Effect of intravenous substance P on laryngeal adductor activity in young dogs

Serotonin and substance P: Synergy or competition in the control of breathing

Numerous neurotransmitters identified in the central nervous system play role in ventilatory control. This mini-review focuses on the respiratory effects of two neurotransmitters: serotonin (5-HT) and substance P (SP). We discuss their co-localization in medullary raphe nuclei, expression of proper receptors within the specific regions of respiratory related structures and contribution to respiratory rhythmogenesis.

Laryngeal Electromyographic, Cardiovascular, and Respiratory Effects of Neuropeptide Injections into the Nucleus Tractus Solitarius of Rats

Identifying central neurotransmitters that mediate laryngeal adductor activity may aid in managing pathological laryngeal adduction as occurs in laryngospasm or apparent life-threatening events in infants. We studied the effect on cricothyroid (CT) and thyroarytenoid (TA) electromyography (EMG) and on cardiovascular parameters of neurotransmitter injections into the rat nucleus tractus solitarius (NTS), the primary sensory relay center of the larynx. Twenty nanoliters of vasoactive intestinal peptide (VIP; 2.5 pmol), neurokinin B (NKB, 16 pmol), calcitonin gene-related peptide (3.0 pmol), neurokinin A (NKA; 35 pmol), or artificial cerebrospinal fluid (control solution) was stereotactically injected into the region of the NTS and the control nucleus gracilis in 119 studies performed in 24 mature, anesthetized Sprague-Dawley rats. Changes in diaphragm, CT, and TA EMG activity and blood pressure (BP) were compared. Injection sites were verified histologically. Injections of both VIP and NKB into the region of the NTS, but not the nucleus gracilis, induced life-threatening changes, including apnea, a marked decline in BP (p < .05), and increases in EMG activity of the CT and TA adductor muscles ranging from sustained contraction to mild phasic increases during inspiration. Calcitonin gene-related peptide injection also decreased BP (p < .05), but caused only mild increases in CT and TA EMG activity. NKA and control injections into the NTS did not alter respiration, BP, or CT or TA EMG activity. VIP and NKB may play important roles in modulating EMG activity of the CT and TA muscles. This information may prove useful in evaluating pharmacological targets of central reflex activity to manage life-threatening laryngeal adduction.

Neurophysiology and Clinical Implications of the Laryngeal Adductor Reflex

The laryngeal adductor reflex (LAR) is an involuntary protective response to stimuli in the larynx. The superior laryngeal nerve (SLN) acts as the afferent limb and the recurrent laryngeal nerve (RLN) as the efferent limb of this reflex, which is modulated by the central nervous system. Perhaps the most clinically significant application of the LAR is its use in laryngopharyngeal (LP) sensory discrimination testing. Importantly, aberrations in the LAR may predict dysphagia or portend clinical phenotypes of chronic cough, vocal cord dysfunction or pediatric apneas. LP sensation is a potential target for interventions addressing the aforementioned conditions though currently remains an area of active investigation.

Capsaicin-induced activation of pulmonary vagal C fibers produces reflex laryngeal closure in the rat

Our recent studies show that intravenous administration of capsaicin induces enhancement of the intralaryngeal thyroarytenoid (TA) branch but a reduction of the intralaryngeal abducent branch, suggesting that the glottis is likely closed by capsaicin. The aim of the present study was to examine whether the glottis is adducted by intravenous administration of capsaicin. Electromyographic (EMG) activity of the TA muscle, subglottal pressure (SGP), and glottal behavior were evaluated before and after intravenous administration of capsaicin in male Wistar rats that were anesthetized and tracheostomized. Catheters were placed in the femoral artery and vein, as well as in the right jugular vein. Low and high doses of capsaicin (0.625 and 1.25 microg/kg) produced apnea and increases in the amplitude of the TA EMG. This enhancement of the TA EMG was observed during apnea as well as during recovery from apnea. Moreover, the onset of the TA EMG was advanced such that it commenced earlier during inspiration. Concomitantly, the SGP substantially increased. Increases in both the TA EMG and SGP were abolished after bilateral sectioning of the recurrent laryngeal nerve. In some animals, movement of the vocal folds was recorded by taking a motion picture with a digital camera under a surgical microscope. With intravenous administration of capsaicin, a tight glottal closure, decreases in blood pressure, and bradycardia were observed. These results strongly suggest that glottal closure is reflexively induced by intravenous administration of capsaicin and that closure of the glottis is beneficial for the defense of the airway and lungs when an animal is exposed to environmental irritants.

