REVERSAL OF PERIPHERAL AND CNS MEDIATED A1 ADENOSINE RECEPTOR HYPOTENSION

Abstract

IntroductionA1 adenosine receptor (A1AR) agonists such as N6‐cyclohexyladenosine (CHA) are known for their neuroprotective and anti‐convulsant properties and for modulation of thermogenesis. We have demonstrated a neuroprotective, thermolytic effect following systemic administration of CHA combined with the peripherally acting adenosine receptor antagonist, 8‐(p‐sulfophenyl)theophylline (8‐SPT). However, A1AR‐mediated cardiovascular side effects limit the translation of this drug class, and clear understanding of the effects of this drug combination on hypotension and bradycardia are lacking. CHA delivered into the CNS increases para‐sympathetic influence on the heart to produce bradycardia similar to what is seen during onset of hibernation. Systemic administration of A1AR agonist produces bradycardia via direct negative chronotropic and inotropic effects. Evidence also supports other mechanisms of A1AR agonist modulation of blood pressure including indirect activation of peripheral β2 adrenergic receptors and central H1 receptors.HypothesisWe test the hypothesis that CHA lowers blood pressure via increased para‐sympathetic tone to the heart and direct effects on the heart.MethodsRats were implanted with telemetry transmitters to monitor Tb, heart rate (HR), mean arterial pressure (MAP) and administered drugs IP as follows, CHA (1.0mg/kg), 8‐SPT (25.0mg/kg), Atropine (1.0mg/kg), diphenhydramine (4.0mg/kg), or pro‐pranolol (4.0mg/kg), 15min prior to CHA. Cage surface temperature was initially cooled to 4°C and adjusted to maintain Tb at 32°C.Results8‐SPT with atropine reversed hypotension. 8‐SPT alone increased rate of resolution in MAP to baseline value. Pre‐treatment with propranolol, atropine, or diphenhydramine alone did not influence MAP. Diphenhydramine with 8‐SPT reduced the magnitude of hypotension (− 24% average one hour baseline change after CHA) compared to pre‐treatment with 8‐SPT (− 36%) alone.ConclusionsOur results suggest that A1AR induced hypotension is mediated through increased parasympathetic tone to the heart in addition to direct effect on the heart. Histamine receptor activation may also play a role, although the resolution of MAP seen may have been due to the anticholinergic effect of diphenhydramine instead of H1 receptor antagonism. Reversing hypotension necessitates addressing both mechanism with atropine and 8‐SPTSupport or Funding InformationNIH U54GM115371, NIH R15 NS070779, NIH: RL5GM118900, TL4 GM 18992, 1UL1GN118991This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.