Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 23
Filtrar
1.
Brain Pathol ; 32(3): e13022, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34585475

RESUMEN

A preclinical strategy to broaden the search of potentially effective treatments in amyotrophic lateral sclerosis (ALS) relies on identifying factors controlling motor neuron (MN) excitability. These partners might be part of still unknown pathogenic pathways and/or useful for the design of new interventions to affect disease progression. In this framework, the bioactive membrane-derived phospholipid lysophosphatidic acid (LPA) affects MN excitability through LPA receptor 1 (LPA1 ). Furthermore, LPA1  knockdown is neuroprotective in transgenic ALS SOD1-G93A mice. On this basis, we raised the hypothesis that the major LPA-synthesizing ectoenzyme, autotaxin (ATX), regulates MN excitability and is a potential target to modulate disease development in ALS mice. We show here that PF-8380, a specific ATX inhibitor, reduced intrinsic membrane excitability (IME) of hypoglossal MNs in brainstem slices, supporting that baseline ATX activity regulates MN IME. PF-8380-induced alterations were prevented by a small-interfering RNA directed against mRNA for lpa1 . These outcomes support that impact of ATX-originated lysophospholipids on MN IME engages, at least, the G-protein-coupled receptor LPA1 . Interestingly, mRNAatx levels increased in the spinal cord of pre-symptomatic (1-2 months old) SOD1-G93A mice, thus preceding MN loss. The rise in transcripts levels also occurred in cultured spinal cord MNs from SOD1-G93A embryos, suggesting that mRNAatx upregulation in MNs is an etiopathogenic event in the ALS cell model. Remarkably, chronic administration in the drinking water of the orally bioavailable ATX inhibitor PF-8380 delayed MN loss, motor deterioration and prolonged life span in ALS mice. Treatment also led to a reduction in LPA1 -immunoreactive patches in transgenic animals mostly in MNs. These outcomes support that neuroprotective effects of interfering with ATX in SOD1-G93A mice rely, at least in part, on LPA1  knockdown in MNs. Therefore, we propose ATX as a potential target and/or a biomarker in ALS and highlight ATX inhibitors as reasonable tools with therapeutic usefulness for this lethal pathology.


Asunto(s)
Esclerosis Amiotrófica Lateral , Esclerosis Amiotrófica Lateral/tratamiento farmacológico , Esclerosis Amiotrófica Lateral/genética , Esclerosis Amiotrófica Lateral/metabolismo , Animales , Modelos Animales de Enfermedad , Ratones , Ratones Transgénicos , Neuronas Motoras/metabolismo , Degeneración Nerviosa/patología , ARN Mensajero/metabolismo , Médula Espinal/patología , Superóxido Dismutasa/metabolismo , Superóxido Dismutasa-1/metabolismo
2.
Front Mol Neurosci ; 14: 788039, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34938160

RESUMEN

Intrinsic membrane excitability (IME) sets up neuronal responsiveness to synaptic drive. Several neurotransmitters and neuromodulators, acting through G-protein-coupled receptors (GPCRs), fine-tune motoneuron (MN) IME by modulating background K+ channels TASK1. However, intracellular partners linking GPCRs to TASK1 modulation are not yet well-known. We hypothesized that isoform 2 of rho-kinase (ROCK2), acting as downstream GPCRs, mediates adjustment of MN IME via TASK1. Electrophysiological recordings were performed in hypoglossal MNs (HMNs) obtained from adult and neonatal rats, neonatal knockout mice for TASK1 (task1 -/-) and TASK3 (task3 -/-, the another highly expressed TASK subunit in MNs), and primary cultures of embryonic spinal cord MNs (SMNs). Small-interfering RNA (siRNA) technology was also used to knockdown either ROCK1 or ROCK2. Furthermore, ROCK activity assays were performed to evaluate the ability of various physiological GPCR ligands to stimulate ROCK. Microiontophoretically applied H1152, a ROCK inhibitor, and siRNA-induced ROCK2 knockdown both depressed AMPAergic, inspiratory-related discharge activity of adult HMNs in vivo, which mainly express the ROCK2 isoform. In brainstem slices, intracellular constitutively active ROCK2 (aROCK2) led to H1152-sensitive HMN hyper-excitability. The aROCK2 inhibited pH-sensitive and TASK1-mediated currents in SMNs. Conclusively, aROCK2 increased IME in task3 -/-, but not in task1 -/- HMNs. MN IME was also augmented by the physiological neuromodulator lysophosphatidic acid (LPA) through a mechanism entailing Gαi/o-protein stimulation, ROCK2, but not ROCK1, activity and TASK1 inhibition. Finally, two neurotransmitters, TRH, and 5-HT, which are both known to increase MN IME by TASK1 inhibition, stimulated ROCK2, and depressed background resting currents via Gαq/ROCK2 signaling. These outcomes suggest that LPA and several neurotransmitters impact MN IME via Gαi/o/Gαq-protein-coupled receptors, downstream ROCK2 activation, and subsequent inhibition of TASK1 channels.

3.
Neuropathol Appl Neurobiol ; 47(7): 1004-1018, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33508894

RESUMEN

AIMS: Alterations in excitability represent an early hallmark in Amyotrophic Lateral Sclerosis (ALS). Therefore, deciphering the factors that impact motor neuron (MN) excitability offers an opportunity to uncover further aetiopathogenic mechanisms, neuroprotective agents, therapeutic targets, and/or biomarkers in ALS. Here, we hypothesised that the lipokine lysophosphatidic acid (lpa) regulates MN excitability via the G-protein-coupled receptor lpa1 . Then, modulating lpa1 -mediated signalling might affect disease progression in the ALS SOD1-G93A mouse model. METHODS: The influence of lpa-lpa1 signalling on the electrical properties, Ca2+ dynamic and survival of MNs was tested in vitro. Expression of lpa1 in cultured MNs and in the spinal cord of SOD1-G93A mice was analysed. ALS mice were chronically treated with a small-interfering RNA against lpa1 (siRNAlpa1 ) or with the lpa1 inhibitor AM095. Motor skills, MN loss, and lifespan were evaluated. RESULTS: AM095 reduced MN excitability. Conversely, exogenous lpa increased MN excitability by modulating task1 'leak' potassium channels downstream of lpa1 . Lpa-lpa1 signalling evoked an excitotoxic response in MNs via voltage-sensitive calcium channels. Cultured SOD1-G93A MNs displayed lpa1 upregulation and heightened vulnerability to lpa. In transgenic mice, lpa1 was upregulated mostly in spinal cord MNs before cell loss. Chronic administration of either siRNAlpa1 or AM095 reduced lpa1 expression at least in MNs, delayed MN death, improved motor skills, and prolonged life expectancy of ALS mice. CONCLUSIONS: These results suggest that stressed lpa-lpa1 signalling contributes to MN degeneration in SOD1-G93A mice. Consequently, disrupting lpa1 slows down disease progression. This highlights LPA1 signalling as a potential target and/or biomarker in ALS.


