Biphasic Cholinergic Modulation of Reverberatory Activity in Neuronal Networks / 神经科学通报·英文版

Acetylcholine (ACh) is an important neuromodulator in various cognitive functions. However, it is unclear how ACh influences neural circuit dynamics by altering cellular properties. Here, we investigated how ACh influences reverberatory activity in cultured neuronal networks. We found that ACh suppressed the occurrence of evoked reverberation at low to moderate doses, but to a much lesser extent at high doses. Moreover, high doses of ACh caused a longer duration of evoked reverberation, and a higher occurrence of spontaneous activity. With whole-cell recording from single neurons, we found that ACh inhibited excitatory postsynaptic currents (EPSCs) while elevating neuronal firing in a dose-dependent manner. Furthermore, all ACh-induced cellular and network changes were blocked by muscarinic, but not nicotinic receptor antagonists. With computational modeling, we found that simulated changes in EPSCs and the excitability of single cells mimicking the effects of ACh indeed modulated the evoked network reverberation similar to experimental observations. Thus, ACh modulates network dynamics in a biphasic fashion, probably by inhibiting excitatory synaptic transmission and facilitating neuronal excitability through muscarinic signaling pathways.

Decreased body-fat accumulation and increased vasorelaxation to glyceryl trinitrate in middle-aged male rats following six-weeks consumption of coconut milk protein

Abstract We investigated whether coconut milk protein (CMP) contributes to the beneficial effects of coconut milk consumption on cardiovascular health markers previously found in middle-aged rats. CMP was isolated and precipitated from dried fresh coconut milk, then gavaged (1 g/kg) to middle-aged male rats for six weeks; control rats received distilled water. Compared to controls, CMP caused decreased body fat and lipid accumulation in liver cells and the platelet count. CMP did not affect basal blood pressure or heart rate in anesthetized rats. Vascular responsiveness to phenylephrine, DL-propargylglycine (PAG), acetylcholine or sodium nitroprusside was unaffected, but vasorelaxation to glyceryl trinitrate (GTN) increased. Effects of ODQ on vasorelaxation to GTN were similar in both groups. Expression of blood vessel eNOS, CSE and sGC was normal. The cyclic guanosine monophosphate (cGMP) level of CMP-treated rats was normal but addition of GTN increased cGMP and NO concentration more in CMP-treated rats than in controls, an effect unaltered by addition of diadzin. Taken together, CMP appears partially responsible for the improvement in cardiovascular health markers caused by coconut milk in middle-aged male rats

Protocolo Clínico e Diretrizes Terapêuticas da miastenia gravis / Clinical Protocol and Therapeutic Guidelines for myasthenia gravis

CONTEXTO: Os PCDT são documentos que visam garantir o melhor cuidado de saúde diante do contexto brasileiro e dos recursos disponíveis no SUS. Podem ser utilizados como materiais educativos aos profissionais de saúde, auxílio administrativo aos gestores, regulamentação da conduta assistencial perante o Poder Judiciário e explicitação de direitos aos usuários do SUS. Os PCDT são os documentos oficiais do SUS que estabelecem critérios para o diagnóstico de uma doença ou agravo à saúde; tratamento preconizado, com os medicamentos e demais produtos apropriados, quando couber; posologias recomendadas; mecanismos de controle clínico; e acompanhamento e verificação dos resultados terapêuticos a serem seguidos pelos gestores do SUS. Os PCDT devem incluir recomendações de condutas, medicamentos ou produtos para as diferentes fases evolutivas da doença ou do agravo à saúde de que se tratam, bem como aqueles indicados em casos de perda de eficácia e de surgimento de intolerância ou reação adversa relevante, provocadas pelo medicamento, produto ou procedimento de primeira escolha. A lei reforçou a análise baseada em evidências científicas para a elaboração dos protocolos, destacando os critérios de eficácia, segurança, efetividade e custo-efetividade para a formulação das recomendações sobre intervenções em saúde. Para a constituição ou alteração dos PCDT, a Portaria GM n° 2.009 de 2012 instituiu na Conitec uma Subcomissão Técnica de Avaliação de PCDT, com as competências de definir os temas para novos protocolos, acompanhar sua elaboração, avaliar as recomendações propostas e as evidências científicas apresentadas, além da revisão periódica dos PCDT vigentes, em até dois anos. A Subcomissão Técnica de Avaliação de PCDT é composta por representantes de Secretarias do Ministério da Saúde interessadas na elaboração de diretrizes clínicas: Secretaria de Atenção Primária à Saúde, Secretaria de Atenção Especializada à Saúde, Secretaria de Vigilância em Saúde, Secretaria Especial de Saúde Indígena e Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Após concluídas as etapas de definição do tema e escopo do PCDT, de busca, seleção e análise de evidências científicas e consequente definição das recomendações, a aprovação do texto é submetida à apreciação do Plenário da Conitec, com posterior disponibilização deste documento para contribuição de sociedade, por meio de consulta pública (CP) pelo prazo de 20 dias, antes da deliberação final e publicação. A consulta pública é uma importante etapa de revisão externa dos PCDT. O Plenário da Conitec é o fórum responsável pelas recomendações sobre a constituição ou alteração de PCDT, além dos assuntos relativos à incorporação, exclusão ou alteração das tecnologias no âmbito do SUS, bem como sobre a atualização da Relação Nacional de Medicamentos Essenciais (RENAME). É composto por treze membros, um representante de cada Secretaria do Ministério da Saúde ­ sendo o indicado pela Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde (SCTIE) o presidente do Plenário ­ e um representante de cada uma das seguintes instituições: ANVISA, Agência Nacional de Saúde Suplementar - ANS, Conselho Nacional de Saúde - CNS, Conselho Nacional de Secretários de Saúde - CONASS, Conselho Nacional de Secretarias Municipais de Saúde - CONASEMS e Conselho Federal de Medicina - CFM. Cabe à Secretaria-Executiva, exercida pelo Departamento de Gestão e Incorporação de Tecnologias e Inovação em Saúde (DGITIS/SCTIE), a gestão e a coordenação das atividades da Conitec. Conforme o Decreto n° 7.646 de 2011, o Secretário de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde deverá submeter o PCDT à manifestação do titular da Secretaria responsável pelo programa ou ação a ele relacionado antes da sua publicação e disponibilização à sociedade. APRESENTAÇÃO: A proposta de atualização do PCDT de Miastenia Gravis é uma demanda que cumpre o Decreto nº 7.508 de 28 de junho de 2011 e as orientações previstas no artigo 26º e o parágrafo único, sobre a responsabilidade do Ministério da Saúde de atualizar os Protocolos Clínicos e Diretrizes Terapêuticas. Este PCDT apresenta a atualização da versão publicada em 2015, com inclusão do exame complementar de diagnóstico dosagem sérica de anticorpos de acetilcolina (anti-AChR). DELIBERAÇÃO INICIAL: Os membros da Conitec presentes na 88ª Reunião do Plenário, realizada nos dias 07, 08 e 09 de julho de 2020, deliberaram para que o tema fosse submetido à consulta pública com recomendação preliminar favorável à publicação deste Protocolo. CONSULTA PÚBLICA: A Consulta Pública nº 27/2020 foi realizada entre os dias 21 de julho a 10 de agosto de 2020. A seguir é apresentado o resumo da análise das contribuições recebidas, ressaltando-se que foram consideradas apenas as encaminhadas no período estipulado e por meio do sítio eletrônico da Conitec. Os dadosforam avaliados quantitativa e qualitativamente, considerando asseguintes etapas: a) leitura de todas as contribuições, b) identificação e categorização das ideias centrais, e c) discussão acerca das contribuições. Foram recebidas ao todo 34 contribuições. A grande maioria dos participantes (n= 33; 97%) classificou a proposta de PCDT como boa ou muito boa na avaliação geral.

