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Shibamoto T, Ono M, Tanida M, Kuda Y, Kurata Y. Mechanisms for hypothermia during anaphylactic hypotension in awake rats. Am J Physiol Regul Integr Comp Physiol 2023; 325:R446-R455. [PMID: 37602385 DOI: 10.1152/ajpregu.00015.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/27/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
Hypothermia develops during systemic anaphylaxis in rodents. The aim of this study was to elucidate the mechanism for the hypothermia by assessing the roles of locomotor activity, tail heat dissipation, heat production in the brown adipose tissue (BAT) activity, and chemical mediators during ovalbumin-induced anaphylactic hypotension in awake rats. We measured the core body temperature (Tcore) and mean blood pressure (MBP), along with the surface temperature of the interscapular region (TiScap), an indirect measure of BAT activity, and the tail (Ttail). During anaphylaxis, MBP decreased to the nadir of 53 ± 2 mmHg at 8 min with recovery toward baseline. Tcore began to decrease at 7.5 min with the nadir of 36.1 ± 0.2°C at 30 min from the baseline of 38.0 ± 0.1°C. TiScap also significantly decreased, but its onset was preceded by that of Tcore. Ttail decreased after antigen, suggesting the absence of increased heat dissipation from the tail. The physical activity, as evaluated by moved distances, did not decrease until 20 min after antigen, followed by a progressive decrease. Reduced movement using a restraint maneuver not only reduced Tcore in nonsensitized rats but also augmented the anaphylactic hypothermia in the early phase (1.5-18 min) in sensitized rats. Combined antagonism against platelet-activating factor (PAF) and histamine H1 receptors abolished antigen-induced hypotension but only attenuated hypothermia. In conclusion, decreased locomotor activity, but not tail heat dissipation or decreased BAT activity, may at least in part contribute to this hypothermia. PAF and histamine are involved mainly in hypotension but only partly in hypothermia during rat anaphylaxis.NEW & NOTEWORTHY Anaphylactic shock is a life-threatening systemic hypotension. Hypothermia is observed during systemic anaphylaxis of rats. We determined the mechanism as follows: decreased locomotor activity, but not tail heat dissipation or decreased BAT activity, may at least in part contribute to this hypothermia. PAF and histamine are involved mainly in hypotension, but only partly in hypothermia during rat anaphylaxis.
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Affiliation(s)
| | - Munenori Ono
- Department of Physiology I, Kanazawa Medical University, Ishikawa, Japan
| | - Mamoru Tanida
- Department of Physiology II, Kanazawa Medical University, Ishikawa, Japan
| | - Yuhichi Kuda
- Department of Physiology II, Kanazawa Medical University, Ishikawa, Japan
| | - Yasutaka Kurata
- Department of Physiology II, Kanazawa Medical University, Ishikawa, Japan
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Tanida M, Iwasaki Y, Yamamoto N. Central Injection of Leptin Increases Sympathetic Nerve Outflows to the Stomach and Spleen in Anesthetized Rats. In Vivo 2020; 33:1827-1832. [PMID: 31662509 DOI: 10.21873/invivo.11675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND/AIM Leptin, one of the hormones produced in white adipose tissue, is an efferent sympathetic stimulator. Actually, an injection of leptin into the brain has been shown to activate sympathetic nerve activities innervating the kidney, adrenal gland, adipose tissues, liver, and lumbar in rats. MATERIALS AND METHODS This study investigated the effects of an intracerebroventricular injection of leptin on the activities of sympathetic nerves innervating the stomach and spleen in anesthetized rats. RESULTS Leptin injection activated the neural activities of sympathetic traffic to both the stomach and spleen. In addition, to investigate the role of AMP-activated protein kinase (AMPK), the effects of 5-aminoimidazole-4-carboxamide 1-beta-D-ribofuranoside (AICAR), an AMPK activator, or compound C, an AMPK inhibitor, on leptin-induced sympathoexcitation, were assessed. Central pretreatment with AICAR or compound C eliminated not only leptin-induced gastric sympathoexcitation but also leptin-induced splenic sympathoexcitation. CONCLUSION Leptin stimulates efferent sympathetic outflow to the stomach and spleen through the hypothalamic AMPK.