Asunto(s)
Esclerosis Amiotrófica Lateral/metabolismo , Esclerosis Amiotrófica Lateral/patología , Neuronas Motoras/patología , Receptores del Ácido Lisofosfatídico/metabolismo , Superóxido Dismutasa-1/genética , Esclerosis Amiotrófica Lateral/genética , Animales , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Ratones Transgénicos , Microglía/patología , Degeneración Nerviosa/genética , Degeneración Nerviosa/patología , Médula Espinal/patología
4.
Nat Commun ; 10(1): 3784, 2019 08 22.
Artículo en Inglés | MEDLINE | ID: mdl-31439839

RESUMEN

Disruption in membrane excitability contributes to malfunction and differential vulnerability of specific neuronal subpopulations in a number of neurological diseases. The adaptor protein p11, and background potassium channel TASK1, have overlapping distributions in the CNS. Here, we report that the transcription factor Sp1 controls p11 expression, which impacts on excitability by hampering functional expression of TASK1. In the SOD1-G93A mouse model of ALS, Sp1-p11-TASK1 dysregulation contributes to increased excitability and vulnerability of motor neurons. Interference with either Sp1 or p11 is neuroprotective, delaying neuron loss and prolonging lifespan in this model. Nitrosative stress, a potential factor in human neurodegeneration, stimulated Sp1 expression and human p11 promoter activity, at least in part, through a Sp1-binding site. Disruption of Sp1 or p11 also has neuroprotective effects in a traumatic model of motor neuron degeneration. Together our work suggests the Sp1-p11-TASK1 pathway is a potential target for treatment of degeneration of motor neurons.


Asunto(s)
Esclerosis Amiotrófica Lateral/patología , Anexina A2/metabolismo , Neuronas Motoras/patología , Degeneración Nerviosa/patología , Proteínas del Tejido Nervioso/genética , Canales de Potasio de Dominio Poro en Tándem/genética , Proteínas S100/metabolismo , Factor de Transcripción Sp1/metabolismo , Esclerosis Amiotrófica Lateral/etiología , Animales , Membrana Celular/patología , Modelos Animales de Enfermedad , Femenino , Regulación de la Expresión Génica , Técnicas de Silenciamiento del Gen , Células HEK293 , Humanos , Masculino , Potenciales de la Membrana , Ratones , Ratones Transgénicos , Neuronas Motoras/citología , Degeneración Nerviosa/etiología , Proteínas del Tejido Nervioso/metabolismo , Canales de Potasio de Dominio Poro en Tándem/metabolismo , Cultivo Primario de Células , Regiones Promotoras Genéticas , Ratas , Factor de Transcripción Sp1/genética , Médula Espinal/citología , Médula Espinal/patología
5.
PLoS Biol ; 13(5): e1002153, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25996636

RESUMEN

Synaptic communication is a dynamic process that is key to the regulation of neuronal excitability and information processing in the brain. To date, however, the molecular signals controlling synaptic dynamics have been poorly understood. Membrane-derived bioactive phospholipids are potential candidates to control short-term tuning of synaptic signaling, a plastic event essential for information processing at both the cellular and neuronal network levels in the brain. Here, we showed that phospholipids affect excitatory and inhibitory neurotransmission by different degrees, loci, and mechanisms of action. Signaling triggered by lysophosphatidic acid (LPA) evoked rapid and reversible depression of excitatory and inhibitory postsynaptic currents. At excitatory synapses, LPA-induced depression depended on LPA1/Gαi/o-protein/phospholipase C/myosin light chain kinase cascade at the presynaptic site. LPA increased myosin light chain phosphorylation, which is known to trigger actomyosin contraction, and reduced the number of synaptic vesicles docked to active zones in excitatory boutons. At inhibitory synapses, postsynaptic LPA signaling led to dephosphorylation, and internalization of the GABAAγ2 subunit through the LPA1/Gα12/13-protein/RhoA/Rho kinase/calcineurin pathway. However, LPA-induced depression of GABAergic transmission was correlated with an endocytosis-independent reduction of GABAA receptors, possibly by GABAAγ2 dephosphorylation and subsequent increased lateral diffusion. Furthermore, endogenous LPA signaling, mainly via LPA1, mediated activity-dependent inhibitory depression in a model of experimental synaptic plasticity. Finally, LPA signaling, most likely restraining the excitatory drive incoming to motoneurons, regulated performance of motor output commands, a basic brain processing task. We propose that lysophospholipids serve as potential local messengers that tune synaptic strength to precedent activity of the neuron.


