Ganglionic Blocker Research Articles

Review on: Experimental Screening Methods for Antihypertensive Agents.

The main goals of preclinical studies are to determine a starting, safe dose for first-in-human study and assess potential toxicity of the product, which typically include new medical devices, prescription drugs, and diagnostics. Preclinical studies refer to the testing of a drug, procedure or other medical treatment in animals before trials may be carried out in humans. They are done to determine efficacy and safety of the drug. Preclinical studies are performed in vitro, in vivo, ex vivo, and in silico` models to obtain basic information about the safety and biological efficacy of a drug candidate before testing it in a final target population, i.e. humans. In a recent days, hypertension becomes very common disease condition. Sometimes this hypertension gives rise other disease conditions and that might be very serious. Anti hypertensive agents are used, to evaluate the action, adverse effects, efficacy and parameters the experimental screening is done. Different types of in vivo studies are there to check Anti hypertensive agent for eg. to check blood pressure in pithed rats, anti hypertensive vasodilator activity in ganglion blocking, angiotensin supported rats, tail cuff method etc

Chronic cannabidiol treatment induces cardiovascular improvement in renovascular hypertensive rats.

Cannabidiol (CBD) is increasingly studied for its therapeutic potential in neurodegenerative diseases. Previous research on acute CBD administration has demonstrated cardiovascular benefits in hypertensive rats, including reduced mean blood pressure and oxidative stress. To investigate the long-term cardiovascular effects of chronic CBD treatment in renovascular hypertension induced by the 2-kidney-1-clip (2K1C) model. Male Wistar rats (180-200 g, 8 weeks old) underwent 2K1C or SHAM surgery. Six weeks later, rats received chronic CBD treatment (20 mg/kg, twice daily for 14 days). A combination of ex vivo, in vitro, and in vivo methods was used to assess CBD's cardiovascular effects in 2K1C hypertensive rats. Chronic CBD treatment significantly reduced blood pressure and the depressor response to hexamethonium (a ganglionic blocker). It also normalized variability in low-frequency (LF) power and LF/high-frequency (HF) ratio. CBD enhanced vasodilation and reduced vasoconstriction in the mesenteric artery of 2K1C rats, accompanied by decreased expression of aortic reactive oxygen species (ROS). Our findings suggest that chronic CBD treatment exerts antihypertensive effects by improving baroreflex sensitivity and vascular function while decreasing arterial ROS levels and sympathetic nerve activity. These results underscore CBD's potential therapeutic role in managing cardiovascular complications associated with renovascular hypertension.

Abstract 66: Early-Life Sodium Restriction Programs Salt-Sensitivity of Autonomics and Blood Pressure in Adult C57BL/6J Mice

Extremely premature birth is a risk factor for sodium (Na) depletion due to renal immaturity and urine Na losses. We have proposed that Na depletion in preterm infants mechanistically contributes to their increased risk for cardiovascular and metabolic disease observed in adulthood, potentially due to changes during hypothalamic development. In humans, the hypothalamus matures between 20-25 weeks of gestation; in mice, this developmental window occurs between postnatal day (PD) 21 and PD42. Previously, we demonstrated in mice that dietary Na restriction from PD21 to PD42 induced long-lasting increases in energy expenditure via exaggerated autonomic activity. Therefore, we hypothesized that restricting dietary Na from PD21 to PD42 would similarly induce programmed changes in cardiovascular control via changes in autonomic and neurohypophyseal functions. Male C57BL/6J mice were provided a customized low (0.04%, n=7) or supplemented (0.30%, n=8) Na version of the soy protein-free Teklad 2920x diet from PD21 to PD42, after which they were returned to the standard (0.15% Na) 2920x diet. Radiotelemetric blood pressure (BP) transducers were implanted at 7-8 weeks of age. At 10 weeks of age, no differences in BP or heart rate (HR) were noted between groups. All animals were switched to a high (1%) Na diet at 12 weeks of age. At 16 weeks of age, systolic BP was not altered in the 0.30% Na group but significantly increased in the 0.04% Na group compared to the week 10 baseline (24h avg: +6±2 mmHg, p<0.05). Ganglionic block with chlorisondamine or β-adrenergic block with propranolol reduced heart rate (HR) to a greater extent (each p<0.05) in the 0.04% group. Conversely, muscarinic block with atropine resulted in a smaller increase in HR in this group (p<0.05). Urine elimination rates of aldosterone (0.30%: 1.96±0.44 vs 0.04%: 2.92±0.064 ng/d) and copeptin (0.30%: 0.16±0.03 vs. 0.04%: 0.14±0.02 ng/d) were similar between groups. Finally, at 18 weeks of age, all mice received the angiotensin AT 1 R antagonist losartan in drinking water. This caused a greater BP reduction in the 0.04% group at 20 weeks (24h avg: -12±2 vs -19±2 mmHg, p<0.05). Together, these data indicate that dietary Na restriction during hypothalamic development programs increased salt sensitivity of BP via a mechanism involving AT 1 R and characterized by increased sympathetic yet decreased parasympathetic activity.

