complete inhibition of gastric acid secretion from the first dose. Many pharmaceutical companies have tried to develop P-CABs, but most of their clinical development has been discontinued due to safety concerns or a similar efficacy to PPIs. Revaprazan was developed in Korea and was the first P-CAB approved for sale. Vonoprazan, approved in 2014 in Japan, has a completely different chemical structure and higher pKa value compared to other P-CABs, and exhibits rapid onset of action and prolonged control of intragastric acidity. Vonoprazan is an effective treatment for ARDs that is especially effective in healing reflux esophagitis and for H. pylori eradication. P-CABs, such as vonoprazan, promise to further improve the management of ARDs.

Central and primary visceral afferents to nucleus tractus solitarii may generate nitric oxide as a membrane-permeant neuronal messenger

An anatomical basis was sought for the postulated roles of nitric oxide (NO) as a labile transcellular messenger in the dorsal vagal complex (NTS-X). The diaphorase activity of NO synthase was used as a marker of neurons in NTS-X that are presumed to convert L-arginine to L-citrulline and NO. Nicotinamide adenine dinucleotide phosphate diaphorase (NADPHd) staining patterns in the nucleus tractus solitarii (NTS) were spatially related to terminal sites of primary visceral afferents from 1) orosensory receptors (e.g., rostral-central nucleus); 2) soft palate, pharynx, larynx, and tracheobronchial tree (e.g., dorsal, intermediate, and interstitial nuclei); 3) esophagus (nucleus centralis); 4) stomach (nucleus gelatinosus); 5) hepatic and coeliac nerves (nucleus subpostrema); and 6) carotid body and baroreceptors (medial commissural and dorsal-lateral nuclei). Primary visceral afferents were identified as sources of NADPHd-stained fiber plexuses in the NTS-X based on three findings: 1) the presence of NADPHd in nodose ganglion cells with morphological features of first-order sensory relay neurons; 2) retrograde transport of Fluoro-Gold (FG) or cholera toxin B (CT-B) from NTS-X to NADPHd-positive nodose ganglion neurons; and 3) striking reductions of NADPHd-stained processes within primary vagal projection fields ipsilateral to unilateral nodose ganglionectomy. A central origin of NADPHd-stained processes in NTS-X was identified in the medial parvicellular subdivision of the paraventricular hypothalamic nucleus. We conclude that NO of peripheral and central origin may modulate viscerosensory signal processing in the NTS-X and autonomic reflex function.

Pituitary adenylate cyclase-activating polypeptide stimulates arginine vasopressin release in conscious rats

The effect of pituitary adenylate cyclase-activating polypeptide (PACAP) on arginine vasopressin (AVP) release was investigated in conscious rats. Intracerebroventricular (i.c.v.) administration of PACAP raised the plasma AVP concentration in a dose-dependent manner (50-500 pmol/rat), and the maximum effect was obtained at 5 min after the administration. This AVP-releasing effect was not due to a fall of blood pressure, increase of plasma Na or decrease of plasma volume, all of which are known to stimulate AVP release. PACAP had little effect on blood pressure at a low dose, but at higher doses increased it. Vasoactive intestinal peptide (VIP), which is homologous to PACAP, also raised the plasma AVP concentration by i.c.v. injection. An antagonist for VIP receptor, [Lys, Pro, Arg, Tyr]-VIP inhibited the VIP-induced increase of plasma AVP, but had little effect on PACAP-induced increase of plasma AVP. These results suggest that PACAP stimulates AVP release, via specific receptors which are distinct from VIP receptors.