Asunto(s)
Lisofosfolípidos/metabolismo , Neuronas Motoras/fisiología , Plasticidad Neuronal , Transmisión Sináptica , Animales , Calcineurina/metabolismo , Femenino , Masculino , Ratones , Técnicas de Placa-Clamp , Embarazo , Ratas Wistar , Receptores de GABA-A/metabolismo , Sinapsis/metabolismo , Quinasas Asociadas a rho/metabolismo , Proteína de Unión al GTP rhoA/metabolismo
6.
J Neurosci ; 32(1): 68-84, 2012 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-22219271

RESUMEN

Rho-associated kinase (ROCK) regulates neural cell migration, proliferation and survival, dendritic spine morphology, and axon guidance and regeneration. There is, however, little information about whether ROCK modulates the electrical activity and information processing of neuronal circuits. At neonatal stage, ROCKα is expressed in hypoglossal motoneurons (HMNs) and in their afferent inputs, whereas ROCKß is found in synaptic terminals on HMNs, but not in their somata. Inhibition of endogenous ROCK activity in neonatal rat brainstem slices failed to modulate intrinsic excitability of HMNs, but strongly attenuated the strength of their glutamatergic and GABAergic synaptic inputs. The mechanism acts presynaptically to reduce evoked neurotransmitter release. ROCK inhibition increased myosin light chain (MLC) phosphorylation, which is known to trigger actomyosin contraction, and reduced the number of synaptic vesicles docked to active zones in excitatory boutons. Functional and ultrastructural changes induced by ROCK inhibition were fully prevented/reverted by MLC kinase (MLCK) inhibition. Furthermore, ROCK inhibition drastically reduced the phosphorylated form of p21-associated kinase (PAK), which directly inhibits MLCK. We conclude that endogenous ROCK activity is necessary for the normal performance of motor output commands, because it maintains afferent synaptic strength, by stabilizing the size of the readily releasable pool of synaptic vesicles. The mechanism of action involves a tonic inhibition of MLCK, presumably through PAK phosphorylation. This mechanism might be present in adults since unilateral microinjection of ROCK or MLCK inhibitors into the hypoglossal nucleus reduced or increased, respectively, whole XIIth nerve activity.


Asunto(s)
Nervio Hipogloso/enzimología , Neuronas Motoras/enzimología , Terminales Presinápticos/enzimología , Transmisión Sináptica/fisiología , Vesículas Sinápticas/enzimología , Quinasas Asociadas a rho/fisiología , Animales , Animales Recién Nacidos , Femenino , Nervio Hipogloso/crecimiento & desarrollo , Nervio Hipogloso/ultraestructura , Sistema de Señalización de MAP Quinasas/fisiología , Masculino , Neuronas Motoras/efectos de los fármacos , Neuronas Motoras/ultraestructura , Técnicas de Cultivo de Órganos , Terminales Presinápticos/metabolismo , Terminales Presinápticos/ultraestructura , Ratas , Ratas Wistar , Transmisión Sináptica/efectos de los fármacos , Vesículas Sinápticas/metabolismo , Vesículas Sinápticas/ultraestructura , Quinasas Asociadas a rho/antagonistas & inhibidores
7.
PLoS One ; 6(9): e24915, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21966384

RESUMEN

Synaptic plasticity involves short- and long-term events, although the molecular mechanisms that underlie these processes are not fully understood. The transient A-type K(+) current (I(A)) controls the excitability of the dendrites from CA1 pyramidal neurons by regulating the back-propagation of action potentials and shaping synaptic input. Here, we have studied how decreases in I(A) affect cognitive processes and synaptic plasticity. Using wild-type mice treated with 4-AP, an I(A) inhibitor, and mice lacking the DREAM protein, a transcriptional repressor and modulator of the I(A), we demonstrate that impairment of I(A) decreases the stimulation threshold for learning and the induction of early-LTP. Hippocampal electrical recordings in both models revealed alterations in basal electrical oscillatory properties toward low-theta frequencies. In addition, we demonstrated that the facilitated learning induced by decreased I(A) requires the activation of NMDA receptors containing the NR2B subunit. Together, these findings point to a balance between the I(A) and the activity of NR2B-containing NMDA receptors in the regulation of learning.


Asunto(s)
Región CA1 Hipocampal/metabolismo , Plasticidad Neuronal , Receptores de N-Metil-D-Aspartato/genética , Potenciales de Acción , Animales , Conducta Animal , Electrofisiología/métodos , Memoria , Ratones , Ratones Transgénicos , Modelos Biológicos , Modelos Genéticos , Oscilometría/métodos , Potasio/metabolismo , Estructura Terciaria de Proteína , Receptores de N-Metil-D-Aspartato/metabolismo , Transmisión Sináptica
8.
Mol Neurobiol ; 43(1): 41-66, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21190141

RESUMEN

Synapse elimination is the main factor responsible for the cognitive decline accompanying many of the neuropathological conditions affecting humans. Synaptic stripping of motoneurons is also a common hallmark of several motor pathologies. Therefore, knowledge of the molecular basis underlying this plastic process is of central interest for the development of new therapeutic tools. Recent advances from our group highlight the role of nitric oxide (NO) as a key molecule triggering synapse loss in two models of motor pathologies. De novo expression of the neuronal isoform of NO synthase (nNOS) in motoneurons commonly occurs in response to the physical injury of a motor nerve and in the course of amyotrophic lateral sclerosis. In both conditions, this event precedes synaptic withdrawal from motoneurons. Strikingly, nNOS-synthesized NO is "necessary" and "sufficient" to induce synaptic detachment from motoneurons. The mechanism involves a paracrine/retrograde action of NO on pre-synaptic structures, initiating a downstream signaling cascade that includes sequential activation of (1) soluble guanylyl cyclase, (2) cyclic guanosine monophosphate-dependent protein kinase, and (3) RhoA/Rho kinase (ROCK) signaling. Finally, ROCK activation promotes phosphorylation of regulatory myosin light chain, which leads to myosin activation and actomyosin contraction. This latter event presumably contributes to the contractile force to produce ending axon retraction. Several findings support that this mechanism may operate in the most prevalent neurodegenerative diseases.