Complete autonomic blockade reveals nitric oxide contribution to blood pressure regulation in obese Black women

PurposeHypertension is one of the major causes of cardiovascular morbidity and mortality in the USA and disproportionately affects Black women. Endothelial-derived nitric oxide (eNO) substantially regulates blood pressure in humans, and impaired NO-mediated vasodilation has been reported in the Black population. Previous studies using an NO synthase inhibitor, NG-monomethyl-L-arginine (L-NMMA) did not fully determine the NO contribution to blood pressure because of baroreflex buffering. Therefore, in the present study we used trimethaphan, a ganglionic blocker, to inhibit baroreflex buffering and study NO modulation of blood pressure in Black women during L-NMMA infusion.MethodsL-NMMA at doses of 250 μg/kg per minute was infused in combination with trimethaphan at doses of 4 mg/min to eliminate baroreflex mechanisms. Heart rate (HR) was obtained with continuous electrocardiogram monitoring, and continuous blood pressure was measured with the volume clamp method. The increase in systolic blood pressure (SBP) during both infusions was used to estimate the contribution of NO to blood pressure.ResultsTen Black (age range 30–50 years, body mass index [BMI] 30–45 kg/m2), and nine White women (age range 30–50 years, body mass index 30–45 kg/m2) were enrolled in this study. During autonomic blockade, there was no difference in the decrease in SBP between Black and White women (− 20 ± 16.45 vs. − 24 ± 15.49 mm Hg, respectively; P = 0.659). When autonomic blockade was combined with L-NMMA, Black women had a significant increase in SBP compared to White women (54 ± 13.62 vs. 39 ± 09.64 mm Hg, respectively; P = 0.022, respectively).ConclusionAutonomic blood pressure regulation was similar between Black and White women. However, NO contribution to blood pressure was significantly greater in Black women compared to White women.RegistrationClinicalTrials.gov: NCT01122407.

Morphology of Perforated Cervicothoracic Ganglion in Indian Cadavers

Abstract Background: Cervicothoracic ganglion (CTG) has surgical significance for the diagnosis and treatment of chronic regional pain syndromes, herpes zoster, refractory angina, vascular occlusive disorders, etc. Rarely, CTG could be perforated by the vertebral artery (VA), which might lead to complications during the ganglionic block. The present study describes the morphology of perforated CTG in Indian cadavers. Methodology: The present study included 25 formalin-embalmed cadavers (male – 18, female – 7) that were utilized for undergraduate teaching in the department of anatomy from 2017 to 2021. Out of 25 cadavers, two specimens on the right side were excluded from the study due to adhesion and damage to the ganglion. A total of 48 specimens (right – 23; left – 25) were included in the study and analyzed for the perforated CTG. Results: CTG was observed in 87.5% of the specimens and the inferior cervical ganglion in 12.5%. Perforated CTG was observed in four specimens (9.52%) exclusively on the left where the VA pierced at its superior pole or middle. The perforated CTG was found exclusively on the left, and in all four specimens, the VA was a branch from the subclavian artery. Conclusion: An analysis of the morphology of perforated CTG in Indian cadavers revealed its significant occurrence in the present study. It is crucial to consider the risk of injuring the VA during a CTG block. Understanding this variation could aid anesthetists, neurosurgeons, and surgeons in preventing complications during the therapeutic and diagnostic ganglionic blocks.