Single midline thalamic neurons projecting to both the ventral striatum and the prefrontal cortex in the rat

The midline thalamic nuclei have been known to send projection fibres to the ventral striatum and the autonomic/limbic-associated areas of the prefrontal cortex. In the present study, we sought to determine whether or not single midline thalamic neurons project both to the ventral striatum and to the cerebral cortical areas. Experiments were performed on chloral hydrate-anaesthetized male Sprague Dawley rats; two fluorescent retrograde tracers were centred on the medial or lateral part of the nucleus accumbens--the major part of the ventral striatum--and the medial or lateral prefrontal viscerolimbic cortex. Our retrograde double-labelling study revealed that a subset of midline thalamic neurons send projection fibres to both the nucleus accumbens and the cerebral cortex. Such neurons projecting to both targets were principally identified in the paraventricular thalamic nucleus. The majority of the dually-labelled neurons in the paraventricular thalamic nucleus projected to the lateral part of the nucleus accumbens and the medial wall of the prefrontal cortex. Dually-labelled neurons were additionally found in other midline nuclei, including the paratenial, intermediodorsal, rhomboid, and reuniens nuclei, as well as in the medial part of the parafascicular thalamic nucleus. Dually-projecting neurons identified in the present study may represent a potential link between the limbic striatum and the viscerolimbic-associated cortex, thus suggesting that non-discriminative information relayed to the prefrontal cortex might exert an influence through the same neurons on the nucleus accumbens implicated in affective behaviour.

Alveolar macrophage deficiency in osteopetrotic mice deficient in macrophage colony-stimulating factor is spontaneously corrected with age and associated with matrix metalloproteinase expression and emphysema

Macrophage colony-stimulating factor (M-CSF) is one of several hematologic growth factors capable of regulating the survival, proliferation, and differentiation of macrophages, but its role in modulation of the accumulation and function of alveolar macrophages (AMs) in vivo is not well defined. Osteopetrotic (Op/Op) mice have no detectable M-CSF and show variable tissue-specific reductions in macrophage numbers. It was hypothesized that AMs would be decreased in number and have altered function in Op/Op mice because of the absence of M-CSF. Lung macrophages identified by Mac-3 staining in lung sections were decreased in number in 20-day-old Op/Op mice (P <.001) but not Op/Op mice older than 4 months (P =.68) compared with findings in age-matched littermate controls. The numbers of AMs recovered by bronchoalveolar lavage (BAL) were also reduced in young but not adult Op/Op mice compared with controls. Expression of interleukin-3 (IL-3) was increased in the lungs of Op/Op mice compared with controls as determined by quantification of IL-3 cytokine levels (P =.04), bioactivity (P =.02), and messenger RNA transcript levels. AMs of Op/Op mice spontaneously released higher levels of matrix metalloproteinases (MMPs) than AMs of controls as determined by immunohistochemical staining of AMs and zymographic assessment of BAL fluid and AM lysates. Consistent with an increased release of MMP, Op/Op mice had abnormal elastin deposition and spontaneously developed emphysema in the absence of molecular or cellular evidence of lung inflammation. These data show that the AM deficiency observed in young Op/Op mice is spontaneously corrected with age and is associated with increased lung levels of IL-3, spontaneous MMP expression by AMs, and destruction of lung tissue.

Projections from the commissural subnucleus of the nucleus of the solitary tract: an anterograde tracing study in the cat

The commissural subnucleus (COM) of the nucleus of the solitary tract (NTS) is known to receive primary afferents from the lungs and other viscera innervated by the vagus nerve, and thus to participate in central autonomic and respiratory control. The aim of the present study was to identify the areas of terminal arborizations of COM neurons in order to examine brainstem sites which may be involved in reflex responses mediated by these neurons. The projections were studied in cats, using biocytin as an anterograde tracer. Labeled fibers and terminal boutons were visualized by horseradish-peroxidase histochemistry, 2-3 days after microinjection of the tracers into the COM 1-2 mm caudal to the obex. Labeled axons were examined in the brainstem from the rostral pons to the caudal medulla and were found bilaterally, with an ipsilateral predominance, mainly in the following regions: (1) The dorsolateral rostral pons. Terminal boutons were observed in the lateral and medial parabrachial nuclei, Kölliker-Fuse nucleus, and around the mesencephalic trigeminal tract. This area corresponds to the pontine respiratory group also known as the "pneumotaxic center." (2) The pontine area dorsolateral to the superior olivary nucleus. This region contains the A5 noradrenergic cell group; (3) Near the ventral surface, below the facial nucleus. This area overlaps with the 'retrotrapezoid nucleus.' (4) Respiration-related areas of the medulla, including the dorsal and ventral respiratory groups, and the Bötzinger complex. (5) The dorsal motor nucleus of the vagus. These results suggest that the COM is involved in reflex arcs, which have both respiratory functions and autonomic functions. The pathway to the dorsolateral pons, which has been identified in our recent electrophysiological study is likely to play a role in mediating respiratory responses from pulmonary rapidly adapting receptors. Other pathways may represent additional projections from second-order neurons receiving input from this group of lung receptors, or projections from as yet unidentified neurons that relay information from different afferents terminating in the COM.

