Asunto(s)
Oxigenoterapia Hiperbárica , Trasplantes , Niño , Cartílago Auricular , Humanos , Colgajos QuirúrgicosAsunto(s)
Anemia de Células Falciformes/complicaciones , Anestesia Local/efectos adversos , Arteriopatías Oclusivas/etiología , Epinefrina/efectos adversos , Complicaciones Intraoperatorias/etiología , Complicaciones Posoperatorias/etiología , Vasoconstrictores/efectos adversos , Anemia de Células Falciformes/fisiopatología , Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Pérdida de Sangre Quirúrgica/prevención & control , Epinefrina/administración & dosificación , Extremidades/irrigación sanguínea , Extremidades/cirugía , Hemostasis Quirúrgica/efectos adversos , Hemostasis Quirúrgica/métodos , Humanos , Procedimientos de Cirugía Plástica , Factores de Riesgo , Torniquetes , Vasoconstrictores/administración & dosificaciónRESUMEN
Gaboxadol or 4,5,6,7-tetrahydroisoxazolo-[5,4-c]pyridine-3-ol (THIP) is a selective agonist for the delta-subunit containing extrasynaptic GABA(A) receptors that will soon enter the U.S. market as a sleep aid [Winsky-Sommerer R, Vyazovskiy VV, Homanics GE, Tobler I (2007) The EEG effects of THIP (gaboxadol) on sleep and waking are mediated by the GABA(A)delta-subunit-containing receptors. Eur J Neurosci 25:1893-1899]. Numerous studies have shown that systemic administration of THIP reduces wakefulness and increases sleep both in humans and rats [Lancel M, Langebartels A (2000) Gamma-aminobutyric acid(A) (GABA(A)) agonist 4,5,6,7-tetrahydroisoxazolo[4,5-c]pyridin-3-ol persistently increases sleep maintenance and intensity during chronic administration to rats. J Pharmacol Exp Ther 293:1084-1090; Walsh JK, Deacon S, Dijk DJ, Lundahl J (2007) The selective extrasynaptic GABAA agonist, gaboxadol, improves traditional hypnotic efficacy measures and enhances slow wave activity in a model of transient insomnia. Sleep 30:593-602]. However, it is yet unclear where in the brain THIP acts to promote sleep. Since the perifornical lateral hypothalamus (PFH) contains orexin neurons and orexin neurons are critical for maintenance of arousal [McCarley RW (2007) Neurobiology of rapid eye movement (REM) and NREM sleep. Sleep Med 8:302-330], we hypothesized that THIP may act on PFH neurons to promote sleep. To test our hypothesis, we used reverse microdialysis to perfuse THIP unilaterally into the PFH and studied its effects on sleep-wakefulness during the light period in freely behaving rats. Microdialysis perfusion of THIP (100 microM) into the PFH produced a significant reduction in wakefulness with a concomitant increase in non-rapid eye movement or slow wave sleep as compared with artificial cerebrospinal fluid perfusion. REM sleep was unaffected. This is the first study implicating the delta-subunit containing extrasynaptic GABA(A) receptors in PFH in control of sleep-wakefulness in freely behaving rats.
Asunto(s)
Agonistas del GABA/administración & dosificación , Hipotálamo/efectos de los fármacos , Isoxazoles/administración & dosificación , Receptores de GABA-A/metabolismo , Sueño/efectos de los fármacos , Vigilia/efectos de los fármacos , Animales , Hipotálamo/metabolismo , Inyecciones Intraventriculares , Masculino , Microdiálisis , Ratas , Ratas Sprague-Dawley , Receptores de GABA-A/efectos de los fármacosRESUMEN
Orexin (hypocretin)-containing neurons of the hypothalamus project to brainstem sites that are involved in the neural control of REM sleep, including the locus coeruleus, the dorsal raphe nucleus, the cholinergic zone of the mesopontine tegmentum, and the pontine reticular formation (PRF). Orexin knockout mice exhibit narcolepsy/cataplexy, and a mutant and defective gene for the orexin type II receptor is present in dogs with an inherited form of narcolepsy/cataplexy. However, the physiological systems mediating these effects have not been described. We reasoned that, since the effector neurons for the majority of REM sleep signs, including muscle atonia, were located in the PRF, this region was likely implicated in the production of these orexin-related abnormalities. To test this possibility, we used microdialysis perfusion of orexin type II receptor antisense in the PRF of rats. Ten to 24 hours after antisense perfusion, REM sleep increased two- to three-fold during both the light period (quiescent phase) and the dark period (active phase), and infrared video showed episodes of behavioral cataplexy. Moreover, preliminary data indicated no REM-related effects following perfusion with nonsense DNA, or when perfusion sites were outside the PRF. More work is needed to provide precise localization of the most effective site of orexin-induced inhibition of REM sleep phenomena.