Pathophysiology Program, Lovelace Respiratory Research Institute, Albuquerque, New Mexico 87108, USA.
Am J Physiol Regul Integr Comp Physiol. 2012 Aug 15;303(4):R449-58. doi: 10.1152/ajpregu.00016.2012. Epub 2012 Jun 13.
Intravenous bolus injection of morphine causes a vagal-mediated brief apnea (∼3 s), while continuous injection, via action upon central μ-opioid receptor (MOR), arrests ventilation (>20 s) that is eliminated by stimulating central 5-hydroxytryptamine 1A receptors (5HT(1A)Rs). Bronchopulmonary C-fibers (PCFs) are essential for triggering a brief apnea, and their afferents terminate at the caudomedial region of the nucleus tractus solitarius (mNTS) that densely expresses 5HT(1A)Rs. Thus we asked whether the vagal-mediated apneic response to MOR agonists was PCF dependent, and if so, whether this apnea was abolished by systemic administration of 8-hydroxy-2-(di-n-propylamino)tetral (8-OH-DPAT) largely through action upon mNTS 5HT(1A)Rs. Right atrial bolus injection of fentanyl (5.0 μg/kg, a MOR agonist) was performed in the anesthetized and spontaneously breathing rats before and after: 1) selective blockade of PCFs' conduction and subsequent bivagotomy; 2) intravenous administration of 5HT(1A)R agonist 8-OH-DPAT; 3) intra-mNTS injection of 8-OH-DPAT; and 4) intra-mNTS injection of 5HT(1A)R antagonist WAY-100635 followed by 8-OH-DPAT (iv). We found the following: First, fentanyl evoked an immediate apnea (2.5 ± 0.4 s, ∼6-fold longer than the baseline expiratory duration, T(E)), which was abolished by either blocking PCFs' conduction or bivagotomy. Second, this apnea was prevented by systemic 8-OH-DPAT challenge. Third, intra-mNTS injection of 8-OH-DPAT greatly attenuated the apnea by 64%. Finally, intra-mNTS microinjection of WAY-100635 significantly attenuated (58%) the apneic blockade by 8-OH-DPAT (iv). We conclude that the vagal-mediated apneic response to MOR activation depends on PCFs, which is fully antagonized by systemic 8-OH-DPAT challenge largely via acting on mNTS 5HT(1A)Rs.
静脉推注吗啡会引起迷走神经介导的短暂呼吸暂停(约 3 秒),而通过作用于中枢 μ 阿片受体(MOR)的连续注射则会导致通气停止(超过 20 秒),这种停止可以通过刺激中枢 5-羟色胺 1A 受体(5HT(1A)Rs)来消除。支气管肺 C 纤维(PCFs)对于触发短暂呼吸暂停至关重要,其传入纤维终止于孤束核尾侧-medial 区(mNTS),该区域密集表达 5HT(1A)Rs。因此,我们想知道 MOR 激动剂引起的迷走神经介导的呼吸暂停反应是否依赖于 PCFs,如果是,那么全身性给予 8-羟基-2-(二-n-丙基氨基)四氢萘(8-OH-DPAT)是否会通过作用于 mNTS 5HT(1A)Rs 来消除这种呼吸暂停。在麻醉和自主呼吸的大鼠中,在以下情况下进行右心房推注芬太尼(5.0 μg/kg,MOR 激动剂):1)选择性阻断 PCFs 的传导,随后行双结扎;2)静脉给予 5HT(1A)R 激动剂 8-OH-DPAT;3)mNTS 内注射 8-OH-DPAT;和 4)mNTS 内注射 5HT(1A)R 拮抗剂 WAY-100635,随后给予 8-OH-DPAT(iv)。我们发现:首先,芬太尼立即引起呼吸暂停(2.5 ± 0.4 秒,比基线呼气时间长约 6 倍),阻断 PCFs 的传导或双结扎可消除呼吸暂停。其次,全身给予 8-OH-DPAT 可预防这种呼吸暂停。第三,mNTS 内注射 8-OH-DPAT 可使呼吸暂停减轻 64%。最后,mNTS 内微量注射 WAY-100635 可显著减轻 8-OH-DPAT(iv)引起的呼吸暂停抑制(58%)。我们的结论是,MOR 激活引起的迷走神经介导的呼吸暂停反应依赖于 PCFs,全身给予 8-OH-DPAT 可完全拮抗,主要通过作用于 mNTS 5HT(1A)Rs。