Parabrachial nucleus induces suppression of baroreflex bradycardia by the release of glutamate in the rostral ventrolateral medulla of the rat

Baroreceptor Modulation of the Cardiovascular System, Pain, Consciousness, and Cognition

Baroreceptors are mechanosensitive elements of the peripheral nervous system that maintain cardiovascular homeostasis by coordinating the responses to external and internal environmental stressors. While it is well known that carotid and cardiopulmonary baroreceptors modulate sympathetic vasomotor and parasympathetic cardiac neural autonomic drive, to avoid excessive fluctuations in vascular tone and maintain intravascular volume, there is increasing recognition that baroreceptors also modulate a wide range of non-cardiovascular physiological responses via projections from the nucleus of the solitary tract to regions of the central nervous system, including the spinal cord. These projections regulate pain perception, sleep, consciousness, and cognition. In this article, we summarize the physiology of baroreceptor pathways and responses to baroreceptor activation with an emphasis on the mechanisms influencing cardiovascular function, pain perception, consciousness, and cognition. Understanding baroreceptor-mediated effects on cardiac and extra-cardiac autonomic activities will further our understanding of the pathophysiology of multiple common clinical conditions, such as chronic pain, disorders of consciousness (e.g., abnormalities in sleep-wake), and cognitive impairment, which may result in the identification and implementation of novel treatment modalities. © 2021 American Physiological Society. Compr Physiol 11:1373-1423, 2021.

Midbrain modulation of the cardiac baroreflex involves excitation of lateral parabrachial neurons in the rat

Activation of the dorsal periaqueductal gray (PAG) evokes defense-like behavior including a marked increase in sympathetic drive and resetting of baroreflex function. The goal of this study was to investigate the role of the lateral parabrachial nucleus (LPBN) in mediating dorsal PAG modulation of the arterial baroreflex. Reflex responses were elicited by electrical stimulation of the aortic depressor nerve (ADN) at 5 Hz or 15 Hz in urethane anesthetized rats (n=18). Electrical stimulation of the dorsal PAG at 10 Hz did not alter baseline mean arterial pressure (MAP) but did significantly attenuate baroreflex control of heart rate (HR) evoked by low frequency ADN stimulation. Alternatively, 40 Hz dorsal PAG stimulation increased baseline MAP (43+/-3 mm Hg) and HR (33+/-3 bpm) and attenuated baroreflex control of HR at both ADN stimulation frequencies. Reflex control of MAP was generally unchanged by dorsal PAG stimulation. Bilateral inhibition of neurons in LPBN area (n=6) with muscimol (0.45 nmol per side) reduced dorsal PAG-evoked increases in MAP and HR by 50+/-4% and 95+/-4%, respectively, and significantly reduced, but did not completely eliminate dorsal PAG attenuation of the cardiac baroreflex. Bilateral blockade of glutamate receptors in the LPBN area (n=6) with kynurenic acid (1.8 nmol) had a similar effect on dorsal PAG-evoked increases in MAP, HR and cardiac baroreflex function. Reflex control of MAP was unchanged with either treatment. These findings suggest that the LPBN area is one of several brainstem regions involved in descending modulation of the cardiac baroreflex function during defensive behavior.

Regional expression of NO synthase, NAD(P)H oxidase and superoxide dismutase in the rat brain

Nitric oxide (NO) derived from the endothelial NO synthase (eNOS) contributes to regulation of cerebral circulation, whereas that produced by neuronal NOS (nNOS) participates in the regulation of brain function. In particular, NO plays an important role in modulation of sympathetic activity and hence central regulation of arterial pressure. Superoxide derived from NAD(P)H oxidase avidly reacts with and inactivates NO and, thereby, modulates its bioavailability. Calmodulin (CM) is required for activation of NOS and soluble guanylate cyclase (sGC) serves as a NO receptor. Superoxide is dismutated to H2O2 by superoxide dismutase (SOD) and H2O2 is converted to H2O by catalase or glutathione peroxidase (GPX). Given the importance of NO in the regulation of brain perfusion and function, we undertook the present study to determine the relative expressions of immunodetectable nNOS, eNOS, CM, sGC, NAD(P)H oxidase and SOD by Western analysis in different regions of the normal rat brain. nNOS was abundantly expressed in the pons cerebellum and hypothalamus and less so in the cortex and medulla. sGC abundance was highest in the hypothalamus and pons, and lowest in the cerebellum and medulla. eNOS and calmodulin were equally abundant in all regions. NAD(P)H oxide was most abundant in the pons compared to other regions. Cytoplasmic SOD was equally distributed among different regions but catalase and GPX were more abundant in pons, hypothalamus and medulla and less so in the cortex and cerebellum. Thus, the study documented regional distributions of NOS, NAD(P)H oxidase, antioxidant enzymes, sGC and calmodulin which collectively regulate production and biological activities of NO and superoxide, the two important small molecular size signaling molecules.