Reduced Cardiac Beta 1 Receptor Expression and Function in a Mouse Model of Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disorder. HCMis characterized by cardiac hypertrophy, fibrosis, and an increased risk of fatalarrhythmias and sudden cardiac death. Previous studies in humans with HCM havedemonstrated increased cardiac norepinephrine spillover and reduced beta-1 receptor(B1R) expression in the left ventricle (LV). We have previously demonstrated thatcardiac sympathetic tone is elevated in an alpha-tropomyosin mutant mouse model ofHCM. We hypothesized that HCM mice would demonstrate reduced B1R expression inthe LV and attenuated heart rate (HR) and dP/dt max responses to ramped infusion of theB1R agonist, dobutamine. First, we utilized western blot to measure B1R proteinexpression in LV tissue from HCM and littermate wild-type (WT) mice (n=4 male micein each group). B1R expression was significantly reduced in the LV of HCM micecompared to WT littermate controls (HCM 60±1% vs. WT 100±4%; paired t-test, p<0.05). Next, we recorded left ventricular pressure in male and female HCM andlittermate WT control (n=5 male mice, each group; n=6 female mice, each group) miceanesthetized with isoflurane (2% in O2). Data were analyzed by 2-way ANOVA withgenotype and sex as factors. Baseline HR and dP/dt max were significantly lower inHCM compared to WT mice (genotype p<0.05), however, there were no sex differencesin either variable (sex p>0.05). Next, in order to assess cardiac B1R function, we firstinfused the ganglionic blocker chlorisondamine (6ug/g) to eliminate autonomic reflexfunction in HCM and littermate WT mice (n=4 mice, each group). Then, we performed adobutamine stress test via ramped infusion of dobutamine starting at 2ng/g/min andincreasing the dose in 2ng/g/min increments every 2 minutes up to 12ng/g/min via aprogrammable syringe pump. Data were analyzed by 2-way ANOVA with dose andgenotype as factors. Contrary to our hypothesis, ramped infusion of dobutamine resultedin a similar, significant (dose p<0.05) increase in HR in both HCM and WT mice(genotype p>0.05). Peak increases in HR occurred during the highest dose ofdobutamine (12ng/g/min; ΔHR HCM 58±19 vs. WT 70±20 beats/min) in both groups.Consistent with our hypothesis, increases in dP/dt max were significantly blunted inHCM mice compared to littermate WT controls (dose x genotype p<0.05). Peakincreases in dP/dt max occurred at a lower dose of dobutamine for HCM (4ng/g/min;ΔdP/dt max 1129±767 mmHg/s) compared to WT (8ng/g/min; ΔdP/dt max 4882±499mmHg/s). In summary, LV B1R expression is reduced in HCM mice. Increases in HR inresponse to ramped infusion of dobutamine were similar between HCM and WT micewhereas increases in dP/dt max were attenuated in HCM mice. We speculate that thedifferential inotropic and chronotropic responses to dobutamine could be due to regionaldifferences in B1R expression or contractile dysfunction in HCM mice. Michigan Technological University Startup. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Blockade of sympathetic ganglia improves vascular dysfunction in septic shock.

Sepsis/septic shock activates the sympathetic nervous system (SNS) to deal with the infection stress. However, an imbalanced or maladaptive response due to excessive or uncontrolled activation characterizes autonomic dysfunction. Our hypothesis was that reducing this excessive activation of the autonomic nervous system would impact positively in sepsis. Using ganglionic blockers as a pharmacological approach, the main aim of the present report was to assess the role of ganglionic transmission in the vascular dysfunction associated with sepsis.Sepsis was induced in rats by cecal ligation and puncture (CLP). One hour after CLP surgery, rats were treated subcutaneously with hexamethonium (15 mg/kg; ganglionic blocker), pentolinium (5 mg/kg; a blocker with a higher selectivity for sympathetic ganglia compared to hexamethonium), or vehicle (PBS). Basal blood pressure and the response to adrenergic agonists were evaluated at 6 and 24 h after CLP surgery. Reactivity to vasoconstrictors, nitric oxide (NO) synthase 2 (NOS-2) expression, IL-1 and TNF plasma levels, and density of α1 adrenergic receptors were evaluated in the aorta 24 h after CLP.Septic shock resulted in hypotension and hyporesponsiveness to norepinephrine and phenylephrine, increased plasma cytokine levels and NOS-2 expression in the aorta, and decreased α1 receptor density in the same vessel. Pentolinium but not hexamethonium recovered responsiveness and α1 adrenergic receptor density in the aorta. Both blockers normalized the in vivo response to vasoconstrictors, and reduced plasma IL-1 and NOx levels and NOS-2 expression in the aorta.Blockade of ganglionic sympathetic transmission reduced the vascular dysfunction in experimental sepsis. This beneficial effect seems to be, at least in part, due to the preservation of α1 adrenergic receptor density and to reduced NOS-2 expression and may lead to adjuvant ways to treat human sepsis.

Concurrent exercise training potentiates the effects of angiotensin-converting enzyme inhibitor on regulatory systems of blood pressure control in ovariectomized hypertensive rats.