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Affiliation(s)
- Mamoru Tanida
- Department of Physiology II, Kanazawa Medical University, Uchinada, Japan
| | - Yusaku Iwasaki
- Laboratory of Animal Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Naoki Yamamoto
- Department of Pharmaceutical Health Care, Faculty of Pharmaceutical Sciences, Himeji Dokkyo University, Himeji, Japan
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Francuzik W, Dölle-Bierke S, Knop M, Scherer Hofmeier K, Cichocka-Jarosz E, García BE, Lang R, Maris I, Renaudin JM, Worm M. Refractory Anaphylaxis: Data From the European Anaphylaxis Registry. Front Immunol 2019; 10:2482. [PMID: 31749797 PMCID: PMC6842952 DOI: 10.3389/fimmu.2019.02482] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 10/04/2019] [Indexed: 12/12/2022] Open
Abstract
Refractory anaphylaxis (unresponsive to treatment with at least two doses of minimum 300 μg adrenaline) is a rare and often fatal hypersensitivity reaction. Comprehensive data on its definition, prevalence, and risk factors are missing. Using the data from the European Anaphylaxis Registry (11,596 cases in total) we identified refractory anaphylaxis cases (n = 42) and analyzed these in comparison to a control group of severe anaphylaxis cases (n = 4,820). The data show that drugs more frequently elicited refractory anaphylaxis (50% of cases, p < 0.0001) compared to other severe anaphylaxis cases (19.7%). Cases elicited by insects (n = 8) were more often due to bees than wasps in refractory cases (62.5 vs. 19.4%, p = 0.009). The refractory cases occurred mostly in a perioperative setting (45.2 vs. 9.05, p < 0.0001). Intramuscular adrenaline (as a first line therapy) was administered in 16.7% of refractory cases, whereas in 83.3% of cases it was applied intravenously (significantly more often than in severe anaphylaxis cases: 12.3%, p < 0.0001). Second line treatment options (e.g., vasopression with dopamine, methylene blue, glucagon) were not used at all for the treatment of refractory cases. The mortality rate in refractory anaphylaxis was significantly higher (26.2%) than in severe cases (0.353%, p < 0.0001). Refractory anaphylaxis is associated with drug-induced anaphylaxis in particular if allergens are given intravenously. Although physicians frequently use adrenaline in cases of perioperative anaphylaxis, not all patients are responding to treatment. Whether a delay in recognition of anaphylaxis is responsible for the refractory case or whether these cases are due to an overflow with mast cell activating substances—requires further studies. Reasons for the low use of second-line medication (i.e., methylene blue or dopamine) in refractory cases are unknown, but their use might improve the outcome of severe refractory anaphylaxis cases.
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Affiliation(s)
- Wojciech Francuzik
- Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Sabine Dölle-Bierke
- Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Macarena Knop
- Department of Dermatology and Allergology, Klinikum der Universität München, Munich, Germany
| | | | - Ewa Cichocka-Jarosz
- Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Blanca E García
- Service of Allergology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Roland Lang
- Department of Dermatology, Paracelsus Private Medical University Salzburg, Salzburg, Austria
| | - Ioana Maris
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Jean-Marie Renaudin
- Réseau d'Allergo-Vigilance (Allergy Vigilance Network), Vandoeuvre les Nancy, France
| | - Margitta Worm
- Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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Kuda Y, Tanida M, Chen F, Kurata Y, Shibamoto T. Anaphylaxis stimulates afferent vagal nerve activity and efferent sympathetic nerve activity in the stomach of anesthetized rats. Am J Physiol Regul Integr Comp Physiol 2019; 317:R337-R345. [PMID: 31116019 DOI: 10.1152/ajpregu.00193.2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Systemic anaphylaxis is a life-threatening and allergic reaction that affects various organs. We previously reported that, in the stomach, gastric vasoconstriction occurring at the late phase (15-55 min after injection of ovalbumin antigen) was observed in anesthetized rats sensitized with ovalbumin. In addition, anaphylaxis enhances gastric motility and delays emptying. However, the role of extrinsic autonomic nervous system on antigen-induced gastric alterations was not known. Thus, using the same rat anaphylaxis model, we aimed to determine the changes in the efferent and afferent autonomic nerve activities in the stomach during anaphylactic hypotension. The findings showed that injection of ovalbumin antigen caused substantial systemic hypotension in all sensitized rats. The efferent gastric sympathetic nerve activity (ef-GSNA), but not the efferent vagal nerve activity, increased only at the early phase (1-10 min after injection of ovalbumin antigen) and showed baroreceptor reflex, as evidenced by a stimulatory response to sodium nitroprusside-induced hypotension. In general, excitation of ef-GSNA could induce pylorus sphincter contraction and gastric vasoconstriction. In the present study, we found that sympathectomy attenuated the anaphylaxis-induced decrease in gastric flux but not the increase in gastric vascular resistance. Thus, the increase in ef-GSNA may cause anaphylactic pylorus sphincter contraction but not anaphylactic gastric vasoconstriction. On the other hand, the afferent gastric vagal nerve activity, but not the afferent sympathetic nerve activity, increased during the early phase of anaphylactic hypotension. However, vagotomy produced no effects on the anaphylactic gastric dysfunction. In conclusion, the gastric sympathetic nerves partly modulate stomach function during systemic anaphylaxis.