Effects of Mlx-8, a phospholipase A2 from Brazilian coralsnake Micrurus lemniscatus venom, on muscarinic acetylcholine receptors in rat hippocampus

Here, we described the presence of a neurotoxin with phospholipase A2 activity isolated from Micrurus lemniscatus venom (Mlx-8) with affinity for muscarinic acetylcholine receptors (mAChRs). Methods: The purification, molecular mass determination, partial amino acid sequencing, phospholipase A2 activity determination, inhibition of the binding of the selective muscarinic ligand [3H]QNB and inhibition of the total [3H]inositol phosphate accumulation in rat hippocampus of the Mlx-8 were determined. Results: Thirty-one fractions were collected from HPLC chromatography, and the Mlx-8 toxin was used in this work. The molecular mass of Mlx-8 is 13.628 Da. Edman degradation yielded the following sequence: NLYQFKNMIQCTNTRSWL-DFADYG-CYCGRGGSGT. The Mlx-8 had phospholipase A2 enzymatic activity. The pKi values were determined for Mlx-8 toxin and the M1 selective muscarinic antagonist pirenzepine in hippocampus membranes via [3H]QNB competition binding assays. The pKi values obtained from the analysis of Mlx-8 and pirenzepine displacement curves were 7.32 ± 0.15, n = 4 and 5.84 ± 0.18, n = 4, respectively. These results indicate that Mlx-8 has affinity for mAChRs. There was no effect on the inhibition ability of the [3H]QNB binding in hippocampus membranes when 1 µM Mlx-8 was incubated with 200 µM DEDA, an inhibitor of phospholipase A2. This suggests that the inhibition of the phospholipase A2 activity of the venom did not alter its ability to bind to displace [3H]QNB binding. In addition, the Mlx-8 toxin caused a blockade of 43.31 ± 8.86%, n = 3 and 97.42 ± 2.02%, n = 3 for 0.1 and 1 µM Mlx-8, respectively, on the total [3H]inositol phosphate content induced by 10 µM carbachol. This suggests that Mlx-8 inhibits the intracellular signaling pathway linked to activation of mAChRs in hippocampus. Conclusion: The results of the present work show, for the first time, that muscarinic receptors are also affected by the Mlx-8 toxin, a muscarinic ligand with phospholipase A2 characteristics, obtained from the venom of the Elapidae snake Micrurus lemniscatus, since this toxin was able to compete with muscarinic ligand [3H]QNB in hippocampus of rats. In addition, Mlx-8 also blocked the accumulation of total [3H]inositol phosphate induced by muscarinic agonist carbachol. Thus, Mlx-8 may be a new pharmacological tool for examining muscarinic cholinergic function.(AU)

A via Nrf2 participa da maior modulação endotelial induzida pela prenhez sobre reatividade de aortas à fenilefrina / The Nrf2 pathway participates in the greater endothelial modulation induced by pregnancy on reactivity of aortas to phenylephrine