Enalapril has shown satisfactory potential in controlling increased and sustained blood pressure (BP). However, multiple dysregulated mechanisms that interact with each other and are involved in the pathophysiology of arterial hypertension may not be affected, contributing to the remaining cardiovascular risk. Using an exercise training protocol, we investigated whether adding both approaches to arterial hypertension management could promote higher modulation of regulatory mechanisms of BP in postmenopausal rats. Spontaneously hypertensive rats were allocated into sedentary (S) and ovariectomized groups: sedentary (OS), sedentary treated with enalapril maleate (OSE) and trained treated with enalapril maleate (OTE). Both the pharmacological and exercise training protocols lasted for 8 weeks. The BP was directly recorded. Inflammation and oxidative stress were evaluated in the cardiac tissue. Although BP reduction was similar between OSE and OTE, trained group showed lower vasopressor systems outflow after sympathetic ganglion blocking by hexamethonium (mean BP) (OTE: -53.7 ± 9.86 vs. OS: -75.7 ± 19.2 mmHg). Bradycardic and tachycardic response were increased in OTE group (-1.4 ± 0.4 and -2.6 ± 0.4 vs. OS: -0.6 ± 0.3 and -1.3 ± 0.4 bpm/mmHg, respectively), as well as BP variability. In addition, the combination of approaches induced an increase in interleukin 10, antioxidant defense (catalase and glutathione peroxidase) and nitrite levels compared with the OS group. Despite similar BP, the inclusion of exercise training in antihypertensive drug treatment exacerbates the positive adaptations induced by enalapril alone on autonomic, inflammatory and oxidative stress profiles, probably affecting end-organ damage and remaining risk.

5-hydroxytryptamine-evoked contractile activity of large gut in neonatal albino rats

Objectives: Serotonin, also known as 5-hydroxytryptamine (5-HT), is a monoamine neurotransmitter. It is abundantly present in the gut of mammals. The extent to which it contributes to the contraction of the neonatal gut requires further investigation. This study aimed to assess the effect of 5-HT on the contractions of the large intestine in newborn albino rats. Materials and Methods: The colon and rectum samples were collected from neonatal and adult albino rats for analysis. Further, in an organ bath, isometric contractions of these isolated gut segments were recorded, in vitro, using a force transducer and a computerised chart recorder, with and without 5-HT in different groups. The 5-HT-induced contractions were also recorded in gut segments pre-treated with various antagonists. Results: 5-HT (0.01–10 μM) caused a significantly (P < 0.05) greater contractile response (g/g wet tissue) in neonate rats as compared to adults. The response was greater in the rectum as compared to the colon in both neonates and adults. In neonate rats, ondansetron, a 5-HT3 antagonist, could not block the 5-HT-induced large gut contractions, while, in adult rats, it significantly blocked the 5-HT-evoked gut contractility. Methysergide, a 5-HT1/2/5-7 antagonist, blocked the response in both the adult and neonate rectum. Conclusion: The 5-HT-evoked response is mediated through 5-HT3 receptor subtypes in adults but not in neonate colon and rectum, indicating possible changes in the distribution of 5-HT receptors in the colon and rectum during development. Furthermore, atropine (a muscarinic cholinergic blocker) and hexamethonium (a ganglion blocker) could not affect the 5-HT-evoked responses in the neonate or adult rats’ colons or rectum. The effect of 5-HT did not appear to involve cholinergic or enteric ganglionic elements.

Early-life sodium deprivation programs long-term changes in ingestive behaviors and energy expenditure in C57BL/6J mice.

Postnatal growth failure remains a significant problem for infants born prematurely, despite aggressive efforts to improve perinatal nutrition. Though often dysregulated in early life when children are born preterm, sodium (Na) homeostasis is vital to achieve optimal growth. We hypothesize that insufficient Na supply in this critical period contributes to growth restriction and programmed risks for cardiometabolic disease in later adulthood. Thus, we sought to ascertain the effects of prolonged versus early-life Na depletion on weight gain, body composition, food and water intake behaviors, and energy expenditure in C57BL/6J mice. In one study, mice were provided a low (0.04%)- or normal/high (0.30%)-Na diet between 3 and 18 wk of age. Na-restricted mice demonstrated delayed growth and elevated basal metabolic rate. In a second study, mice were provided 0.04% or 0.30% Na diet between 3 and 6 wk of age and then returned to standard (0.15%)-Na diet through the end of the study. Na-restricted mice exhibited growth delays that quickly caught up on return to standard diet. Between 6 and 18 wk of age, previously restricted mice exhibited sustained, programmed changes in feeding behaviors, reductions in total food intake, and increases in water intake and aerobic energy expenditure while maintaining normal body composition. Although having no effect in control mice, administration of the ganglionic blocker hexamethonium abolished the programmed increase in basal metabolic rate in previously restricted mice. Together these data indicate that early-life Na restriction can cause programmed changes in ingestive behaviors, autonomic function, and energy expenditure that persist well into adulthood.

