Donal S. O'Leary

Activation of P2-purinoceptors in the nucleus tractus solitarius mediate depressor responses

The purpose of the study was to examine the role of P2 purinergic receptors in mechanisms of cardiovascular control mediated by the nucleus tractus solitarius (NTS), a major integrative site in the brainstem involved in the reflex coordination of cardiorespiratory and visceral response patterns. Microinjections of ATP and its analogues were made into the subpostremal NTS of anesthetized, spontaneously breathing rats. ATP, alpha,beta-methylene ATP (alpha beta-meATP) and 2-methylthio-ATP (2-meSATP) produced significant dose-related reductions in arterial blood pressure. alpha beta-meATP was slightly more potent than ATP and 2-meSATP. Pretreatment with the P2 receptor antagonist, suramin (0.5 nmol/rat), into the same NTS site 10 min prior to agonist administration completely blocked pronounced depressor response pattern elicited by the highest dose of alpha beta-meATP (0.1 nmol/rat). The present findings suggest that endogenous ATP may serve as a fast transmitter substance in NTS-mediated mechanisms of cardiovascular control.

Neural Regulation of Cardiovascular Response to Exercise: Role of Central Command and Peripheral Afferents

During dynamic exercise, mechanisms controlling the cardiovascular apparatus operate to provide adequate oxygen to fulfill metabolic demand of exercising muscles and to guarantee metabolic end-products washout. Moreover, arterial blood pressure is regulated to maintain adequate perfusion of the vital organs without excessive pressure variations. The autonomic nervous system adjustments are characterized by a parasympathetic withdrawal and a sympathetic activation. In this review, we briefly summarize neural reflexes operating during dynamic exercise. The main focus of the present review will be on the central command, the arterial baroreflex and chemoreflex, and the exercise pressure reflex. The regulation and integration of these reflexes operating during dynamic exercise and their possible role in the pathophysiology of some cardiovascular diseases are also discussed.

Purines and the nucleus tractus solitarius: effects on cardiovascular and respiratory function.

1. The roles of adenosine and adenosine 5′‐triphosphate in cardiorespiratory regulation by the nucleus tractus solitarius (NTS) have been evaluated in a range of experiments, using microinjections of selective agonists and antagonists of purinoceptors.

Experimental Biology 2000 Symposium on Differential Control of Sympathetic Outflow DIFFERENTIAL PATTERNS OF SYMPATHETIC RESPONSES TO SELECTIVE STIMULATION OF NUCLEUS TRACTUS SOLITARIUS PURINERGIC RECEPTOR SUBTYPES

1. Studies are described that indicate that stimulation of different purinergic receptor subtypes (A1, A2A and P2X) located in the sub‐postremal nucleus tractus solitarius (NTS) evokes qualitatively and quantitatively different regional haemodynamic and efferent sympathetic responses.

Activation of P2x-purinoceptors in the nucleus tractus solitarius elicits differential inhibition of lumbar and renal sympathetic nerve activity

Activation of P2x-purinoceptors in the nucleus tractus solitarius (NTS) via microinjection of alpha,beta-methylene ATP (alpha,beta-MeATP) elicits large dose-dependent decreases in mean arterial pressure (MAP) and heart rate (HR) and preferential dilation of the iliac vascular bed in comparison to renal and mesenteric vascular beds. We investigated whether sympathoinhibition contributes to the depressor responses and whether differential changes in regional sympathetic output occur. In 43 chloralose/urethane anesthetized male Sprague-Dawley rats, MAP, HR, renal (RSNA) and lumbar sympathetic nerve activity (LSNA) were recorded. Data were analyzed as both the maximum decrease and the integral of the decrease over the duration of the depressor response. Microinjection of alpha,beta-MeATP (25 and 100 pmol in 50 nl volume) into the subpostremal NTS caused significant and dose-dependent decreases in MAP, HR, RSNA and LSNA. However, the changes in RSNA were significantly greater than those observed in LSNA for both doses and both methods of analysis of data (maximum responses in delta %: 84 +/- 3 vs 62 +/- 4, and 93 +/- 3 vs 74 +/- 4 for low and high dose of alpha,beta-MeATP, respectively; integral responses in delta % x min: 32 +/- 4 vs 18 +/- 3 and 179 +/- 7 vs 134 +/- 14 for low and high dose of alpha,beta-MeATP, respectively). Blockade of P2-purinoceptors in the NTS by the specific P2-receptor antagonist suramin abolished responses to 100 pmol alpha,beta-MeATP and microinjections of vehicle did not alter neural nor hemodynamic parameters. We conclude that activation of P2x-purinoceptors in the NTS inhibits sympathetic nerve activity and evokes differential regional sympathetic responses. However, differential sympathoinhibition does not explain differential vascular responses to the activation of P2x-purinoceptors in the NTS.