Asunto(s)
Neuronas Motoras/patología , Neuronas Motoras/ultraestructura , Enfermedades Neurodegenerativas/patología , Enfermedades Neurodegenerativas/fisiopatología , Óxido Nítrico/metabolismo , Terminales Presinápticos/metabolismo , Esclerosis Amiotrófica Lateral/patología , Esclerosis Amiotrófica Lateral/fisiopatología , Animales , Comunicación Celular , Modelos Animales de Enfermedad , Humanos , Ratones , Ratones Transgénicos , Neuronas Motoras/metabolismo , Óxido Nítrico Sintasa de Tipo I/metabolismo , Enfermedades del Sistema Nervioso Periférico/patología , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Superóxido Dismutasa/genética , Superóxido Dismutasa/metabolismo
9.
J Neurosci ; 30(3): 973-84, 2010 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-20089906

RESUMEN

The molecular signaling that underpins synapse loss in neuropathological conditions remains unknown. Concomitant upregulation of the neuronal nitric oxide (NO) synthase (nNOS) in neurodegenerative processes places NO at the center of attention. We found that de novo nNOS expression was sufficient to induce synapse loss from motoneurons at adult and neonatal stages. In brainstem slices obtained from neonatal animals, this effect required prolonged activation of the soluble guanylyl cyclase (sGC)/protein kinase G (PKG) pathway and RhoA/Rho kinase (ROCK) signaling. Synapse elimination involved paracrine/retrograde action of NO. Furthermore, before bouton detachment, NO increased synapse myosin light chain phosphorylation (p-MLC), which is known to trigger actomyosin contraction and neurite retraction. NO-induced MLC phosphorylation was dependent on cGMP/PKG-ROCK signaling. In adulthood, motor nerve injury induced NO/cGMP-dependent synaptic stripping, strongly affecting ROCK-expressing synapses, and increased the percentage of p-MLC-expressing inputs before synapse destabilization. We propose that this molecular cascade could trigger synapse loss underlying early cognitive/motor deficits in several neuropathological states.


Asunto(s)
Proteínas Quinasas Dependientes de GMP Cíclico/metabolismo , Neuronas Motoras/patología , Cadenas Ligeras de Miosina/metabolismo , Óxido Nítrico Sintasa de Tipo I/metabolismo , Sinapsis/patología , Quinasas Asociadas a rho/metabolismo , Análisis de Varianza , Animales , Animales Recién Nacidos , Tronco Encefálico/citología , Proteínas Quinasas Dependientes de GMP Cíclico/antagonistas & inhibidores , Proteínas de Unión al ADN/genética , Inhibidores Enzimáticos/farmacología , Proteínas Fluorescentes Verdes/genética , Humanos , Enfermedades del Nervio Hipogloso/patología , Técnicas In Vitro , Masculino , Microscopía Inmunoelectrónica/métodos , Neuronas Motoras/efectos de los fármacos , Neuronas Motoras/ultraestructura , Óxido Nítrico/farmacología , Óxido Nítrico Sintasa de Tipo I/genética , Óxido Nítrico Sintasa de Tipo I/farmacología , Proteínas Nucleares/genética , Técnicas de Placa-Clamp , Fosforilación/efectos de los fármacos , Fosforilación/fisiología , Terminales Presinápticos/efectos de los fármacos , Terminales Presinápticos/metabolismo , Terminales Presinápticos/ultraestructura , Ratas , Ratas Wistar , Sinapsis/efectos de los fármacos , Sinapsis/ultraestructura , Potenciales Sinápticos/efectos de los fármacos , Potenciales Sinápticos/genética , Sinaptofisina/metabolismo , Transfección , Proteína 2 de Transporte Vesicular de Glutamato/metabolismo , Proteínas del Transporte Vesicular de Aminoácidos Inhibidores/metabolismo , Quinasas Asociadas a rho/antagonistas & inhibidores
10.
Eur J Neurosci ; 28(1): 107-16, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18616563

RESUMEN

Motoneurons integrate interneuronal activity into commands for skeletal muscle contraction and relaxation to perform motor actions. Hypoglossal motoneurons (HMNs) are involved in essential motor functions such as breathing, mastication, swallowing and phonation. We have investigated the role of the gaseous molecule nitric oxide (NO) in the regulation of the inspiratory-related activity of HMNs in order to further understand how neural activity is transformed into motor activity. In adult rats, we observed nitrergic fibers and bouton-like structures in close proximity to motoneurons, which normally lack the molecular machinery to synthesize NO. In addition, immunohistochemistry studies demonstrated that perfusion of animals with a NO donor resulted in an increase in the levels of cyclic guanosine monophosphate (cGMP) in motoneurons, which express the soluble guanylyl cyclase (sGC) in the hypoglossal nucleus. Modulators of the NO/cGMP pathway were micro-iontophoretically applied while performing single-unit extracellular recordings in the adult decerebrated rat. Application of a NO synthase inhibitor or a sGC inhibitor induced a statistically significant reduction in the inspiratory-related activity of HMNs. However, excitatory effects were observed by ejection of a NO donor or a cell-permeable analogue of cGMP. In slice preparations, application to the bath of a NO donor evoked membrane depolarization and a decrease in rheobase, which were prevented by co-addition to the bath of a sGC inhibitor. These effects were not prevented by reduction of the spontaneous synaptic activity. We conclude that NO from afferent fibers anterogradely modulates the inspiratory-related activity of HMNs by a cGMP-dependent mechanism in physiological conditions.


Asunto(s)
Guanosina Monofosfato/metabolismo , Nervio Hipogloso/citología , Inhalación/fisiología , Neuronas Motoras/metabolismo , Óxido Nítrico/metabolismo , Transducción de Señal/fisiología , Animales , Membrana Celular/metabolismo , GMP Cíclico/análogos & derivados , GMP Cíclico/metabolismo , Inhibidores Enzimáticos/metabolismo , Iontoforesis , Masculino , Neuronas Motoras/citología , Técnicas de Placa-Clamp , Ratas , Ratas Wistar
11.
J Neurosci ; 27(23): 6302-12, 2007 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-17554004

RESUMEN

Glutamate-induced excitotoxicity, the most common pathological mechanism leading to neuronal death, may occur even with normal levels of glutamate if it coincides with a persistent enhancement of neuronal excitability. Neurons expressing nitric oxide (NO) synthase (NOS-I), which is upregulated in many human chronic neurodegenerative diseases, are highly susceptible to neurodegeneration. We hypothesized that chronic production of NO in damaged neurons may increase their intrinsic excitability via modulation of resting or "leak" K+ currents. Peripheral XIIth nerve injury in adult rats induced de novo NOS-I expression and an increased incidence of low-threshold motor units, the latter being prevented by chronic inhibition of the neuronal NO/cGMP pathway. Accordingly, sustained synthesis of NO maintained an enhanced basal activity in injured motoneurons that was slowly reverted (over the course of 2-3 h) by NOS-I inhibitors. In slice preparations, persistent, but not acute, activation of the NO/cGMP pathway evoked a robust augment in motoneuron excitability independent of synaptic activity. Furthermore, chronic activation of the NO/cGMP pathway fully suppressed TWIK-related acid-sensitive K+ (TASK) currents through a protein kinase G (PKG)-dependent mechanism. Finally, we found evidence for the involvement of this long-term mechanism in regulating membrane excitability of motoneurons, because their pH-sensitive currents were drastically reduced by nerve injury. This NO/cGMP/PKG-mediated modulation of TASK conductances might represent a new pathological mechanism that leads to hyperexcitability and sensitizes neurons to excitotoxic damage. It could explain why de novo expression of NOS-I and/or its overexpression makes them susceptible to neurodegeneration under pathological conditions.