Galantamine ameliorates experimental pancreatitis

BackgroundAcute pancreatitis is a common and serious inflammatory condition currently lacking disease modifying therapy. The cholinergic anti-inflammatory pathway (CAP) is a potent protective anti-inflammatory response activated by vagus nerve-dependent α7 nicotinic acetylcholine receptor (α7nAChR) signaling using splenic CD4+ T cells as an intermediate. Activating the CAP ameliorates experimental acute pancreatitis. Galantamine is an acetylcholinesterase inhibitor (AChEI) which amplifies the CAP via modulation of central muscarinic ACh receptors (mAChRs). However, as mAChRs also activate pancreatitis, it is currently unknown whether galantamine would be beneficial in acute pancreatitis.MethodsThe effect of galantamine (1–6 mg/kg-body weight) on caerulein-induced acute pancreatitis was evaluated in mice. Two hours following 6 hourly doses of caerulein (50 µg/kg-body weight), organ and serum analyses were performed with accompanying pancreatic histology. Experiments utilizing vagotomy, gene knock out (KO) technology and the use of nAChR antagonists were also performed.ResultsGalantamine attenuated pancreatic histologic injury which was mirrored by a reduction in serum amylase and pancreatic inflammatory cytokines and an increase the anti-inflammatory cytokine IL-10 in the serum. These beneficial effects were not altered by bilateral subdiaphragmatic vagotomy, KO of either choline acetyltransferase+ T cells or α7nAChR, or administration of the nAChR ganglionic blocker mecamylamine or the more selective α7nAChR antagonist methyllycaconitine.ConclusionGalantamine improves acute pancreatitis via a mechanism which does not involve previously established physiological and molecular components of the CAP. As galantamine is an approved drug in widespread clinical use with an excellent safety record, our findings are of interest for further evaluating the potential benefits of this drug in patients with acute pancreatitis.

HIGH-FAT DIET IN THE PERI-PUBERTAL PERIOD PROGRAMS CARDIOVASCULAR DYSFUNCTION IN ADULT MALE WISTAR RATS

Stress during peri-pubertal period can determine no communicable disease in adulthood. Thisstudy aims to evaluate whether high fat diet exposure during adolescence induces long-termcardiovascular dysfunctions. The ethic committee approved the animal protocol nº1527130815. Wistar rats, 30-days-old, were feed to a high fat diet (HFD, 35% lard w/w) until60-days-old, then fed a normal fat diet for a further 60 days dietary recovery. Control animalsate normal fat diet throughout life. Body weight and food intake were evaluated weekly. AtPN120, cardiovascular and histological analysis were done. Student´s T test were applied.PN120, feed by HFD during adolescence increase systolic and diastolic blood pressure (upper10% and 4%, respectively; p <0.05 and p <0.005). Using ganglionic blocker, hexamethonium(30 mg/kg, iv), blood pressure was greater in the HFD rats (26%; p <0,01). Increasedperivascular and interstitial fibrosis (42% and 62% respectively; p<0,01 and p<0,001) wereobserved in the HFD rats, accompanied by a left ventricular hypertrophy (29%; p<0,001).Rats who were fed with HFD during peri-pubertal age present hypertension, hyperactivity ofthe vascular sympathetic nervous system and morphological cardiac alterations in adulthood.Current study remarks that adolescence is a plastic phase which permit to programs diseaseslater in life.

