Pathology of the Olfactory Epithelium: Smoking and Ethanol Exposure

OBJECTIVE

To investigate the effects of tobacco smoke on the olfactory epithelium. Cigarette smoking has been associated with hyposmia; however, the pathophysiology is poorly understood. The sense of smell is mediated by olfactory sensory neurons (OSNs) exposed to the nasal airway, rendering them vulnerable to environmental injury and death. As a consequence, a baseline level of apoptotic OSN death has been demonstrated even in the absence of obvious disease. Dead OSNs are replaced by the mitosis and maturation of progenitors to maintain sufficient numbers of neurons into adult life. Disruption of this balance has been suggested as a common cause for clinical smell loss. This current study will evaluate the effects of tobacco smoke on the olfactory mucosa, with emphasis on changes in the degree of OSN apoptosis.

STUDY DESIGN

A rat model was used to assess the olfactory epithelium after exposure to tobacco smoke.

METHODS

Rats were exposed to tobacco smoke alone (for 12 weeks), smoke plus dietary ethanol (for the final 5 weeks), or to neither (control). Immunohistochemical analysis of the olfactory epithelium was performed using an antibody to the active form of caspase-3. Positive staining for this form of the caspase-3 enzyme indicates a cell undergoing apoptotic proteolysis.

RESULTS

Control rats demonstrated a low baseline level of caspase-3 activity in the olfactory epithelium. In contrast, tobacco smoke exposure triggered a dramatic increase in the degree of OSN apoptosis that affected all stages of the neuronal lineage.

CONCLUSIONS

These results support the following hypothesis: smell loss in smokers is triggered by increased OSN death, which eventually overwhelms the regenerative capacity of the epithelium.

Differential expression of beta tubulin isotypes in the adult gerbil cochlea

Tubulin, the principal component of microtubules, exists as two polypeptides, termed alpha and beta. Seven isotypes of beta tubulin are known to exist in mammals. The distributions of four beta tubulin isotypes, beta(I), beta(II), beta(III), and beta(IV), have been examined in the adult cochlea by indirect immunofluorescence using isotype-specific antibodies. In the organ of Corti, outer hair cells contained only beta(I) and beta(IV), while inner hair cells contained only beta(I) and beta(II). Inner and outer pillar cells contained beta(II) and beta(IV), but Deiters cells contained those isotypes plus beta(I). Fine fibers in the inner spiral bundle, tunnel crossing fibers, and outer spiral fibers, probably efferent in character, contained beta(I), beta(II), and beta(III), but not beta(IV). In the spiral ganglion, the somas and axons of neurons contained all four isotypes, and the myelination of ganglion cells also contained beta(I). Fibers of the intraganglionic spiral bundle contained beta(I), beta(II), and beta(III). No antibody labeled the dendritic processes of spiral ganglion neurons. The differences in isotype distribution in organ of Corti and neurons described here are consistent with and support the multi-tubulin hypothesis, which states that tubulin isotypes are expressed specifically in different cell types and may therefore have different functions.

Tubulin expression in the developing and adult gerbil organ of Corti

In the late stages of inner ear development, the relatively undifferentiated cells of Kollicker's organ are transformed into the elaborately specialized cell types of the organ of Corti. Microtubules are prominent features of adult cells in the organ of Corti, particularly supporting cells. To test the possible role of microtubules in organ of Corti development, the microtubule organization in the organ of Corti has been examined using indirect immunofluorescence to beta-tubulin in the developing gerbil cochlea. Tubulin first appears at post-natal day 0 (P0) as filamentous asters in inner hair cells and by P2, asters are also seen in outer hair cells. Tubulin appears at P3 in inner pillar cells in a tooth crown-like figure. By P6, tubulin expression is also evident in outer pillar cells and by P9, it is seen in Deiters cells. Elaboration of microtubules in pillar cells was observed to proceed from the reticular lamina towards the basilar membrane. The pattern of tubulin expression in the apical organ of Corti lags the base by about 3 days until P6, but by P9, apical and basal organ of Corti appear substantially the same.

