Equity, Diversity and Inclusion (EDI) in Organ Transplantation: An ESOT Survey About EDI Within ESOT as an Organization and its Educational Activities, and Transplantation Research and Science

The European Society of Organ Transplantation (ESOT) strives to promote equity, diversity, and inclusion (EDI) across all its activities. We surveyed the transplant community's experiences and perspectives regarding EDI within ESOT as an organization and its educational activities, and research in general. A total of 299 respondents completed the questionnaire. About half agreed that ESOT's Executive Committee, Council, and Sections/Committees are diverse and inclusive (51%) and that ESOT promotes EDI in its live and digital educational activities (54%). Forty percent of respondents agreed that scientific and clinical trials in the field of transplantation are diverse and inclusive. Despite the wide distribution of the survey, most of the respondents self-identified as White and were either physician or surgeon. However, the results contribute a unique insight into the experiences and perspectives of the transplantation community regarding EDI. Whilst ESOT is committed to the principles of EDI, perceptions and the high number of proposals show the apparent need to prioritize efforts to embed EDI across ESOT and transplantation science. These data should constitute a starting point for change and provide guidance for future efforts to promote EDI within the transplantation community.

O45: DEFINING CELL-ENRICHED MICRORNAS TO SUPPORT RATIONAL BIOMARKER SELECTION IN HUMAN RENAL TRANSPLANTATION

Introduction

MicroRNAs are promising biomarkers of renal disease, however the cellular origin of their expression is usually unclear limiting their interpretation when measured in renal biopsies and urine. We hypothesised that by first defining renal cell-enriched microRNAs, we could select biomarkers based on the expected histopathological profile.

Method

Small RNA-sequencing of cortical, proximal tubular (LTL), macrophage (F480), endothelial (CD31) and fibroblast (PDGFRb) populations from the reversible unilateral ureteric obstruction (rUUO) murine model was performed. Hierarchical clustering was used to identify clusters. Findings were translated into an ischaemia reperfusion injury (IRI) model and then into urine samples from renal transplant recipients (n=16) with delayed graft function (DGF) vs. those with primary function.

Result

Kidney injury resulted in significant macrophage infiltration and tubular injury which improved upon reversal. We characterised novel microRNA clusters enriched for each cell type. With injury there was a significant increase in macrophage (p<0.0001), fibroblast (p<0.01) and decrease in proximal tubule (p<0.0001) enriched microRNAs vs. non-enriched microRNAs. We validated macrophage enriched miR-18a, miR-16 and tubular enriched miR-194 in the IRI model, demonstrating that microRNA expression reflected the histological profile. In humans, urinary miR-16 (FC 16.9; p<0.05) and miR-18a (FC 10: p=0.06) were upregulated at day 2 in patients with DGF; outperforming the traditional injury marker KIM1.

Conclusion

This is the first study to characterise cell-enriched microRNAs during renal injury and repair. By defining the source of microRNA expression we were able to rationally select miR-16 and miR-18a as promising urinary biomarkers of renal injury.

Take-home message

We have found that microRNAs have differences in expression between cell types and renal injury states which is important when considering microRNA expression in samples composed of varying cellular composition. By defining the cellular origins of microRNA expression we were able to rationally select microRNA biomarkers of human renal injury.

Nitrergic relaxations and phenylephrine contractions are not compromised in isolated urethra in a rat model of diabetes

In vivo experiments in a diabetic rat model revealed compromised nitrergic urethral relaxations and increased sensitivity to adrenergic agonists. This study evaluated contractile and relaxation properties of urethral smooth muscle after streptozotocin (STZ)-induced diabetes, in vitro, with the aim of determining whether in vivo deficiencies are related to smooth muscle dysfunction. Urethral tissue was collected from adult female Sprague-Dawley rats naive, STZ-treated, vehicle-treated and sucrose-fed at 9-12 week post treatment. Strips from proximal, mid, and distal urethra were placed in tissue baths and stimulated using electric field stimulation (EFS) and pharmacological agents. nNOS staining was evaluated using immunohistochemistry. Phenylephrine (PE, 10μM) contracted all urethral strips with the highest amplitude in mid urethra, in all treatment groups. Likewise, EFS-induced relaxation amplitudes were larger and were observed more frequently in mid urethra. Relaxations were inhibited by the NOS inhibitor, L-NAME (1-100μM). Sodium nitroprusside (0.01-1μM), an NO donor, reversed PE-induced contractions. No statistical differences were observed between treatment groups with respect to any parameters. Qualitative immunohistochemistry showed no differences in the urethral nNOS innervation patterns across the treatment groups. In summary, nitrergic relaxations and adrenergic-induced contractions in the isolated diabetic rat urethra display similar properties to controls, suggesting no dysfunction on the nitrergic or alpha1 adrenergic receptor function in the smooth muscle. This further implies that compromised urethral relaxation and increased adrenergic agonist sensitivity observed in vivo in this model may be due to the disruption of neural signaling between the urethra and the spinal cord, or within the CNS.

Identification of neural circuits involved in female genital responses in the rat: a dual virus and anterograde tracing study

The spinal and peripheral innervation of the clitoris and vagina are fairly well understood. However, little is known regarding supraspinal control of these pelvic structures. The multisynaptic tracer pseudorabies virus (PRV) was used to map the brain neurons that innervate the clitoris and vagina. To delineate forebrain input on PRV-labeled cells, the anterograde tracer biotinylated dextran amine was injected in the medial preoptic area (MPO), ventromedial nucleus of the hypothalamus (VMN), or the midbrain periaqueductal gray (PAG) 10 days before viral injections. These brain regions have been intimately linked to various aspects of female reproductive behavior. After viral injections (4 days) in the vagina and clitoris, PRV-labeled cells were observed in the paraventricular nucleus (PVN), Barrington's nucleus, the A5 region, and the nucleus paragigantocellularis (nPGi). At 5 days postviral administration, additional PRV-labeled cells were observed within the preoptic region, VMN, PAG, and lateral hypothalamus. Anterograde labeling from the MPO terminated among PRV-positive cells primarily within the dorsal PVN of the hypothalamus, ventrolateral VMN (VMNvl), caudal PAG, and nPGi. Anterograde labeling from the VMN terminated among PRV-positive cells in the MPO and lateral/ventrolateral PAG. Anterograde labeling from the PAG terminated among PRV-positive cells in the PVN, ventral hypothalamus, and nPGi. Transynaptically labeled cells in the lateral hypothalamus, Barrington's nucleus, and ventromedial medulla received innervation from all three sources. These studies, together, identify several central nervous system (CNS) sites participating in the neural control of female sexual responses. They also provide the first data demonstrating a link between the MPO, VMNvl, and PAG and CNS regions innervating the clitoris and vagina, providing support that these areas play a major role in female genital responses.