Parabrachial neurons mediate dorsal periaqueductal gray evoked respiratory responses in the rat

The neural substrates mediating autonomic components of the behavioral defense response reside in the periaqueductal gray (PAG). The cardiovascular components of the defense response evoked from the dorsal PAG (DPAG) have been well described and are dependent, in part, on the integrity of neurons in the region of the parabrachial nucleus as well as the rostral ventrolateral medulla. Descending pathways mediating the ventilatory response associated with activation of DPAG neurons are unknown. The present study was undertaken to test the hypothesis that parabrachial area neurons are also involved in mediating the respiratory response to DPAG stimulation. In urethane-anesthetized, spontaneously breathing rats, electrical stimulation of the DPAG significantly increased respiratory rate, arterial pressure, and heart rate. Changes in respiratory frequency were associated with significant decreases in inspiratory and expiratory durations. After bilateral inhibition of neurons in the lateral parabrachial nucleus (LPBN) region with 5 mM muscimol ( n = 6), DPAG-evoked increases in respiration and heart rate were attenuated by 90 ± 6 and 72 ± 13%, respectively. The pressor response evoked by DPAG stimulation, however, was attenuated by only 57 ± 6%. Bilateral blockade of glutamate receptors with 20 mM kynurenic acid ( n = 6) in the LPBN also markedly attenuated DPAG-evoked increases in respiration and heart rate (65 ± 15 and 53 ± 9% reduction, respectively) but only modestly changed the DPAG-evoked pressor response (34 ± 16% reduction). These results demonstrate that LPBN neurons play a significant role in the DPAG-mediated respiratory component of behavioral defense responses. This finding supports previous work demonstrating that the dorsolateral pons plays a significant role in mediating most physiological adjustments associated with activation of the DPAG.

Blockade of N-methyl-d-aspartate receptors within the rostral ventrolateral medulla antagonizes clonidine-induced cardiovascular effects

There is wide agreement that the rostral ventrolateral medulla (RVLM) plays a crucial role in the regulation of blood pressure (BP), and that there may be a close correlation between the actions of centrally acting antihypertensive agents and N-methyl-D-aspartate (NMDA) receptor functional states. The present study was done to test the hypothesis that NMDA receptors within the RVLM were involved in the cardiovascular effects of centrally acting antihypertensive drug clonidine in anesthetized and paralyzed rats. Prior unilateral microinjection of NMDA receptor antagonist dizocilpine (MK801, 500 pmol) into the RVLM significantly attenuated (p<0.01, n=9) the reductions of BP (-24+/-6 to -8+/-4 mm Hg) and heart rate (-49+/-9 to -14+/-7 bpm) induced by unilaterally injected clonidine (5 nmol) into the RVLM. Prior bilateral microinjection of MK801 (500 pmol for each side) into the RVLM effectively (p<0.01, n=7) antagonized the hypotension (-25+/-5 to -8+/-2 mm Hg) and bradycardia (-43+/-7 to -11+/-4 bpm) of intravenously administered clonidine (10 microg kg(-1)). Importantly, iontophoretic application of MK801 (60 nA) significantly (p<0.01, n=9) prevented the inhibitory effect of intravenously (10 microg kg(-1)) injected clonidine on the discharge of presympathetic neurons in the RVLM (neuronal inhibition: -39+/-6 to -10+/-2%). In conclusion, the present study shows that the RVLM administrated MK801 effectively antagonizes clonidine-induced cardiovascular effects, and suggests that NMDA receptors within the RVLM contribute to clonidine actions.

Downregulation of angiotensin subtype 1 receptor in rostral ventrolateral medulla during endotoxemia

We reported recently that an upregulation of the inducible nitric oxide synthase (iNOS) in the rostral ventrolateral medulla (RVLM), where sympathetic premotor neurons are located, is a crucial determinant for the elicitation of cardiovascular depression during experimental endotoxemia. The current study evaluated the hypothesis that a downregulation of the molecular synthesis and functional expression of angiotensin subtype 1 receptor (AT1R) in the RVLM is consequential to this upregulated iNOS. In adult Sprague-Dawley rats maintained under propofol anesthesia, intravenous administration of Escherichia coli lipopolysaccharide (15 mg/kg) elicited a reduction, followed by an augmentation and a secondary decrease in sympathetic vasomotor outflow, together with progressive hypotension and bradycardia. There was also a progressive increase in iNOS mRNA and protein level in the ventrolateral medulla. This was followed by a significant downregulation of both mRNA and protein levels of AT1R in the ventrolateral medulla, alongside reduced efficacy of angiotensin II (50 pmol) to induce an increase in systemic arterial pressure, heart rate, or sympathetic vasomotor outflow on unilateral microinjection into the RVLM. Pretreatment with microinjection of a selective iNOS inhibitor, S-methylisothiourea (250 pmol) bilaterally into the RVLM significantly reversed the reduction in both synthesis and activity of AT1R. We conclude that a downregulation of molecular synthesis and functional expression of AT1R in the ventrolateral medulla is consequential to the overproduction of NO through upregulation of iNOS in the RVLM and may underlie the cardiovascular depression that takes place during experimental endotoxemia.

