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gorzata Szereda-Przestaszewska11 Laboratory of Respiratory Reflexes, Polish Academy of Sciences Medical Research Centre, 5 Pawiñski Street, 02-106 Warsaw, Poland
| Abstract |
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2-adrenergic receptors were studied in spontaneously breathing anaesthetized rats that were neurally intact, or bilaterally vagotomized, or subjected to bilateral combined midcervical vagotomy and section of the carotid sinus nerves. An intravenous clonidine bolus (15 µg kg1) evoked a prolonged slowing of the respiratory rate in all the neural states explored. Vagotomy reduced the early clonidine-evoked decline, but not the augmentation of tidal volume that followed the decline. After section of the carotid sinus nerves, clonidine challenge continued to decrease the respiratory rate, but not the tidal volume. Blockade of
2-adrenergic receptors with intravenous doses of SKF 86466 (200 µg kg1) abolished all respiratory effects of the clonidine challenge. In all the neural states studied, clonidine evoked a significant short-lived rise in mean arterial blood pressure followed by a decrease below the respective prechallenge value. The SKF 86466 pretreatment lowered mean arterial blood pressure control values and reduced the magnitude of postclonidine changes. These results indicate that: (i) clonidine-evoked activation of
2-adrenergic receptors affects the two components of the breathing pattern differently, and this occurs beyond the lung vagi; and (ii) changes in tidal volume result from excitation of the carotid bodies and are coupled with centrally mediated slowing of the respiratory rhythm.
(Received 11 August 2005;
accepted after revision 7 November 2005; first published online 10 November 2005)
Corresponding author K. Kaczyñska: Laboratory of Respiratory Reflexes, Polish Academy of Sciences Medical Research Centre, 5 Pawiñski Street, 02-106 Warsaw, Poland. Email: kkacz{at}cmdik.pan.pl
| Introduction |
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2-Adrenergic receptors came to the fore as regulators of exocytosis of a number of neurotransmitters, sympathetic nervous system function and blood pressure homeostasis (Philipp et al. 2002). Adrenergic pathways have been identified in the brain regions that belong to central respiratory network, such as nucleus tractus solitarii (NTS; Feldman & Moises, 1988; Hayward et al. 2002), nucleus ambiguus and ventral respiratory group (Ellenberger & Feldman, 1990). Their activation results in depression of ventilation, which implicates the involvement of
2-adrenergic receptors in the control of breathing (Burton et al. 1990; Rives & Bernard, 2001).
Clonidine is a non-specific
2-adrenergic receptor agonist that is widely used in clinical practice for the treatment of hypertension and postoperative pain, and in intensive care as a sedative and analgesic agent (Eisenach, 1988; Philipp et al. 2002). Some studies showed that clonidine produced depression of minute ventilation (Jarvis et al. 1992), snoring, obstructive sleep apnoea and episodes of arterial oxygen desaturation in man (Narchi et al. 1992).
While the effects of
2-adrenoceptor agonists on central cardiorespiratory activity are relatively well documented, few attempts have been made to demonstrate whether these agents are involved in the peripheral control of breathing and circulation. Intravenous clonidine administration in experimental animals evokes heterogeneous respiratory effects. Anaesthetized dogs (Burton et al. 1990) and goats (Hedrick et al. 1994) respond to clonidine with a slowing of the respiratory rhythm, whereas awake goats show an irregular pattern of breathing, including episodes of apnoea and tachypnoea (Hedrick et al. 1994).
Earlier studies in rats have shown an inhibitory action of clonidine (Fuxe et al. 1982) and an excitatory effect of
2-adrenergic blockade (Coles et al. 1998) on breathing rate. A contribution of peripheral afferents to ventilatory changes evoked by clonidine has not been described in this species. The present study was undertaken to determine the respiratory pattern evoked by I.V. clonidine administration in the rat, to asses the contribution of vagal and carotid body afferents to the respiratory effects observed, and to establish, with the use of the selective
2-antagonist SKF 86466, whether the respiratory effects of clonidine are due to stimulation of
2-adrenergic receptors.