The effect of quinine on outer hair cell shape, compliance and force

Quinine intoxication causes a well-described syndrome that includes tinnitus, sensorineural hearing loss and vertigo. The pathophysiology of quinine's effects on hearing is unknown, but may include a peripheral component. The cochlear outer hair cell is known to be motile and to contribute force to amplify the vibration pattern of the organ of Corti. The outer hair cell is also a target of diseases involving tinnitus and sensorineural hearing loss, including salicylate intoxication. These effects may be mediated through changes either in motile force or in mechanical properties. Quinine's effects on outer hair cell motility and mechanical properties have therefore been examined in vitro. Quinine at 5.0 mM substantially decreased active force generation in isolated guinea pig cochlear outer hair cells. Isolated cells also elongated and dilated in diameter when exposed to 5.0 mM quinine. No consistent changes in mechanical properties were observed. 1.0 mM quinine was ineffective in either force reduction or elongation. Trifluoperazine, a calmodulin inhibitor, and ML-9, a blocker of myosin light chain kinases, were ineffective in blocking quinine-induced force reduction or elongation. Deferoxamine, a hydroxyl free radical scavenger, also failed to block either the force decrease or the elongation.

Modulation of outer hair cell compliance and force by agents that affect hearing

Force generated by outer hair cells is thought to be an essential source of mechanical input to the normal cochlea. Many disease processes in the inner ear act via outer hair cells. It is therefore plausible that such disease processes modulate outer hair cell force generation. The force generated by an isolated, electrically stimulated outer hair cell against a load may be represented by an intrinsic motor and a passive axial stiffness in series. Thus modulation of outer hair cell force generation may occur either by action on the motor or indirectly by an action on cell stiffness. In this study, the effects of agents that affect hearing on outer hair cell stiffness and force generation have been examined. Overstimulation and hypoosmotic challenge caused cells to decrease in length and increase in stiffness. The force generated by a constant voltage stimulus increased consequent to the stiffness increase. Hyperosmotic challenge elicited a stiffness decrease and a force decrease. In contrast, salicylate caused a decrease in force without stiffness change. The results suggest that outer hair cell force generation in vivo may be modulated in at least two ways.

Passive compliance and active force generation in the guinea pig outer hair cell

1. Cochlear outer hair cells 20-80 microns in length were compressed axially in vitro using calibrated glass fibers mounted on a piezoelectric actuator. 2. When driven by rectangular pulses in the compression direction, the motion of the fiber tip consisted of a rapid initial compression that was complete in 10-20 ms followed by a smaller compression of slower time course. 3. The initial fiber deflections were found to be linear in amplitude for compressions up to 400 nm. The axial compliances of outer hair cells were calculated from the difference between the fiber tip motions when unattached and when in contact with a cell. Axial compliances were found to be in the range of 0.04-1.2 km/N for 149 cells. The axial compliance was an increasing function of cell length. 4. The peak forces generated by electrically stimulated outer hair cells were measured from the deflection of a glass fiber when the cells were stimulated by sinusoidal voltage commands. The slope gains of force generation (force generated per mV of command at the cell membrane) were estimated to range from 0.01 to 100 pN/mV. Most of the results fell in the range of 0.1-20 pN/mV. 5. When the apparent stiffness of the fiber was increased by moving the cell closer to the fiber base, the peak amplitude of the fiber deflection generated by the cell decreased and the peak force increased, for the same sinusoidal voltage command. 6. The results of the previous experiment were interpreted in the light of a model of outer hair cell motility in which an ideal extension generating element is in series with an internal stiffness element. This internal stiffness was then calculated for 13 cells. 7. The internal stiffnesses of cells calculated by the above procedure were found to be positively correlated with the axial stiffness measurements obtained for the same cells. 8. The implications of the above results for the effectiveness of outer hair cell motility in vivo are discussed.

Atomic force microscope observations of otoconia in the newt

Calcitic and aragonitic otoconia from the Japanese red-bellied newt, Cynops pyrrhogaster, were examined using an atomic force microscope. The surface structure of both otoconial polymorphs consisted of arrays of elements approximately 50 nm in diameter. Elements were generally round and were separated by shallow depressions of no more than 20 nm. The elements are suggested to be single crystals of calcium carbonate. The relationship of these observations to theories of otoconial genesis is discussed.