Modulation of cardiac output alters the mechanisms of the muscle metaboreflex pressor response.

Muscle metaboreflex activation during submaximal dynamic exercise in normal subjects elicits a pressor response primarily due to increased cardiac output (CO). However, when the ability to increase CO is limited, such as in heart failure or during maximal exercise, the muscle metaboreflex-induced increases in arterial pressure occur via peripheral vasoconstriction. How the mechanisms of this pressor response are altered is unknown. We tested the hypothesis that this change in metaboreflex function is dependent on the level of CO. The muscle metaboreflex was activated in dogs during mild dynamic exercise (3.2 km/h) via a partial reduction of hindlimb blood flow. Muscle metaboreflex activation increased CO and arterial pressure, whereas vascular conductance of all areas other than the hindlimbs did not change. CO was then reduced to the same level observed during exercise before the muscle metaboreflex activation via partial occlusion of the inferior and superior vena cavae. Arterial pressure dropped rapidly with the reduction in CO but, subsequently, nearly completely recovered. With the removal of the muscle metaboreflex-induced rise in CO, substantial peripheral vasoconstriction occurred that maintained arterial pressure at the same levels as before CO reduction. Therefore, the muscle metaboreflex function is nearly instantaneously shifted from increased CO to increased vasoconstriction when the muscle metaboreflex-induced rise in CO is removed. We conclude that whether vasoconstriction occurs with muscle metaboreflex depends on whether CO rises.

Purinergic mechanisms of the nucleus of the solitary tract and neural cardiovascular control

Abstract Objectives: This review addresses the role of central purinergic receptors in the operation of the cardiovascular reflexes. Methods: Potential physiological role of purinergic receptors operating in the nucleus of the solitary tract (NTS) was assessed via comparison of the regional patterns of hemodynamic and sympathetic responses evoked by selective stimulation/inhibition of NTS purinergic receptor subtypes, with the patterns evoked by stimulation and unloading of arterial baroreceptors, and other known patterns of autonomic responses. The effects of sino-aortic denervation plus vagotomy and ionotropic glutamatergic blockade of NTS mechanisms on the patterns of the responses were also considered. Results: Selective stimulation of NTS A1 receptors with CPA evoked a pattern of regional autonomic responses consistent with inhibition of baroreflex mechanisms and facilitation/ disinhibition of chemoreflex mechanisms. Selective stimulation of NTS A2a receptors with CGS 21680-evoked pattern of the responses different than that evoked by stimulation of baroreflex afferents what remains in contrast to previous reports suggesting that NTS A2a receptors facilitate baroreflex transmission. The pattern of the responses was similar to that observed during hypotensive hemorrhage. Preferential, b -adrenergic iliac vasodilation evoked by stimulation of adenosine A2a receptors and preferential activation of sympathetic output to the adrenal medulla by both adenosine A1 and A2a receptors are consistent with contribution of these receptors to the defense response, stress and exercise. These observations support previous findings that NTS A1 receptors contribute to the hypothalamic defense response. The effects of stimulation and blockade of NTS P2x receptors with α, β-methylene ATP and suramin, respectively, suggested that neuronally-released ATP operating via P2x receptors may be a crucial co-transmitter with glutamate in mediating baroreflex responses. Discussion: The above observations strongly suggest that purinergic receptor subtypes operating in NTS circuitry are linked to specific afferent and descending mechanisms primarily integrated in the NTS.

