Central Regulation Of Arterial Pressure Research Articles

The compensatory renin-angiotensin system in the central regulation of arterial pressure: new avenues and new challenges.

Hypertension is a widespread condition that affects millions of people around the world and has a major impact in public health. The classic renin-angiotensin system is a complex system comprised of multiple peptides and pathways that have been the driver of drug development over the years to control hypertension. However, there are still patients whose hypertension is very difficult to control with current drugs and strategies, thus motivating further research in this field. In the past two decades, important discoveries have expanded our knowledge of this system and new pathways are emerging that are helping us understand the complex interaction taking place not only in the periphery, but also in the central nervous system where the renin-angiotensin system is also very active. A new arm, called the ACE2/Ang-(1-7)/Mas receptor axis, was shown to exert antihypertensive properties and serve as a counterbalance to the classic ACE/angiotensin II/AT1 receptor axis, in this way modulating or even counteracting the negative effects of angiotensin II in blood pressure regulation and water retention. Modulation of this new axis through ACE2 activation, ADAM17 regulation or AT1 receptor internalization are some of the novel avenues and challenges that have the potential to become a target for new drug research and development for the treatment of hypertension.

Regional expression of NO synthase, NAD(P)H oxidase and superoxide dismutase in the rat brain

Nitric oxide (NO) derived from the endothelial NO synthase (eNOS) contributes to regulation of cerebral circulation, whereas that produced by neuronal NOS (nNOS) participates in the regulation of brain function. In particular, NO plays an important role in modulation of sympathetic activity and hence central regulation of arterial pressure. Superoxide derived from NAD(P)H oxidase avidly reacts with and inactivates NO and, thereby, modulates its bioavailability. Calmodulin (CM) is required for activation of NOS and soluble guanylate cyclase (sGC) serves as a NO receptor. Superoxide is dismutated to H2O2 by superoxide dismutase (SOD) and H2O2 is converted to H2O by catalase or glutathione peroxidase (GPX). Given the importance of NO in the regulation of brain perfusion and function, we undertook the present study to determine the relative expressions of immunodetectable nNOS, eNOS, CM, sGC, NAD(P)H oxidase and SOD by Western analysis in different regions of the normal rat brain. nNOS was abundantly expressed in the pons cerebellum and hypothalamus and less so in the cortex and medulla. sGC abundance was highest in the hypothalamus and pons, and lowest in the cerebellum and medulla. eNOS and calmodulin were equally abundant in all regions. NAD(P)H oxide was most abundant in the pons compared to other regions. Cytoplasmic SOD was equally distributed among different regions but catalase and GPX were more abundant in pons, hypothalamus and medulla and less so in the cortex and cerebellum. Thus, the study documented regional distributions of NOS, NAD(P)H oxidase, antioxidant enzymes, sGC and calmodulin which collectively regulate production and biological activities of NO and superoxide, the two important small molecular size signaling molecules.

Sympatho-Inhibitory Action of Endogenous Adrenomedullin Through Inhibition of Oxidative Stress in the Brain

Central sympathetic activation is one of the possible mechanisms underlying hypertension, in which reactive oxygen species may play a role. Thus, we examined whether adrenomedullin, an antioxidant peptide, is involved in the central regulation of arterial pressure through sympatho-modulatory action. Adrenomedullin knockout mice were fed with high-salt diet for 4 weeks to stimulate adrenomedullin production. In the wild-type littermates, brain adrenomedullin content was significantly increased with salt loading, but not in the knockout mice. Intracerebroventricular hyperosmotic saline increased arterial pressure and sympathetic nerve activity in a dose-dependent fashion. With the normal salt diet, the hyperosmotic saline-induced response did not significantly differ between the knockout and wild-type mice; with the high-salt diet, however, the response was significantly greater in the knockout mice than in wild-type littermates (arterial pressure: 35.3+/-5.7% versus 20.1+/-2.1%, P<0.05; sympathetic nerve activity: 30.3+/-4.8% versus 15.9+/-1.5%, P<0.05; respectively). Moreover, pretreatment with 4-hydroxy-2,2,6,6-tetramethylpiperidine-N-oxyl (tempol), a membrane-permeable superoxide dismutase mimetic, inhibited the augmented response to central hyperosmotic saline in salt-loaded knockout mice. Consistently, the hyperosmotic saline-induced production of reactive oxygen species, measured by the lucigenin chemiluminescence method, was significantly greater in the isolated hypothalamus of salt-loaded knockout mice than in that of salt-loaded wild-type ones. In conclusion, endogenous adrenomedullin in the brain may inhibit sympathetic activation through its antioxidant action.

Role of endogenous carbon monoxide in central regulation of arterial pressure.