The location and mechanism of electromotility in guinea pig outer hair cells

1. The microchamber method was used to examine the motile responses of isolated guinea pig outer hair cells to electrical stimulation. In the microchamber method, an isolated cell is drawn partway into a suction pipette and stimulated transcellularly. The relative position of the cell in the microchamber is referred to as the exclusion fraction. 2. The length changes of the included and excluded segments were compared for constant sinusoidal stimulus amplitude as functions of the exclusion fraction. Both included and excluded segments showed maximal responses when the cell was excluded approximately halfway. Both segments showed smaller or absent responses when the cell was almost fully excluded or almost fully included. 3. When the cell was near to, but not at, the maximum exclusion, the included segment response amplitude was zero, whereas the excluded segment response amplitude was nonzero. In contrast, when the cell was nearly fully included, the excluded segment response amplitude was zero, but the included segment response amplitude was still detectable. A simple model of outer hair cell motility based on these results suggests that the cell has finite-resistance terminations and that the motors are restricted to a region above the nucleus and below its ciliated apex (cuticular plate). 4. The function describing length change as a function of command voltage was measured for each segment as the exclusion fraction was varied. The functions were similar at midrange exclusions (i.e., when the segments were about equal length), showing nonlinearity and saturability. The functions were strikingly different when the segment lengths were different. The effects of exclusion on the voltage to length-change functions suggested that the nonlinearity and saturability are local properties of the motility mechanism. 5. The diameter changes of both segments were examined. The segment diameter changes were always antiphasic to the length changes. This finding implies that the motility mechanism has an active antiphasic diameter component. The diameter change amplitude was a monotonically increasing function of exclusion for the included segment, and a decreasing function for the excluded segment. 6. The voltage to length-change and voltage to diameter-change functions were measured for the same cell and exclusion fraction. The voltage to diameter-change function was smaller in amplitude than the voltage to length-change function. The functions were of opposite polarity to each other, but were otherwise similar in character. Thus it is likely that the same motor mechanism is responsible for both axial and diameter deformations.

Theory of electrically driven shape changes of cochlear outer hair cells

1. A theory of cochlear outer hair cell electromotility is developed and specifically applied to somatic shape changes elicited in a microchamber. The microchamber permits the arbitrary electrical and mechanical partitioning of the outer hair cell along its length. This means that the two partitioned segments are stimulated with different input voltages and undergo different shape changes. Consequently, by imposing more constraints than other methods, experiments in the microchamber are particularly suitable for testing different theories of outer hair cell motility. 2. The present model is based on simple hypotheses. They include a distributed motor associated with the cell membrane or cortex and the assumption that the displacement generated by the motor is related to the transmembrane voltage across the associated membrane element. It is expected that the force generated by the motor is counterbalanced by an elastic restoring force indigenous to the cell membrane and cortex, and a tensile force due to intracellular pressure. It is assumed that all changes take place while total cell volume is conserved. The above elements of the theory taken together permit the development of qualitative and quantitative predictions about the expected motile responses of both partitioned segments of the cell. Only a DC treatment is offered here. 3. Both a linear motor and an expanded treatment that incorporates a stochastic molecular motor model are considered. The latter is represented by a two-state Boltzmann process. We show that the linear motor treatment is an appropriate extrapolation of the stochastic motor theory for the case of small voltage driving signals. Comparison of experimental results with model responses permits the estimation of model parameters. Good match of data is obtained if it is assumed that the molecular motors undergo conformational length changes of 0.7-1.0 nm, that they have an effective displacement vector at approximately -20 degrees with the long axis of the cell, and that their linear density is approximately 80/microns. 4. An effort is made to parcel out motile response components that are a direct consequence of the motor action from those that are mediated by cytoplasmic pressure changes brought about by the concerted action of the motors. We show that pressure effects are of minor importance, and thus rule out models that rely on radial constriction/expansion-mediated internal pressure change as the primary cause of longitudinal motility. 5. As a consequence of the interaction between the Boltzmann process and the mechanical characteristics of the cell, the electromotile response is asymmetric.(ABSTRACT TRUNCATED AT 400 WORDS)

Outer hair cell electromotility: the sensitivity and vulnerability of the DC component

A technique was devised in order to study the fast electromechanical length changes of outer hair cells at low stimulus levels. Solitary outer hair cells were drawn into a glass microchamber. Length changes were evoked by the application of transcellular potentials and were detected with a photodiode. The method is non-invasive to the cell and offers superior sensitivity and stability for the recording of cell length changes. The function relating command voltage and cell length (V-delta L) change was determined. A nonlinearity, consisting of a DC component superimposed on the AC response, was shown to be present at the lowest stimulus levels measured. The nonlinearity was sensitive to imposed electrical bias as well as vulnerable to overstimulation. The observations are interpreted in reference to the V-delta L function. A parallel is suggested between the nonlinearity seen in the mechanical response and that observed in the responses of the intact cochlea.

Nature of the motor element in electrokinetic shape changes of cochlear outer hair cells

It is the prevailing notion that cochlear outer hair cells function as mechanical effectors as well as sensory receptors. Electrically induced changes in the shape of mammalian outer hair cells, studied in vitro, are commonly assumed to represent an aspect of their effector process that may occur in vivo. The nature of the motile process is obscure, even though none of the established cellular motors can be involved. Although it is known that the motile response is under voltage control, it is uncertain whether the stimulus is a drop in the voltage along the long axis of the cell or variation in the transmembrane potential. We have now performed experiments with cells partitioned in differing degrees between two chambers. Applied voltage stimulates the cell membrane segments in opposite polarity to an amount dependent on the partitioning. The findings show, in accordance with previous suggestions, that the driving stimulus is a local transmembrane voltage drop and that the cellular motor consists of many independent elements, distributed along the cell membrane and its associated cortical structures. We further show that the primary action of the motor elements is along the longitudinal dimension of the cell without necessarily involving changes in intracellular hydrostatic pressure. This establishes the outer hair cell motor as unique among mechanisms that control cell shape.