Alterações em diferentes vias de sinalização levam a disfunção vascular e endotelial e consequentemente a hipertensão. A hipertensão está relacionada diretamente com o aumento da produção de espécies reativas de oxigênio (ROS) e diminuição da biodisponibilidade de óxido nítrico (NO) nos vasos sanguíneos. A via do Nrf2 (fator nuclear eritróide 2) está envolvida nos mecanismos que levam ao aumento da biodisponibilidade vascular de NO, pois controla a expressão de enzimas antioxidantes. A ativação do Nrf2 é modulada por sua ligação com a Keap-1 (Kelch-like ECH-associated protein 1) e sua atividade é modulada pelo fator de transcrição Bach-1, que compete pelo mesmo sitio ativo no DNA com o Nrf2. Em ratas normotensas e em ratas espontaneamente hipertensas (SHR) é observada uma redução da pressão arterial ao final da prenhez, que tem sido associada à redução do estresse oxidativo e maior biodisponibilidade de NO. Com o aumento da biodisponibilidade de NO, é aumentada a modulação do endotélio sobre a reatividade vascular à agonistas vasoconstritores, como à fenilefrina (PE). Levantamos a hipótese que a prenhez altera a expressão e ou a atividade do Nrf2 e de seus inibidores Keap-1 e Bach-1 e que estas possíveis alterações estariam associadas à maior modulação endotelial sobre contração de aortas à PE. Para testarmos esta hipótese, a expressão de Nrf2, Keap-1 e Bach-1 e também das enzimas antioxidantes transcritas pelo Nrf2, como a NADP(H) quinona oxirredutase-1 (NQO1), SOD-1 e SOD-2 foram avaliadas em aortas de ratas prenhes e comparadas as aortas de ratas não-prenhes. A fim de identificarmos outros possíveis mecanismos alterados pela prenhez em ratas Wistar e SHR, avaliamos a expressão de NOXO-1, subunidade regulatória da NOX1 e de p47phox, subunidade regulatória de NOX2. A participação do Nrf2 na produção de NO endotelial em aortas de ratas prenhes, foi avaliada pela utilização de Brusatol, uma droga inibidora do Nrf2. Avaliamos também a participação do Nrf2 na reatividade de aortas de ratas prenhes à fenilefrina e à acetilcolina, utilizando o Brusatol. Todos os resultados foram comparados entre ratas não-prenhes normotensas (Wistar) e hipertensas (SHR) e entre ratas não-prenhes e prenhes nos grupos (análise de multivariância, post-test Tukey, p< 0,05). Os resultados mostraram que a expressão de Nrf2 está aumentada em aortas de ratas prenhes Wistar, apesar da expressão de Keap-1 e de Bach1 não estar alterada. Associado a expressão aumentada de Nrf2 observamos maior expressão de SOD-2, mas não de SOD-1 ou NQO1, em aortas de ratas prenhes. Em aortas de ratas SHR não prenhes, observamos entre todas as proteínas avaliadas, menor expressão de Bach-1 e de NQO1 quando comparadas às aortas de ratas normotensas. A prenhez reduziu ainda mais a expressão apenas de NQO1 em aortas de SHR. A prenhez reduziu a expressão de NOXO-1 e de p47phox em aortas de SHR, enquanto que em aortas de ratas Wistar reduziu apenas a expressão de NOXO-1. Os resultados obtidos neste estudo mostraram também que a incubação de HUVEC com Brusatol aumentou as concentrações intracelulares de ERO, mas não alterou as concentrações de NO, no entanto, reduziu significativamente a concentração de NOx estimulada pela ACh em aortas de ratas prenhes, Wistar ou SHR. Além disto, o Brusatol aumentou a reatividade à PE em aortas de ratas normotensas não prenhes e prenhes, igualando a reatividade de aortas de ratas prenhes as aortas de ratas não prenhes. No entanto, o Brusatol não alterou a reatividade de aortas de SHR, prenhes ou não-prenhes. Nenhum efeito significativo do Brusatol foi observado na reatividade à Acetilcolina em aortas de ratas Wistar ou SHR, prenhes ou não prenhes. Em conclusão, nossos resultados sugerem que a atividade da via de sinalização do Nrf2 está aumentada, favorecendo a maior atividade de enzimas antioxidantes como a SOD-2, que contribuiria para maior biodisponibilidade de NO e maior modulação endotélio-dependente da contração vascular à PE em aortas de ratas normotensas prenhes. No entanto, em aortas de SHR prenhes, este mecanismo parecer não ser mais importante que a redução da atividade de isoformas NOX e de suas subunidades regulatórias que contribuiria para menor geração de O2•- e consequentemente, maior biodisponibilidade de NO(AU)

Modifications in different signaling pathways lead to vascular and endothelial dysfunction and, consequently, hypertension. Hypertension is directly related to an increase in the production of reactive oxygen species (ROS) and a decrease in the bioavailability of nitric oxide (NO) in blood vessels. The Nrf2 (erythroid nuclear factor 2) pathway is involved in the mechanisms that lead to the increased vascular bioavailability of NO, as it controls the expression of antioxidant enzymes. The activation of Nrf2 is modulated by Keap-1 (Kelch-like ECH-associated protein 1) and its activity is modulated by the transcription factor Bach-1, which competes for the same active site in DNA with Nrf2. In normotensive rats and spontaneously hypertensive rats (SHR), a reduction in blood pressure at the end of pregnancy is observed, which has been associated with a reduction in oxidative stress and greater bioavailability of NO. This increased NO bioavailability has been associated with the higher endothelium modulation over blood vessel reactivity to vasoconstrictor agonists, such as phenylephrine (PE), observed in pregnant rats. We hypothesized that pregnancy alters the expression and/or activity of Nrf2 and its inhibitors Keap-1 and Bach-1 and that these changes are associated with greater endothelial modulation on the contraction of aortas to PE. To test this hypothesis, the expression of Nrf2, Keap-1 and Bach-1 and the antioxidant enzymes transcribed by Nrf2, such as NADP (H) quinone oxidoreductase-1 (NQO1), SOD-1 and SOD-2 were evaluated in aortas of pregnant rats and compared to aortas of non-pregnant rats. In order to identify other possible mechanisms altered by pregnancy in Wistar rats and SHR, we evaluated the expression of NOXO-1, NOX1 regulatory subunit and p47phox, NOX2 regulatory subunit. The role of Nrf2 in the production of endothelial NO in aortas of pregnant rats was evaluated by use of Brusatol, an inhibitor of Nrf2. We also evaluated the role of Nrf2 in the reactivity of aortas of pregnant rats to phenylephrine and acetylcholine, using Brusatol. All results were compared between normotensive (Wistar) and hypertensive (SHR) non-pregnant rats and between pregnant and non-pregnant rats in the groups (multivariate analysis, Tukey post-test, p< 0.05). The results showed that the expression of Nrf2 is increased in aortas of pregnant Wistar rats, although the expression of Keap-1 and Bach-1 is not altered. The increased expression of Nrf2 was associated with the greater expression of SOD-2, but not of SOD-1 or NQO1, in aortas of pregnant rats. In aortas of non-pregnant SHR rats, we observed among all evaluated proteins, lower expression of Bach-1 and NQO1 when compared to the aortas of normotensive rats. Pregnancy reduced even more the expression of NQO1 in SHR aortas. Pregnancy reduced the expression of NOXO-1 and p47phox in SHR aortas, whereas in aorta of Wistar rats it reduced only the expression of NOXO-1. The results obtained in this study also showed that the incubation of HUVEC with Brusatol increased the intracellular concentrations of ROS, but did not alter the concentrations of NO, however, Brusatol significantly reduced the concentration of NOx stimulated by ACh in aortas of pregnant rats, Wistar or SHR. Moreover, Brusatol increased the reactivity to PE in aortas of pregnant normotensive rats and pregnant, matching the reactivity of aortas of pregnant rats to aortas of non-pregnant rats. However, Brusatol did not alter the reactivity of pregnant or non-pregnant SHR aortas. No significant effect of Brusatol was observed in the reactivity to Acetylcholine in aortas of Wistar rats or SHR, pregnant or non-pregnant rats. In conclusion, our results suggest that the activity of the Nrf2 signaling pathway is increased, favoring the greater activity of antioxidant enzymes such as SOD-2, which would contribute to greater bioavailability of NO and greater endothelium-dependent modulation of vascular contraction to PE in aortas of pregnant normotensive rats. However, in pregnant SHR aortas, this mechanism appears to be no more important than the lower the activity of NOX isoforms and their regulatory subunits that would contribute to lower O2•- generation and, consequently, greater NO bioavailability(AU)