Differential effects of simultaneous or sequential administration of paroxetine and WAY-100,635 on ejaculatory behavior

Clinical treatment of depression or anxiety with selective serotonin reuptake inhibitors (SSRIs) often results in delayed ejaculation or anorgasmia. Co-treatment with subtype-selective serotonin receptor antagonists may alter the timing of onset of action and potentiate or reduce sexual side effects. Sexual behavior in male Sprague-Dawley rats was examined after acute administration of the SSRI, paroxetine and the serotonin1A antagonist, WAY-100,635. Acute administration of paroxetine alone did not alter male ejaculatory behavior. However, administration of paroxetine plus WAY-100,635 resulted in a significant delay in mounting behavior and increased the time to ejaculation. Simultaneous administration of paroxetine and WAY-100,635 produced a greater delay in initiation of mounting behavior and ejaculation compared to sequential administration of paroxetine followed by WAY-100,635. The differential effect on sexual behavior or addition of specific serotonin receptor antagonists may be relevant for clinical treatment therapies of premature ejaculation.

Identification of neural pathways involved in genital reflexes in the female: a combined anterograde and retrograde tracing study

The medial preoptic area (MPOA) is important for reproductive behavior in females. However, the descending pathways mediating these responses to the spinal motor output are unknown. The MPOA does not directly innervate the spinal cord. Therefore, pathways mediating MPOA-induced changes in sexual behavior must relay in the brain. The nucleus paragigantocellularis (nPGi) projects heavily to spinal circuits involved in female sexual reflexes and is involved in the tonic inhibition of genital reflexes. However, the periaqueductal gray (PAG) is also important for female sexual behavior. The present study examined the hypothesis that the MPOA output relays through PAG and the nPGi before descending to the spinal cord. We used anterograde and retrograde tracing techniques to examine the descending pathways and relay sites from the MPOA to the spinal cord and the nPGi in the female rat. Injection of biotinylated dextran amine into the MPOA produced dense labeling in specific regions of the PAG and Barrington's nucleus; anterogradely labeled fibers terminated close to neurons retrogradely labeled from the spinal cord in the PAG, Barrington's nucleus, nPGi, lateral hypothalamus and paraventricular nucleus (PVN). Anterogradely labeled fibers and varicosities were also found close to neurons retrogradely labeled from the nPGi in the PAG, lateral hypothalamus and PVN. These results suggest that the major MPOA output relays in the PAG and nPGi before descending to innervate spinal circuits regulating female genital reflexes and that the MPOA plays a multifaceted role in female reproductive behavior through its modulation of PAG output systems.

Serotonergic projections to the rostroventrolateral medulla from midbrain and raphe nuclei

Double-label fluoresence immunohistochemistry was performed to define serotonergic projections from the raphe and midbrain to the sympathoexcitatory region of the rostroventrolateral medulla (RVLM). Immunolabelling of cholera toxin B subunit retrogradely transported from the pressor region of the RVLM was combined with serotonin (5-HT) immunohistochemistry. Major sources of serotonergic input to the RVLM were shown to include the raphe obscurus, raphe pallidus and raphe magnus with a minor contribution from the ventrolateral, lateral and ventral regions of the periaqueductal gray matter, and the dorsal raphe nucleus. Serotonergic modulation of sympathoexcitatory neurons may establish patterns of sympathetic nerve activity evident in many aspects of cardiovascular regulation.

Selectively bred male rat lines differ in naïve and experienced sexual behavior

Ejaculatory behavior is facilitated by activating 5-hydroxytryptamine(1A) (5-HT(1A)) receptors. The present study examined male sexual behavior in rat lines that were selectively bred for their different hypothermic responses to 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT). Sexual behavior was examined in naïve and experienced HDS (high 8-OH-DPAT sensitive), LDS (low 8-OH-DPAT sensitive), and RDS (randomly bred) rats lines. In addition, the effects of 8-OH-DPAT (0.05 mg/kg) and N-(2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl)-N-(2-pyridinyl)-cyclohexane-carboxamide (WAY 100,635; 1 mg/kg) were examined. Naïve HDS animals had diminished ejaculatory behavior (as indicated by a decreased number of intromissions, mounts and ejaculations, increased ejaculation and intromission latency, and longer inter-copulatory interval), compared to the LDS and RDS groups. In addition, the post-ejaculatory interval (PEI) was longer in the HDS group. With experience, the HDS group improved its ejaculatory behavior. Experienced HDS animals had a lower number of intromissions and a longer PEI compared to the LDS group. 8-OH-DPAT facilitated ejaculatory behavior in both HDS and LDS groups. This effect was more pronounced in the LDS group. WAY 100,635 did not alter sexual behavior in either group. In summary, alteration in forebrain 5-HT(1A) receptors in HDS animals may be involved in the ability of naïve rats to achieve ejaculation. 5-HT(1A) receptors are involved in the regulation of resumption of sexual behavior after ejaculation.