Asunto(s)
Proteínas Quinasas Dependientes de GMP Cíclico/metabolismo , GMP Cíclico/metabolismo , Potenciación a Largo Plazo/fisiología , Neuronas/metabolismo , Óxido Nítrico/metabolismo , Canales de Potasio/metabolismo , Animales , Inhibidores Enzimáticos/farmacología , Nervio Hipogloso/efectos de los fármacos , Nervio Hipogloso/enzimología , Nervio Hipogloso/patología , Potenciación a Largo Plazo/efectos de los fármacos , Masculino , Neuronas/efectos de los fármacos , Neuronas/enzimología , Óxido Nítrico Sintasa/antagonistas & inhibidores , Óxido Nítrico Sintasa/metabolismo , Ratas , Ratas Wistar , Transducción de Señal/efectos de los fármacos , Transducción de Señal/fisiología
12.
Rev Neurosci ; 17(3): 309-57, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16878402

RESUMEN

The adult brain retains the capacity to rewire mature neural circuits in response to environmental changes, brain damage or sensory and motor experiences. Two plastic processes, synaptic remodeling and neurogenesis, have been the subject of numerous studies due to their involvement in the maturation of the nervous system, their prevalence and re-activation in adulthood, and therapeutic relevance. However, most of the research looking for the mechanistic and molecular events underlying synaptogenic phenomena has been focused on the extensive synaptic reorganization occurring in the developing brain. In this stage, a vast number of synapses are initially established, which subsequently undergo a process of activity-dependent refinement guided by target-derived signals that act as synaptotoxins or synaptotrophins, promoting either loss or consolidation of pre-existing synaptic contacts, respectively. Nitric oxide (NO), an autocrine and/or paracrine-acting gaseous molecule synthesized in an activity-dependent manner, has ambivalent actions. It can act by mediating synapse formation, segregation of afferent inputs, or growth cone collapse and retraction in immature neural systems. Nevertheless, little information exists about the role of this ambiguous molecule in synaptic plasticity processes occurring in the adult brain. Suitable conditions for elucidating the role of NO in adult synaptic rearrangement include physiopathological conditions, such as peripheral nerve injury. We have recently developed a crush lesion model of the XIIth nerve that induces a pronounced stripping of excitatory synaptic boutons from the cell bodies of hypoglossal motoneurons. The decline in synaptic coverage was concomitant with de novo expression of the neuronal isoform of NO synthase in motoneurons. We have demonstrated a synaptotoxic action of NO mediating synaptic withdrawal and preventing synapse formation by cyclic GMP (cGMP)-dependent and, probably, S-nitrosylation-mediated mechanisms, respectively. This action possibly involves the participation of other signaling molecules working together with NO. Brain-derived neurotrophic factor (BDNF), a target-derived synaptotrophin synthesized and released postsynaptically in an activity-dependent form, is a potential candidate for effecting such a concerted action. Several items of evidence support an interrelationship between NO and BDNF in the regulation of synaptic remodeling processes in adulthood: i) BDNF and its receptor TrkB are expressed by motoneurons and upregulated by axonal injury; ii) they promote axon arborization and synaptic formation, and modulate the structural dynamics of excitatory synapses; iii) NO and BDNF each control the production and activity of the other at the level of individual synapses; iv) the NO/cGMP pathway inhibits BDNF secretion; and finally, v) BDNF protects F-actin from depolymerization by NO, thus preventing the collapsing and retracting effects of NO on growth cones. Therefore, we propose a mechanism of action in which the NO/BDNF ratio regulates synapse dynamics after peripheral nerve lesion. This hypothesis also raises the possibility that variations in this NO/BDNF balance constitute a common hallmark leading to synapse loss in the progression of diverse neurodegenerative diseases such as amyotrophic lateral sclerosis, Alzheimer's and Parkinson's diseases.


Asunto(s)
Encéfalo/enzimología , Encéfalo/fisiopatología , Óxido Nítrico/metabolismo , Dinámicas no Lineales , Sinapsis/fisiología , Animales , Humanos , Proteínas del Tejido Nervioso/metabolismo , Enfermedades Neurodegenerativas/enzimología , Enfermedades Neurodegenerativas/fisiopatología
13.
Brain ; 128(Pt 9): 2175-88, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15987757

RESUMEN

The question whether general tetanus arises from the independent sum of multiple local tetani or results from the actions of the transynaptic tetanus neurotoxin (TeNT) in higher brain centres remains unresolved. Despite the blood-borne dissemination of TeNT from an infected wound, the access to the central nervous system is probably prevented by the blood-brain barrier. However, several long-term sequelae (e.g. autonomic dysfunction, seizures, myoclonus, and sleep disturbances) present after the subsidence of muscle spasms might be indicative of central actions that occur farther away from lower motoneurons. Subsequently, the obvious entry route is the peripheral neurons followed by the transynaptic passage to the brain. We aimed at describing the pathophysiological correlates of TeNT translocation using the oculomotor system as a comprehensive model of cell connectivity and neuronal firing properties. In this study, we report that injection of TeNT into the medial rectus muscle of one eye resulted in bilateral gaze palsy attributed to firing alterations found in the contralaterally projecting abducens internuclear neurons. Functional alterations in the abducens-to-oculomotor internuclear pathway resembled in part the classically described TeNT disinhibition. We confirmed the transynaptic targeted action of TeNT by analysing vesicle-associated membrane protein2 (VAMP2) immunoreactivity (the SNARE protein cleaved by TeNT). VAMP2 immunoreactivity decreased by 94.4% in the oculomotor nucleus (the first synaptic relay) and by 62.1% presynaptic to abducens neurons (the second synaptic relay). These results are the first demonstration of physiological changes in chains of connected neurons that are best explained by the transynaptic action of TeNT on premotor neurons as shown with VAMP2 immunoreactivity which serves as an indicator of TeNT activity.


