Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin;
J Appl Physiol (1985). 2013 Oct 1;115(7):1088-98. doi: 10.1152/japplphysiol.00293.2013. Epub 2013 Jul 18.
A current and major unanswered question is why the highly sensitive central CO2/H(+) chemoreceptors do not prevent hypoventilation-induced hypercapnia following carotid body denervation (CBD). Because perturbations involving the carotid bodies affect central neuromodulator and/or neurotransmitter levels within the respiratory network, we tested the hypothesis that after CBD there is an increase in inhibitory and/or a decrease in excitatory neurochemicals within the ventrolateral medullary column (VMC) in awake goats. Microtubules for chronic use were implanted bilaterally in the VMC within or near the pre-Bötzinger Complex (preBötC) through which mock cerebrospinal fluid (mCSF) was dialyzed. Effluent mCSF was collected and analyzed for neurochemical content. The goats hypoventilated (peak +22.3 ± 3.4 mmHg PaCO2) and exhibited a reduced CO2 chemoreflex (nadir, 34.8 ± 7.4% of control ΔVE/ΔPaCO2) after CBD with significant but limited recovery over 30 days post-CBD. After CBD, GABA and glycine were above pre-CBD levels (266 ± 29% and 189 ± 25% of pre-CBD; P < 0.05), and glutamine and dopamine were significantly below pre-CBD levels (P < 0.05). Serotonin, substance P, and epinephrine were variable but not significantly (P > 0.05) different from control after CBD. Analyses of brainstem tissues collected 30 days after CBD exhibited 1) a midline raphe-specific reduction (P < 0.05) in the percentage of tryptophan hydroxylase-expressing neurons, and 2) a reduction (P < 0.05) in serotonin transporter density in five medullary respiratory nuclei. We conclude that after CBD, an increase in inhibitory neurotransmitters and a decrease in excitatory neuromodulation within the VMC/preBötC likely contribute to the hypoventilation and attenuated ventilatory CO2 chemoreflex.
一个当前且重要的未解决问题是,为什么高度敏感的中枢 CO2/H(+)化学感受器不能防止颈动脉体去神经(CBD)后通气不足引起的高碳酸血症。由于涉及颈动脉体的扰动会影响呼吸网络中的中枢神经调质和/或神经递质水平,我们测试了这样一个假设,即在 CBD 后,在清醒的山羊的腹外侧延髓柱(VMC)中,抑制性神经化学物质增加和/或兴奋性神经化学物质减少。通过双侧将微管植入 VMC 内或靠近 Pre-Bötzinger 复合体(preBötC),通过该复合体模拟脑脊髓液(mCSF)被透析。收集并分析流出物 mCSF 的神经化学物质含量。在 CBD 后,山羊出现通气不足(峰值+22.3±3.4mmHg PaCO2),并表现出 CO2 化学感受反射减弱(nadir,34.8±7.4%对照ΔVE/ΔPaCO2),在 CBD 后 30 天内有显著但有限的恢复。在 CBD 后,GABA 和甘氨酸的水平高于 CBD 前水平(分别为 CBD 前的 266±29%和 189±25%;P<0.05),而谷氨酰胺和多巴胺的水平明显低于 CBD 前水平(P<0.05)。5-羟色胺、P 物质和肾上腺素的水平变化但没有统计学差异(P>0.05)。在 CBD 后 30 天收集的脑干组织分析显示,1)中缝特异性的色氨酸羟化酶表达神经元比例减少(P<0.05),2)五个延髓呼吸核中的 5-羟色胺转运体密度减少(P<0.05)。我们的结论是,在 CBD 后,VMC/preBötC 中的抑制性神经递质增加和兴奋性神经调质减少可能导致通气不足和呼吸性 CO2 化学感受反射减弱。