We investigated the contribution of neural mechanisms to the arterial pressure increase produced by zinc deuteroporphyrin 2,4-bis glycol (ZnDPBG), an inhibitor of endogenous carbon monoxide synthesis. The arterial baroreceptor reflex control of heart rate was examined in rats with and without ZnDPBG pretreatment (45 micromol/kg IP) by analysis of the arterial pressure-heart rate relationship during infusions of phenylephrine or sodium nitroprusside to vary arterial pressure. ZnDPBG increased arterial pressure from 110 +/- 3 to 126 +/- 2 mm Hg without eliciting bradycardia. The maximum gain of the heart rate response to changes in arterial pressure was attenuated by ZnDPBG treatment (-1.9 +/- 0.3 versus -4.8 +/- 1.0 bpm/mm Hg). The possibility that ZnDPBG elevates arterial pressure by attenuating baroreceptor reflex function was addressed by comparing the pressor response to ZnDPBG (45 micromol/kg IP) in rats with and without sinoaortic denervation. The pressor effect of ZnDPBG was similar in rats with and without arterial baroreceptor deafferentation, implying that the increase in pressure is not simply the consequence of attenuated baroreceptor reflex function per se. The possibility that ZnDPBG increases arterial pressure via an effect on the nucleus tractus solitarii (NTS) also was investigated. ZnDPBG (1 nmol in 100 nL) injected into the NTS of rats increased arterial pressure from 111 +/- 4 to 126 +/- 5 mm Hg, and this effect was reversed by an ipsilateral microinjection of carbon monoxide into the NTS. Accordingly, the pressor effect of ZnDPBG may rely on inhibition of carbon monoxide production in the NTS. This implies that carbon monoxide formed by brain heme oxygenase plays a role in the central regulation of arterial pressure.

Neuropeptide Y-like substances are released from the rostral brainstem of cats during the muscle pressor response.

1. In this study, the release of immunoreactive neuropeptide Y (NPY)-like substances (irNPYs) was measured from the rostral brainstem in response to fatiguing isometric contractions of the hindlimb muscle of cats anaesthetized with alpha-chloralose. 2. The irNPYs were measured using a solid phase autoradiographic immunoassay. NPY antibody-coated glass microelectrodes were inserted stereotaxically into the rostral brainstem during rest and contractions. Control procedures such as passive leg flexing, stimulation of the central end of the cut tibial nerve, brief repeated carotid occlusions and carotid sinus nerve stimulations were performed to determine whether patterns of release of irNPYs were specific to the pathways activated during the muscle pressor response. 3. During isometric contractions, the mean arterial blood pressure (MABP) and heart rate (HR) increased by 60-70 mmHg and 15-20 beats min-1, respectively. Only the brief carotid occlusions caused a similar increase in MABP and HR. 4. During isometric contractions, less irNPYs were released from sites in the lateral reticular nucleus, lateral tegmental field and vestibular nuclei at a level in the brainstem 4.0-4.4 mm rostral to the obex. In contrast, irNPYs were released from sites near the lateral tegmental field and nucleus ambiguus at a more caudal level tested (1.3 mm anterior to the obex) in response to contractions. Brief carotid occlusions caused a release of irNPYs from the lateral reticular nucleus on the contralateral side of the brainstem (at 3.5 mm anterior to the obex). None of the other procedures resulted in a release of irNPYs from these sites in the brainstem. 5. These data indicate there are differences in the patterns of release of irNPYs in response to activation of reflex pathways which increase arterial pressure. Given the sites in the rostral brainstem where irNPYs were released, irNPYs may be involved with the central regulation of arterial pressure during the muscle pressor response.

Physiological Significance of Na+/K+-ATPase Activity in the Central Nervous System and Endogenous Sodium-Pump Inhibitors in the Neural Regulation of Arterial Blood Pressure

In anesthetized Sprague-Dawley rats, cerebrolateral ventricular administration of potassium chloride solutions (KCl, 0.375-1.25 mumol, i.c.v.) produced concentration-dependent reductions in the arterial blood pressure and heart rate. These responses were significantly attenuated by prior i.c.v.-administration ouabain, a selective inhibitor of the Na+ pump, and by endothelin (ET-1), an endogenous peptide that is present in the CNS, suggesting that this peptide may participate in the neural regulation of arterial pressure via modulation of Na(+)-pump activity. Although both acute fluid volume expansion and/or osmotic stimulus have been shown to facilitate the release of the endogenous Na(+)-pump inhibitor(s) into the circulation, only volume expansion significantly attenuated the cardiovascular effects of i.c.v. potassium chloride. These observations collectively suggest that the Na+, K(+)-ATPase activity in CNS and Na(+)-pump inhibitors may play a significant role in the central regulation of arterial pressure under certain physiological conditions.

