Shanks Julia, Xia Zhiqiu, Lisco Steven J, Rozanski George J, Schultz Harold D, Zucker Irving H, Wang Han-Jun
Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska.
Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska.
Physiol Rep. 2018 Jun;6(12):e13742. doi: 10.14814/phy2.13742.
The sensory innervation of the lung is well known to be innervated by nerve fibers of both vagal and sympathetic origin. Although the vagal afferent innervation of the lung has been well characterized, less is known about physiological effects mediated by spinal sympathetic afferent fibers. We hypothesized that activation of sympathetic spinal afferent nerve fibers of the lung would result in an excitatory pressor reflex, similar to that previously characterized in the heart. In this study, we evaluated changes in renal sympathetic nerve activity (RSNA) and hemodynamics in response to activation of TRPV1-sensitive pulmonary spinal sensory fibers by agonist application to the visceral pleura of the lung and by administration into the primary bronchus in anesthetized, bilaterally vagotomized, adult Sprague-Dawley rats. Application of bradykinin (BK) to the visceral pleura of the lung produced an increase in mean arterial pressure (MAP), heart rate (HR), and RSNA. This response was significantly greater when BK was applied to the ventral surface of the left lung compared to the dorsal surface. Conversely, topical application of capsaicin (Cap) onto the visceral pleura of the lung, produced a biphasic reflex change in MAP, coupled with increases in HR and RSNA which was very similar to the hemodynamic response to epicardial application of Cap. This reflex was also evoked in animals with intact pulmonary vagal innervation and when BK was applied to the distal airways of the lung via the left primary bronchus. In order to further confirm the origin of this reflex, epidural application of a selective afferent neurotoxin (resiniferatoxin, RTX) was used to chronically ablate thoracic TRPV1-expressing afferent soma at the level of T1-T4 dorsal root ganglia pleura. This treatment abolished all sympatho-excitatory responses to both cardiac and pulmonary application of BK and Cap in vagotomized rats 9-10 weeks post-RTX. These data suggest the presence of an excitatory pulmonary chemosensitive sympathetic afferent reflex. This finding may have important clinical implications in pulmonary conditions inducing sensory nerve activation such as pulmonary inflammation and inhalation of chemical stimuli.
众所周知,肺的感觉神经支配由迷走神经和交感神经起源的神经纤维共同完成。虽然肺的迷走神经传入神经支配已得到充分描述,但对于脊髓交感神经传入纤维介导的生理效应却知之甚少。我们推测,肺的交感脊髓传入神经纤维的激活会导致一种兴奋性升压反射,类似于先前在心脏中所描述的那样。在本研究中,我们通过向麻醉的、双侧迷走神经切断的成年Sprague-Dawley大鼠的脏胸膜应用激动剂以及向主支气管给药,评估了对TRPV1敏感的肺脊髓感觉纤维激活后肾交感神经活动(RSNA)和血流动力学的变化。向肺的脏胸膜应用缓激肽(BK)会导致平均动脉压(MAP)、心率(HR)和RSNA升高。与左肺背侧表面相比,当BK应用于左肺腹侧表面时,这种反应明显更大。相反,向肺的脏胸膜局部应用辣椒素(Cap)会使MAP产生双相反射变化,同时HR和RSNA增加,这与心外膜应用Cap时的血流动力学反应非常相似。这种反射在具有完整肺迷走神经支配的动物中也会诱发,并且当BK通过左主支气管应用于肺的远端气道时也会出现。为了进一步证实这种反射的起源,硬膜外应用选择性传入神经毒素(树脂毒素,RTX)用于在T1-T4背根神经节胸膜水平长期消融表达TRPV1的胸段传入神经元胞体。这种处理消除了在RTX处理后9-10周的迷走神经切断大鼠中对心脏和肺应用BK和Cap的所有交感兴奋反应。这些数据表明存在一种兴奋性肺化学敏感交感传入反射。这一发现可能对诱导感觉神经激活的肺部疾病(如肺部炎症和化学刺激物吸入)具有重要的临床意义。