Wu Xu, Lu Huan, Hu Lijuan, Gong Wankun, Wang Juan, Fu Cuiping, Liu Zilong, Li Shanqun
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan UniversityShanghai, China; Clinical Center for Sleep Breathing Disorder and Snoring, Zhongshan Hospital, Fudan UniversityShanghai 200032, China.
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University Shanghai, China.
Am J Transl Res. 2017 Feb 15;9(2):546-557. eCollection 2017.
Evidence has shown that hypoxic episodes elicit hypoglossal neuroplasticity which depends on elevated serotonin (5-HT), in contrast to the rationale of obstructive sleep apnea (OSA) that deficient serotonergic input to HMs fails to keep airway patency. Therefore, understanding of the 5-HT dynamic changes at hypoglossal nucleus (HN) during chronic intermittent hypoxia (CIH) will be essential to central pathogenic mechanism and pharmacological therapy of OSA. Moreover, the effect of CIH on BDNF-TrkB signaling proteins was quantified in an attempt to elucidate cellular cascades/synaptic mechanisms following 5-HT alteration. Male rats were randomly exposed to normal air (control), intermittent hypoxia of 3 weeks (IH3) and 5 weeks (IH5) groups. Through electrical stimulation of dorsal raphe nuclei (DRN), we conducted amperometric technique with carbon fiber electrode in vivo to measure the real time release of 5-HT at XII nucleus. 5-HT receptors immunostaining measured by intensity and c-Fos quantified visually were both determined by immunohistochemistry. CIH significantly reduced endogenous serotonergic inputs from DRN to XII nucleus, shown as decreased peak value of 5-HT signals both in IH3 and IH5groups, whereas time to peak and half-life period of 5-HT were unaffected. Neither 5-HT receptors nor c-Fos expression in HN were significantly altered by CIH. Except for marked increase in phosphorylation of ERK in IH5 rats, BDNF-TrkB signaling and synaptophys consistently demonstrated downregulated levels. These results suggest that the deficiency of 5-HT and BDNF-dependent synaptic proteins in our CIH protocol contribute to the decompensated mechanism of OSA.
有证据表明,与阻塞性睡眠呼吸暂停(OSA)的理论基础相反,缺氧发作会引发舌下神经可塑性,而舌下神经可塑性依赖于血清素(5-HT)升高,阻塞性睡眠呼吸暂停的理论基础是向舌下运动神经元(HMs)的血清素能输入不足无法维持气道通畅。因此,了解慢性间歇性缺氧(CIH)期间舌下神经核(HN)的5-HT动态变化对于OSA的中枢致病机制和药物治疗至关重要。此外,对CIH对脑源性神经营养因子-酪氨酸激酶受体B(BDNF-TrkB)信号蛋白的影响进行了量化,以试图阐明5-HT改变后的细胞级联反应/突触机制。雄性大鼠被随机分为正常空气组(对照组)、3周间歇性缺氧组(IH3)和5周间歇性缺氧组(IH5)。通过电刺激中缝背核(DRN),我们在体内用碳纤维电极进行安培测量技术,以测量舌下神经核处5-HT的实时释放。通过强度测量的5-HT受体免疫染色和通过视觉量化的c-Fos均通过免疫组织化学测定。CIH显著降低了从DRN到舌下神经核的内源性血清素能输入,在IH3和IH5组中均表现为5-HT信号峰值降低,而5-HT的达峰时间和半衰期未受影响。CIH对HN中的5-HT受体和c-Fos表达均无显著改变。除了IH5大鼠中细胞外调节蛋白激酶(ERK)磷酸化显著增加外,BDNF-TrkB信号和突触素水平持续下调。这些结果表明,在我们的CIH方案中,5-HT和BDNF依赖的突触蛋白缺乏促成了OSA的失代偿机制。