| Methods |
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-chloralose (Fluka AG). Supplementary urethane doses were administered I.V. as indicated by response(s) to nociceptive test stimuli. The animals were placed supine recumbency and breathed room air spontaneously. The trachea was exposed in the neck, sectioned below the larynx and cannulated. Catheters were inserted into the femoral vein for drug administration and into the femoral artery for blood pressure monitoring. Rectal temperature was maintained at 38°C with a heating pad. The midcervical segments of the vagi were isolated and prepared for vagotomy prior to measuring studied respiratory variables in neurally intact rats. The carotid region on both sides was dissected under an operating microscope, and carotid sinus nerves (CSNs) were prepared and cut bilaterally at their junctions with glossopharyngeal nerves later during the experiment. The carotid denervation was confirmed by the absence of any response to I.V. injection of 50 µg of NaCN, which dose elicits a brisk response in rats with intact CSNs. Baroreceptor denervation was completed when no hypertensive response occurred on clamping both common carotid arteries. Tidal volume (VT) signals were recorded with a model CS6 spirometer (Mercury) attached to the tracheal cannula. Arterial blood pressure was measured with a BP-2 monitor (Columbus Instruments). End-tidal CO2 concentration was measured with a capnograph (Engstrom Eliza Plus, Gambro). Electromyogram of the costal diaphragm was recorded with bipolar electrodes connected to a model NL 104 amplifier (Digitimer), and filtered and measured with a model AS 101 (Asbit) leaky integrator (time constant, 100 ms). The recordings were registered with an Omnilight 8M36 apparatus (Honeywell).
The respiratory effects of the stimulation of
2-adrenergic receptors were tested using single clonidine boluses in the following experimental designs: (i) before and after bilateral midcervical vagotomy in otherwise neurally intact rats (n
= 8); (ii) before and after section of the CSNs in vagotomized rats (n
= 10); and (iii) before and after blockade of
2-adrenergic receptors with SKF 86466 in vagotomized rats (n
= 7). Clonidine hydrochloride (Sigma) was dissolved (18.8 µg ml1) in 0.9% NaCl and injected at a dose of 15 µg kg1 into the femoral vein. The dose was derived from our preliminary doseresponse experiment, which revealed that this dose resulted in maximum while most uniform decline in the respiratory rate in neurally intact rats (see Fig. 1). SKF 86466 (6- chloro-3-methyl-2,3,4,5-tetrahydro-3-benzazepine, SmithKline Beecham) was dissolved (250 µg ml1) in 0.9% NaCl solution and injected I.V. at a dose of 200 µg kg1 (O'Halloran et al. 2001) 1 min before the clonidine bolus. Each drug bolus was immediately flushed with a 0.2 ml aliquot of the saline.
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| Results |
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2-adrenoceptor blockade prevented the clonidine-evoked changes in VT and in the respiratory rate. Two-way ANOVA revealed a significant effect of time (P
= 0.029), but not of SKF 86466 (P
= 0.150), and a significant time x SKF 86466 pretreatment interaction effect (P
= 0.0029) on
2-adrenoceptors with SKF 86466 (before SKF 86466, 210.0 ± 43.2 ml min1 and after SKF 86466, 204.9 ± 49.3 ml min1, P
= 0.71). The SKF 86466 pretreatment significantly affected blood pressure (P
= 0.001), which was evidenced by the lower average MAP values before and up to 60 s after the injection of clonidine. The immediate clonidine-evoked rise in MAP was still present, yet the SKF 86466 pretreatment apparently prevented the hypotension that formerly occurred at 2 min after clonidine injections (Fig. 4B). | Discussion |
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2-agonist clonidine was a prolonged slowing of the respiratory rhythm. In neurally intact rats, this response was associated with a short-lived decline in VT followed by an increase. Midcervical vagal deafferentation of the lungs had little influence on the respiratory changes evoked by clonidine in our experiments. This observation is in general agreement with previously published results obtained in awake goats, which responded to I.V. infusion of clonidine with dysrhythmic breathing consisting of tachypnoeic and apnoeic episodes (Hedrick et al. 1994; O'Halloran et al. 1999a,b).
