Williams Maurice A, Smith Scott A, O'Brien Daniel E, Mitchell Jere H, Garry Mary G
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-9174, USA.
J Physiol. 2008 Feb 1;586(3):835-45. doi: 10.1113/jphysiol.2007.140392. Epub 2007 Dec 6.
The exercise pressor reflex (EPR) is an important neural mechanism that controls blood pressure and heart rate during static muscle contraction. It has been previously demonstrated that the EPR is exaggerated in cardiomyopathy. Both mechanically (group III) and metabolically (group IV) sensitive afferent neurons are important to this reflex in normal humans and animals. In cardiomyopathy, however, the metabolically sensitive afferents are less responsive to activation whereas the mechanically sensitive fibres are overactive. We have demonstrated that this overactivity is responsible for the exaggeration in the EPR. Of importance, we have also demonstrated that the reduced responsiveness in the group IV afferent neuron is an initiating factor in the development of the exaggerated EPR. To date, the mechanism mediating this reduced group IV responsiveness remains unclear. Given that group IV afferent neurons are activated via chemically sensitive receptors, it is logical to suggest that changes in receptor function are responsible for the blunted behaviour of group IV neurons in cardiomyopathy. In order to test this postulate, however, potential receptor candidates must first be identified. The transient receptor potential vanilloid 1 (TRPv1) receptor is a non-selective cation channel that serves as a marker of the group IV afferent neurons in the periphery. We have demonstrated that the TRPv1 is abnormal in cardiomyopathy. It has been shown that the TRPv1 receptor is colocalized with the cannabinoid 1 (CB(1)) receptor on group IV afferent neurons. Therefore, we hypothesized that the function of CB(1) receptors is abnormal in cardiomyopathy. We explored this possibility by using anandamide (AEA), an endogenously produced cannabinoid that has been shown to control blood pressure via activation of the CB(1) receptor. In these studies, we evaluated the cardiovascular responses to intra-arterial injection of AEA into the hindlimb of normal, cardiomyopathic and neonatally capsaicin-treated (NNCAP) rats (rats that lack group IV afferent neurons) to determine whether administration of AEA results in abnormal responses of group IV afferent neurons in cardiomyopathic rats. We determined that AEA controls changes in blood pressure, predominately via activation of the CB(1) receptor in this preparation. We further observed that the blood pressure response to AEA is blunted in cardiomyopathic rats when compared to normal rats. We also observed a reduced blood pressure response to AEA in NNCAP animals, indicating that AEA is acting on group IV afferent neurons in this preparation. To determine whether programmed cell death could account for the decreased responsiveness that we observed during activation of the CB(1) and TRPv1 receptors on group IV afferent neurons in heart failure, we performed terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling (TUNEL) assay. We observed no evidence of cell death within the dorsal root ganglia in rats with cardiomyopathy. The data suggest that the responsiveness of CB(1) receptors on group IV afferent neurons is blunted in cardiomyopathy. Importantly, these data indicate that group IV primary afferent neurons express multiple receptor defects in cardiomyopathy that may contribute to the decreased CB(1) receptor sensitivity in this disease.
运动升压反射(EPR)是一种重要的神经机制,在静态肌肉收缩过程中控制血压和心率。此前已有研究表明,心肌病患者的EPR会增强。在正常人和动物中,机械敏感性(III组)和代谢敏感性(IV组)传入神经元对该反射均很重要。然而,在心肌病中,代谢敏感性传入神经对激活的反应性降低,而机械敏感性纤维则过度活跃。我们已经证明,这种过度活跃是EPR增强的原因。重要的是,我们还证明,IV组传入神经元反应性降低是EPR增强发展的起始因素。迄今为止,介导这种IV组反应性降低的机制尚不清楚。鉴于IV组传入神经元通过化学敏感受体被激活,因此有理由认为受体功能的变化是心肌病中IV组神经元反应迟钝的原因。然而,为了验证这一假设,必须首先确定潜在的受体候选物。瞬时受体电位香草酸1(TRPv1)受体是一种非选择性阳离子通道,是外周IV组传入神经元的标志物。我们已经证明,心肌病患者的TRPv1异常。研究表明,TRPv1受体与IV组传入神经元上的大麻素1(CB(1))受体共定位。因此,我们假设心肌病中CB(1)受体的功能异常。我们通过使用花生四烯酸乙醇胺(AEA)来探讨这种可能性,AEA是一种内源性产生的大麻素,已被证明可通过激活CB(1)受体来控制血压。在这些研究中,我们评估了正常大鼠、心肌病大鼠和新生辣椒素处理(NNCAP)大鼠(缺乏IV组传入神经元)后肢动脉内注射AEA后的心血管反应,以确定AEA的给药是否会导致心肌病大鼠IV组传入神经元的异常反应。我们确定,在该实验中,AEA主要通过激活CB(1)受体来控制血压变化。我们进一步观察到,与正常大鼠相比,心肌病大鼠对AEA的血压反应迟钝。我们还观察到NNCAP动物对AEA的血压反应降低,这表明AEA在此实验中作用于IV组传入神经元。为了确定程序性细胞死亡是否可以解释我们在心力衰竭时IV组传入神经元上CB(1)和TRPv1受体激活过程中观察到的反应性降低,我们进行了末端脱氧核苷酸转移酶介导的dUTP缺口末端标记(TUNEL)分析。我们没有观察到心肌病大鼠背根神经节内细胞死亡的证据。数据表明,心肌病中IV组传入神经元上CB(1)受体的反应性降低。重要的是,这些数据表明,IV组初级传入神经元在心肌病中存在多种受体缺陷,这可能导致该疾病中CB(1)受体敏感性降低。