Abstract

Panic disorder (PD) is ~2 times more frequent in women. An excessive ventilatory response to CO2 inhalation is more likely during the premenstrual phase. While ovarian hormones appear important in the pathophysiology of PD, their role remains poorly understood as female animals are rarely used in pre-clinical studies. Using neonatal maternal separation (NMS) to induce a “PD-like” respiratory phenotype, we tested the hypothesis that NMS disrupts hormonal regulation of the ventilatory response to CO2 in female rats. We then determined whether NMS attenuates the inhibitory actions of 17-β estradiol (E2) on orexin neurons (ORX). Pups were exposed to NMS (3 h/day; postnatal day 3–12). The ventilatory response to CO2-inhalation was tested before puberty, across the estrus cycle, and following ovariectomy. Plasma E2 and hypothalamic ORXA were measured. The effect of an ORX1 antagonist (SB334867; 15 mg/kg) on the CO2 response was tested. Excitatory postsynaptic currents (EPSCs) were recorded from ORX neurons using whole-cell patch-clamp. NMS-related increase in the CO2 response was observed only when ovaries were functional; the largest ventilation was observed during proestrus. SB334867 blocked this effect. NMS augmented levels of ORXA in hypothalamus extracts. EPSC frequency varied according to basal plasma E2 levels across the estrus cycle in controls but not NMS. NMS reproduces developmental and cyclic changes of respiratory manifestations of PD. NMS disrupts the inhibitory actions of E2 on the respiratory network. Impaired E2-related inhibition of ORX neurons during proestrus is a novel mechanism in respiratory manifestations of PD in females.

Highlights

  • Many panic disorder (PD) patients experience respiratory symptoms, including hyperventilation, sleep apnea, chest pain, and dyspnea[1,2,3]

  • CO2 inhalation induced a rapid and robust hyperpnoea, which was greater in neonatal maternal separation (NMS) females than controls (Fig. 1A, B)

  • Elucidating how ovarian function affects respiratory manifestations of PD is of utmost importance to our understanding of the pathophysiology of this disorder

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Summary

Methods

Experiments were performed on sexually mature female Sprague–Dawley rats and pre-pubertal rat pups (14–15 days old) of both sexes. Rats were weaned and raised under standard animal care conditions until experiments were performed. The effects of higher E2 supplementation was tested in Another group of OVX females by injecting with 25 μg. Four weeks-old females were injected with an AAV construct that expresses a green fluorescent protein (GFP) under the control of an ORX promoter. Statistics Multifactorial analysis of variance (ANOVA) assessed the effects of NMS and estrous cycle on respiratory variables, 17β-estradiol (E2), immunohistochemical, and electrophysiological data. Since patch-clamp data often originate from multiple cells from the same animal, a mixed ANOVA model (mixed-effect model) was used to ensure that between-group differences were not attributable to a specific subject[41]. A significant ANOVA results (P ≤ 0.05) was followed by a post hoc test (Fisher’s least significant difference) to identify specific differences; a Bonferroni correction was applied when multiple comparisons were performed. Analyses were performed using Statview 5.0 (SAS Institute, Cary, NC, USA) and JASP (version 0.13; University of the Netherlands)

Results
Discussion
Limitations and conclusion
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