Increased c-Fos expression in select lateral parabrachial subnuclei following chemical versus electrical stimulation of the dorsal periaqueductal gray in rats

The parabrachial nucleus (PBN) is located in the rostral dorsolateral pons and has been identified as a critical relay for cardiovascular responses (sympathoexcitation and baroreflex attenuation) evoked by the dorsal periaqueductal gray (PAG). We examined the pattern of c-Fos protein immunoreactivity throughout the rostral-caudal extent of the PBN in four groups of anesthetized male Sprague-Dawley rats to identify the specific PBN regions activated by dorsal PAG stimulation. Both electrical stimulation and chemical (0.3 mM bicuculline methobromide) activation of the dorsal PAG elicited a selective increase in Fos-like immunoreactivity (FLI) in the superior lateral and central lateral subnuclei of the rostral lateral PBN (LPBN) relative to surgery and blood pressure control groups. In the middle LPBN chemical stimulation of the dorsal PAG selectively increased FLI in the central lateral subnucleus while electrical stimulation increased FLI in the Kolliker-Fuse area only. Finally, in the caudal LPBN only electrical stimulation of the dorsal PAG induced significant changes in FLI above control. Significant changes in FLI in the medial PBN were not observed under any experimental conditions. These results confirm neuroanatomical data demonstrating that neurons in superior lateral and central lateral subnuclei of the rostral and middle LPBN are the primary targets of the dorsal PAG. Our results also demonstrate that this descending projection to the central lateral and superior lateral subnuclei of the LPBN is in part excitatory. Finally, our results raise the possibility that neurons in the central lateral subnucleus of the middle and rostral LPBN are integrally involved in descending modulation of sympathetic drive associated with dorsal PAG activation.

Complement inhibitor factor H binding to Lyme disease spirochetes is mediated by inducible expression of multiple plasmid-encoded outer surface protein E paralogs

Borrelia burgdorferi spirochetes can circumvent the vertebrate host's immune system for long periods of time. B. burgdorferi sensu stricto and B. afzelii, but not B. garinii, bind the complement inhibitor factor H to protect themselves against complement-mediated opsonophagocytosis and killing. We found that factor H binding and complement resistance are due to inducible expression of a wide repertoire of outer surface protein E (OspE) lipoproteins variably called OspE, p21, ErpA, and ErpP. Individual Borrelia strains carry multiple plasmid-encoded OspE paralogs. Together the OspE homologs were found to constitute an array of proteins that bind factor H via multiple C-terminal domains that are exposed outwards from the Borrelial surface. Charged residue substitutions in the key binding regions account for variations between OspE family members in the optimal binding pH, temperature, and ionic strength. This may help the spirochetes to adapt into various host environments. Our finding that multiple plasmid-encoded OspE proteins act as virulence factors of Borrelia can provide new tools for the prevention and treatment of borreliosis.

GABAergic neurotransmission at the nucleus tractus solitarii in the suppression of reflex bradycardia by parabrachial nucleus

We investigated the role of GABAergic neurotransmission at the nucleus tractus solitarii (NTS) in the suppression of cardiac baroreceptor reflex (BRR) response induced by parabrachial nucleus (PBN) complex in adult Sprague-Dawley rats maintained under pentobarbital anesthesia. Based on in vivo microdialysis coupled with high-performance liquid chromatography-fluorescence detection for gamma-aminobutyric acid (GABA), we found that electrical stimulation of the ventrolateral regions and Koelliker-Fuse (KF) subnucleus of PBN complex resulted in a site-specific increase in GABA concentration in the dialysate collected from the NTS. The temporal increase in extracellular GABA concentration in the NTS coincided with the time course of PBN-induced cardiac BRR inhibition. In addition, the PBN-induced cardiac BRR suppression was reversed by microinjection bilaterally into the NTS of a GABA(A) receptor antagonist, bicuculline methiodide (5 pmol), or a GABA(B) receptor antagonist, 2-OH saclofen (500 pmol). Blockade of neuronal activity in the ventrolateral regions and KF subnucleus of PBN complex with lidocaine (5%) elicited an enhancement of the same reflex response. The time course of this facilitatory effect of lidocaine correlated positively with the temporal decrease in extracellular GABA concentration in the NTS. Anatomically, Fast Blue-labeled neurons were identified in the same subnuclei of the PBN complex after microinjection of the retrograde transport tracer into the NTS. Some of these Fast Blue-labeled neurons were also immunoreactive to glutamic acid decarboxylase. These results suggest that a direct GABAergic descending projection from the KF subnucleus and surrounding areas of the PBN complex to the NTS may inhibit cardiac BRR response by activating GABA(A) and GABA(B) receptors at the NTS.