Possible mechanisms involved in the effect of the subchronic administration of rosuvastatin on endothelial function in rats with metabolic syndrome

Metabolic syndrome is a multifaceted condition associated with a greater risk of various disorders (e.g., diabetes and heart disease). In a rat model of metabolic syndrome, an acute in vitro application of rosuvastatin causes relaxation of aortic rings. Since the outcome of a subchronic rosuvastatin treatment is unknown, the present study explored its effect on acetylcholine-induced vasorelaxation of aortic rings from rats with metabolic syndrome. Animals were submitted to a 16-week treatment, including a standard diet, a cafeteria-style diet (CAF-diet), or a CAF-diet with daily rosuvastatin treatment (10 mg/kg). After confirming the development of metabolic syndrome in rats, aortic segments were extracted from these animals (those treated with rosuvastatin and untreated) and the acetylcholine-induced relaxant effect on the corresponding rings was evaluated. Concentration-response curves were constructed for this effect in the presence/absence of L-NAME, ODQ, KT 5823, 4-aminopyridine (4-AP), tetraethylammonium (TEA), apamin plus charybdotoxin, glibenclamide, indomethacin, clotrimazole, and cycloheximide pretreatment. Compared to rings from control rats, acetylcholine-induced vasorelaxation decreased in rings from animals with metabolic syndrome, and was maintained at a normal level in animals with metabolic syndrome plus rosuvastatin treatment. The effect of rosuvastatin was inhibited by L-NAME, ODQ, KT 5823, TEA, apamin plus charybdotoxin, but unaffected by 4-AP, glibenclamide, indomethacin, clotrimazole, or cycloheximide. In conclusion, the subchronic administration of rosuvastatin to rats with metabolic syndrome improved the acetylcholine-induced relaxant response, involving stimulation of the NO/cGMP/PKG/Ca2+-activated K+ channel pathway.

Efeitos de análogos da acetilcolina e noradrenalina sobre interações entre timócitos e células epiteliais tímicas / Effects of acetylcholine and norepinephrine analogs on interactions between thymocytes and thymic epithelial cells

O timo é um órgão linfoide primário responsável pelo desenvolvimento e seleção de células T. Diversos fatores podem afetar o desenvolvimento de células T, como citocinas, quimiocinas e moléculas da matriz extracelular, mas também hormônios, neuropeptídeos e neurotransmissores. O timo recebe densa inervação simpática, liberando majoritariamente noradrenalina (NA), timócitos e células tímicas não linfoides expressam receptores adrenérgicos e podem sintetizar catecolaminas, sugerindo modulação de NA por diferentes vias. Por outro lado, poucas evidências anatômicas suportam a hipótese da inervação tímica parassimpática. Entretanto, acetilcolina (ACh) parece ser endogenamente produzida no órgão, uma vez que diferentes células no timo expressam a enzima sintetizadora de ACh (ChAT) e receptores colinérgicos. Sendo assim, o objetivo deste trabalho foi determinar o papel funcional de ACh e NA sobre os componentes linfoide e microambiental do timo, e sobre as interações entre células epiteliais e timócitos. Avaliamos a expressão de receptores adrenérgicos α1A, α1D, α2C, ß2 e colinérgicos M1, M3, M5 e α7 em timócitos e TECs, através do método de PCR quantitativa. Todas as populações celulares testadas expressavam os receptores selecionados.