Bladder function in female rats: effects of aging and pregnancy

In vivo anesthetized cystometrograms and in vitro bladder tissue strip responses were examined in three groups of female rats: young virgins (3 month), older virgins (8 month), and retired breeders (8-9 month). Significant age-related in vivo changes were observed including greater resting pressures, but smaller voided volumes, void durations and void-to-void intervals in older versus young virgin rats. There were significant age-related changes in the in vitro responses. Greater peak and steady state contractions to high K+-modified Krebs (80 mM) depolarization were observed in young animals compared to older animals. Plus, young virgins exhibited greater sensitivity but smaller maximal, normalized contractions to acetylcholine (ACh) than older virgins. Diminished responses to adenosine-5'-triphosphate (ATP) were detected in young versus older virgin rats. Pregnancy-related changes were compared between retired breeders and their age-matched controls, older virgin rats. In vivo voided volumes were greater in the retired breeders than in the older virgins. Smaller in vitro steady state contractions to high K+-modified Krebs depolarization and smaller normalized contractions to maximal concentrations of ACh were observed in the retired breeders than in the older virgins. Retired breeders exhibited diminished relaxation responses to norepinephrine compared to older virgins. ATP produced greater dose-dependent responses and greater maximal contractions in the retired breeders compared to the older virgins. In conclusion, age-related changes were present even prior to the onset of senescence, and multiple pregnancies altered bladder function.

Oxytocinergic innervation of autonomic nuclei controlling penile erection in the rat

In the rat, spinal autonomic neurons controlling penile erection receive descending pathways that modulate their activity. The paraventricular nucleus of the hypothalamus contributes oxytocinergic fibers to the dorsal horn and preganglionic sympathetic and parasympathetic cell columns. We used retrograde tracing techniques with pseudorabies virus combined with immunohistochemistry against oxytocin and radioligand binding detection of oxytocinergic receptors to evidence the oxytocinergic innervation of thoracolumbar and lumbosacral spinal neurons controlling penile erection. Spinal neurons labelled with pseudo-rabies virus transsynaptically transported from the corpus cavernosum were present in the intermediolateral cell column and the dorsal gray commissure of the thoracolumbar and lumbosacral spinal cord. Confocal laser scanning microscopic observation of the same preparations revealed close appositions between oxytocinergic varicosities and pseudorabies virus-infected neurons, suggesting strongly the presence of synaptic contacts. Electron microscopy confirmed this hypothesis. Oxytocin binding sites were present in the superficial layers of the dorsal horn, the dorsal gray commissure and the intermediolateral cell column in both the thoracolumbar and lumbosacral segments. In rats, stimulation of the paraventricular nucleus induces penile erection, but the link between the nucleus and penile innervation remains unknown. Our findings support the hypothesis that oxytocin, released by descending paraventriculo-spinal pathways, activates proerectile spinal neurons.

5-Hydroxytryptamine2C receptors on spinal neurons controlling penile erection in the rat

The localization of 5-hydroxytryptamine2C receptors in the lumbosacral spinal cord of the rat was investigated using selective antibodies raised against the carboxyl-terminal part of the rat receptor. The distribution of immunoperoxidase labelling at the light microscope level revealed numerous labelled neurons in the gray matter, with a higher intensity in the sacral parasympathetic nucleus, the dorsal gray commissure and particularly the motoneurons of the ventral horn. Confocal microscope analysis showed that immunostaining was mainly intracellular (motoneurons), but could also be associated with the membrane of cell bodies and dendrites. Actually, electron microscope immunogold experiments demonstrated an exclusive staining of the cis-Golgi apparatus. Following pseudo-rabies virus transsynaptic retrograde labelling from the corpus cavernosum, labelled neurons were found in the sacral parasympathetic nucleus and the dorsal gray commissure of the L6-S1 segments. All virus-labelled neurons exhibited 5-hydroxytryptamine2C receptor immunoreactivity. These results indicate that all parasympathetic preganglionic neurons and their related interneurons which contribute to the innervation of cavernosal tissue bear 5-hydroxytryptamine2C receptors. In the sacral parasympathetic nucleus, most neurons which were retrogradely-labelled from the pelvic ganglion with Fast Blue also showed 5-hydroxytryptamine2C receptor immunoreactivity. In the ventral horn, motoneurons retrogradely labelled from the ischiocavernosus muscle and the bulbospongiosus muscle, both of which are involved in erection and ejaculation, were also 5-hydroxytryptamine2C receptor-immunopositive. The supraspinal serotoninergic control of erection at the lumbosacral level therefore appears to be strongly associated with the activation of 5-hydroxytryptamine2C receptors, consistent with the proerectile properties of 5-hydroxytryptamine2C agonists.

Identification of CNS neurons innervating the rat prostate: a transneuronal tracing study using pseudorabies virus

The spinal and brain neurons that innervate the rat prostate were identified using the transneuronal tracing technique. Three groups of rats were prepared: (1) nerve intact, (2) bilateral pelvic nerve cut and right hypogastric nerve cut and (3) bilateral hypogastric nerve cut and right pelvic nerve cut. Pseudorabies virus (PRV) was injected into the ventral prostate on the left side. After 2-4 days, the rats were perfused transcardially under deep anesthesia and the spinal cord and brain removed. PRV-labelled cells were identified using immunohistochemistry. After 3 days survival, sympathetic and parasympathetic preganglionic neurons were labelled with PRV. In addition, spinal interneurons were found in the dorsal gray commissure (DGC) of T13-S1. Rats with only one hypogastric nerve intact resulted in spinal labelling of sympathetic preganglionic neurons in the DGC and ipsilateral intermediolateral cell column (IML). In addition, many spinal interneurons were found from L1 to L6 in the medial gray. Rats with only one pelvic nerve intact displayed PRV-labelled cells in the parasympathetic preganglionic nucleus ipsilateral to the injection site. Spinal interneurons were present in the region of the IML and in the medial cord. In the brain, areas predominately labelled with PRV included the nucleus gigantocellularis and paragigantocellularis, raphe magnus, raphe pallidus, A5, Barrington's nucleus, central gray, ventral tegmental area, the paraventricular nucleus of the hypothalamus, lateral hypothalamus and medial preoptic area. These data demonstrate the sympathetic and parasympathetic spinal circuits and demonstrate the overlap of supraspinal innervation of the spinal interneurons.