Selective Nrf2 Overexpression in the RVLM ameliorates Obesity-induced Sympathoexcitation

The rostral part of the ventrolateral medulla (RVLM) in the brainstem is an important region responsible for both the resting levels and the reflex control of sympathetic nerve activity (SNA). Oxidative stress-induced hyperactivation of the glutamatergic neurons in the RVLM has been associated with increases in SNA. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a major transcription factor ubiquitously expressed in all cell types and regulates the expression of several antioxidant and anti-inflammatory genes. Previous studies from our lab have demonstrated that obesity-induced sympathoexcitation was associated with Nrf2 dysfunction in the RVLM. Based on this, we hypothesized that Nrf2 overexpression at the level of the RVLM would reverse obesity-induced sympathoexcitation. To address this hypothesis, we selectively overexpressed Nrf2 at the level of the RVLM using a Nrf2 lentiviral vector (HIV-CamKIIa-GFP-Nrf2). This vector drives Nrf2 gene overexpression under the control of CamKIIa promoter that specifically targets the excitatory glutamatergic neurons. A control GFP vector (CamKIIa-GFP-virus) was used in the sham surgeries. For this experiment, two-month-old C57BL/6J mice (n=34, both sexes) were fed a high-fat diet (HFD; 60kcal% fat) or a chow diet (Control; 10kcal% fat) for 4-6 months. The animals were then subdivided into four subgroups (each group included an equal number of animals of both sexes): Chow + Control GFP lentiviral vector, HFD + Control GFP lentiviral vector, Chow + Nrf2 lentiviral vector, HFD + Nrf2 lentiviral vector. After 16 weeks of dietary treatment, the animals were microinjected with either control GFP or Nrf2 lentiviral vector in the RVLM. Two weeks after the microinjection surgery, radiotelemeters were implanted in the mice, and hemodynamic parameters were measured. Hexamethonium, a ganglionic blocker was injected into the animals to measure the drop in MAP, which is an indirect measurement of the whole-body SNA. Major findings from this study include a) As expected, HFD treatment increased systolic blood pressure (SBP), and mean arterial pressure (MAP). Nrf2 overexpression in the RVLM reversed SBP but not MAP in HFD mice when compared to control GFP vector group. b) Consistent with our earlier findings, animals fed with HFD diet showed a significant drop in blood pressure after hexamethonium injection compared to the control animals indicating HFD-induced increase in SNA. Nrf2 overexpression was also able to reduce the drop in MAP in response to hexamethonium in the HFD animals compared to control GFP vector group, suggesting Nrf2 overexpression attenuated obesity-mediated sympathoexcitation. These results indicate that Nrf2 upregulation in the RVLM can be a potential therapeutic option for obesity-induced increase in blood pressure and sympathoexcitation. Supported by: National Heart, Blood and Lung Institute grant R15HL148844 and American Heart Association Institutional Research Enhancement Award - 959725 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Differential engagement of inhibitory and excitatory cardiopulmonary reflexes by capsaicin and phenylbiguanide in C57BL/6 mice.

The Bezold-Jarisch reflex is a powerful inhibitory reflex initiated by activation of cardiopulmonary vagal nerves during myocardial ischemia, hemorrhage, and orthostatic stress leading to bradycardia, vasodilation, hypotension, and vasovagal syncope. This clinically relevant reflex has been studied by measuring heart rate (HR) and mean arterial pressure (MAP) responses to injections of a variety of chemical compounds. We hypothesized that reflex responses to different compounds vary due to differential activation of vagal afferent subtypes and/or variable coactivation of excitatory afferents. HR and MAP responses to intravenous injections of the transient receptor potential vanilloid-1 (TRPV1) agonist capsaicin and the serotonin 5-HT3 receptor agonist phenylbiguanide (PBG) were measured in anesthetized C57BL/6 mice before and after bilateral cervical vagotomy. Capsaicin and PBG evoked rapid dose-dependent decreases in HR and MAP followed by increases in HR and MAP above baseline. Bezold-Jarisch reflex responses were abolished after vagotomy, whereas the delayed tachycardic and pressor responses to capsaicin and PBG were differentially enhanced. The relative magnitude of bradycardic versus depressor responses (↓HR/↓MAP) in vagus-intact mice was greater with capsaicin. In contrast, after vagotomy, the magnitude of excitatory tachycardic versus pressor responses (↑HR/↑MAP) was greater with PBG. Although capsaicin-induced increases in MAP and HR postvagotomy were strongly attenuated or abolished after administration of the ganglionic blocker hexamethonium, PBG-induced increases in MAP and HR were mildly attenuated and unchanged, respectively. We conclude that responses to capsaicin and PBG differ in mice, with implications for delineating the role of endogenous agonists of TRPV1 and 5-HT3 receptors in evoking cardiopulmonary reflexes in pathophysiological states.

Remote ischemic preconditioning-induced late cardioprotection: possible role of melatonin-mitoKATP-H2S signaling pathway.