Além disso, buscamos caracterizar o efeito de drogas análogas aos neurotransmissores sobre a morte e a proliferação de timócitos, através da marcação com anexina-V/iodeto de propídio (IP) e CFSE respectivamente. Timócitos obtidos do timo de camundongos C57BL/6 fêmeas, foram tratados com carbacol (análogo de Ach - em concentrações variando de 10 nM a 1000 nM) ou arterenol (análogo de NA - em concentrações variando de 10 nM a 1 mM). Verificamos que apenas arterenol na concentração de 1 mM induziu a apoptose nas células tratadas. Nenhum dos análogos modulou a proliferação celular. Avaliamos ainda o efeito das drogas sobre a migração de timócitos, agindo como quimioatrente ou modulando a migração induzida por fibronectina. Nenhuma das drogas demonstrou efeito quimioatraente ou alterou a migração induzida por fibronectina. Além disso, avaliamos o efeito das drogas sobre a interação TEC/timócitos atraves de ensaios de adesão e observamos que carbacol foi capaz de diminuir a adesão de timócitos a TECs em todas as concentrações testadas. Essa diminuição é refletida no número de timócitos que aderem às TECs e parece estar associada a modulação da expressão do receptor de laminina VLA-6. Nossos dados sugerem que timócitos e as linhagens de TECs testadas expressam receptores e que neurotransmissores, em especial a ACh, podem modular a interação entre TECs e timócitos. (AU)

Gαq-RGS2 loop activator modulates the activity of vario us agonists on isolated heart and aorta of normal rats

The Gαq-RGS2 loop activator, 1-(5-chloro-2-hydroxyphenyl)-3-(4-(trifluoromethyl)-phenyl)-1H-1,2,4-triazol-5(4H)-one has demonstrated Gαq signaling inhibitor activity. Therefore, we aimed to study the effect of Gαq-RGS2 loop activator on isolated heart and aorta of normal rats. Heart and aorta were isolated from the sacrificed rats (n=6) and mounted on the langendroff's and organ bath assembly, respectively. The effect of various receptor-dependent (acetylcholine, angiotensin II and adrenaline) and independent (calcium chloride and sodium nitroprusside) agonists in absence and presence of Gαq-RGS2 loop activator on left ventricular systolic pressure (LVSP) and the contractile responseswere evaluated in isolated heart and aorta, respectively. Gαq-RGS2 loop activator (100 µM) significantly attenuated the adrenaline (p<0.001,) and angiotensin II (p<0.001) induced increase in LVSP in isolated heart and contractile response of adrenaline (p<0.01) and angiotensin II (p<0.01) in the aorta. However, effect calcium chloride did not significantly alter by Gαq-RGS2 loop activator. The effect of acetylcholinewas significantly (p<0.01, p<0.05) increased by Gαq-RGS2 loop activator in isolated heart and aorta. The effect of sodium nitroprusside significantly (p<0.01) potentiated by Gαq-RGS2 loop activator (100 µM) in isolated heart while it did not significantly alters in the aorta. Ultimately, the Gαq-RGS2 loop activator modulated the action of receptor-dependent agonists in isolated heart and aorta

Interaction of genetic background and exercise training intensity on endothelial function in mouse aorta

The purpose of this study was to characterize the genetic contribution to endothelial adaptation to exercise training. Vasoreactivity was assessed in aortas from four inbred mouse strains (129S1, B6, NON, and SJL) after 4 weeks of moderate intensity continuous exercise training (MOD), high intensity interval training (HIT) or in sedentary controls (SED). Intrinsic variations in endothelium-dependent vasorelaxation (EDR) to acetylcholine (ACh) as well as vasocontractile responses were observed across SED groups. For responses to exercise training, there was a significant interaction between mouse strain and training intensity on EDR. Exercise training had no effect on EDR in aortas from 129S1 and B6 mice. In NON, EDR was improved in aortas from MOD and HIT compared with respective SED, accompanied by diminished responses to PE in those groups. Interestingly, EDR was impaired in aorta from SJL HIT compared with SED. The transcriptional activation of endothelial genes was also influenced by the interaction between mouse strain and training intensity. The number of genes altered by HIT was greater than MOD, and there was little overlap between genes altered by HIT and MOD. HIT was associated with gene pathways for inflammatory responses. NON MOD genes showed enrichment for vessel growth pathways. These findings indicate that exercise training has non-uniform effects on endothelial function and transcriptional activation of endothelial genes depending on the interaction between genetic background and training intensity.

Cholinergic anti-inflammatory pathway and its role in treatment of sepsis / 中南大学学报(医学版)

The cholinergic anti-inflammatory pathway (CAP) is a neuro-immunomodulatory pathway,in which acetylcholine (ACh) released by the interaction of vagal nerves with α7 nicotinic acetylcholine receptor (α7nAChR),which prevents the synthesis and release of pro-inflammatory cytokines and ultimately regulates the local or systemic inflammatory response in a feedback manner. It has been shown that there are many possible effective treatments for sepsis, including vagus nerve stimulation by physical therapy, drugs such as acetylcholine receptor agonist and ultrasound therapy.

The Inhibitory Mechanism on Acetylcholine-Induced Contraction of Bladder Smooth Muscle in the Streptozotocin-Induced Diabetic Rat

Most diabetic patients experience diabetic mellitus (DM) urinary bladder dysfunction. A number of studies evaluate bladder smooth muscle contraction in DM. In this study, we evaluated the change of bladder smooth muscle contraction between normal rats and DM rats. Furthermore, we used pharmacological inhibitors to determine the differences in the signaling pathways between normal and DM rats. Rats in the DM group received an intraperitoneal injection of 65 mg/kg streptozotocin and measured blood glucose level after 14 days to confirm DM. Bladder smooth muscle contraction was induced using acetylcholine (ACh, 10⁻⁴ M). The materials such as, atropine (a muscarinic receptor antagonist), U73122 (a phospholipase C inhibitor), DPCPX (an adenosine A1 receptor antagonist), udenafil (a PDE5 inhibitor), prazosin (an α₁-receptor antagonist), papaverine (a smooth muscle relaxant), verapamil (a calcium channel blocker), and chelerythrine (a protein kinase C inhibitor) were pre-treated in bladder smooth muscle. We found that the DM rats had lower bladder smooth muscle contractility than normal rats. When prazosin, udenafil, verapamil, and U73122 were pre-treated, there were significant differences between normal and DM rats. Taken together, it was concluded that the change of intracellular Ca²⁺ release mediated by PLC/IP3 and PDE5 activity were responsible for decreased bladder smooth muscle contractility in DM rats.