Asunto(s)
Metaloendopeptidasas/toxicidad , Oftalmoplejía/inducido químicamente , Toxina Tetánica/toxicidad , Nervio Abducens/efectos de los fármacos , Nervio Abducens/metabolismo , Nervio Abducens/fisiopatología , Animales , Biomarcadores/metabolismo , Gatos , Movimientos Oculares/efectos de los fármacos , Femenino , Proteínas de la Membrana/metabolismo , Metaloendopeptidasas/farmacocinética , Neuronas Motoras/efectos de los fármacos , Neuronas Motoras/fisiología , Conducción Nerviosa/efectos de los fármacos , Inhibición Neural/efectos de los fármacos , Vías Nerviosas/fisiopatología , Músculos Oculomotores/efectos de los fármacos , Músculos Oculomotores/metabolismo , Músculos Oculomotores/fisiopatología , Nervio Oculomotor/efectos de los fármacos , Nervio Oculomotor/metabolismo , Nervio Oculomotor/fisiopatología , Oftalmoplejía/metabolismo , Oftalmoplejía/fisiopatología , Proteínas R-SNARE , Toxina Tetánica/farmacocinética
14.
Proc Natl Acad Sci U S A ; 102(20): 7344-9, 2005 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-15883359

RESUMEN

Mammalian spinal motoneurons are considered to be output elements of the spinal cord that generate exclusively cholinergic actions on Renshaw cells, their intraspinal synaptic targets. Here, we show that antidromic stimulation of motor axons evokes depolarizing monosynaptic potentials in Renshaw cells that are depressed, but not abolished, by cholinergic antagonists. This residual potential was abolished by 2-amino-5-phosphonovaleric acid and 6-cyano-7-nitroquinoxaline-2,3-dione. In the presence of cholinergic antagonists, motor axon stimulation triggered locomotor-like activity that was blocked by 2-amino-5-phosphonovaleric acid. Some cholinergic motoneuronal terminals on both Renshaw cells and motoneurons were enriched in glutamate, but none expressed vesicular glutamate transporters. Our results raise the possibility that motoneurons release an excitatory amino acid in addition to acetylcholine and that they may be more directly involved in the genesis of mammalian locomotion than previously believed.


Asunto(s)
Antagonistas Colinérgicos/farmacología , Potenciales Evocados Motores/efectos de los fármacos , Neuronas Motoras/fisiología , Médula Espinal/fisiología , 2-Amino-5-fosfonovalerato/farmacología , 6-Ciano 7-nitroquinoxalina 2,3-diona/farmacología , Acetilcolina , Animales , Animales Recién Nacidos , Ácido Glutámico/metabolismo , Inmunohistoquímica , Locomoción/efectos de los fármacos , Ratones , Microscopía Confocal , Técnicas de Placa-Clamp , Terminales Presinápticos/metabolismo
15.
J Neurosci ; 25(6): 1448-58, 2005 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-15703399

RESUMEN

In adult mammals, learning, memory, and restoration of sensorimotor lost functions imply synaptic reorganization that requires diffusible messengers-mediated communication between presynaptic and postsynaptic structures. A candidate molecule to accomplish this function is the gaseous intercellular messenger nitric oxide (NO), which is involved in synaptogenesis and projection refinement during development; however, the role of NO in synaptic reorganization processes in adulthood remains to be established. In this work, we tested the hypothesis that this free radical is a mediator in the adult mammal CNS synaptic remodeling processes using a model of hypoglossal axonal injury recently developed by us. Axonal injury-induced disconnection of motoneurons from myocytes produces withdrawal of synaptic inputs to motoneurons and concomitant upregulation of the neuronal isoform of NO synthase (NOS-I). After recovery of the neuromuscular function, synaptic coverage is reestablished and NOS-I is downregulated. We also report, by using functional and morphological approaches, that chronic inhibition of the NO/cGMP pathway prevents synaptic withdrawal evoked by axon injury, despite the persistent muscle disconnection. After successful withdrawal of synaptic boutons, inhibition of NO synthesis, but not of cGMP, accelerated the recovery of synaptic coverage, although neuromuscular disconnection was maintained. Furthermore, protein S-nitrosylation was upregulated after nerve injury, and this effect was reversed by NOS-I inhibition. Our results suggest that during synaptic remodeling in the adult CNS, NO acts as a signal for synaptic detachment and inhibits synapse formation by cGMP-dependent and probably S-nitrosylation-mediated mechanisms, respectively. We also suggest a feasible role of NO in neurological disorders coursing with NOS-I upregulation.


Asunto(s)
GMP Cíclico/fisiología , Nervio Hipogloso/fisiología , Neuronas Motoras/fisiología , Regeneración Nerviosa/fisiología , Proteínas del Tejido Nervioso/fisiología , Plasticidad Neuronal/fisiología , Óxido Nítrico Sintasa/fisiología , Óxido Nítrico/fisiología , Sinapsis/fisiología , Animales , Inducción Enzimática , Nervio Hipogloso/enzimología , Traumatismos del Nervio Hipogloso , Masculino , Neuronas Motoras/enzimología , Neuronas Motoras/ultraestructura , NG-Nitroarginina Metil Éster/farmacología , Compresión Nerviosa , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Proteínas del Tejido Nervioso/biosíntesis , Proteínas del Tejido Nervioso/genética , Óxido Nítrico/biosíntesis , Óxido Nítrico Sintasa/antagonistas & inhibidores , Óxido Nítrico Sintasa/biosíntesis , Óxido Nítrico Sintasa/genética , Óxido Nítrico Sintasa de Tipo II , Ratas , Ratas Wistar , Transducción de Señal , Sinapsis/enzimología
16.
J Neurosci ; 25(8): 2010-23, 2005 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-15728841