Axonal projections of pulmonary slowly adapting receptor relay neurons in the rat

We elucidated efferent projections of second-order relay neurons (P-cells) activated by afferents originating from slowly adapting pulmonary receptors (SARs) to determine the central pathway of the SAR-evoked reflexes. Special attention was paid to visualizing the P-cell projections within the nucleus tractus solitarii (NTS), which may correspond to the inhibitory pathway from P-cells to second-order relay neurons (RAR-cells) of rapidly adapting pulmonary receptors. P-cells were recorded from the NTS in Nembutal-anesthetized, paralyzed, and artificially ventilated rats. First, we used electrophysiological methods of antidromic mapping and showed that the majority of the P-cells examined projected their axons to the caudal NTS and to the dorsolateral pons corresponding to the parabrachial complex. Second, a mixture of HRP and Neurobiotin was injected intracellularly or juxtramembranously into P-cells. (1) Stained P-cells (n = 7) were located laterally to the solitary tract and had dendrites extending characteristically along the lateral border of the solitary tract. (2) All P-cells had stem axons projecting to the ipsilateral medulla. Of these, the axons from five P-cells projected to the nucleus ambiguus and its vicinity with distributing boutons. Some of these axons further ascended in the ventrolateral medulla, and distributed boutons in the areas ventral or ventrolateral to the nucleus ambiguus. (3) All the P-cells had axonal branches with boutons in the NTS area. In particular, axons from three P-cells projected bilaterally to the medial NTS caudal to the obex, i.e., to the area of RAR-cells. These results show anatomic substrates for the connections implicated in the P-cell inhibition of RAR-cells as well as the SAR-induced respiratory reflexes.

Morphology of expiratory neurons of the Bötzinger complex: an HRP study in the cat

In anesthetized and artificially ventilated cats, the physiological and morphological properties of expiratory neurons or their axons of the Bötzinger complex (BOT) were studied using intracellular recording and intracellular HRP labeling techniques. Thirteen expiratory neurons (nine cell somata and four axons) were successfully stained. Four of them were motoneurons, having relatively large cell somata in the retrofacial nucleus (RFN) and axons without any collaterals inside the brainstem. All the motoneurons showed a plateau shape of depolarization potentials during the expiratory phase. Any of the other nine expiratory neurons exhibited augmenting type firing or membrane potential changes during the expiratory phase. In five out of nine augmenting neurons, cell somata were stained and located ventral to the RFN. In four, only axons were stained. The majority of the augmenting neurons had two major axonal branches: one traveling toward the contralateral side and the other descending ipsilaterally in the brainstem. The most striking feature of the axonal trajectory was that all of the stained augmenting expiratory neurons, including the axons, had collateral branches with synaptic boutons in the BOT area, thus indicating that BOT expiratory neurons interact with some respiratory neurons in the BOT area and its vicinity.