Pharmacological characterization of the calcium influx pathways involved in nitric oxide production by endothelial cells / Caracterização farmacológica das vias de influxo de cálcio envolvidas na produção de óxido nítrico por células endoteliais

ABSTRACT Objective: To characterize the calcium influx pathways implicated in the sustained elevation of endothelial intracellular calcium concentration, required for the synthesis and release of relaxing factors. Methods: We evaluated the effect of the newly synthesized pyrazole derivatives, described as selective inhibitors for ORAI (BTP2/Pyr2 and Pyr6) and TRPC3 (Pyr3 and Pyr10) channels, upon endothelium- and extracellular calcium-dependent relaxations stimulated by acetylcholine and thapsigargin, in pre-constricted rat thoracic aortic rings. Results: Acetylcholine and thapsigargin responses were completely reverted by Pyr2 and Pyr6 (1 to 3μM). Pyr3 (0.3 to 3μM) caused a rapid reversal of acetylcholine (6.2±0.08mg.s−1) and thapsigargin (3.9±0.25mg.s−1) relaxations, whereas the more selective TRPC3 blocker Pyr10 (1 to 3μM) had no effect. The recently described TRPC4/5 selective blocker, ML204 (1 to 3μM), reverted completely acetylcholine relaxations, but minimally thapsigargin induced ones. Noteworthy, relaxations elicited by GSK1016790A (TRPV4 agonist) were unaffected by pyrazole compounds or ML204. After Pyr2 and Pyr6 pre-incubation, acetylcholine and thapsigargin evoked transient relaxations similar in magnitude and kinetics to those observed in the absence of extracellular calcium. Sodium nitroprusside relaxations as well as phenylephrine-induced contractions (denuded aorta) were not affected by any of pyrazole compounds (1 to 3μM). Conclusion: These observations revealed a previously unrecognized complexity in rat aorta endothelial calcium influx pathways, which result in production and release of nitric oxide. Pharmacologically distinguishable pathways mediate acetylcholine (ORAI/TRPC other than TRPC3/TRPC4 calcium-permeable channels) and thapsigargin (TRPC4 not required) induced calcium influx.

RESUMO Objetivo: Caracterizar as vias do influxo de cálcio envolvidas no aumento sustentado da concentração intracelular de cálcio na célula endotelial, essencial para a síntese e a liberação de fatores relaxantes. Métodos: Analisamos o efeito de derivados pirazólicos sintetizados recentemente, descritos como inibidores seletivos para canais ORAI (BTP2/Pyr2 e Pyr6) e TRPC3 (Pyr3 e Pyr10), nos relaxamentos dependentes de endotélio e cálcio extracelular, produzidos por acetilcolina e tapsigargina, em anéis pré-contraídos da aorta torácica de rato. Resultados: As respostas de acetilcolina e tapsigargina foram completamente revertidas por Pyr2 e Pyr6 (1 a 3μM). Pyr3 (0,3 a 3μM) produziu reversão rápida dos relaxamentos de acetilcolina (6,2±0,08mg.s−1) e tapsigargina (3,9±0,25mg.s−1), enquanto o bloqueador mais seletivo para TRPC3, Pyr10 (1 a 3μM), não apresentou efeito. ML204 (1 a 3μM), bloqueador seletivo de TRPC4, descrito há pouco tempo, reverteu os relaxamentos induzidos por acetilcolina de forma completa, mas afetou minimamente aqueles produzidos por tapsigargina. Os derivados pirazólicos ou ML204 não afetaram os relaxamentos estimulados com GSK1016790A (TRPV4-agonista). Ainda, após pré-incubação com Pyr2 e Pyr6, acetilcolina e tapsigargina provocaram relaxamentos transitórios semelhantes em magnitude e cinética àqueles observados na ausência de cálcio extracelular. Os relaxamentos do nitroprussiato de sódio e as contrações induzidas pela fenilefrina (aorta sem endotélio) não foram afetados pelos compostos pirazólicos (1 a 3μM). Conclusão: Essas observações revelaram uma complexidade desconhecida das vias de influxo de cálcio no endotélio da aorta de rato, que resultam na produção e na liberação de óxido nítrico. Vias distinguíveis farmacologicamente medeiam o influxo estimulado por acetilcolina (ORAI TRPC, diferentes de TRPC3 TRPC4) e tapsigargina (TRPC4 não requerido).

Pharmacological Modulation of Vagal Nerve Activity in Cardiovascular Diseases / 神经科学通报·英文版

Cardiovascular diseases are life-threatening illnesses with high morbidity and mortality. Suppressed vagal (parasympathetic) activity and increased sympathetic activity are involved in these diseases. Currently, pharmacological interventions primarily aim to inhibit over-excitation of sympathetic nerves, while vagal modulation has been largely neglected. Many studies have demonstrated that increased vagal activity reduces cardiovascular risk factors in both animal models and human patients. Therefore, the improvement of vagal activity may be an alternate approach for the treatment of cardiovascular diseases. However, drugs used for vagus nerve activation in cardiovascular diseases are limited in the clinic. In this review, we provide an overview of the potential drug targets for modulating vagal nerve activation, including muscarinic, and β-adrenergic receptors. In addition, vagomimetic drugs (such as choline, acetylcholine, and pyridostigmine) and the mechanism underlying their cardiovascular protective effects are also discussed.