Effect of respiratory syncytial virus on apnea in weanling rats

Apnea is a common complication of respiratory syncytial virus (RSV) infection in young infants. The purpose of this study was to determine whether this infection affects apnea triggered by sensorineural stimulation in weanling rats. We also studied which neurotransmitters are involved in this response and whether passive prophylaxis with a specific neutralizing antibody (palivizumab) confers protection against it. Weanling rats were inoculated intranasally with RSV, adenovirus, or virus-free medium. Changes in respiratory rate and apnea in response to nerve stimulation with increasing doses of capsaicin were measured by plethysmography. Capsaicin-induced apnea was significantly longer in RSV-infected rats at postinoculation days 2 (upper airways infection) and 5 (lower airways infection), and apnea-related mortality occurred only in the RSV-infected group. Reduction in the duration of apnea was observed after selective inhibition of central gamma-aminobutyric acid (GABA) type A receptors and neurokinin type 1 receptors for substance P. Prophylactic palivizumab protected against apnea and apnea-related mortality. These results suggest that sensorineural stimulation during RSV infection is associated with the development of apnea and apnea-related death in early life, whose mechanism involves the release of GABA acting on central GABA type A receptors and substance P acting on neurokinin type 1 receptors.

Effect of substance P injection into the nucleus tractus solitarius of rats on cricothyroid and thyroarytenoid motor activity and cardiovascular and respiratory systems

Identification of central neurotransmitters that mediate laryngeal adductor and/or tensor activity may prove useful in managing pathological laryngeal adduction as occurs in laryngospasm or apparent life-threatening events. The putative transmitter substance P (SP) is found in the nucleus tractus solitarius (NTS), in which laryngeal afferents terminate. Therefore, we studied the laryngeal, cardiovascular, and respiratory effects of SP injected into the NTS of rats. We completed bilateral stereotactic injections of 20 nL of SP (15 micromol) or control solution into the region of the NTS, the dorsal motor nucleus (DMN), or the nucleus gracilis (GR) in 30 anesthetized rats. Changes in diaphragm, cricothyroid (CT), and thyroarytenoid (TA) electromyography (EMG), as well as blood pressure (BP), were compared. The injection sites were verified histologically. Injection of SP into the NTS altered CT and/or TA EMG activity in all animals. The change ranged from complete inhibition, to a phasic increase, to a tonic increase. No change in laryngeal adductor EMG activity was seen in 8 of 9 animals after SP injections into the DMN (4/5) or GR (4/4), but 1 animal demonstrated brief inhibition of CT and TA EMG activity after SP injection into the DMN. Injection of SP into the NTS induced central apnea and a significant decrease in BP in all animals. The duration of apnea tended to be longer after NTS injections than after DMN or GR injections (p < .10 and p < .05, respectively). We conclude that stereotactic injections of putative neurotransmitters in rats may be accomplished to identify effects on laryngeal motor activity. Direct application of SP into the NTS consistently elicits a change in CT and/or TA EMG activity, ranging from inhibition to excitation. This model may prove useful in evaluating pharmacological targets of central reflex activity to manage life-threatening laryngeal reflex activity.

Response of the cricothyroid and thyroarytenoid muscles to stereotactic injection of substance P into the region of the nucleus tractus solitarius in developing dogs

Substance P (SP), a putative sensory neurotransmitter, mediates reflex laryngeal adductor activity in developing dogs. Such reflex activity includes life-threatening laryngospasm induced by stimulation of distal esophageal afferent nerves. The site of SP's activity is unknown. This research was undertaken to determine whether injection of SP into the nucleus tractus solitarius (NTS) of developing beagles alters laryngeal adductor motor activity. Six animals, 57 to 78 days of age, underwent stereotactic injection of 5 to 10 microL of SP into the region of the NTS, identified by electrical stimulation of the ipsilateral superior laryngeal nerve. In 8 additional studies, SP was injected into the cerebellum (2) or brain stem (6) distant from the NTS. Cardiovascular and electromyographic (EMG) responses of the diaphragm and the cricothyroid (CT) and/or thyroarytenoid (TA) muscles were recorded in all 6 animals. Injection of SP into the region of the NTS induced a decrease in blood pressure in all animals and an increase in either ipsilateral CT or TA activity. Three of these animals experienced mixed apnea characterized by sustained EMG activity (spasm) of the ipsilateral CT or TA muscles and an absence of diaphragm EMG activity. The apnea event was fatal in 1 of these animals. In the 6 animals who underwent injections in the brain stem but outside the region of the NTS, diaphragm and laryngeal EMG activity generally did not change after injection of SP, with the exception of 1 animal who experienced a mild, short-lived increase in ipsilateral CT activity. A brief phasic increase in ipsilateral CT activity was seen in both animals who underwent injection of SP into the cerebellum. A putative sensory neurotransmitter, SP evokes ipsilateral CT and/or TA EMG activity when injected into the region of the NTS in developing beagle dogs. This research suggests that SP in the NTS may play a role in mediating life-threatening laryngeal adductor reflexes in developing mammals and may provide important information regarding therapeutic intervention.