Adrenergic innervation of forebrain neurons that project to the paraventricular thalamic nucleus in the rat

The paraventricular thalamic nucleus (PVT) lies in a pivotal position between the sensorium and a neural network involved in viscerolimbic integration. The aim of this study was to identify pathways used by adrenergic afferents to influence the outflow of the PVT. Potential disynaptic adrenergic projections to the PVT were investigated in chloral hydrate-anesthetized male Sprague-Dawley rats. PVT afferents were retrogradely labeled with cholera toxin B subunit on tissues processed with phenylethanolamine N-methyltransferase (PNMT) immunohistochemistry for displaying putative adrenergic innervation. In several regions of subcortical forebrain, PNMT-immunoreactive terminal-like varicosities were found to be closely associated with the soma and proximal dendritic segments of neurons retrogradely labeled from the PVT. These cell groups formed two topographically organized projection systems. The lateral telencephalic system was composed of a cell continuum formed by the central nucleus of amygdala, sublenticular substantia innominata and bed nucleus of the stria terminalis. The medial diencephalic system included the lateral hypothalamic area, perifornical nucleus, dorsomedial and periventricular hypothalamic nuclei. Adrenergic neurons in the medulla oblongata may modulate the activity of midline thalamic circuit neurons implicated in behavior.

Fos expression in afferents to the rat midline thalamus following immobilization stress

The paraventricular thalamic nucleus (PVT), the most dorsal component of the thalamic midline, is known to be strongly activated following a variety of stressors and thus might be suggested to play a role as a relay for stress-related information targeted for viscerolimbic areas in the brain. This thalamic midline nucleus, however, lacks significant direct connections with the paraventricular hypothalamic nucleus (PVH), which is a key player in the hypothalamic-pituitary-adrenal (HPA) axis whose activation and subsequent glucocorticoid secretion are clearly crucial for homeostasis under 'stressful' conditions. The present study was designed to identify afferents of the PVT, which are activated by an immobilization stress, one type of the 'neurogenic' stress paradigms, using combined Fos immunohistochemistry and retrograde tracing experiments with cholera toxin B subunit. Dual immunohistochemistry revealed that immobilization stress induced expression of Fos immunoreactive nuclei was constantly observed in many regions of the neuraxis. Dually-labeled neurons in the cerebral cortex were mainly observed in the hippocampus, exclusively in the pyramidal layer of the caudal part of the ventral subiculum. In diencephalons a small number of dually labeled neurons was observed in the rostromedial zona incerta. In the midbrain, many of the retrogradely labeled neurons in the dorsal raphe nucleus were also immunoreactive for Fos protein. Mesencephalic periaqueductal gray contained a substantial number of dually labeled neurons. In the pons, the parabrachial nuclei, locus ceruleus, Barrington's nucleus and raphe nucleus contained only small numbers of dually labeled neurons. Within the medulla, nearly all of the retrogradely labeled neurons in the caudal part of the ventrolateral medulla were also immunoreactive for Fos antigen. Dually labeled neurons in the medulla were also observed in the nucleus of the solitary tract, exclusively in its commissural part. Given the known fact that most of the regions mentioned above provide important inputs to the HPA axis, our results suggest that a diencephalic network, presumably implicated in behavioral responses to given stress, might be activated by the parallel projection system that activate the HPA axis and might add some important insights to the understanding of animal and human stress-related HPA pathology.

Efferent projections of pulmonary rapidly adapting receptor relay neurons in the cat

Axonal projections of second order neurons activated by vagal afferent fibers originating from pulmonary rapidly adapting receptors (RARs) were studied electrophysiologically in Nembutal-anesthetized, paralyzed and artificially ventilated cats. Extracellular recordings from these neurons (referred to as 'RAR-cells') were made in the commissural subnucleus (COM) of the nucleus of the solitary tract (NTS). They were identified by a combination of stimuli including stimulation of the vagus nerve(s), hyperinflation and deflation of the lungs, and a brief period of ammonia vapor inhalation. A total of 80 RAR-cells were tested for axonal projections to a respiration-related area in the brain-stem, either the dorsolateral rostral pons or the dorsal respiratory group (DRG) or the ventral respiratory group (VRG) or the Bötzinger complex (BOT) and/or the spinal cord. Twenty-two of the 47 (47%) RAR-cells tested for ipsilateral pontine projection could be antidromically activated, and in 8 cases evidence for axonal arborization was obtained. Only 1 of the 11 RAR-cells tested for DRG projection, and 1 of the 10 RAR-cells tested for VRG projection, were antidromically activated. No RAR-cells were activated from the BOT (n = 8) or from the C3-C4 segments of the spinal cord (n = 11). Bilateral lesions of the COM abolished the reflex responses induced by ammonia inhalation or hyperinflation of the lungs, but not the Hering-Breuer reflex. These results indicate that a pathway from the COM to the rostral pons forms part of the reflex arc originating from RARs.