Angiotensin-Converting Enzyme 2 in the Rostral Ventrolateral Medulla Regulates Cholinergic Signaling and Cardiovascular and Sympathetic Responses in Hypertensive Rats / 神经科学通报·英文版

The rostral ventrolateral medulla (RVLM) is a key region in cardiovascular regulation. It has been demonstrated that cholinergic synaptic transmission in the RVLM is enhanced in hypertensive rats. Angiotensin-converting enzyme 2 (ACE2) in the brain plays beneficial roles in cardiovascular function in hypertension. The purpose of this study was to determine the effect of ACE2 overexpression in the RVLM on cholinergic synaptic transmission in spontaneously hypertensive rats (SHRs). Four weeks after injecting lentiviral particles containing enhanced green fluorescent protein and ACE2 bilaterally into the RVLM, the blood pressure and heart rate were notably decreased. ACE2 overexpression significantly reduced the concentration of acetylcholine in microdialysis fluid from the RVLM and blunted the decrease in blood pressure evoked by bilateral injection of atropine into the RVLM in SHRs. In conclusion, we suggest that ACE2 overexpression in the RVLM attenuates the enhanced cholinergic synaptic transmission in SHRs.

Association between Ischemic Electrocardiographic Changes during Acetylcholine Provocation Test and Long-Term Clinical Outcomes in Patients with Vasospastic Angina / 고신대학교의과대학학술지

OBJECTIVES: Intracoronary injection of acetylcholine (Ach) has been shown to induce significant coronary artery spasm (CAS) in patients with vasospastic angina. Clinical significance and angiographic characteristics of patients with ischemic electrocardiogram (ECG) changes during the Ach provocation test are not clarified yet. METHODS: A total 4,418 consecutive patients underwent coronary angiography with Ach provocation tests from 2004 to 2012 were enrolled. Ischemic ECG changes were defined as transient ST-segment depression or elevation ( > 1 mm) and T inversion with/without chest pain. Finally, a total 2,293 patients (28.5% of total subjects) proven CAS were enrolled for this study. RESULTS: A total 119 patients (5.2%) showed ECG changes during Ach provocation tests. The baseline clinical and procedural characteristics are well balanced between the two groups. Ischemic ECG change group showed more frequent chest pain, higher incidence of baseline spasm, severe vasospasm, multi-vessel involvement, and more diffuse spasm ( > 30 mm) than those without ischemic ECG changes. At 5 years, the incidences of death, major adverse cardiac events (MACE) and major adverse cardiac and cerebral events (MACCE) were higher in the ischemic ECG change group despite of optimal medical therapy. CONCLUSIONS: The patients with ischemic ECG changes during Ach provocation tests were associated with more frequent chest pain, baseline spasm, diffuse, severe and multi-vessel spasm than patients without ischemic ECG changes. At 5-years, the incidences of death, MACE and MACCE were higher in the ischemic ECG change group, suggesting more intensive medical therapy with close clinical follow up will be required.

Pyridostigmine in Pediatric Intestinal Pseudo-obstruction: Case Report of a 2-year Old Girl and Literature Review

Pediatric chronic intestinal pseudo-obstruction is a rare disorder characterized by a severe impairment of gastrointestinal motility leading to intestinal obstruction symptoms in the absence of mechanical causes. The diagnosis is usually clinical and diagnostic work is usually aimed to rule out mechanical obstruction and to identify any underlying diseases. Treatment is challenging and requires a multidisciplinary effort. In this manuscript we describe the youngest child successfully treated with the orally administrable, long-acting, reversible anti-cholinesterase drug, pyridostigmine. Like other drugs belonging to cholinesterase inhibitors, pyridostigmine enhances gut motility by increasing acetylcholine availability in the enteric nervous system and neuro-muscular junctions. Based on the direct evidence from the reported case, we reviewed the current literature on the use of pyridostigmine in severe pediatric dysmotility focusing on intestinal pseudo-obstruction. The overall data emerged from the few published studies suggest that pyridostigmine is an effective and usually well tolerated therapeutic options for patients with intestinal pseudo-obstruction. More specifically, the main results obtained by pyridostigmine included marked reduction of abdominal distension, reduced need of parenteral nutrition, and improvement of oral feeding. The present case and review on pyridostigmine pave the way for eagerly awaited future randomized controlled studies testing the efficacy of cholinesterase inhibitors in pediatric severe gut dysmotility.

The effects of Xiaotan Huayu Liqiao formula on mesenteric artery function in rats exposed to chronic intermittent hypoxia / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of Xiaotan Huayu Liqiao formula (the Chinese Medicine) on mesenteric artery function in rats exposed to chronic intermittent hypoxia (CIH), and to explore the related mechanism.@*METHODS@#Forty-eight male SD rats were randomly divided into four groups as Normoxia, CIH, Formula+CIH and formula group. Rats were exposed to normoxia in the Normoxia and Formula group, or intermittent hypoxia in CIH or Formula+CIH group. Xiaotan Huayu Liqiao formula was given at 24g/kg by intragastric administration before intermittent hypoxia exposure. The pathological changes of mesenteric artery were determined by HE staining, and the relaxation of mesenteric artery (induced by acetylcholine(ACh) and L-arginine(L-Arg)) was recorded by microvascular ring technique. Serums of all rats were collected (0 d and 21 d) and the content of NO was detected by ELISA. The levels of endothelial nitric oxide synthase (eNOS) and p-eNOS were measured by Western blot.@*RESULTS@#Compared with Normoxia group, the mesenteric arterial endothelial injury and media thickening were observed and the relaxation of mesenteric artery was significantly reduced in rats exposed to CIH. The level of NO in serum and the ratio of p-eNOS/eNOS were also decreased in the CIH group. Xiaotan Huayu Liqiao formula administration improved the pathologic changes and dilatation function of mesenteric artery, increased the levels of NO and p-eNOS. Compared with Normoxia group,all the results were not observed significant difference in Formula group.@*CONCLUSION@#Xiaotan Huayu Liqiao formula increased the bioavailability of NO, and ameliorated the CIH induced mesenteric artery function injury.

