PACAP-PAC1 Receptor Activation Is Necessary for the Sympathetic Response to Acute Intermittent Hypoxia.

Repetitive hypoxia is a key feature of obstructive sleep apnoea (OSA), a condition characterized by intermittent airways obstruction. Patients with OSA present with persistent increases in sympathetic activity and commonly develop hypertension. The objectives of this study were to determine if the persistent increases in sympathetic nerve activity, known to be induced by acute intermittent hypoxia (AIH), are mediated through activation of the pituitary adenylate cyclase activating polypeptide (PACAP) signaling system. Here, we show that the excitatory neuropeptide PACAP, acting in the spinal cord, is important for generating the sympathetic response seen following AIH. Using PACAP receptor knockout mice, and pharmacological agents in Sprague Dawley rats, we measured blood pressure, heart rate, pH, PaCO2, and splanchnic sympathetic nerve activity, under anaesthesia, to demonstrate that the sympathetic response to AIH is mediated via the PAC1 receptor, in a cAMP-dependent manner. We also report that both intermittent microinjection of glutamate into the rostroventrolateral medulla (RVLM) and intermittent infusion of a sub-threshold dose of PACAP into the subarachnoid space can mimic the sympathetic response to AIH. All the sympathetic responses are independent of blood pressure, pH or PaCO2 changes. Our results show that in AIH, PACAP signaling in the spinal cord helps drive persistent increases in sympathetic nerve activity. This mechanism may be a precursor to the development of hypertension in conditions of chronic intermittent hypoxia, such as OSA.

Surgical preparation of mice for recording cardiorespiratory parameters in vivo.

BACKGROUND: The explosion in the use of genetically modified mouse strains to investigate function in biology has an enormous potential to expand on pharmacological studies traditionally conducted in rats. A key limitation to date is the inability to record from multiple nerves in an anaesthetised mouse for long periods. NEW METHOD: Here we describe an in vivo preparation that maintains mice in a suitable physiological state, under anaesthesia, for at least 6 hr and also enables multiple cardiorespiratory recordings over that time. RESULTS: Using the method described, blood pressure, heart rate, phrenic nerve activity, splanchnic nerve activity and heart rate were able to be recorded for hours in an anaesthetised, paralysed and mechanically ventilated mouse. COMPARISON WITH EXISTING METHOD: Existing anaesthetised mouse preparations are limited by difficulties in maintaining mice under anaesthesia for long periods. This time constraint therefore limits the surgical time and number of cardiorespiratory variables recorded. It also limits the type of stimuli that can be administered and the length of recorded responses. The method described here optimises these variables to overcome these challenges. CONCLUSIONS: In summary, we report an approach that enables physiological and pharmacological studies previously undertaken in larger animals or 'reduced' preparations, to be conducted in vivo in mice. We anticipate that the use of this preparation will enable a deeper understanding of genetic variation, and allow a much greater level of phenotypic characterisation in genetically modified mice.

The essential role of peripheral respiratory chemoreceptor inputs in maintaining breathing revealed when CO2 stimulation of central chemoreceptors is diminished.

Central sleep apnoea is a condition characterized by oscillations between apnoea and hyperpnoea during sleep. Studies in sleeping dogs suggest that withdrawal of peripheral chemoreceptor (carotid body) activation following transient ventilatory overshoots plays an essential role in causing apnoea, raising the possibility that sustaining carotid body activity during ventilatory overshoots may prevent apnoea. To test whether sustained peripheral chemoreceptor activation is sufficient to drive breathing, even in the absence of central chemoreceptor stimulation and vagal feedback, we used a vagotomized, decerebrate dual-perfused in situ rat preparation in which the central and peripheral chemoreceptors are independently and artificially perfused with gas-equilibrated medium. At varying levels of carotid body stimulation (CB PO2/PCO2: 40/60, 100/40, 200/15, 500/15 Torr), we decreased the brainstem perfusate PCO2 in 5 Torr steps while recording phrenic nerve activity to determine the central apnoeic thresholds. The central apnoeic thresholds decreased with increased carotid body stimulation. When the carotid bodies were strongly stimulated (CB 40/60), the apnoeic threshold was 3.6 ± 1.4 Torr PCO2 (mean ± SEM, n = 7). Stimulating carotid body afferent activity with either hypercapnia (60 Torr PCO2) or the neuropeptide pituitary adenylate cyclase-activating peptide restored phrenic activity during central apnoea. We conclude that peripheral stimulation shifts the central apnoeic threshold to very hypocapnic levels that would likely increase the CO2 reserve and have a protective effect on breathing. These data demonstrate that peripheral respiratory chemoreceptors are sufficient to stave off central apnoeas when the brainstem is perfused with low to no CO2.

Pro-inflammatory cytokines do not affect basal or hypoxia-stimulated discharge of rat vagal paraganglia.

Vagal paraganglia are structurally similar to the carotid body and are chemosensitive to reduction in the P(O(2)). We hypothesized that they may also mediate communication between the immune system and the central nervous system via pro-inflammatory cytokines or endotoxin. In vitro experiments with isolated superior laryngeal nerve (SLN) paraganglia were performed to test this hypothesis. We exposed the cells to increasing concentrations of interleukin-1ß, tumour necrosis factor-α or interleukin-6 (0.1, 0.3 and 1 ng ml(-1)) or bacterial lipopolysaccharide (LPS, 10 and 100 ng ml(-1)) during both normoxia ( P(O(2)) ≈ 100 mmHg) and hypoxia (P(O(2)) < 40 mmHg) whilst single-fibre recordings were made from the main SLN trunk using a glass suction electrode. The results of these experiments confirmed previous findings that these cells respond strongly to changes in P(O(2)), significantly increasing their discharge rate in response to hypoxia (from 0.71 ± 0.23 to 10.95 ± 1.74 Hz, P < 0.0001). However, neither the cytokines nor LPS had any significant effect on the baseline discharge rate of the SLN units at any concentration. When compared with time-matched controls, the cytokines and LPS also had no effect on the peak hypoxic discharge rate of the SLN (P = 0.59 and 0.65, respectively). In conclusion, neither the basal nor the hypoxic discharge rate of the SLN paraganglia is modulated by the inflammatory mediators tested above, suggesting that these structures are not the afferent limb of an 'immune reflex'.

The effect of pro-inflammatory cytokines on the discharge rate of vagal nerve paraganglia in the rat.

Vagal paraganglia resemble the carotid body and are chemosensitive to reduction in the partial pressure of oxygen (P O2) (O'Leary et al., 2004). We hypothesised that they may also mediate communication between the immune system and the central nervous system and more specifically respond to the pro-inflammatory cytokines: interleukin-1 beta (IL-1 beta) and tumour necrosis factor-alpha (TNF-alpha). We recorded axonal firing rate of isolated superfused rat glomus cells - located at the bifurcation of the superior laryngeal nerve - to IL-1 beta or TNF-alpha at concentrations of 0.5 ng/ml, 5 ng/ml and 50 ng/ml. Twenty-three successful single fibre recordings were obtained from 10 animals. IL-1 beta and TNF-alpha had no statistically significant effect on the frequency of action potentials observed (p=0.39 and 0.42, respectively, repeated measures ANOVA). The activity of both cytokines was tested by observing translocation of P65-NF kappaB from cytoplasm to nucleus in cultured HELA cells. In conclusion, an immune role for SLN paraganglia has not been established.