Cholecystokinin and substance P immunoreactive projections to the paraventricular thalamic nucleus in the rat

Cholecystokinin (CCK) and substance P (SP) are thought to play an important role in a variety of stress responses. Both CCK- and SP-positive fibers innervating the thalamus are found principally in the midline nuclei, including the paraventricular thalamic nucleus (PVT), which has strong reciprocal connections with the medial prefrontal cortex. In the present study, we determined the source of the CCK- and SP-immunoreactive fibers to the PVT, employing combination of retrograde neuronal tracing and immunohistochemistry in the rat. The PVT-projecting neurons showing CCK immunoreactivity were detected in the dorsomedial nucleus of the hypothalamus, and ventral mesencephalic periaqueductal gray, including the Edinger-Westphal nucleus and the dorsal raphe nucleus. Sources of SP afferents to the PVT were detected in the Edinger-Westphal nucleus, the mesopontine tegmentum and the medullary raphe nucleus. CCK- and SP-immunoreactive fibers may exert modulatory influence on the prefrontal cortical activity via the PVT and regulate behavioral components of stress-adaptation responses.

Vestibular afferents to the dorsal vagal complex: substrate for vestibular-autonomic interactions in the rat

Vestibular afferents to the nucleus tractus solitarii (NTS) were identified for the first time in the male Sprague-Dawley rat. Cells of vestibular origin were labeled by deposits of cholera toxin B (CT-B) centered on the general viscerosensory division of NTS and dorsal motor nucleus (DMX). Vestibular-visceral afferents derive from neurons concentrated at caudal levels of medial and inferior vestibular nuclei as observed in other species. Vestibular afferent processes were labeled in the NTS and DMX by anterograde transport of the tracer, biotinylated dextran-amine from injection deposits confined to the inferior and/or medial vestibular nuclei. Vestibular axons terminate in the NTS, predominantly at intermediate levels of the dorsal vagal complex. Projections overlapped sites in NTS that receive terminal input from first-order alimentary and cardiorespiratory afferents. The somato-visceral reflex circuit corroborates recent evidence in the rat of increases in functional activity in the vestibular nuclear complex and NTS in response to changes in gravito-inertial force [Kaufman, G.D., Anderson, J.H. and Beitz, A.J., J. Neurosci., 12 (1992) 4489-4500]. Vestibular input to the NTS and DMX may assist in compensating for the effects imposed by movements and gravity on breathing, alimentary reflex function and the systemic circulation.

Sites of origin of corticotropin-releasing factor-like immunoreactive projection fibers to the paraventricular thalamic nucleus in the rat

Neurons containing the peptide corticotropin-releasing factor (CRF) are thought to play a pivotal role in orchestrating autonomic and behavioral responses to stress. CRF afferents to the thalamus are almost entirely concentrated in the midline nuclei, especially in the paraventricular thalamic nucleus. In chloral hydrate-anesthetized male Wistar rats, we sought to determine the sites of origin of the CRF projection fibers to the thalamus, employing a combination of retrograde neuronal tracing and immunocytochemistry for CRF. Prethalamic neurons showing CRF immunoreactivity were detected in the continuum formed by the central nucleus of amygdala and the bed nucleus of the stria terminalis. Additional sources of the CRF fibers to the thalamus were also detected in the parabrachial nuclei and ventrolateral medulla.