Telmisartan Inhibits Nitric Oxide Production and Vessel Relaxation via Protein Phosphatase 2A-mediated Endothelial NO Synthase-Ser¹¹⁷⁹ Dephosphorylation

BACKGROUND: Apart from its blood pressure-lowering effect by blocking the renin-angiotensin-aldosterone system, telmisartan, an angiotensin II type 1 receptor blocker (ARB), exhibits various ancillary effects including cardiovascular protective effects in vitro. Nonetheless, the protective effects of telmisartan in cerebrocardiovascular diseases are somewhat variable in large-scale clinical trials. Dysregulation of endothelial nitric oxide (NO) synthase (eNOS)-derived NO contributes to the developments of various vascular diseases. Nevertheless, the direct effects of telmisartan on endothelial functions including NO production and vessel relaxation, and its action mechanism have not been fully elucidated. Here, we investigated the mechanism by which telmisartan regulates NO production and vessel relaxation in vitro and in vivo. METHODS: We measured nitrite levels in culture medium and mouse serum, and performed inhibitor studies and western blot analyses using bovine aortic endothelial cells (BAECs) and a hyperglycemic mouse model. To assess vessel reactivity, we performed acetylcholine (ACh)-induced vessel relaxation assay on isolated rat aortas. RESULTS: Telmisartan decreased NO production in normoglycemic and hyperglycemic BAECs, which was accompanied by reduced phosphorylation of eNOS at Ser¹¹⁷⁹ (p-eNOS-Ser¹¹⁷⁹). Telmisartan increased the expression of protein phosphatase 2A catalytic subunit (PP2Ac) and co-treatment with okadaic acid completely restored telmisartan-inhibited NO production and p-eNOS-Ser¹¹⁷⁹ levels. Of the ARBs tested (including losartan and fimasartan), only telmisartan decreased NO production and p-eNOS-Ser¹¹⁷⁹ levels, and enhanced PP2Ac expression. Co-treatment with GW9662 had no effect on telmisartan-induced changes. In line with in vitro observations, telmisartan reduced serum nitrite and p-eNOS-Ser¹¹⁷⁹ levels, and increased PP2Ac expression in high fat diet-fed mice. Furthermore, telmisartan attenuated ACh-induced rat aorta relaxation. CONCLUSION: We demonstrated that telmisartan inhibited NO production and vessel relaxation at least in part by PP2A-mediated eNOS-Ser¹¹⁷⁹ dephosphorylation in a peroxisome proliferator-activated receptor γ-independent manner. These results may provide a mechanism that explains the inconsistent cerebrocardiovascular protective effects of telmisartan.

Influence of Local Myocardial Infarction on Endothelial Function, Neointimal Progression, and Inflammation in Target and Non-Target Vascular Territories in a Porcine Model of Acute Myocardial Infarction

BACKGROUND: Patients with acute myocardial infarction (AMI) have worse clinical outcomes than those with stable coronary artery disease despite revascularization. Non-culprit lesions of AMI also involve more adverse cardiovascular events. This study aimed to investigate the influence of AMI on endothelial function, neointimal progression, and inflammation in target and non-target vessels. METHODS: In castrated male pigs, AMI was induced by balloon occlusion and reperfusion into the left anterior descending artery (LAD). Everolimus-eluting stents (EES) were implanted in the LAD and left circumflex (LCX) artery 2 days after AMI induction. In the control group, EES were implanted in the LAD and LCX in a similar fashion without AMI induction. Endothelial function was assessed using acetylcholine infusion before enrollment, after the AMI or sham operation, and at 1 month follow-up. A histological examination was conducted 1 month after stenting. RESULTS: A total of 10 pigs implanted with 20 EES in the LAD and LCX were included. Significant paradoxical vasoconstriction was assessed after acetylcholine challenge in the AMI group compared with the control group. In the histologic analysis, the AMI group showed a larger neointimal area and larger area of stenosis than the control group after EES implantation. Peri-strut inflammation and fibrin formation were significant in the AMI group without differences in injury score. The non-target vessel of the AMI also showed similar findings to the target vessel compared with the control group. CONCLUSION: In the pig model, AMI events induced endothelial dysfunction, inflammation, and neointimal progression in the target and non-target vessels.

A Novel Immunomodulatory Mechanism Dependent on Acetylcholine Secreted by Human Bone Marrow-derived Mesenchymal Stem Cells

BACKGROUND AND OBJECTIVES: Mesenchymal stem cells (MSCs) are used to treat autoimmune or inflammatory diseases. Our aim was to determine the immunomodulatory mechanisms elicited by MSCs during inflammation. METHODS AND RESULTS: We cocultured MSCs with peripheral blood mononuclear cells for a mixed lymphocyte reaction or stimulated them by phytohemagglutinin. Morphological changes of MSCs and secretion of acetylcholine (ACh) from MSCs were measured. The effects of an ACh antagonist and ACh agonist on lymphocyte proliferation and proinflammatory-cytokine production were determined. The inflammatory milieu created by immune-cell activation caused MSCs to adopt a neuronlike phenotype and induced them to release ACh. Additionally, nicotinic acetylcholine receptors (nAChRs) were upregulated in activated peripheral blood mononuclear cells. We observed that ACh bound to nAChR on activated immune cells and led to the inhibition of lymphocyte proliferation and of proinflammatory-cytokine production. MSC-mediated immunosuppression through ACh activity was reversed by an ACh antagonist called α-bungarotoxin, and lymphocyte proliferation was inhibited by an ACh agonist, ACh chloride. CONCLUSIONS: Our findings point to a novel immunomodulatory mechanism in which ACh secreted by MSCs under inflammatory conditions might modulate immune cells. This study may provide a novel method for the treatment of autoimmune diseases by means of MSCs.