A comparative study of the Abrams-Griffiths nomogram and the linear passive urethral resistance relation to determine bladder outlet obstruction

PURPOSE

The Abrams-Griffiths and linear passive urethral relationship (PURR) nomograms are commonly used to diagnose bladder outlet obstruction. To the best of our knowledge there are no clinical studies comparing these 2 evaluations to determine if they similarly predict the findings of bladder outlet obstruction.

MATERIALS AND METHODS

From October 1994 through December 1996 multichannel urodynamic studies were performed in 72 men with lower urinary tract symptoms. The data from each urodynamic study were plotted on the Abrams-Griffiths and PURR nomograms.

RESULTS

Using the Abrams-Griffiths nomogram 23 patients (46%) were unobstructed, 15 (21%) were equivocal for obstruction and 24 patients (33%) were obstructed. When the linear PURR nomogram was applied to the pressure-flow data in each group all unobstructed cases were categorized into grade 0 or 1 (no obstruction), equivocal into grade 2 (mild obstruction) and obstructed into grades 3 through 6 (moderate to severe obstruction).

CONCLUSIONS

The Abrams-Griffiths and linear PURR nomograms are helpful and comparable clinical tools to assess lower urinary tract symptoms in men. The linear PURR nomogram not only detects the presence of bladder outlet obstruction but grades its severity, which may be helpful to monitor treatment.

Effects of prenatal morphine and cocaine exposure on spinal sexual reflexes in male and female rats

Previous studies demonstrated that in utero exposure to morphine or cocaine differentially alters adult sexual behaviors, which are dependent on circulating gonadal hormones in male and female rats. In the present study, the effects of in utero morphine and cocaine exposure on the urethrogenital reflex were examined. The urethrogenital reflex is thought to be a hormone-independent spinal sexual reflex in both males and females. This reflex is tonically inhibited by supraspinal neurons but can be consistently evoked by urethral stimulation in the spinally transected animals. Prenatal morphine or cocaine exposure did not remove the supraspinal inhibition of the urethrogenital reflex in spinally intact male or female rats. In spinally transected animals, the urethrogenital reflex was qualitatively similar in all groups. However, morphine-exposed males required a stronger stimulus to elicit the urethrogenital reflex but once elicited, the frequency of the urethrogenital reflex was significantly higher compared to either controls or cocaine-exposed males. In contrast, in female rats, neither prenatal morphine nor cocaine exposure had any effect on the urethrogenital reflex. Thus, the urethrogenital reflex appears to be differentially affected by prenatal exposure to morphine in males and females.

Identification of central nervous system neurons that innervate the bladder body, bladder base, or external urethral sphincter of female rats: a transneuronal tracing study using pseudorabies virus

Transneuronal tracing techniques were used to identify the putative spinal and brainstem neurons involved in continence and voiding in the female rat. Pseudorabies virus, Bartha's K strain, was injected into either the external urethral sphincter, the bladder base, or the bladder body. After 3-5 days, the rats were perfused with fixative, and virus-labelled cells were identified by using immunohistochemistry. External urethral sphincter (EUS) injections resulted in labelling of pudendal motoneurons in the dorsolateral nucleus of L6. Putative spinal interneurons were found in the medial cord from T13 to S1 and in the lateral gray of T13-L2 and L5-S1. After both bladder base and bladder body injections, the majority of pseudorabies virus-labelled cells were found in the lateral gray and medial cord of L6-S1. A number of those found in the intermediolateral cell column resembled the parasympathetic preganglionic neurons; the remaining neurons in the lateral and medial gray were presumed to be interneurons. Very few pseudorabies virus-labelled cells were found rostral to T10. In the brainstem, transneuronally labelled cells were found in the parapyramidal medullary reticular formation, Barrington's nucleus, raphe magnus, raphe pallidus, subcoeruleus pars alpha, locus coeruleus, the A5 noradrenergic cell group, and ventromedial periaqueductal gray after all injection sites. Pseudorabies virus-labelled cells were also seen in the forebrain following the longest survival times; areas consistently labelled included the lateral hypothalamus, the parvocellular region of the paraventricular nucleus, and the medial preoptic area. These studies indicate that there is a substantial overlap of central nervous system neurons that innervate the EUS and the bladder in the female.

CNS cell groups involved in the control of the ischiocavernosus and bulbospongiosus muscles: a transneuronal tracing study using pseudorabies virus

Transneuronal tracing techniques were used to identify spinal and brainstem neurons involved in the control of perineal muscles in the male rat. Two penile muscles, the bulbospongiosus and ischiocavernosus muscles, were injected with Bartha's strain of pseudorabies virus. After survival periods of 2, 4, and 5 days, the rats were killed and viral labeled neurons identified by immunohistochemistry. After a 2 day survival period, only pudendal motoneurons were labeled. More spinal and brainstem neurons were labeled at longer survival times. Putative spinal interneurons were found from T13 to S1. Large numbers of neurons were found in the lateral horn of the T13-L2 and L6-S1 segments which contain sympathetic and parasympathetic preganglionic neurons, respectively. However, retrograde labeling experiments verified that very few of the viral neurons were preganglionic neurons. Other labeled neurons were found in the intermediate cord, especially around the central canal. Relatively few labeled neurons were seen in the dorsal or ventral horn. In the brainstem, consistent labeling was seen in the ventrolateral medulla, raphe pallidus, and magnus, the A5 and locus ceruleus noradrenergic cell groups. Barrington's nucleus in the pontine tegmentum, the periaqueductal gray, and the paraventricular nucleus of the hypothalamus. The transneuronal labeling was consistent with what is currently known of the central nervous system (CNS) control of the perineal muscles.

