Abstract

BackgroundVolatile anesthetics increase levels of the neurotransmitter nitric oxide (NO) and the secondary messenger molecule cyclic guanosine monophosphate (cGMP) in the brain. NO activates the enzyme guanylyl cyclase (GC) to produce cGMP. We hypothesized that the NO-GC-cGMP pathway contributes to anesthesia-induced unconsciousness.MethodsSevoflurane-induced loss and return of righting reflex (LORR and RORR, respectively) were studied in wild-type mice (WT) and in mice congenitally deficient in the GC-1α subunit (GC-1−/− mice). Spatial distributions of GC-1α and the GC-2α subunit in the brain were visualized by in situ hybridization. Brain cGMP levels were measured in WT and GC-1−/− mice after inhaling oxygen with or without 1.2% sevoflurane for 20 min.ResultsHigher concentrations of sevoflurane were required to induce LORR in GC-1−/− mice than in WT mice (1.5 ± 0.1 vs. 1.1 ± 0.2%, respectively, n = 14 and 14, P < 0.0001). Similarly, RORR occurred at higher concentrations of sevoflurane in GC-1−/− mice than in WT mice (1.0 ± 0.1 vs. 0.8 ± 0.1%, respectively, n = 14 and 14, P < 0.0001). Abundant GC-1α and GC-2α mRNA expression was detected in the cerebral cortex, medial habenula, hippocampus, and cerebellum. Inhaling 1.2% sevoflurane for 20 min increased cGMP levels in the brains of WT mice from 2.6 ± 2.0 to 5.5 ± 3.7 pmol/mg protein (n = 13 and 10, respectively, P = 0.0355) but not in GC-1−/− mice.ConclusionCongenital deficiency of GC-1α abolished the ability of sevoflurane anesthesia to increase cGMP levels in the whole brain, and increased the concentration of sevoflurane required to induce LORR. Impaired NO-cGMP signaling raises the threshold for producing sevoflurane-induced unconsciousness in mice.

Highlights

  • Volatile anesthetics increase levels of the neurotransmitter nitric oxide (NO) and the secondary messenger molecule cyclic guanosine monophosphate in the brain

  • The sevoflurane concentration required for loss of righting reflex (LORR) is higher in guanylyl cyclase (GC)-1−/− mice of both genders compared to wild-type mice (WT) mice LORR and return of the righting reflex (RORR) are well-established endpoints to determine anesthetic-induced unconsciousness and recovery of consciousness in mice [22]

  • LORR occurred at higher mean sevoflurane concentrations in GC-1−/− mice than in WT mice (1.5%, 95% CI: 1.4 to 1.6%, vs. 1.1%, 95% CI: 1.0 to 1.2%, respectively, n = 14 and 14, P < 0.0001)

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Summary

Introduction

Volatile anesthetics increase levels of the neurotransmitter nitric oxide (NO) and the secondary messenger molecule cyclic guanosine monophosphate (cGMP) in the brain. NO activates the enzyme guanylyl cyclase (GC) to produce cGMP. Nitric oxide (NO) is a neurotransmitter in the central nervous system that modulates signaling pathways relevant to general anesthesia, including those involving GABA [4], NMDA [5], and acetylcholine [6]. NO is enzymatically generated by NO synthase (NOS) and can signal through a multitude of downstream targets, including guanylyl cyclase (GC). Upon activation by NO, GC, a cytosolic heme protein consisting of an α1 or α2 subunit combined with a common β1 subunit, produces the second messenger cyclic guanosine monophosphate. In the central nervous system, GC behaves like a neurotransmitter receptor characterized by rapid activation and slow desensitization [9]. Downstream targets of cGMP include cGMP-dependent protein kinases (PKG), phosphodiesterases, and cGMP-gated ion channels

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