RESUMEN

Renshaw cells (RCs) receive excitatory inputs from motoneurons to which then they inhibit. The gain of this spinal recurrent inhibitory circuit is modulated by inhibitory synapses on RCs. Inhibitory synapses on RCs mature postnatally, developing unusually large postsynaptic gephyrin clusters that colocalize glycine and GABA(A) receptors. We hypothesized that these features potentiate inhibitory currents in RCs. Thus, we analyzed glycinergic and GABAergic "inhibitory" miniature postsynaptic currents (mPSCs) in neonatal [postnatal day 1 (P1) to P5] and mature (P9-P15) RCs and compared them to other ventral interneurons (non-RCs). Recorded neurons were Neurobiotin filled and identified as RCs or non-RCs using post hoc immunohistochemical criteria. Glycinergic, GABAergic, and mixed glycine/GABA mPSCs matured differently in RCs and non-RCs. In RCs, glycinergic and GABA(A) mPSC peak amplitudes increased 230 and 45%, respectively, from P1-P5 to P9-P15, whereas in non-RCs, glycinergic peak amplitudes changed little and GABA(A) amplitudes decreased. GABA(A) mPSCs were slower in RCs (P1-P5, tau = 58 ms; P9-P15, tau = 43 ms) compared with non-RCs (P1-P5, tau = 27 ms; P9-P15, tau = 14 ms). Thus, fast glycinergic currents dominated "mixed" mPSC peak amplitudes in mature RCs, and GABA(A) currents dominated their long decays. In non-RCs, GABAergic and mixed events had shorter durations, and their frequencies decreased with development. Functional maturation of inhibitory synapses on RCs correlates well with increased glycine receptor recruitment to large gephyrin patches, colocalization with alpha3/alpha5-containing GABA(A) receptors, and maintenance of GABA/glycine corelease. As a result, charge transfer in GABA, glycine, or mixed mPSCs was larger in mature RCs than in non-RCs, suggesting RCs receive potent inhibitory synapses.


Asunto(s)
Interneuronas/fisiología , Receptores de GABA-A/fisiología , Receptores de Glicina/fisiología , Médula Espinal/citología , Transmisión Sináptica/fisiología , 6-Ciano 7-nitroquinoxalina 2,3-diona/farmacología , Animales , Células del Asta Anterior/fisiología , Bicuculina/farmacología , Biomarcadores , Calbindinas , Procesamiento de Imagen Asistido por Computador , Proteínas de Transporte de Membrana/análisis , Microscopía Confocal , Ratas , Proteína G de Unión al Calcio S100/análisis , Médula Espinal/crecimiento & desarrollo , Estricnina/farmacología , Tetrodotoxina/farmacología , Tubocurarina/farmacología , Proteínas de Transporte Vesicular de Acetilcolina
17.
J Neurosci ; 25(2): 417-29, 2005 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-15647485

RESUMEN

Renshaw cells receive a high density of inhibitory synapses characterized by large postsynaptic gephyrin clusters and mixed glycinergic/GABAergic inhibitory currents with large peak amplitudes and long decays. These properties appear adapted to increase inhibitory efficacy over Renshaw cells and mature postnatally by mechanisms that are unknown. We tested the hypothesis that heterosynaptic influences from excitatory motor axon inputs modulate the development of inhibitory synapses on Renshaw cells. Thus, tetanus (TeNT) and botulinum neurotoxin A (BoNT-A) were injected intramuscularly at postnatal day 5 (P5) to, respectively, elevate or reduce motor axon firing activity for approximately 2 weeks. After TeNT injections, the average gephyrin cluster areas on Renshaw cells increased by 18.4% at P15 and 28.4% at P20 and decreased after BoNT-A injections by 17.7% at P15 and 19.9% at P20. The average size differences resulted from changes in the proportions of small and large gephyrin clusters. Whole-cell recordings in P9-P15 Renshaw cells after P5 TeNT injections showed increases in the peak amplitude of glycinergic miniature postsynaptic currents (mPSCs) and the fast component of mixed (glycinergic/GABAergic) mPSCs compared with controls (60.9% and 78.9%, respectively). GABAergic mPSCs increased in peak amplitude to a smaller extent (45.8%). However, because of the comparatively longer decays of synaptic GABAergic currents, total current transfer changes after TeNT were similar for synaptic glycine and GABA(A) receptors (56 vs 48.9% increases, respectively). We concluded that motor axon excitatory synaptic activity modulates the development of inhibitory synapse properties on Renshaw cells, influencing recruitment of postsynaptic gephyrin and glycine receptors and, to lesser extent, GABA(A) receptors.


Asunto(s)
Proteínas Portadoras/química , Interneuronas/fisiología , Proteínas de la Membrana/química , Neuronas Motoras/fisiología , Proteínas del Tejido Nervioso/química , Inhibición Neural/fisiología , Sinapsis/fisiología , Animales , Animales Recién Nacidos , Axones/efectos de los fármacos , Axones/fisiología , Toxinas Botulínicas Tipo A/farmacología , Proteínas Portadoras/efectos de los fármacos , Electrofisiología , Femenino , Glicina/fisiología , Interneuronas/química , Masculino , Proteínas de la Membrana/efectos de los fármacos , Neuronas Motoras/efectos de los fármacos , Complejos Multiproteicos/efectos de los fármacos , Proteínas del Tejido Nervioso/efectos de los fármacos , Inhibición Neural/efectos de los fármacos , Vías Nerviosas/fisiología , Unión Neuromuscular/efectos de los fármacos , Unión Neuromuscular/fisiología , Ratas , Ratas Wistar , Médula Espinal/citología , Sinapsis/efectos de los fármacos , Toxina Tetánica/farmacología , Ácido gamma-Aminobutírico/fisiología
18.
J Physiol ; 557(Pt 3): 991-1011, 2004 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-15090609

