Ganglia within the Gut, Heart, Urinary Bladder, and Airways: Studies in Tissue Culture

Purinergic Signaling in the Cardiovascular System

There is nervous control of the heart by ATP as a cotransmitter in sympathetic, parasympathetic, and sensory-motor nerves, as well as in intracardiac neurons. Centers in the brain control heart activities and vagal cardiovascular reflexes involve purines. Adenine nucleotides and nucleosides act on purinoceptors on cardiomyocytes, AV and SA nodes, cardiac fibroblasts, and coronary blood vessels. Vascular tone is controlled by a dual mechanism. ATP, released from perivascular sympathetic nerves, causes vasoconstriction largely via P2X1 receptors. Endothelial cells release ATP in response to changes in blood flow (via shear stress) or hypoxia, to act on P2 receptors on endothelial cells to produce nitric oxide, endothelium-derived hyperpolarizing factor, or prostaglandins to cause vasodilation. ATP is also released from sensory-motor nerves during antidromic reflex activity, to produce relaxation of some blood vessels. Purinergic signaling is involved in the physiology of erythrocytes, platelets, and leukocytes. ATP is released from erythrocytes and platelets, and purinoceptors and ectonucleotidases are expressed by these cells. P1, P2Y₁, P2Y₁₂, and P2X1 receptors are expressed on platelets, which mediate platelet aggregation and shape change. Long-term (trophic) actions of purine and pyrimidine nucleosides and nucleotides promote migration and proliferation of vascular smooth muscle and endothelial cells via P1 and P2Y receptors during angiogenesis, vessel remodeling during restenosis after angioplasty and atherosclerosis. The involvement of purinergic signaling in cardiovascular pathophysiology and its therapeutic potential are discussed, including heart failure, infarction, arrhythmias, syncope, cardiomyopathy, angina, heart transplantation and coronary bypass grafts, coronary artery disease, diabetic cardiomyopathy, hypertension, ischemia, thrombosis, diabetes mellitus, and migraine.

Cardiac purinergic signalling in health and disease

This review is a historical account about purinergic signalling in the heart, for readers to see how ideas and understanding have changed as new experimental results were published. Initially, the focus is on the nervous control of the heart by ATP as a cotransmitter in sympathetic, parasympathetic, and sensory nerves, as well as in intracardiac neurons. Control of the heart by centers in the brain and vagal cardiovascular reflexes involving purines are also discussed. The actions of adenine nucleotides and nucleosides on cardiomyocytes, atrioventricular and sinoatrial nodes, cardiac fibroblasts, and coronary blood vessels are described. Cardiac release and degradation of ATP are also described. Finally, the involvement of purinergic signalling and its therapeutic potential in cardiac pathophysiology is reviewed, including acute and chronic heart failure, ischemia, infarction, arrhythmias, cardiomyopathy, syncope, hypertrophy, coronary artery disease, angina, diabetic cardiomyopathy, as well as heart transplantation and coronary bypass grafts.

Neurogenic mechanisms in bladder and bowel ageing

The prevalence of both urinary and faecal incontinence, and also chronic constipation, increases with ageing and these conditions have a major impact on the quality of life of the elderly. Management of bladder and bowel dysfunction in the elderly is currently far from ideal and also carries a significant financial burden. Understanding how these changes occur is thus a major priority in biogerontology. The functions of the bladder and terminal bowel are regulated by complex neuronal networks. In particular neurons of the spinal cord and peripheral ganglia play a key role in regulating micturition and defaecation reflexes as well as promoting continence. In this review we discuss the evidence for ageing-induced neuronal dysfunction that might predispose to neurogenic forms of incontinence in the elderly.

Cotransmission in the autonomic nervous system

After some early hints, cotransmission was proposed in 1976 and then "chemical coding" later established for sympathetic nerves (noradrenaline/norepinephrine, adenosine 5'-triphosphate (ATP), and neuropeptide Y), parasympathetic nerves (acetylcholine, ATP, and vasoactive intestinal polypeptide (VIP)), enteric nonadrenergic, noncholinergic inhibitory nerves (ATP, nitric oxide, and VIP), and sensory-motor nerves (calcitonin gene-related peptide, substance P, and ATP). ATP is a primitive signaling molecule that has been retained as a cotransmitter in most, if not all, nerve types in both the peripheral and central nervous systems. Neuropeptides coreleased with small molecule neurotransmitters in autonomic nerves do not usually act as cotransmitters but rather as prejunctional neuromodulators or trophic factors. Autonomic cotransmission offers subtle, local variation in physiological control mechanisms, rather than the dominance of inflexible central control mechanisms envisaged earlier. The variety of information imparted by a single neuron then greatly increases the sophistication and complexity of local control mechanisms. Cotransmitter composition shows considerable plasticity in development and aging, in pathophysiological conditions and following trauma or surgery. For example, ATP appears to become a more prominent cotransmitter in inflammatory and stress conditions.

Purinergic cotransmission

ATP is a cotransmitter with classical transmitters in most nerves in the peripheral nervous system and central nervous system, although the proportions vary between species and tissues and in different developmental, physiological and pathophysiological conditions. ATP is released together with noradrenaline and neuropeptide Y from sympathetic nerves. It is released as a cotransmitter with acetylcholine from parasympathetic nerves supplying the bladder, developing skeletal neuromuscular junctions and some neurons in the brain. It is also released with nitric oxide and vasoactive intestinal polypeptide from non-adrenergic inhibitory enteric nerves, with glutamate from primary afferent sensory nerves and in the hypothalamus, and with dopamine and 5-hydroxytryptamine from some neurons in the central nervous system. Cotransmission offers subtle, local variations in neurotransmission and neuromodulation mechanisms.