Effects of beta-FNA on sympathoadrenal, cardiovascular, and analgesic responses to DAMPGO at rest and during stress

To elucidate further the role of mu-opioid receptors in mediating analgesia and cardiovascular function at rest and during stress, rats were pretreated ICV with either saline (5 microliters) or beta-funaltrexamine (beta-FNA, 5 nmol/5 microliters), a noncompetitive opioid receptor antagonist that inactivates irreversibly mu receptors, 2 days prior to [D-Ala2, N MePhe4, Gly5-ol]enkephalin (DAMPGO, 1 nmol, ICV) administration. Pretreatment with beta-FNA blocked DAMPGO-induced analgesia as measured by the tail-flick test. DAMPGO also produced an increase in blood pressure (BP), sympathoadrenal outflow, and a bradycardia. Pretreatment with beta-FNA converted the DAMPGO-induced bradycardia to a tachycardia, significantly reduced the DAMPGO-induced increase in epinephrine by 60%, and the norepinephrine response by 45%, and attenuated mildly the increase in BP due to DAMPGO. In saline-treated rats, restraint stress evoked an increase in HR, BP, and plasma catecholamines. Pretreatment with beta-FNA partially attenuated the increase in HR in response to stress. In the presence of DAMPGO, restraint stress resulted in a further bradycardia, which was significantly blocked by pretreatment with beta-FNA. Stress also produced increases in BP and plasma catecholamines, which were not prevented by pretreating rats with beta-FNA. These results indicate that beta-FNA may not have inactivated all the receptors accessible to DAMPGO which control BP, or alternatively, beta-FNA may selectively inactivate a subtype of mu receptors. In addition, brain mu opioid receptors appear to be significantly involved in mediating supraspinal analgesia and regulating parasympathetic outflow to the heart and sympathoadrenal release of catecholamines.

Central nervous system neurons identified after injection of pseudorabies virus into the rat clitoris

Transneuronal tracing techniques were used to identify putative spinal and brain neurons involved in the efferent control of the clitoris. Pseudorabies virus was injected into the rat clitoris and virus-labeled neurons were identified immunohistochemically. Neurons were found primarily in L5-S1 segments of the spinal cord. In addition, virus-labeled cells were found in T12-L4 and S2-S4. In the brain, virus-labeled cells were found in the nucleus paragigantocellularis, raphe pallidus, raphe magnus, Barrington's nucleus, ventrolateral central gray, hypothalamus and medial pre-optic region. These data identify a multisynaptic circuit of neurons which may be involved in clitoral control.

Parasympathetic preganglionic neurons in the spinal cord involved in uterine innervation are cholinergic and nitric oxide-containing

BACKGROUND

The purpose of this study was to elucidate parasympathetic preganglionic neurons in the spinal cord that project axons in pathways to the uterus and to reveal their neurotransmitter phenotype.

METHODS

"Uterine-related" neurons were identified by using a combination of retrograde axonal tracers: (1) Fluorogold injected into the ganglia of termination of preganglionic fibers, and (2) a transganglionic axonal tracer (pseudorabies virus) injected into the uterus. Immunohistochemistry was used to reveal virus-labeled neurons and their neurotransmitter marker.

RESULTS

Double-labeled (Fluorogold+pseudorabies virus) "uterine" preganglionic neurons were identified in the sacral parasympathetic nucleus of the rat lumbosacral spinal cord. Subpopulations of neurons in the sacral parasympathetic nucleus were shown to be immunoreactive for choline acetyltransferase or nitric oxide synthase. Double-staining immunohistochemistry (for pseudorabies virus+neurotransmitter enzyme) revealed that some of the uterine-related preganglionic neurons were cholinergic and some nitric oxide synthase-containing.

CONCLUSIONS

These results demonstrate a subpopulation of preganglionic parasympathetic neurons in the sacral parasympathetic nucleus that are involved in uterine innervation. In addition, both acetylcholine and nitric oxide could be used to modify activity in the postganglionic neurons, which directly innervate the uterus.

Lack of effect of carbon monoxide inhibitor on relaxation induced by electrical field stimulation in corpus cavernosum

Carbon monoxide has been proposed as a possible neurotransmitter because of its ability to bind to the iron atom of the heme of guanylyl cyclase, which is similar to that of nitric oxide. To determine whether carbon monoxide exerts an effect on the penis, strips of rabbit corpus cavernosum were mounted in an organ bath for isometric tension studies and the effect of zinc deuteroporphyrin, an inhibitor of heme oxygenase which metabolizes hemoprotein and releases carbon monoxide, on relaxation induced by electrical field stimulation (neurally mediated) was determined. Also observed was relaxation induced by electrical field stimulation after incubation with atropine and guanethidine to isolate nonadrenergic noncholinergic neurotransmission. Zinc deuteroporphyrin (10(-6) M, 10(-5) M, 10(-4) M and 3 x 10(-4) M) did not affect relaxation induced by electrical field stimulation in the absence or presence of guanethidine and atropine. Therefore, it appears that carbon monoxide does not contribute to neurally mediated relaxation of the rabbit corpus cavernosum.

Serotonergic neurotoxic lesions facilitate male sexual reflexes

The effects of the neurotoxin 5,7 dihydroxytryptamine (5,7 DHT) on the urethrogenital reflex was examined in anesthetized male rats. Both ICV and intrathecal administration of 5,7 DHT produced a marked depletion (92%) of spinal 5-hydroxytryptamine (5-HT) and 5-hydroxyindole acetic acid (5-HT IAA) levels. ICV but not intrathecal administration of 5,7 DHT also caused a moderate reduction in 5-HT and 5-HT IAA levels in the medulla and hypothalamus (40-48%). No reduction in adrenergic levels were observed. In spinally intact, vehicle-treated rats the urethrogenital reflex could not be evoked. However, the urethrogenital reflex could be evoked in rats pretreated with either ICV or intrathecal 5,7 DHT prior to section of the spinal cord. These data support the hypothesis that 5-HT mediates the descending inhibition of male sexual reflexes.

Stimulation of the hypothalamus initiates the urethrogenital reflex in male rats

The urethrogenital (UG) reflex is a spinal sexual reflex which is tonically inhibited in the intact male rat by neurons in the nucleus paragigantocellularis (nPGi). The medial preoptic area of the hypothalamus (MPOA) is involved in the activation of male sexual behavior. The present study examines the effect of hypothalamic stimulation on the UG reflex in the intact male rat. Areas of the hypothalamus were stimulated bilaterally with either electrical stimulation or D,L-homocysteic acid (DLH) and the presence of the UG reflex examined. Stimulation of discrete aras of the hypothalamus evoked the UG reflex. The UG reflex could be initiated in the absence of genital stimulation. Microinjections of DLH into the MPOA also initiate the UG reflex. These data suggest that stimulation of neurons in the MPOA overcome the inhibition by the nPGi and facilitate spinal genital reflexes leading to ejaculation.