Central role for vasopressin in cardiovascular regulation and the pathogenesis of hypertension.

In recent years the role of neuropeptides in the central regulation of arterial pressure and the pathogenesis of hypertension has been the subject of considerable attention. Of all the neuropeptides, vasopressin (AVP) has been one of the most widely studied. The availability of sophisticated immunocytochemical and biochemical methods has permitted localization of AVP in areas of the brain known to be involved in cardiovascular regulation

Intracerebroventricular injections of endothelin increase arterial pressure in conscious rats.

We investigated the possible effects of endothelin (ET) on the central regulation of arterial pressure by injecting ET intracerebroventricularly (ICV) into conscious rats. ICV injections of ET caused dose-dependent elevation of arterial pressure and increase of heart rate. The first reaction was abolished by bunazosin, an alpha 1-adrenergic blocker, injected intravenously. However, the increase in arterial pressure and heart rate caused the rats, injected with ET ICV, to roll to the left on their long axis for 20-30 min, followed by prolonged sedation. Furthermore, the pressor responses and tachycardia were significantly attenuated by the ICV pretreatment with nicardipine, a calcium channel blocker, and nicorandil, a nitrate derivative, respectively. These results suggest that ET may elevate the intracellular Ca2+ concentration ([Ca2+]i) of sympathetic nerve activity regulatory neurons of the brain, leading to an accelerated outflow of sympathetic nerve activity and cause the elevation of arterial pressure.

In vivo voltammetry in the B3 group of serotonin neurons of the rat medulla oblongata after drug-induced modifications of arterial pressure

Differential normal pulse voltammetry (DNPV) using an electrochemically treated carbon fiber electrode was applied to the investigation of the in vivo changes in extracellular 5-hydroxyindoleacetic acid (5HIAA) in the B3 group of serotonin neurons during experimental manipulations of arterial pressure. Drug-induced hypertension (phenylephrine infusion) caused, during the infusion, an increase in extracellular 5HIAA concentration which continued to rise, reaching +100% 2 hours after stopping the infusion. In contrast, drug-induced hypotension (sodium nitroprusside infusion) was not associated with any change in extracellular 5HIAA during the infusion while the return to the initial arterial pressure caused a progressive increase in the electrochemical signal, reaching +50% one hour after stopping the infusion. These data show that the extracellular 5HIAA concentration is increased when the arterial pressure increases, a result which suggests that B3 serotonin neurons could have a vasodepressor role in the central regulation of arterial pressure.

Role of GABAergic mechanisms in the central regulation of arterial pressure.

Gamma aminobutyric acid (GABA) may represent the single most prevalent neurotransmitter in the mammalian central nervous system. Consequently, it should come as little surprise that the neural circuitry concerned with regulating systemic arterial pressure through the autonomic nervous system utilizes a number of GABAergic inhibitory mechanisms which are anatomically and functionally distinct. This article will, first, summarize findings from our laboratory and other which suggest some of these roles in the mammalian brainstem, and, second, trace a line of research pointing to a particular GABAergic inhibitory mechanism in the forebrain that may have some relevance to experimental and human hypertension.

Importance of new catecholamine pathways in control of blood pressure.

The first comprehensive maps of central catecholamine pathways referred to both noradrenaline and dopamine neurons. They described the catecholamine neurons as having their cell bodies in the brainstem with spinal axons descending mainly from two medullary cell groups (A1 and A2) and with ascending axons arising mainly from more rostral groups (A3-A13). More recent work utilising immunohistochemistry has established the presence of adrenaline neurons in the brain, in two medullary cell groups (C1 and C2). While these were originally thought to lie within the rostral part of the A1 and A2 cell groups, work from this laboratory has now established that the adrenaline neurons are topographically distinct from the A1 and A2 cells, do not fluoresce with standard methods, and are collected into three groups, the third group (C3) lying in the midline of the rostral medulla. Work in this laboratory using a combination of histochemical fluorescence and retrograde transport of horseradish peroxidase has demonstrated that existence of a descending dopaminergic projection from the hypothalamus to the spinal cord, indicating that descending pathways can arise well above the medulla. Recent studies on the A1 neurons have established the presence of projections from the A1 cells to the median eminence of the hypothalamus and towards the nucleus tractus solitarius in the medulla. Other experiments have demonstrated that most of the descending catecholamine axons do not arise from the A1 and A2 cell groups in the caudal medulla, but higher up in the brainstem especially from the A5 and A7 cell groups. These new descriptions of central catecholamine neurons will necessarily modify the interpretation of many experiments on the central regulation of arterial pressure.