Moraes Davi J A, Machado Benedito H
Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
J Physiol. 2015 Feb 1;593(3):619-34. doi: 10.1113/jphysiol.2014.283085. Epub 2015 Jan 5.
The respiratory control of the glottis by laryngeal motoneurones is characterized by inspiratory abduction and post-inspiratory adduction causing decreases and increases in upper airway resistance, respectively. Chronic intermittent hypoxia (CIH), an important component of obstructive sleep apnoea, exaggerated glottal abduction (before inspiration), associated with active expiration and decreased glottal adduction during post-inspiration. CIH increased the inspiratory and decreased the post-inspiratory laryngeal motoneurone activities, which is not associated to changes in their intrinsic electrophysiological properties. We conclude that the changes in the respiratory network after CIH seem to be an adaptive process required for an appropriated pulmonary ventilation and control of upper airway resistance under intermittent episodes of hypoxia.
To keep an appropriate airflow to and from the lungs under physiological conditions a precise neural co-ordination of the upper airway resistance by laryngeal motoneurones in the nucleus ambiguus is essential. Chronic intermittent hypoxia (CIH), an important component of obstructive sleep apnoea, may alter these fine mechanisms. Here, using nerve and whole cell patch clamp recordings in in situ preparations of rats we investigated the effects of CIH on the respiratory control of the upper airway resistance, on the electrophysiological properties of laryngeal motoneurones in the nucleus ambiguus, and the role of carotid body (CB) afferents to the brainstem on the underlying mechanisms of these effects. CIH rats exhibited longer pre-inspiratory and lower post-inspiratory superior laryngeal nerve activities than control rats. These changes produced exaggerated glottal abduction (before inspiration) and decreased glottal adduction during post-inspiration, indicating a reduction of upper airway resistance during these respiratory phases after CIH. CB denervation abolished these changes produced by CIH. Regarding choline acetyltransferase positive-laryngeal motoneurones, CIH increased the firing frequency of inspiratory and decreased the firing frequency of post-inspiratory laryngeal motoneurones, without changes in their intrinsic electrophysiological properties. These data show that the effects of CIH on the upper airway resistance and laryngeal motoneurones activities are driven by the integrity of CB, which afferents induce changes in the central respiratory generators in the brainstem. These neural changes in the respiratory network seem to be an adaptive process required for an appropriated pulmonary ventilation and control of upper airway resistance under intermittent episodes of hypoxia.
喉运动神经元对声门的呼吸控制特点是吸气时外展,吸气后内收,分别导致上气道阻力降低和增加。慢性间歇性缺氧(CIH)是阻塞性睡眠呼吸暂停的一个重要组成部分,它会加剧声门外展(吸气前),这与主动呼气有关,且吸气后声门内收减少。CIH增加了吸气时喉运动神经元的活动,减少了吸气后喉运动神经元的活动,这与它们内在的电生理特性变化无关。我们得出结论,CIH后呼吸网络的变化似乎是在间歇性缺氧发作期间进行适当的肺通气和控制上气道阻力所需的适应性过程。
在生理条件下,为了保持进出肺部的适当气流,延髓疑核中的喉运动神经元对上气道阻力进行精确的神经协调至关重要。慢性间歇性缺氧(CIH)是阻塞性睡眠呼吸暂停的一个重要组成部分,可能会改变这些精细机制。在这里,我们使用大鼠原位制剂中的神经和全细胞膜片钳记录,研究了CIH对上气道阻力呼吸控制的影响、对延髓疑核中喉运动神经元电生理特性的影响,以及颈动脉体(CB)传入脑干的神经在这些影响的潜在机制中的作用。与对照大鼠相比,CIH大鼠的吸气前时间更长,吸气后喉上神经活动更低。这些变化导致声门外展加剧(吸气前),吸气后声门内收减少,表明CIH后这些呼吸阶段上气道阻力降低。切除CB消除了CIH产生的这些变化。对于胆碱乙酰转移酶阳性的喉运动神经元,CIH增加了吸气时的放电频率,降低了吸气后喉运动神经元的放电频率,而它们的内在电生理特性没有变化。这些数据表明,CIH对上气道阻力和喉运动神经元活动的影响是由CB的完整性驱动的,CB传入神经会引起脑干中枢呼吸发生器的变化。呼吸网络中的这些神经变化似乎是在间歇性缺氧发作期间进行适当的肺通气和控制上气道阻力所需的适应性过程。