Remote ischemic preconditioning (RIPC) confers cardioprotection against ischemia reperfusion (IR) injury. However, the precise mechanisms involved in RIPC-induced cardioprotection are not fully explored. The present study was aimed to identify the role of melatonin in RIPC-induced late cardioprotective effects in rats and to explore the role of H2S, TNF-α and mitoKATP in melatonin-mediated effects in RIPC. Wistar rats were subjected to RIPC in which hind limb was subjected to four alternate cycles of ischemia and reperfusion of 5 min duration by using a neonatal blood pressure cuff. After 24 h of RIPC or ramelteon-induced pharmacological preconditioning, hearts were isolated and subjected to IR injury on the Langendorff apparatus. RIPC and ramelteon preconditioning protected the hearts from IR injury and it was assessed by a decrease in LDH-1, cTnT and increase in left ventricular developed pressure (LVDP). RIPC increased the melatonin levels (in plasma), H2S (in heart) and decreased TNF-α levels. The effects of RIPC were abolished in the presence of melatonin receptor blocker (luzindole), ganglionic blocker (hexamethonium) and mitochondrial KATP blocker (5-hydroxydecanoic acid). RIPC produce delayed cardioprotection against IR injury through the activation of neuronal pathway, which may increase the plasma melatonin levels to activate the cardioprotective signaling pathway involving the opening of mitochondrial KATP channels, decrease in TNF-α production and increase in H2S levels. Ramelteon-induced pharmacological preconditioning may also activate the cardioprotective signaling pathway involving the opening of mitochondrial KATP channels, decrease in TNF-α production and increase in H2S levels.

Clinical Practice Guidelines for the Use of Electroconvulsive Therapy.

Clinical Practice Guidelines for the Use of Electroconvulsive Therapy.

Oxidative stress in the RVLM mediates sympathetic hyperactivity induced by circadian disruption

Circadian rhythm plays a significant role in maintaining the function of the cardiovascular system. Emerging studies have demonstrated that circadian disruption enhances the risk of cardiovascular diseases by activating the sympathetic nervous system; however, the underlying mechanisms remain unknown. Therefore, this study aimed to clarify the role of oxidative stress in the rostral ventrolateral medulla (RVLM) in sympathetic hyperactivity induced by circadian disruption. Rats were randomly divided into two groups: the normal light and dark (LD) group and the circadian disruption (CD) group. Sympathetic nerve activity of rats was assessed by recording renal sympathetic nerve activity (RSNA) and indirect methods such as plasma level of norepinephrine (NE). The level of oxidative stress in the RVLM was detected by dihydroethidium probes. Moreover, the expression levels of the oxidative stress-related proteins in the RVLM were detected by Western blotting. Circadian disruption significantly increased blood pressure (BP), RSNA, and plasma levels of NE. Compared to the LD group, the CD group exhibited a more significant depressor response to i.v. hexamethonium bromide, a ganglionic blocker. Furthermore, the reactive oxygen species (ROS) production in the RVLM of rats with circadian disruption was significantly increased. In addition, BP and RSNA of rats with circadian disruption exhibited a greater decrease in the effects of microinjection of tempol, a superoxide scavenger, into the RVLM, compared to artificial cerebrospinal fluid (aCSF). Further investigation of the molecular mechanism by Western blotting showed that nuclear factor-erythroid-2-related factor 2 (Nrf2)/heme oxygenase 1 (HO1)/NAD(P)H: quinone oxidoreductase 1 (NQO1) signaling was down-regulated in the RVLM of circadian disruption rats. These data suggest that oxidative stress in the RVLM mediates sympathetic hyperactivity induced by circadian disruption and possibly by down-regulating Nrf2/HO1/NQO1 signaling.

Hypothalamic orexin prevents non-alcoholic steatohepatitis and hepatocellular carcinoma in obesity.

Non-alcoholic steatohepatitis (NASH) occasionally occurs under obesity; however, factors modulating the natural history of fatty liver disease remain unknown. Since hypothalamic orexin that regulates physical activity and autonomic balance prevents obesity, we investigate its role in NASH development. Male orexin-deficient mice fed a high-fat diet (HFD) show severe obesity and progression of NASH with fibrosis in the liver. Hepatic fibrosis also develops in ovariectomized orexin-deficient females fed an HFD but not ovariectomized wild-type controls. Moreover, long-term HFD feeding causes hepatocellular carcinoma (HCC) in orexin-deficient mice. Intracerebroventricular injection of orexin A or pharmacogenetic activation of orexin neurons acutely activates hepatic mTOR-sXbp1 pathway to prevent endoplasmic reticulum (ER) stress, a NASH-causing factor. Daily supplementation of orexin A attenuates hepatic ER stress and inflammation in orexin-deficient mice fed an HFD, and autonomic ganglionic blocker suppresses the orexin actions. These results suggest that hypothalamic orexin is an essential factor for preventing NASH and associated HCC under obesity.

