Perhaps because they are a small minority of the total population of renal afferents, myelinated renal afferents (MRA ) have been the least studied. Yet, they are promising targets for neuromodulation because of their low thresholds for electrical stimulation. We are studying the calibers, branching patterns, terminal morphologies, and intrarenal targets of MRA. We identify the myelin sheaths and axons of MRA using antibodies to myelin protein zero and heavy‐chain neurofilament, respectively. The diameters of a majority of MRA range between 1 and 4 u. The diameters of a small minority range between 6 and 10u. Thus, the diameters of MRA are distinctly bimodal. Unmyelinated terminal segments of MRA arise from the myelinated segments of axons at two sites. First, an unmyelinated segment of axon projects from the end of each MRA. Second, unmyelinated segments arise as axon collaterals at nodes of Ranvier along the course of the myelinated axon. Most unmyelinated segments end without any terminal specialization. However, some terminate in small “bulbs, that are approximately twice the diameter of the axon. We have not observed receptor‐related, connective tissue specializations surrounding either type of termination. The distal myelinated portions of MRA are frequently tortuous, sometimes forming hairpin turns and loops. These complex features result in spatial concentrations of nodes of Ranvier, concentrations of unmyelinated collaterals, and concentrations of receptors. A marked narrowing at the origin of each unmyelinated segment suggests the presence of a spike‐initiation zone. The majority of MRA terminate deep in the renal cortex, most often in the extracellular space and frequently within bundles of connective tissue. Some terminations closely appose, but never penetrate, the renal tubular system. However, a small number of MRA appear to penetrate the walls of small arteries and venules. Terminations of MRA show no consistent relationship to glomeruli. The functions of MRA are, thus far, uncertain. Their terminations in the extracellular space would permit them to respond to changes in the composition of the extracellular fluid. However, their associations with connective tissue in the extracellular space could also provide them with mechanoreceptor properties. Their presence in the walls of the vasculature could mediate either chemoreceptor or mechanoreceptor functions. The distinctly bimodal distribution of the diameters of MRA suggests that they may participate in more than one physiological function. From a clinical perspective, the differences in stimulation thresholds afforded by those differences in axon caliber could facilitate selective neuromodulation of multiple physiological processes.Support or Funding InformationSupported by SPARC Award 1U01DK116320‐02, JW Osborn, Jr., PI
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