Calibration of photodiode measurements of cell motion by a transmission optical lever method

A method of calibrating photodiode measurements of cell motion is described. A transparent glass plane is inserted perpendicular to the light path, in front of the photodiode. When the glass plane is rotated, changing the angle between the plane and the light path, the image is displaced. The rotatable glass plane acts as an optical lever to simulate cell motion. The optical lever is easy to construct and offers excellent linearity and accuracy.

Sodium restriction and blood pressure in hypertensive type II diabetics: randomised blind controlled and crossover studies of moderate sodium restriction and sodium supplementation

OBJECTIVE

To determine the effect of moderate dietary sodium restriction on the hypertension of non-insulin-dependent (type II) diabetes.

DESIGN

Randomised parallel controlled study of moderate sodium restriction for three months compared with usual diabetic diet, followed by randomised double blind crossover trial of sustained release preparation of sodium for one month versus placebo for one month in patients continuing with sodium restriction.

SETTING

Patients attending diabetic outpatient clinic of city hospital.

PATIENTS

Thirty four patients with established type II diabetes complicated by mild hypertension (systolic blood pressure greater than 160 mm Hg or diastolic pressure greater than 95 mm Hg on three consecutive occasions). Patients already taking antihypertensive agents (but not diuretics) not barred from study provided that criteria for mild hypertension still met. Conditions precluding patients from study were diabetic or hypertensive nephropathy, cardiac failure, and pregnancy.

INTERVENTIONS

After run in phase with recordings at seven weeks, three weeks, and time zero patients were allocated at random to receive moderate dietary sodium restriction for three months (n = 17) or to continue with usual diabetic diet. Subsequently nine patients in sodium restriction group continued with regimen for a further two months, during which they completed a randomised double blind crossover trial of sustained release preparation of sodium (Slow Sodium 80 mmol daily) for one month versus matching placebo for one month.

END POINT

Reduction in blood pressure in type II diabetics with mild hypertension.

MEASUREMENTS AND MAIN RESULTS

Supine and erect blood pressure, body weight, and 24 hour urinary sodium and potassium excretion measured monthly during parallel group and double blind crossover studies. After parallel group study sodium restriction group showed significant reduction in systolic blood pressure (supine 19.2 mm Hg, erect 21.4 mm Hg; p less than 0.001) and mean daily urinary sodium excretion (mean reduction 60 mmol/24 h). There were no appreciable changes in weight, diabetic control, or diastolic pressure. No significant changes occurred in controls. In double blind crossover study mean supine systolic blood pressure rose significantly (p less than 0.005) during sodium supplementation (to 171 mm Hg) compared with value after three months of sodium restriction alone (159.9 mm Hg) and after one month of placebo (161.8 mm Hg).

CONCLUSIONS

Moderate dietary restriction of sodium has a definite hypotensive effect, which may be useful in mild hypertension of type II diabetes.

Compound action potentials and single unit responses to a 1 kHz haversine in the cat

The single-cycle 1 kHz haversine (one cycle of a 1 kHz sine wave beginning at -90 degrees) is a low-frequency impulsive stimulus which has been little use, but which has significant potential applications both as a clinical and a research tool. The auditory nerve compound action potential (CAP) and single unit discharge patterns evoked by a single-cycle 1 kHz haversine stimulus were studied in anesthetized cats. The haversine CAP waveform consisted of two or three short latency peaks with peak to peak intervals of about 1.0 ms. Latencies of the CAP peaks decreased with increased stimulus intensity and were also strongly dependent on stimulus polarity. Typically, CAP peak latencies changed by about 0.5 ms with stimulus polarity reversal. Single unit responses were classified by the peak latency pattern of their haversine post-stimulus time histograms (PSTHs). Low CF units had low thresholds and PSTHs resembling their click responses. High CF units had high thresholds and PSTHs comprised of one or two short latency peaks whose latencies were polarity-sensitive. Some units in an intermediate CF range (approximately 1.5-3.0 kHz) had PSTHs which were a transitional form between the high and low CF types of response. The unit discharge patterns strongly suggested a low frequency origin for the haversine CAP at all intensities.