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Affiliation(s)
- Yuhichi Kuda
- Department of Physiology II, Kanazawa Medical University, Ishikawa, Japan
| | - Mamoru Tanida
- Department of Physiology II, Kanazawa Medical University, Ishikawa, Japan
| | - Fu Chen
- Department of Physiology II, Kanazawa Medical University, Ishikawa, Japan.,Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Yasutaka Kurata
- Department of Physiology II, Kanazawa Medical University, Ishikawa, Japan
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Kakall ZM, Nedoboy PE, Farnham MMJ, Pilowsky PM. Activation of µ-opioid receptors in the rostral ventrolateral medulla blocks the sympathetic counterregulatory response to glucoprivation. Am J Physiol Regul Integr Comp Physiol 2018; 315:R1115-R1122. [PMID: 30281326 DOI: 10.1152/ajpregu.00248.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Activation of neurons in the rostral ventrolateral medulla (RVLM) following glucoprivation initiates sympathoadrenal activation, adrenaline release, and increased glucose production. Here, we aimed to determine the role of RVLM µ-opioid receptors in the counterregulatory response to systemic glucoprivation. Experiments were performed in pentobarbital sodium anesthetized male Sprague-Dawley rats ( n = 30). Bilateral activation of RVLM µ-opioid receptors with [d-Ala2, N-Me-Phe4, Gly5-ol]-enkephalin (DAMGO) (8 mM, 50 nl) depressed adrenal sympathetic nerve activity for ~60 min ( n = 6; Δ49.9 ± 5.8%, P < 0.05). The counterregulatory response to glucoprivation (measured by adrenal sympathetic efferent nerve activity) induced by 2-deoxyglucose (2-DG) ( n = 6; Δ63.6 ± 16.5%, P < 0.05) was completely blocked 60 min after DAMGO microinjections ( n = 6; Δ10.2 ± 3.5%, P < 0.05). Furthermore, DAMGO pretreatment attenuated the increase in blood glucose levels after 2-DG infusion ( n = 6; 6.1 ± 0.7mmol/l vs. baseline 5.2 ± 0.3mmol/l, P > 0.05) compared with 2-DG alone ( n = 6; 7.6 ± 0.4mmol/l vs. baseline 6.0 ± 0.4mmol/l, P < 0.05). Thus, activation of RVLM µ-opioid receptors attenuated the neural efferent response to glucoprivation and reduced glucose production.
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Affiliation(s)
- Zohra M Kakall
- Department of Physiology, Sydney Medical School, The University of Sydney , Sydney, NSW , Australia.,Heart Research Institute , Sydney, NSW , Australia
| | - Polina E Nedoboy
- Department of Physiology, Sydney Medical School, The University of Sydney , Sydney, NSW , Australia.,Heart Research Institute , Sydney, NSW , Australia
| | - Melissa M J Farnham
- Department of Physiology, Sydney Medical School, The University of Sydney , Sydney, NSW , Australia.,Heart Research Institute , Sydney, NSW , Australia
| | - Paul M Pilowsky
- Department of Physiology, Sydney Medical School, The University of Sydney , Sydney, NSW , Australia.,Heart Research Institute , Sydney, NSW , Australia
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