Yet it was shown that in response to clonidine challenge anaesthetized goats (Hedrick et al. 1994) and rats (Fuxe et al. 1982) displayed the depression of the respiratory rate which corresponds with prolonged slowing of breathing in our study. The paper by Fuxe et al. (1982) showed no data on clonidine effects on VT, and anaesthetized and artificially ventilated goats showed a stable amplitude of phrenic nerve discharge (Hedrick et al. 1994). The present study revealed a transient postclonidine decrease in VT, followed by an increase both before and after midcervical vagotomy. The immediate postclonidine drop in VT tended to be lesser in vagotomized compared to neurally intact rats and did not always reach significance. We presume that this biphasic pattern may be related to the use of a threefold higher dose of clonidine than that in the reports cited above. Midcervical neurotomy of the vagal nerves eliminated input from the lungs, revealing that clonidine might affect the volume component of the breathing pattern through chemoafferent nerves. Our next step, therefore, was to remove the input from the carotid body and carotid sinuses. This deafferentation abolished the decrease and the subsequent augmentation of VT but did not abrogate the decrease in the respiratory rate (Fig. 3). The latter finding falls in line with the depression of respiratory rate produced by clonidine challenge in anaesthetized goats that invariably occurs before and after vagotomy and chemosensory withdrawal (Hedrick et al. 1994). The carotid bodies are endowed with
2-adrenergic receptors (Kou et al. 1991; Almaraz et al. 1997), and the clonidine-evoked changes in VT observed in our study presumably resulted from the excitation of these
2-receptors. Earlier reports showed both inhibitory and stimulatory effects of I.V. clonidine on chemoreceptor activity. It was suggested that imidazoline I1 receptors are responsible for the excitatory effects, whereas the inhibition might be mediated by
2-adrenergic receptors (Ernsberger et al. 1998). Studies on the contribution of
2-adrenergic receptors to the posthypoxic decrease in respiratory rate in rats have produced inconsistent results (see Coles et al. 1998; Bach et al. 1999). Our study clearly demonstrated that the decline was succeeded by an increase in VT, and that the clonidine-evoked depression of the respiratory rate occurred exclusively via stimulation of the
2-adrenergic pathway, because pretreatment with the selective
2-antagonist SKF 86466 precluded all respiratory effects of the clonidine challenge. This result is in line with the effectiveness of this antagonist in reversing respiratory disturbances in goats (Hedrick et al. 1994; O'Halloran et al. 2001) and rats (Coles et al. 1998).
Since clonidine easily penetrates the bloodbrain barrier (Panagiotidis et al. 1993), its ability to depress the respiratory rate in CSNs-denervated vagotomized rats may imply a central origin of the response. The role of CNS
2-adrenergic receptors in regulation of breathing has been extensively investigated. Central application of
2-agonists inhibits respiration both in experimental animals (McCrimmon & Lalley, 1981; Burton et al. 1990; Errichidi et al. 1991) and in humans (Ooi et al. 1991; Narchi et al. 1992). In contrast, selective blockade of
2-adrenergic receptors stimulates respiration in dogs (Burton et al. 1990) and rats (Coles et al. 1998), presumably as a consequence of the absence of
2-adrenergic tonic inhibitory effects on the respiratory generator in the medulla. As mentioned in the Introduction,
2-adrenergic receptors are widespread in the neural circuits of the medulla oblongata that are engaged in the control of breathing (Guyenet et al. 1994; Schreihofer & Guyenet, 2000).
The depressive component of the respiratory response evoked by clonidine beyond the direct stimulation of
2-adrenergic receptors may be the result of interaction or interference with other neurotransmitter systems. Burton et al. (1990) proposed that depressant ventilatory effects of clonidine were due to inhibition of the cholinergic system. Moreover, it has been shown that activation of
2-adrenergic receptors reduces the release of L-glutamate (Kamisaki et al. 1993), an excitatory neurotransmitter involved in the control of breathing.
Intravenous administration of clonidine evoked a biphasic blood pressure response: a short-lived rise followed by prolonged hypotension. This type of response was observed after I.V. injections of
2-adrenergic receptor agonists in man (Kallio et al. 1989; Bloor et al. 1992) and experimental animals (Sannajust et al. 1992; Soares de Moura et al. 2000). It has been shown that the pressor component of the blood pressure effects depends on activation of
2-adrenergic receptors in the vascular smooth muscles, whereas hypotension is due to their excitation within the rostral ventrolateral medulla (Guimaraes & Moura, 2001; Yamazato et al. 2001). Indeed, neither vagotomy nor combined section of the vagi and CSNs prevented the clonidine-evoked blood pressure changes in our experiments. The significant SKF 86466 pretreatment x time interaction effect with the preserved but smaller initial increase in blood pressure in our study suggests that the
2-antagonist may counteract the clonidine-evoked hypotension. While this observation is consistent with the study in humans by Hayar & Guyenet (2000), the trend for a hypotensive effect of SKF 86466 (P
= 0.07) in our study does not permit unequivocal acceptance of this interpretation.
In conclusion, this study has shown that I.V. clonidine challenge depresses ventilation, primarily due to the large decrease in respiratory rate. The depression is executed via activation of
2-adrenoceptors outside the lung vagi. Carotid chemoreceptors most probably constitute a crucial neural pathway for changes in VT, whereas the predominant effect of the timing component may rely on central
2-adrenergic mechanisms.
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| Acknowledgements |
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