RESUMEN

The effects of peripheral nerve lesions on the membrane and synaptic properties of motoneurones have been extensively studied. However, minimal information exists about how these alterations finally influence discharge activity and motor output under physiological afferent drive. The aim of this work was to evaluate the effect of hypoglossal (XIIth) nerve crushing on hypoglossal motoneurone (HMN) discharge in response to the basal inspiratory afferent drive and its chemosensory modulation by CO(2). The evolution of the lesion was assessed by recording the compound muscle action potential evoked by XIIth nerve stimulation, which was lost on crushing and then recovered gradually to control values from the second to fourth weeks post-lesion. Basal inspiratory activities recorded 7 days post-injury in the nerve proximal to the lesion site, and in the nucleus, were reduced by 51.6% and 35.8%, respectively. Single unit antidromic latencies were lengthened by lesion, and unusually high stimulation intensities were frequently required to elicit antidromic spikes. Likewise, inspiratory modulation of unitary discharge under conditions in which chemoreceptor drive was varied by altering end-tidal CO(2) was reduced by more than 60%. Although the general recruitment scheme was preserved after XIIth nerve lesion, we noticed an increased proportion of low-threshold units and a reduced recruitment gain across the physiological range. Immunohistochemical staining of synaptophysin in the hypoglossal nuclei revealed significant reductions of this synaptic marker after nerve injury. Morphological and functional alterations recovered with muscle re-innervation. Thus, we report here that nerve lesion induced changes in the basal activity and discharge modulation of HMNs, concurrent with the loss of afferent inputs. Nevertheless, we suggest that an increase in membrane excitability, reported by others, and in the proportion of low-threshold units, could serve to preserve minimal electrical activity, prevent degeneration and favour axonal regeneration.


Asunto(s)
Células Quimiorreceptoras/fisiología , Traumatismos del Nervio Hipogloso , Neuronas Motoras/fisiología , Mecánica Respiratoria/fisiología , Potenciales de Acción/efectos de los fármacos , Animales , Axotomía , Dióxido de Carbono/farmacología , Diferenciación Celular , Electromiografía , Nervio Hipogloso/citología , Inmunohistoquímica , Masculino , Compresión Nerviosa , Unión Neuromuscular/fisiología , Ratas , Ratas Wistar , Sinaptofisina/fisiología
19.
J Comp Neurol ; 471(2): 201-18, 2004 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-14986313

RESUMEN

A low or a high dose of tetanus neurotoxin (TeNT) injected in the lateral rectus muscle of the cat causes respectively, functional block of inhibitory synapses only or of both inhibitory and excitatory synapses simultaneously in abducens neurons (González-Forero et al. [2003] J. Neurophysiol. 89:1878-1890). As a consequence, neuronal firing activity increases (at low dose) or decreases (at high dose). We investigated possible structural modifications of inhibitory synapses in response to these activity alterations induced by TeNT. We used immunofluorescence against postsynaptic (gephyrin) and presynaptic (vesicular gamma-aminobutyric acid [GABA] transporter [VGAT]) markers of inhibitory synapses in combination with cell type markers for abducens motoneurons (calcitonin gene-related peptide or choline acetyltransferase) or internuclear neurons (calretinin). Seven days after high-dose treatment, the number of gephyrin-immunoreactive (IR) clusters per 100 microm of membrane perimeter was reduced on the soma of abducens motoneurons by 55.3% and by 60.1% on internuclear neurons. Proximal dendritic gephyrin-IR clusters were also significantly altered but to a lesser degree. Partial synaptic re-establishment was observed 15 days post injection, and complete recovery occurred after 42 days. Coverage by VGAT-IR terminals was reduced in parallel. In contrast, a low dose of TeNT caused no structural alterations. With electron microscopy we estimated that overall synaptic coverage was reduced by 40% in both types of neurons after a high dose of TeNT. However, F-type terminals with postsynaptic gephyrin were preferentially lost. Thus, the ratio between F and S terminals diminished from 1.28 to 0.39 on motoneurons and from 1.26 to 0.47 on internuclear neurons. These results suggest that the maintenance of proximal inhibitory synaptic organization on central neurons is best related to neuronal activity and not to the level of inhibitory synaptic function, which was equally blocked by the high or low dose of TeNT.


Asunto(s)
Nervio Abducens/efectos de los fármacos , Metaloendopeptidasas/farmacología , Sinapsis/efectos de los fármacos , Transmisión Sináptica/efectos de los fármacos , Toxina Tetánica/farmacología , Nervio Abducens/fisiología , Nervio Abducens/ultraestructura , Animales , Gatos , Sinapsis/fisiología , Sinapsis/ultraestructura , Transmisión Sináptica/fisiología
20.
J Neurophysiol ; 90(4): 2240-52, 2003 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-12801900

RESUMEN

Abducens neurons undergo a dose-dependent synaptic blockade (either disinhibition or complete blockade) when tetanus neurotoxin (TeNT) is injected into the lateral rectus muscle at either a low (0.5) or a high dose (5 ng/kg). We studied the firing pattern and recruitment order in abducens neurons both in control and after TeNT injection. The eye position threshold for recruitment of control abducens neurons was exponentially related to the eye position and velocity sensitivities. We also found a constancy of recruitment threshold for different eye movement modalities (spontaneous, optokinetic, and vestibular). Exponential relationships were found, as well, for eye velocity sensitivity during saccades and for position and velocity sensitivities during the vestibulo-ocular reflex. Likewise, inverse relationships were found between recruitment threshold or position sensitivity with the antidromic latency in control abducens neurons. These relationships, however, did not apply following TeNT treatment. Neuronal firing after TeNT appeared either disinhibited (low dose) or depressed (high dose), but the relationships between neuronal sensitivities and recruitment still applied. However, the pattern of recruitment shifted toward the treated side as more inputs were blocked by the low- and high-dose treatments, respectively. Nonetheless, although the recruitment-to-sensitivity relationships persisted under the TeNT synaptic blockade, we conclude that synaptic inputs are determinant for establishing the recruitment threshold and recruitment spacing of abducens motoneurons and internuclear neurons.


Asunto(s)
Nervio Abducens/fisiología , Potenciales de Acción/fisiología , Movimientos Oculares/fisiología , Neuronas Motoras/fisiología , Nervio Abducens/efectos de los fármacos , Potenciales de Acción/efectos de los fármacos , Animales , Gatos , Relación Dosis-Respuesta a Droga , Movimientos Oculares/efectos de los fármacos , Femenino , Metaloendopeptidasas/farmacología , Neuronas Motoras/efectos de los fármacos , Neuronas/efectos de los fármacos , Neuronas/fisiología , Toxina Tetánica/farmacología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA