Levitt Erica S, Abdala Ana P, Paton Julian F R, Bissonnette John M, Williams John T
Vollum Institute, Oregon Health and Science University, Portland, OR, 97239, USA.
School of Physiology and Pharmacology, University of Bristol, Bristol, BS8 1TD, UK.
J Physiol. 2015 Oct 1;593(19):4453-69. doi: 10.1113/JP270822. Epub 2015 Aug 19.
In addition to reductions in respiratory rate, opioids also cause aspiration and difficulty swallowing, indicating impairment of the upper airways. The Kölliker-Fuse (KF) maintains upper airway patency and a normal respiratory pattern. In this study, activation of μ opioid receptors in the KF reduced respiratory frequency and tidal volume in anaesthetized rats. Nerve recordings in an in situ preparation showed that activation of μ opioid receptors in the KF eliminated the post-inspiration phase of the respiratory cycle. In brain slices, μ opioid agonists hyperpolarized a distinct population (61%) of KF neurons by activation of an inwardly rectifying potassium conductance. These results suggest that KF neurons that are hyperpolarized by opioids could contribute to opioid-induced respiratory disturbances, particularly the impairment of upper airways.
Opioid-induced respiratory effects include aspiration and difficulty swallowing, suggesting impairment of the upper airways. The pontine Kölliker-Fuse nucleus (KF) controls upper airway patency and regulates respiration, in particular the inspiratory/expiratory phase transition. Given the importance of the KF in coordinating respiratory pattern, the mechanisms of μ opioid receptor activation in this nucleus were investigated at the systems and cellular level. In anaesthetized, vagi-intact rats, injection of opioid agonists DAMGO or [Met(5) ]enkephalin (ME) into the KF reduced respiratory frequency and amplitude. The μ opioid agonist DAMGO applied directly into the KF of the in situ arterially perfused working heart-brainstem preparation of rat resulted in robust apneusis (lengthened low amplitude inspiration due to loss of post-inspiratory drive) that was rapidly reversed by the opioid antagonist naloxone. In brain slice preparations, activation of μ opioid receptors on KF neurons hyperpolarized a distinct population (61%) of neurons. As expected, the opioid-induced hyperpolarization reduced the excitability of the neuron in response to either current injection or local application of glutamate. In voltage-clamp recordings the outward current produced by the opioid agonist ME was concentration dependent, reversed at the potassium equilibrium potential and was blocked by BaCl2 , characteristics of a G protein-coupled inwardly rectifying potassium (GIRK) conductance. The clinically used drug morphine produced an outward current in KF neurons with similar potency to morphine-mediated currents in locus coeruleus brain slice preparations. Thus, the population of KF neurons that are hyperpolarized by μ opioid agonists are likely mediators of the opioid-induced loss of post-inspiration and induction of apneusis.
除了呼吸频率降低外,阿片类药物还会导致误吸和吞咽困难,提示上呼吸道功能受损。柯利克 - 富斯核(KF)维持上呼吸道通畅和正常呼吸模式。在本研究中,麻醉大鼠中KF内μ阿片受体的激活降低了呼吸频率和潮气量。原位标本的神经记录显示,KF内μ阿片受体的激活消除了呼吸周期的吸气后阶段。在脑片中,μ阿片类激动剂通过激活内向整流钾电导使KF神经元的一个特定群体(61%)发生超极化。这些结果表明,被阿片类药物超极化的KF神经元可能导致阿片类药物引起的呼吸紊乱,尤其是上呼吸道功能受损。
阿片类药物引起的呼吸效应包括误吸和吞咽困难,提示上呼吸道功能受损。脑桥柯利克 - 富斯核(KF)控制上呼吸道通畅并调节呼吸,特别是吸气/呼气阶段的转换。鉴于KF在协调呼吸模式中的重要性,在系统和细胞水平研究了该核内μ阿片受体激活的机制。在麻醉的、迷走神经完整的大鼠中,向KF内注射阿片类激动剂DAMGO或[Met(5)]脑啡肽(ME)可降低呼吸频率和幅度。将μ阿片类激动剂DAMGO直接应用于大鼠原位动脉灌注工作心脏 - 脑干标本的KF中,可导致强烈的长吸(由于吸气后驱动力丧失导致吸气延长且幅度降低),阿片类拮抗剂纳洛酮可迅速逆转这种情况。在脑片标本中,KF神经元上μ阿片受体的激活使一个特定群体(61%)的神经元发生超极化。正如预期的那样,阿片类药物诱导的超极化降低了神经元对电流注入或局部应用谷氨酸的兴奋性。在电压钳记录中,阿片类激动剂ME产生的外向电流具有浓度依赖性,在钾平衡电位处反转,并被BaCl2阻断,这是G蛋白偶联内向整流钾(GIRK)电导的特征。临床使用的药物吗啡在KF神经元中产生外向电流,其效力与在蓝斑脑片标本中吗啡介导的电流相似。因此,被μ阿片类激动剂超极化的KF神经元群体可能是阿片类药物引起的吸气后驱动力丧失和长吸诱导的介质。