SP-A enhances viral clearance and inhibits inflammation after pulmonary adenoviral infection

Surfactant protein A (SP-A) is a member of the collectin family of host defense molecules expressed primarily in the epithelial cells of the lung. To determine the role of SP-A in pulmonary adenoviral infection, SP-A-deficient (SP-A -/-) mice were intratracheally infected with a replication-deficient recombinant adenovirus, Av1Luc1. Lung inflammation was markedly increased in SP-A -/- compared with SP-A +/+ mice and was associated with increased hemorrhage and epithelial cell injury. Polymorphonuclear cells in bronchoalveolar lavage fluid (BALF) were increased in SP-A -/- mice after administration of adenovirus. Coadministration of adenovirus and purified human SP-A ameliorated adenoviral-induced lung inflammation in SP-A -/- mice. Concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, and IL-1beta were increased in BALF of SP-A -/- mice. Likewise, TNF-alpha, IL-6, macrophage inflammatory protein (MIP)-1alpha, monocyte chemotactic protein-1, and MIP-2 mRNAs were increased in lung homogenates from SP-A -/- mice 6 and 24 h after viral administration. Clearance of adenoviral DNA from the lung and uptake of fluorescent-labeled adenovirus by alveolar macrophages were decreased in SP-A -/- mice. SP-A enhances viral clearance and inhibits lung inflammation during pulmonary adenoviral infection, providing support for the importance of SP-A in antiviral host defense.

Axonal projections from Bötzinger expiratory neurons to contralateral ventral and dorsal respiratory groups in the cat

We studied projection patterns of the augmenting expiratory neurons of the Bötzinger complex (BOT) in the contralateral brainstem. Three experimental approaches were used: 1) electrophysiological analysis using antidromic microstimulation, and morphological analyses using 2) intraaxonal injection of HRP, and 3) application of the anterograde tracer Phaseolus vulgaris leucoagglutinin (PHA-L). Taken together, the three methods revealed morphological details of the axonal arborizations of the expiratory neurons in the BOT and the ventral respiratory group (VRG). The majority of augmenting expiratory neurons of the BOT had axonal collaterals in the contralateral brainstem. The stem axons to the contralateral side crossed the midline almost at the level of the cell somata. They descended dorsomedial to the ventral spinocerebellar tract and gave off collateral branches directed dorsomedially. Terminal boutons were distributed abundantly in the caudal part of the BOT and in the more caudally situated VRG. Axon collaterals sometimes ran to the dorsal respiratory group (DRG) and distributed terminal boutons there. Together with the fact of extensive ipsilateral arborizations shown previously, the present results indicate that the augmenting expiratory neurons of the BOT have wide bilateral influence on the BOT, VRG, DRG, and spinal cord.

Excitation and inhibition of medullary inspiratory neurons by two types of burst inspiratory neurons in the cat

In Nembutal-anesthetized and artificially ventilated cats, we studied the connectivity of burst inspiratory (I) neurons in the Bötzinger complex and the ventral respiratory group (VRG) with spike-triggered averaging methods. Burst I neurons exhibited tonic (I-TON) or decrementing (I-DEC) firing patterns. Spikes of I-TON neurons induced monosynaptic EPSPs in intracellularly recorded I neurons of both the VRG and the dorsal respiratory group (DRG). Spikes of I-DEC neurons induced monosynaptic inhibitory postsynaptic potentials (IPSPs) in both VRG and DRG I neurons.

Cardiovascular medication use in patients with undiagnosed obstructive sleep apnoea

BACKGROUND

A study was undertaken in patients with undiagnosed sleep apnoea/hypopnoea syndrome (OSAS) to document the use of prescribed medications, especially those used in cardiovascular diseases, in the year before the OSAS diagnosis was confirmed.

METHODS

A total of 549 patients with OSAS (401 men of mean age 47.2 years, mean body mass index (BMI) 35.5 kg/m(2), mean apnoea/hypopnoea index (AHI) 47.2 and148 women of mean age 50.2 years, BMI 39.6 kg/m(2), AHI 32.6) were each matched to one general population control by age, sex, geographical location, and family physician. Medication use was evaluated for patients and controls using a database containing information about all prescriptions completed in the province of Manitoba, Canada.

