Pathophysiology Program, Lovelace Respiratory Research Institute, Albuquerque, New Mexico, USA.
Anesthesiology. 2011 Aug;115(2):353-63. doi: 10.1097/ALN.0b013e318224cc1f.
: The commissural subnucleus of the nucleus tractus solitarius (comNTS) is a key region in the brainstem responsible for the hypoxic ventilatory response (HVR) because it contains the input terminals of the carotid chemoreceptor. Because opioids inhibit the HVR via activating central μ-receptors that are expressed abundantly in the comNTS, the authors of the current study asked whether activating local μ-receptors attenuated the carotid body-mediated HVR.
: To primarily stimulate the carotid body, brief hypoxia (100% N2) and hypercapnia (15% CO2) for 10 s and/or intracarotid injection of NaCN (10 μg/100 μl) were performed in anesthetized and spontaneously breathing rats. These stimulations were repeated after: (1) microinjecting three doses of μ-receptor agonist [d-Ala2, N-Me-Phe4, Gly-ol]-Enkephalin (DAMGO) (approximately 3.5 nl) into the comNTS; (2) carotid body denervation; and (3) systemic administration of DAMGO (300 μg/kg) without and with previous intracomNTS injection of d-Phe-Cys-Tyr-d-Trp-Arg-Thr-Pen-Thr-NH2, a μ-receptor antagonist.
: Study results showed that DAMGO at 0.25 and 2.5, but not 0.025 mM, caused a similar decrease in baseline ventilation (approximately 12%). DAMGO at 0.25 mM largely reduced (64%) the HVR, whereas DAMGO at 2.5 mM abolished the HVR (and the VE response to NaCN) and moderately attenuated (31%) the hypercapnic ventilatory response. Interestingly, similar HVR abolition and depression of the hypercapnic ventilatory response were observed after carotid body denervation. Blocking comNTS μ-receptors by d-Phe-Cys-Tyr-d-Trp-Arg-Thr-Pen-Thr-NH2 significantly attenuated the HVR depression by systemic DAMGO with little change in the DAMGO modulatory effects on baseline ventilation and the hypercapnic ventilatory response.
: The data suggest that opioids within the comNTS, via acting on μ-receptors, are able to abolish the HVR by affecting the afferent pathway of the carotid chemoreceptor.
孤束核连合亚核(comNTS)是脑干中负责低氧通气反应(HVR)的关键区域,因为它包含颈动脉化学感受器的输入终端。由于阿片类药物通过激活大量表达于 comNTS 的中枢 μ 受体来抑制 HVR,因此当前研究的作者询问激活局部 μ 受体是否会减弱颈动脉体介导的 HVR。
为了主要刺激颈动脉体,在麻醉且自主呼吸的大鼠中进行短暂的缺氧(100% N2)和高碳酸血症(15% CO2)10 秒,和/或颈动脉内注射 NaCN(10μg/100μl)。在以下情况下重复这些刺激:(1)将 μ 受体激动剂 [d-Ala2, N-Me-Phe4, Gly-ol]-Enkephalin(DAMGO)(约 3.5nl)分三次微注射到 comNTS 中;(2)颈动脉体去神经支配;(3)不进行和进行 comNTS 内注射 d-Phe-Cys-Tyr-d-Trp-Arg-Thr-Pen-Thr-NH2(μ 受体拮抗剂)情况下,给予 DAMGO(300μg/kg)。
研究结果表明,DAMGO 浓度为 0.25 和 2.5mM,但不是 0.025mM,引起基线通气量相似的降低(约 12%)。DAMGO 浓度为 0.25mM 时,HVR 显著降低(64%),而 DAMGO 浓度为 2.5mM 时,HVR 被完全阻断(并使 VE 对 NaCN 的反应),并适度降低(31%)对高碳酸血症的通气反应。有趣的是,颈动脉体去神经支配后也观察到类似的 HVR 阻断和高碳酸血症通气反应抑制。用 d-Phe-Cys-Tyr-d-Trp-Arg-Thr-Pen-Thr-NH2 阻断 comNTS μ 受体,显著减弱了全身 DAMGO 对 HVR 抑制的作用,而对 DAMGO 调节基线通气和高碳酸血症通气反应的作用影响较小。
数据表明,孤束核内的阿片类药物通过作用于 μ 受体,通过影响颈动脉化学感受器的传入通路,能够消除 HVR。