Purinergic signalling in autonomic control

Intercellular purinergic signalling, which utilizes ATP as a transmitter, is fundamental for the operation of the autonomic nervous system. ATP is released together with 'classical' transmitters from sympathetic and parasympathetic nerves supplying various peripheral targets, modulates neurotransmission in autonomic ganglia, has an important role in local enteric neural control and coordination of intestinal secretion and motility, and acts as a common mediator for several distinct sensory modalities. Recently, the role of ATP-mediated signalling in the central nervous control of autonomic function has been addressed. Emerging data demonstrate that in the brain ATP is involved in the operation of several key cardiorespiratory reflexes, contributes to central processing of viscerosensory information, mediates central CO(2) chemosensory transduction and triggers adaptive changes in breathing, and modulates the activities of the brainstem vagal preganglionic, presympathetic and respiratory neural networks.

Purinergic cotransmission

Adenosine 5'-triphosphate (ATP) is a cotransmitter with classical transmitters in most nerves in the peripheral and central nervous systems, although the proportions vary between tissues and species and in different developmental and pathophysiological circumstances. There was early evidence that ATP was released together with acetylcholine (ACh) from motor nerves supplying skeletal muscle, although it was considered at the time as a molecule involved in the vesicular uptake and storage of ACh. Later it was shown that in the developing neuromuscular junction, released ATP acted on P2X receptor ion channels as a genuine cotransmitter with ACh. Adenosine triphosphate was shown to be released from sympathetic nerves supplying the guinea-pig taenia coli in 1971. Soon after, the possibility was raised that ATP was coreleased with noradrenaline from sympathetic nerves to guinea-pig seminal vesicle, cat nictitating membrane and guinea-pig vas deferens. Sympathetic purinergic cotransmission has also been demonstrated in many blood vessels. Parasympathetic nerves supplying the urinary bladder use ACh and ATP as cotransmitters; ATP acts through P2X ionotropic receptors, whereas the slower component of the response is mediated by the metabotropic muscarinic receptor. Adenosine triphosphate and glutamate appear to be cotransmitters in primary afferent sensory neurons. Adenosine triphosphate, calcitonin gene-related peptide and substance P coexist in some sensory-motor nerves. A subpopulation of intramural enteric nerves provides non-adrenergic, non-cholinergic inhibitory innervation of gut smooth muscle. Three cotransmitters are involved, namely ATP, nitric oxide and vasoactive intestinal polypeptide. In recent years, studies have shown that ATP is released with ACh, noradrenaline, glutamate, gamma-aminobutyric acid, 5-hyroxytryptamine and dopamine in different subpopulations of neurons in the central nervous system.

Physiology and pathophysiology of purinergic neurotransmission

This review is focused on purinergic neurotransmission, i.e., ATP released from nerves as a transmitter or cotransmitter to act as an extracellular signaling molecule on both pre- and postjunctional membranes at neuroeffector junctions and synapses, as well as acting as a trophic factor during development and regeneration. Emphasis is placed on the physiology and pathophysiology of ATP, but extracellular roles of its breakdown product, adenosine, are also considered because of their intimate interactions. The early history of the involvement of ATP in autonomic and skeletal neuromuscular transmission and in activities in the central nervous system and ganglia is reviewed. Brief background information is given about the identification of receptor subtypes for purines and pyrimidines and about ATP storage, release, and ectoenzymatic breakdown. Evidence that ATP is a cotransmitter in most, if not all, peripheral and central neurons is presented, as well as full accounts of neurotransmission and neuromodulation in autonomic and sensory ganglia and in the brain and spinal cord. There is coverage of neuron-glia interactions and of purinergic neuroeffector transmission to nonmuscular cells. To establish the primitive and widespread nature of purinergic neurotransmission, both the ontogeny and phylogeny of purinergic signaling are considered. Finally, the pathophysiology of purinergic neurotransmission in both peripheral and central nervous systems is reviewed, and speculations are made about future developments.

Tissue culture of the enteric nervous system from equine ileum

Ileal samples were harvested fresh from euthanized adult horses. The tissues were microdissected to prepare wholemount preparations for immunohistochemistry and for either explant or dissociated culture systems of the enteric nervous system. Explant culture systems were established using whole-mounts of either the submucous plexus or the muscularis externa (including the myenteric plexus). Dissociated cell cultures could only be obtained from the submucous plexus. Culture systems were maintained for up to 5 days. Immunoreactivity for a neuronal marker (Pan-N) and for glial cell markers (GFAP and S100) indicated the presence of both neurons and enteric glia in the tissue culture preparations. This is the first report of equine enteric neurons being grown in tissue culture Further refinements to the techniques will be required before this in vitro model can be used for quantitative analysis.

Neurons and glial cells of the enteric nervous system: studies in tissue culture

The enteric nervous system (ENS) has been recognized as the main component in regulating the function of the digestive tract and as a model for studying neuronal physiology and pharmacology. Most of the present knowledge on the ENS was derived from in vitro studies on freshly isolated plexuses. In 1978 the first study on cultured myenteric neurons was published and since then there has been a growing interest in this method. Several different culture preparations have been introduced, including the recent development of cultures from adult guinea-pigs and humans. This review summarizes the findings which have been made using cultured enteric neurons and glia. The main topics that are described are the role of the extracellular matrix and of hormones on neuronal growth, neuron-glia interactions, release of neuropeptides and their actions on neurons and co-transmission between neurons.