Altered reflex cardiovascular control during exercise in heart failure: animal studies

This brief review summarizes recent studies describing the potential role of the muscle metaboreflex in mediating the altered cardiovascular responses to dynamic exercise in heart failure and the interaction between the muscle metaboreflex and the arterial baroreflex in these responses. In normal dogs, activation of the muscle metaboreflex (via partial reductions in hindlimb blood flow) during submaximal exercise, elicits a powerful pressor response. This increase in arterial pressure is mediated by an increase in cardiac output with little, if any, peripheral vasoconstriction. The metaboreflex pressor response is buffered by the arterial baroreflex via baroreflex‐mediated inhibition of metaboreflex‐induced peripheral vasoconstriction. In contrast, after induction of heart failure, the mechanisms involved in the muscle metaboreflex are shifted to vasoconstriction with little, if any, increase in cardiac output. The loss of the cardiac output response of the metaboreflex in heart failure probably stems from inability to improve ventricular function. The shift towards vasoconstriction in this setting may be due to depressed ability of the arterial baroreflex to buffer metaboreflex‐induced peripheral vasoconstriction. The relative underperfusion of active skeletal muscle in heart failure may tonically activate the metaboreflex and this probably contributes to the enhanced sympatho‐excitation seen during exercise in heart failure.

Activation of A2a adenosine receptors in the nucleus tractus solitarius inhibits renal but not lumbar sympathetic nerve activity

The activation of adenosine A2a receptors in the nucleus tractus solitarius (NTS) via microinjection of the selective agonist CGS 21680 elicits long-lasting, dose-dependent decreases in mean arterial pressure (MAP) and heart rate (HR) and preferential dilation of the iliac vascular bed in comparison to the renal and mesenteric vascular beds. We investigated whether differential changes in regional sympathetic output occur with A2a receptor activation. In 24 chloralose/urethane anesthetized male Sprague-Dawley rats MAP, HR, renal (RSNA) and lumbar sympathetic nerve activity (LSNA) were recorded simultaneously. Data were analyzed as both the maximum decrease and the integral of the decrease over the duration of the depressor response. Microinjection of CGS 21680 (2 and 20 pmol in 50 nl volume) into the subpostremal NTS caused significant and dose-dependent decreases in MAP, HR and RSNA, however, did not significantly decrease LSNA in comparison to the effect of vehicle. Maximum responses of RSNA vs. LSNA in delta% of control values were: -32 +/- 4 vs. -9 +/- 2, and -59 +/- 4 vs. -19 +/- 5 for low (n = 9) and high (n = 8) doses of CGS 21680 respectively; integral responses of RSNA vs. LSNA in delta% x min were: -487 +/- 112 vs. -19 +/- 35 and -1258 +/- 164 vs. -175 +/- 126 for low and high doses of CGS 21680 respectively. Microinjections of vehicle (n = 7) did not alter integral hemodynamic or neural parameters. We conclude that activation of A2a adenosine receptors in the NTS evokes differential changes in visceral vs. somatic sympathetic nerve activity which cannot explain differential vascular responses in terms of simple sympathetic withdrawal. Lack of significant inhibition of LSNA combined with preferential vasodilation in hindquarter vascular bed suggests that active vasodilation may be triggered by activation of A2a adenosine receptors in the subpostremal NTS.

Neural control of circulation and exercise: a translational approach disclosing interactions between central command, arterial baroreflex, and muscle metaboreflex

The last 100 years witnessed a rapid and progressive development of the body of knowledge concerning the neural control of the cardiovascular system in health and disease. The understanding of the complexity and the relevance of the neuroregulatory system continues to evolve and as a result raises new questions. The purpose of this review is to articulate results from studies involving experimental models in animals as well as in humans concerning the interaction between the neural mechanisms mediating the hemodynamic responses during exercise. The review describes the arterial baroreflex, the pivotal mechanism controlling mean arterial blood pressure and its fluctuations along with the two main activation mechanisms to exercise: central command (parallel activation of central somatomotor and autonomic descending pathways) and the muscle metaboreflex, the metabolic component of exercise pressor reflex (feedback from ergoreceptors within contracting skeletal muscles). In addition, the role of the cardiopulmonary baroreceptors in modulating the resetting of arterial baroreflex is identified, and the mechanisms in the central nervous system involved with the resetting of baroreflex function during dynamic exercise are also described. Approaching a very relevant clinical condition, the review also presents the concept that the impaired arterial baroreflex function is an integral component of the metaboreflex-mediated exaggerated sympathetic tone in subjects with heart failure. This increased sympathetic activity has a major role in causing the depressed ventricular function observed during submaximal dynamic exercise in these patients. The potential contribution of a metaboreflex arising from respiratory muscles is also considered.