Distribution and co-localization of 5-hydroxytryptamine, thyrotropin-releasing hormone and substance P in the cat medulla

This study demonstrates the co-existence of three neurochemicals in ventral medullary neurons of the cat utilizing fluorescence immunohistochemistry. Neurons containing 5-hydroxytryptamine, thyrotropin-releasing hormone and substance P were identified within the rostrocaudal extent of the medulla, specifically within the raphe pallidus and raphe magnus and in the reticular formation of the ventrolateral medulla in the nucleus paragigantocellularis lateralis. Within the raphe pallidus the majority of 5-hydroxytryptamine-containing neurons were co-localized with thyrotropin-releasing hormone and substance P. However, in the raphe magnus the majority of stained neurons contained 5-hydroxytryptamine and thyrotropin-releasing hormone but were devoid of substance P. In the ventrolateral medulla two major populations of neurons were identified rostral to the inferior olivary nuclei, one containing 5-hydroxytryptamine and thyrotropin-releasing hormone, while a more lateral group contained substance P alone. More caudally, at the level of the inferior olives, the majority of 5-hydroxytryptamine-containing cells also displayed immunoreactivity for thyrotropin-releasing hormone and substance P. A consistent finding in both the ventromedial and ventrolateral regions of the medulla was a population of 5-hydroxytryptamine-containing cells which did not stain for either thyrotropin-releasing hormone or substance P. The functional role of co-localized neurochemicals remains unknown but co-existence of neurotransmitter substances in medullary neurons may allow for specific and multiple actions in the spinal cord.

Central nervous system innervation of the penis as revealed by the transneuronal transport of pseudorabies virus

Transneuronal tracing techniques were used in order to identify putative spinal interneurons and brainstem sites involved in the control of penile function. Pseudorabies virus was injected into the corpus cavernosus tissue of the penis in rats. After a four day survival period, rats were perfused with fixative and virus-labelled neurons were identified by immunohistochemistry. Postganglionic neurons were retrogradely labelled in the major pelvic ganglia. In the spinal cord, sympathetic and parasympathetic preganglionic neurons were labelled transneuronally. Presumptive interneurons were also labelled in the lower thoracic and lumbosacral spinal cord in locations consistent with what is currently known about such interneurons. In the brainstem, transneuronally labelled neurons were found in the medulla, pons and hypothalamus. Regions consistently labelled included the nucleus paragigantocellularis, parapyramidal reticular formation of the medulla, raphe pallidus, raphe magnus, A5 noradrenergic cell group, Barrington's nucleus and the paraventricular nucleus of the hypothalamus. This study confirmed previous studies from our lab and others concerning the preganglionic and postganglionic neurons innervating the penis. The number, morphology and location of these neurons were consistent with labelling seen following injection of conventional tracers into the penis. The brainstem nuclei labelled in this study were also consistent with what is currently known about the brainstem control of penile function. The labelling appeared to be highly specific, in that descending systems involved in other functions were not labelled. These results provide further evidence that the pseudorabies virus transneuronal tracing technique is a valuable method for identifying neural circuits mediating specific functions.

Lesions of the nucleus paragigantocellularis alter ex copula penile reflexes

The effects of electrolytic lesions of the rostral nucleus paragigantocellularis (nPGi) were examined on ex copula sexual reflexes in male rats. Bilateral lesions of the nPGi significantly reduced (by 50%) the onset of the first ex copula reflex, which usually was a glans erection. In addition, the number of dorsiflexions (flips) was significantly increased. In the anesthetized spinally intact rat the urethrogenital reflex cannot be evoked. However, after chronic bilateral lesions of the rostral nPGi, half of the rats tested displayed the urethrogenital reflex prior to section of the spinal cord. These data support a role for the rostral nPGi in the descending inhibition of male sexual reflexes.

A role for 5-hydroxytryptamine in descending inhibition of spinal sexual reflexes

Neurons in the region of the rostral nucleus paragigantocellularis (nPGi) mediate the inhibition of spinal sexual reflexes. Anatomical and pharmacological evidence is presented supporting a role for 5-hydroxytryptamine (5-HT) in this inhibition. Neurons in the rostral nPGi project to the ventral horn in the vicinity of the pudendal motoneurons. A significant number (78% ipsilateral) of these neurons contain 5-HT. Anterograde tracing with Phaseolus leucoagglutinin (PHA-L) confirmed the nPGi projection to pudendal motoneuron and interneuronal areas of the lumbar cord. 5-HT immunoreactive fibers and presumptive terminals surround the pudendal motoneurons. Urethral stimulation, in the anesthetized male rat, elicited penile erections, ejaculation and rhythmic contractions of the perineal muscles, we have used the term coitus reflex to describe this response. Intrathecal injection of 5-HT (4-50 micrograms) abolished the coitus reflex. Methysergide (1-10 mg/kg i.v.) prevented the 5-HT induced blockade of the coitus reflex. These data support the hypothesis that 5-HT is involved in the descending inhibition of spinal sexual reflexes.

Nicotine-induced alteration in Tyr-Gly-Gly and Met-enkephalin in discrete brain nuclei reflects altered enkephalin neuron activity

Nicotine acts in CNS, but the pathways and mechanisms of its actions are poorly understood. Recent studies suggest an interaction between brain nicotinic receptors and endogenous opioid peptides. Acute administration of nicotine may alter enkephalin release without affecting brain enkephalin level. Tyr-Gly-Gly has been shown previously to be an extraneuronal metabolite of opioid peptides derived from proenkephalin A. Concentrations of Tyr-Gly-Gly in brain were used to provide an index of enkephalin release in vivo. Thus we examined the thesis that nicotine alters brain neuronal enkephalin release, by measuring Tyr-Gly-Gly levels in specific brain nuclei from rats treated with nicotine 0.3 mg/kg SC 10 min before decapitation. Of 30 brain regions investigated, acute nicotine increased Tyr-Gly-Gly immunoreactivity in nucleus accumbens and in lower brain stem areas including dorsal raphe, pontine reticular formation, gigantocellular reticular formation, locus coeruleus, sensory trigeminal nucleus and the caudal part of ventrolateral medulla oblongata. Concomitantly, nicotine produced a significant decrease in native Met-enkephalin in central amygdala, flocculo-nodular lobe of cerebellum, caudal part of the ventrolateral medulla and intermediolateral cell column of the spinal cord. It is probable that the effects of nicotine to increase Tyr-Gly-Gly and alter Met-enkephalin concentration are mediated by nicotine-induced release of enkephalin at these brain sites. Furthermore, some of the physiologic and pharmacologic effects of nicotine may be mediated by such enkephalin release.

