Patel Kaushik P, Xu Bo, Liu Xuefei, Sharma Neeru M, Zheng Hong
From the Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha.
Hypertension. 2016 Jul;68(1):175-84. doi: 10.1161/HYPERTENSIONAHA.115.06794. Epub 2016 May 16.
Renal denervation (RDN) has been postulated to reduce sympathetic drive during heart failure (HF), but the central mechanisms are not completely understood. The purpose of the present study was to assess the contribution of neuronal nitric oxide synthase (nNOS) within the paraventricular nucleus (PVN) in modulating sympathetic outflow in rats with HF that underwent RDN. HF was induced in rats by ligation of the left coronary artery. Four weeks after surgery, bilateral RDN was performed. Rats with HF had an increase in FosB-positive cells in the PVN with a concomitant increase in urinary excretion of norepinephrine, and both of these parameters were ameliorated after RDN. nNOS-positive cells immunostaining, diaphorase staining, and nNOS protein expression were significantly decreased in the PVN of HF rats, findings that were ameliorated by RDN. Microinjection of nNOS inhibitor N(G)-monomethyl l-arginine into the PVN resulted in a blunted increase in lumbar sympathetic nerve activity (11±2% versus 24±2%) in HF than in sham group. This response was normalized after RDN. Stimulation of afferent renal nerves produced a greater activation of PVN neurons in rats with HF. Afferent renal nerve stimulation elicited a greater increase in lumbar sympathetic nerve activity in rats with HF than in sham rats (45±5% versus 22±2%). These results suggest that intact renal nerves contribute to the reduction of nNOS in the PVN, resulting in the activation of the neurons in the PVN of rats with HF. RDN restores nNOS and thus attenuates the sympathoexcitation commonly observed in HF.
肾去神经支配术(RDN)被认为可以降低心力衰竭(HF)期间的交感神经驱动,但其中枢机制尚未完全明确。本研究的目的是评估室旁核(PVN)内神经元型一氧化氮合酶(nNOS)在调节接受RDN的HF大鼠交感神经输出中的作用。通过结扎左冠状动脉在大鼠中诱导HF。手术后四周,进行双侧RDN。HF大鼠PVN中FosB阳性细胞增加,同时去甲肾上腺素尿排泄增加,而RDN后这两个参数均得到改善。HF大鼠PVN中nNOS阳性细胞免疫染色、黄递酶染色和nNOS蛋白表达均显著降低,RDN可改善这些结果。向PVN中微量注射nNOS抑制剂N(G)-单甲基-L-精氨酸导致HF大鼠腰交感神经活动的增加减弱(11±2%对24±2%),而假手术组则无此现象。RDN后这种反应恢复正常。刺激肾传入神经在HF大鼠中引起PVN神经元更大的激活。与假手术大鼠相比,刺激肾传入神经在HF大鼠中引起的腰交感神经活动增加更大(45±5%对22±2%)。这些结果表明,完整的肾神经有助于降低PVN中的nNOS,导致HF大鼠PVN中的神经元激活。RDN恢复nNOS,从而减轻HF中常见的交感神经兴奋。