Abstract 060: Angiotensin Type-2 Receptors In The Median Preoptic Nucleus Demarcate A Novel Depressor Neural Circuit In Mice

Blood pressure (BP) is under constant control and regulation by an extensive neural network that spans a number of brain regions. This includes the median preoptic nucleus (MnPO) which directly projects to the pre-autonomic neurons of the hypothalamus to increase BP. While angiotensin type-1 receptors (AT 1 R) are expressed in the MnPO and project to the hypothalamus to increase BP, the role of angiotensin type-2 receptors (AT 2 R) is not clear. Here, we combine the use of AT 2 R-Cre mice, neuroanatomical techniques, in vivo optogenetics, pharmacology, and cardiovascular physiology to test the hypothesis that AT 2 R neurons of MnPO (MnPO AT2R ) elicit cardioprotective effects. We found an abundance of AT 2 R-containing neurons in the MnPO that expressed the mRNA(s) for AT 2 R with high fidelity (~77%; 241 of 313 neurons; n=7). Using RNAscope in situ hybridization, we found that ~ 42% (153 of 364 neurons; n=8) of MnPO AT2R expressed genetic markers for GABA, an inhibitory neurotransmitter. Next, we delivered a Cre-inducible AAV to direct expression of channelrhodopsin-2 (ChR2) and/or enhanced yellow fluorescent protein (eYFP) within MnPO AT2R of AT 2 R-Cre mice. Using in vitro electrophysiology, we confirmed functional expression of ChR2 within MnPO AT2R , with pulses of light reliably producing action potentials (n= 12 neurons/3 animals). Subsequently, we found that activation of MnPO AT2R elicited inhibitory post-synaptic currents in neighboring AT 2 R-negative neurons. The in vivo optogenetic excitation of MnPO AT2R elicited depressor responses in both adult male (ΔSBP: +2.8 ± 1.3 vs. -4.1 ± 1.9 mmHg, p<0.05 eYFP vs. ChR2, n=15) and female mice (ΔSBP: +0.8 ± 2.2 vs.-5.3 ± 1.9 mmHg, p<0.05 eYFP vs. ChR2, n=5). These responses were abolished in the presence of the autonomic ganglion blocker, hexamethonium. Finally, to assess whether the depressor effects were AT 2 R-mediated, we administered the selective AT 2 R-agonist, compound 21, into the MnPO and observed depressor responses (ΔSBP: +0.5 ± 0.3 vs.-4.9 ± 1.0 mmHg, p<0.05 Saline vs. C21, n=7). In conclusion, our results demonstrate that MnPO AT2R are depressor inhibitory neurons that can be targeted with compound 21 to lower blood pressure.

Supplemental treatment to atropine improves the efficacy to reverse nerve agent induced bronchoconstriction

Exposure to highly toxic organophosphorus compounds causes inhibition of the enzyme acetylcholinesterase resulting in a cholinergic toxidrome and innervation of receptors in the neuromuscular junction may cause life-threatening respiratory effects. The involvement of several receptor systems was therefore examined for their impact on bronchoconstriction using an ex vivo rat precision-cut lung slice (PCLS) model. The ability to recover airways with therapeutics following nerve agent exposure was determined by quantitative analyses of muscle contraction.PCLS exposed to nicotine resulted in a dose-dependent bronchoconstriction. The neuromuscular nicotinic antagonist tubocurarine counteracted the nicotine-induced bronchoconstriction but not the ganglion blocker mecamylamine or the common muscarinic antagonist atropine. Correspondingly, atropine demonstrated a significant airway relaxation following ACh-exposure while tubocurarine did not. Atropine, the M3 muscarinic receptor antagonist 4-DAMP, tubocurarine, the β2-adrenergic receptor agonist formoterol, the Na+-channel blocker tetrodotoxin and the K+ATP-channel opener cromakalim all significantly decreased airway contractions induced by electric field stimulation. Following VX-exposure, treatment with atropine and the Ca2+-channel blocker magnesium sulfate resulted in significant airway relaxation. Formoterol, cromakalim and magnesium sulfate administered in combinations with atropine demonstrated an additive effect.In conclusion, the present study demonstrated improved airway function following nerve agent exposure by adjunct treatment to the standard therapy of atropine.