The identification of a brainstem site controlling spinal sexual reflexes in male rats

It has long been assumed that the brainstem exerts a tonic descending inhibitory influence on spinal sexual reflexes, but the source of this inhibition is unknown. Sexual responses (penile erection and ejaculatory movements) were elicited in anesthetized male rats using urethral stimuli. Using brainstem transections and electrolytic and neurotoxic lesions, we have identified a group of neurons in the paragigantocellular reticular nucleus in the ventral medulla which mediates this descending inhibition. Correlative neuroanatomical studies indicate that the inhibition is mediated via a direct projection to pelvic efferent neurons and interneurons. These results promise new approaches to the treatment of human sexual disorders.

Sympathoadrenal, cardiovascular and blood gas responses to highly selective mu and delta opioid peptides

The relative importance of mu and delta opioid receptors in brain regulation of sympathoadrenal, cardiovascular and respiratory function was investigated using highly selective mu and delta opioid peptide analogs. Groups of conscious rats received i.c.v. injections of either the mu-selective agonist, [D-Ala2, MePhe4, Gly-ol5]enkephalin (DAMGO) or the delta-selective agonist, [D-Pen2, D-Pen5]enkephalin (DPDPE). Blood pressure and heart rate were recorded continuously via a chronic catheter in the carotid artery, and arterial blood samples were taken at intervals through the same catheter for determination of blood pH, pCO2, pO2 and plasma catecholamine concentrations. Both DAMGO and DPDPE increased plasma catecholamine levels and blood pressure in a dose-related manner. The slopes of the dose-response lines were parallel, but the delta compound was about 250 times less potent than DAMGO. Only the highest dose of 5 nmol of DAMGO caused a significant bradycardia, mediated by parasympathetic (vagal) activation. DAMGO and DPDPE also induced dose-dependent acidosis, with DAMGO again being much more potent than DPDPE. The effects of both DAMGO and DPDPE on plasma catecholamines, blood pressure and blood gases were antagonized by a mu-selective dose of naloxone (0.4 mg/kg i.a.). Intracerebroventricular administration of the delta-selective antagonist, ICI 174,864, only partially attenuated sympathoadrenal and blood gas responses to DAMGO or DPDPE. The pressor responses to DAMGO or DPDPE were resistant to antagonism by ICI 174,864. These results indicate that brain opioid receptors regulating autonomic outflow, cardiovascular and respiratory function are mainly of the mu type, although a delta opioid system may contribute to sympathoadrenal and respiratory effects of opioids.

mu-Opioid peptide modulation of cardiovascular and sympathoadrenal responses to stress

The effects of mu- and delta-opioid receptor activation on sympathoadrenal and cardiovascular responses to stress were examined in conscious rats. The mu-selective agonist [D-Ala2,N-Me-Phe4,Gly5-ol]enkephalin (DAGO) or the delta-selective agonist [D-Pen2,D-Pen5]enkephalin (DPDPE) was injected into a lateral cerebral ventricle, then rats were stressed by restraint. Plasma catecholamines were measured, and arterial blood pressure and heart rate were recorded continuously. Restraint stress evoked increases in plasma catecholamines and heart rate in saline-pretreated rats. Both DAGO and DPDPE increased basal plasma levels of catecholamines and blood pressure, and DAGO, 5 nmol, produced bradycardia. DAGO, 5 nmol, but not DPDPE, potentiated the plasma catecholamine responses to restraint. However, the presence of DAGO or DPDPE during restraint resulted in decreases in heart rate and blood pressure. The effects of DAGO and DPDPE on plasma catecholamines, heart rate, and blood pressure were blocked by a mu-selective dose of naloxone but were not reversed by the delta-selective antagonist ICI 174864. These results indicate that mu-receptor stimulation during restraint stress facilitates sympathoadrenal and parasympathetic outflow and results in vasodilatation of some peripheral vascular beds.

Evidence for colocalization of substance P and 5-hydroxytryptamine in spinally projecting neurons from the cat medulla oblongata

Substance P (SP)- and 5-hydroxytryptamine (5-HT)-like immunoreactivities were localized in bulbospinal neurons of the raphe nuclei and ventrolateral medulla (VLM). In raphe pallidus and raphe obscurus virtually all of the spinally projecting neurons contained SP and/or 5-HT. Furthermore, SP and 5-HT were colocalized in half of these spinal-raphe neurons. In raphe magnus few spinally projecting neurons contained either SP or 5-HT. Half of the bulbospinal neurons in the caudal VLM contained SP and/or 5-HT and in 50% of these SP and 5-HT were colocalized. However, no SP-containing neurons in the rostral VLM projected to the spinal cord.

Immunohistochemical distribution of cholecystokinin, dynorphin A and Met-enkephalin neurons in sheep hypothalamus

The distribution of cholecystokinin (CCK)-, Met-enkephalin (M-ENK)- and dynorphin (DYN)-like immunoreactive perikarya were examined in the sheep hypothalamus using the peroxidase-anti-peroxidase technique. CCK- and DYN-containing neurons were found primarily in the suprachiasmatic nucleus (SCH) and supraoptic nucleus (SO). No CCK- or DYN-containing neurons were found in the paraventricular nucleus (PVN). M-ENK-containing neurons were found mainly in the PVN of the hypothalamus. In addition, M-ENK neurons were found in the dorsomedial (DMH), lateral (LH), anterior (AH) and periventricular hypothalamic areas. The distribution of these neuropeptides may provide a basis for understanding differences in responsiveness to centrally administered peptides.