RESULTS

In the year before OSAS was diagnosed, prescribed medication costs were $155.91 (Canadian dollars) (95% CI $91.34 to $220.49) greater for cases than for controls. Cases were dispensed 3.3 (95% CI 1.5 to 5.2) more prescriptions, were on 1.2 (95% CI 0.8 to 1.6) more medications, and were supplied with 157.4 (95% CI 95.9 to 218.8) more daily doses of medication. The odds ratio of OSAS cases being on a prescribed medication was 1.88 relative to controls (95% CI 1.38 to 2.54, p<0.0001). In the same year 36.6% of cases and 19.7% of controls were using medications for cardiovascular disease (OR 2.82, 95% CI 2.05 to 3.89, p<0.0001), consuming 79.4 (95% CI 48.9 to 109.8) more daily doses of medication, having been dispensed 1.7 (95% CI 1.0 to 2.4) more prescriptions, and at a $75.26 (95% CI $44.03 to $106.50) greater cost. The odds ratio of patients with OSAS being on medications indicated for the treatment of systemic hypertension was 2.71 (95% CI 1.96 to 3.77) relative to controls; however, such medications might also be prescribed for other indications such as angina pectoris and congestive heart failure, and for the secondary prevention of myocardial infarction. The use of medications indicated for the treatment of systemic hypertension was predicted significantly by age (odds ratio (OR) 1.10 per year), BMI (OR 1.05 per unit), and AHI (OR 1.01 per unit).

CONCLUSIONS

In the year before OSAS was diagnosed, patients with OSAS were heavy users of medications, particularly those used to treat cardiovascular diseases.

Human immunodeficiency virus type 1 Nef protein on the cell surface is cytocidal for human CD4+ T cells

We have previously shown that the carboxyl-terminal region of human immunodeficiency virus type 1 (HIV-1) Nef antigen present on the outer surface of virus-infected cells has affinity for uninfected T cells. Here, the in vitro cytotoxic potential of HIV-1 Nef on the T cell surface against CD4+ T cells was investigated in detail. Human T cells expressing Nef on the cell surface by transfection with non-infectious mutant HIV-1 proviruses were demonstrated to kill CD4+ T cells efficiently. Furthermore, it was shown that the carboxyl-terminal portion of Nef was cytotoxic for CD4+ T cells and that monoclonal antibody against the carboxyl-terminal region of Nef inhibited Nef induced-cytolysis. Thus, we concluded that Nef protein on CD4+ T cells may play an important role in the specific loss of CD4+ T lymphocytes during HIV-1 infection.

Morphology of pulmonary rapidly adapting receptor relay neurons in the rat

The term rapidly adapting pulmonary stretch receptor (RAR) refers to one of the major pulmonary sensory receptors that responds to inflation and deflation of the lungs as well as to irritant stimuli with rapidly adapting irregular discharges. The functional role and central pathways are largely unknown. The aim of this study was to elucidate morphological characteristics of second-order neurons (RAR cells) activated by vagal afferent fibers originating from RARs. A mixture of horseradish peroxidase (HRP) and Neurobiotin was injected intracellularly into physiologically identified RAR cells in Nembutal-anesthetized, immobilized, and artificially ventilated Wister rats. Direct visualization of individual RAR cells (n = 12), including their somata, dendritic arborizations, and fine axonal branches with terminal boutons, was possible for the first time. Their somata were located in the commissural or medial subdivision of the nucleus of the solitary tract, caudal to the level of the area postrema. The RAR cells had, in addition to dendrites extending into the NTS area, one or two long dendrites extending laterally and/or ventrolaterally into the medullary reticular formation. The stem axons issuing from the RAR cells first coursed ventrolaterally toward the reticular formation in the vicinity of the ambiguus nucleus and then bifurcated into ascending and descending axons: three RAR cells possessed only ascending axons. Some of the ascending axons could be traced as far as the level of the facial nucleus and some of the descending axons beyond the spinomedullary junction. These ascending and/or descending axons gave off extensive axon collaterals distributing boutons within and in the vicinity of the ambiguus nucleus. These results, showing an anatomical substrate for the network implicated in RAR-evoked reflexes, provide useful clues for study of the RAR system.