Opioid peptides and the control of feeding in sheep

Opioid peptides, particularly beta-endorphin, methionine- (MEK) and leucine-enkephalin, and dynorphin, are involved in the regulation of food intake in mammals. The precursor molecules of these peptides undergo differential processing in brain areas producing regional concentration differences in opioids. Intraregional concentration changes also accompany alterations in feeding states. For example, MEK concentrations decrease in the basomedial hypothalamus, amygdala, and olfactory bulb in fed sheep compared with fasted sheep. Moreover, these changes are species specific. In sheep, beta-endorphin decreases in the dorsomedial and posterior hypothalami after feeding, but in the rat it is increased in the ventromedial hypothalamus and decreased in the posterior hypothalamus. In addition, immunohistochemical localization of cell bodies shows interspecies differences in concentrations. For example, dynorphin is found predominantly in the suprachiasmatic area in sheep, but in the paraventricular nucleus in the rat. These observations indicate that regulation of food intake may be differentially controlled in these species. In sheep, kappa agonists increase food intake, whereas stimulation of delta receptors inhibits feeding. Further clarification of the receptors involved in food intake will necessitate studies with more specific agonists.

Evidence for the role of insulin-like growth factor II (IGF-II) in the control of food intake

Highly purified insulin-like growth factors I and II and insulin (100 ng peptide/animal) were injected intracerebroventricularly in rats and the effect on 24 hour food consumption examined. IGF-II injections resulted in a 21% decrease in food intake and 4% body weight loss over the 24 hour period following peptide administration whereas IGF-I and insulin had no effect on either parameter. Increasing the amount of IGF-II injected also increased these responses with depressions of 22, 33 and 44% occurring in rats given 33, 100 and 300 ng IGF-II respectively. In addition, tissue concentrations of IGF-II were detected and found to be differentially distributed, via radioimmunoassay, in specific regions of the brain implicated in the regulation of food intake. IGF-I was not found in these same tissue punches despite radioimmunoassay sensitivity of 6 pg.

Descending noradrenergic pathways involved in the A5 depressor response

The objective of the present study was to analyze the anatomical basis of the A5 depressor response and to test if the putative neurotransmitter noradrenaline is involved in the response. Two approaches were used; one was neuroanatomical and the other was pharmacological. First, the retrograde transport method in which two fluorescent markers (Fast blue and rhodamine microspheres) was used in combination with the indirect immunofluorescence technique to establish that A5 catecholamine neurons project to both the spinal cord and the region of the nucleus tractus solitarii (NTS). Second, we analyzed the effects of 6-hydroxydopamine (6-OHDA) lesions of the spinal cord and/or NTS area on the A5 depressor response. This response was elicited by a 80-nl microinjection of L-glutamate (500 mM) into the A5 region in pentobarbital anesthetized rats; it was characterized by a decrease in blood pressure and heart rate. After destruction of various noradrenergic terminal fields we have found that intraspinal injections of 6-OHDA caused a 30% reduction in the blood pressure component of the A5 depressor response and a transient depression of the bradycardic response. This result suggests that only a small portion of the A5 depressor response depends on the descending A5 spinal pathway. Injections of 6-OHDA into the NTS region caused a transient depression of the A5 depressor response, and by 7-14 days postinjection, the response returned to normal. After combined 6-OHDA injections into the spinal cord and NTS area, the blood pressure and heart rate components of the A5 depressor response were reduced to 80% of the control level at 3 days postinjection. By 14 days, even with severe depletion of noradrenaline in the spinal cord (96%) and a moderate depletion of noradrenaline in the NTS (50%), the A5 response was restored to about 80% of its original magnitude, suggesting some type of functional recovery occurs in this system. Third, the blood pressure decrease elicited by L-glutamate stimulation of the A5 cell group was unaffected by pharmacological blockade of the heart. In addition, this response appeared to be normal in rats that had both their autonomic supply to the heart blocked pharmacologically and their spinal cord noradrenaline levels depleted (14 days after intraspinal 6-OHDA injections). These data suggest that the major A5 depressor response operates mainly by inhibition of the sympathetic outflow involved in control of total peripheral resistance and that this system is controlled by a descending spinal pathway which probably does not use noradrenaline as a neurotransmitter.

Topographic organization of substance P and monoamine cells in the ventral medulla of the cat

A topographic map of the substance P and monoamine neurons in the ventrolateral medulla of the cat has been constructed from peroxidase anti-peroxidase immunohistochemically stained sections. The coordinates of this map use the foramen cecum of the medulla oblongata (i.e. the triangular depression at the junction between the caudal boundary of the pons and the rostral limit of the median fissure between the pyramidal tracts) as the zero point. Two distinct groups of substance P neurons have been found: a rostral group lies ventral to the facial nucleus and a caudal one is found ventrolateral to the inferior olivary nucleus. Two dopamine beta-hydroxylase-containing cell groups were identified that correspond to the A1 and A5 cell groups. The A5 cell group lies dorsal, lateral and caudal to superior olivary nucleus. The A1 cell group lies approximately 4.0-5.0 mm lateral to the midline at the level of the inferior olive; these cells lie mainly dorsolateral to the region of the magnocellular division of the lateral reticular nucleus. The B1 and B3 serotonin (5-hydroxytryptamine) cell groups of the ventrolateral medulla appear to form a continuous column with a rostral and a caudal swelling. The rostral group begins at the level of the facial nucleus (approximately 4 mm caudal to the foramen cecum) and is concentrated in the area just lateral to the pyramidal tract. It becomes reduced in size approximately 8.0 mm caudal to the foramen cecum, and then enlarges to form a caudal group (approximately 10 mm caudal to foramen cecum). Portions of this column overlap with the caudal substance P cell group. The C1 cell group lies in a restricted zone approximately 4.0 mm lateral to the midline at the level of the rostral part of the inferior olivary nucleus.