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Experimental Physiology 91.2 pp 403-411
DOI: 10.1113/expphysiol.2005.032409
© The Physiological Society 2006
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P2X purinoceptor subtypes on paraventricular nucleus neurones projecting to the rostral ventrolateral medulla in the rat

Joo Lee Cham1, Neil C. Owens1, Julian. A. Barden2, Andrew J. Lawrence3 and Emilio Badoer1

1 School of Medical Sciences, Division of Biosciences, RMIT University, PO Box 71, Bundoora 3083, Melbourne, Victoria, Australia2 Institute of Biomedical Research, University of Sydney, Sydney, NSW 2006, Australia3 Howard Florey Institute, University of Melbourne, Melbourne, Victoria, VIC 3010, Australia


    Abstract
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 References
 
The rostral ventrolateral medulla (RVLM) is essential for the generation of sympathetic nerve activity. The RVLM receives a substantial innervation from the hypothalamic paraventricular nucleus (PVN). Activation of P2X purinoceptors via ATP has been shown to mediate fast excitatory synaptic neurotransmission. There is mounting evidence to suggest the presence of P2X purinoceptors in hypothalamic nuclei, including the PVN. In this study, we determined whether P2X1–P2X6 purinoceptor subtypes were present on PVN neurones that projected to the RVLM. Injection of the retrogradely transported tracer, rhodamine-tagged microspheres, into the pressor region of the RVLM was used to identify the neurones in the PVN that innervated the RVLM. P2X1–P2X6 purinoceptors were detected by immunohistochemistry. Double-labelled neurones were quantified and expressed as a proportion of the retrogradely labelled neurones. The proportions of double-labelled neurones for each of the P2X purinoceptor subtypes varied, on average, from 14 to 29%. The P2X3 purinoceptor subtype was found to be the dominant purinoceptor subtype present on PVN neurones projecting to the RVLM. Additionally it was apparent that more than one P2X purinoceptor subtype was present on the PVN neurones projecting to the RVLM, since the sum of the average percentages of double-labelled neurones for each P2X purinoceptor subtype exceeded 100%. These findings highlight the presence of the P2X1–P2X6 purinoceptors on PVN neurones projecting to the RVLM. The results suggest a potential role for ATP in the PVN in the regulation of sympathetic nerve activity.

(Received 29 September 2005; accepted after revision 18 November 2005; first published online 18 November 2005)
Corresponding author E. Badoer: School of Medical Sciences, Division of Biosciences, RMIT University, PO Box 71, Bundoora 3083, Melbourne, Victoria, Australia. Email: emilio.badoer{at}rmit.edu.au


    Introduction
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 References
 
The rostral ventrolateral medulla (RVLM) is well known to be an essential region for the tonic generation of sympathetic nerve activity (Ross et al. 1984; Dampney, 1994; Dampney et al. 2000). Neurones in this region project to the sympathetic preganglionic motoneurones in the spinal cord. Excitation of the RVLM elicits pressor responses and increases in sympathetic nerve activity, whilst destruction of this region reduces sympathetic nerve activity to levels seen after spinal transaction (Dampney, 1994). The RVLM also appears to be the major conduit for reflex changes in sympathetic nerve activity initiated by cardiovascular stimuli, including activation of arterial baroreceptors and chemoreceptors (Granata et al. 1985; Sun & Spyer, 1991; Polson et al. 1995; Hirooka et al. 1997).

The paraventricular nucleus of the hypothalamus (PVN) is a key integrative nucleus in the forebrain mediating neuroendocrine responses (Swanson & Sawchenko, 1980; Coote, 1995; Badoer, 1996, 2001). Additionally, it is clear that activation of the PVN can elicit changes in blood pressure and heart rate that are also mediated by changes in sympathetic nerve activity (Kannan et al. 1987; Dampney, 1994; Coote, 1995; Dampney et al. 2000; Deering & Coote, 2000; Badoer, 2001; Badoer et al. 2002). The PVN projects strongly to the RVLM (Luiten et al. 1985; Shafton et al. 1998; Pyner & Coote, 2000), and this pathway contributes to the changes in sympathetic nerve activity observed following activation of the PVN. Thus, neurotransmitters that can influence the activity of those PVN neurones that project to the RVLM have the potential to influence basal resting sympathetic tone.

ATP mediates its main actions as a neurotransmitter via activation of P2-purinoceptors (Burnstock, 1980, 1996, 1997), of which there are two major classes, namely, the P2Y and P2X purinoceptors. P2Y purinoceptors are G-protein-coupled purinoceptors, while P2X purinoceptors are ligand-gated ion channels (Burnstock & Kennedy, 1985; Dubyak, 1991; Fredholm et al. 1994; Harden et al. 1995). Based on expression cloning of the purinoceptors in various different cell lines, seven different subtypes of P2X purinoceptors (P2X1–P2X7) have been identified (Buell et al. 1996). These different P2X purinoceptor subtypes have been differentiated by the rate of desensitization, agonist/antagonist selectivity, permeation properties and sensitivity to changes in the extracellular pH (Buell et al. 1996; King et al. 1997; North, 2002). There are seven subtypes of P2X purinoceptors, but only P2X1–P2X6 purinoceptors are believed to be involved in the fast excitatory synaptic transmission between neurones (Edwards et al. 1992; Evans et al. 1992; Ueno et al. 1992, 1999). P2X7 purinoceptors were believed to play a role in apoptosis and were thought to be mainly found on cells involved in immune function (Collo et al. 1997). More recent studies, however, indicate that P2X7 purinoceptors may influence neurotransmission (Deuchars et al. 2001; Sperlach et al. 2002). Recently, though, the nature of the P2X7 purinoceptor labelling in the brain has been questioned (Sanchez-Noguiero et al. 2005).

Numerous studies utilizing autoradiography, in situ hybridization and immunohistochemistry have been employed to demonstrate the widespread distribution of P2X purinoceptors in many regions of the brain, including the hypothalamus (Bo & Burnstock, 1994; Collo et al. 1996; Vulcanova et al. 1996, 1997; Tuyau et al. 1997; Kanjhan et al. 1999; Yao et al. 2000, 2001). ATP applied to rat hypothalamic neurones has been shown to induce a rapid increase in intracellular calcium concentration (Chen et al. 1994). Indeed, microinjections of ATP into the PVN of the hypothalamus can induce the release of arginine-vasopressin (Mori et al. 1992). In addition, electrophysiological studies have also provided evidence that indicates the use of ATP as a transmitter by the caudal brainstem noradrenergic neurones in their interaction with vasopressinergic neurosecretory cells in the hypothalamic supraoptic nucleus (Buller et al. 1996). Thus, these studies strongly indicate the presence of functional purinoceptors in the hypothalamic nuclei.

Despite the increasing evidence to support the presence of the various P2X purinoceptor subtypes in the hypothalamus, their distribution has not been examined in great detail. At present, it is unclear whether PVN neurones that project to the RVLM also contain P2X purinoceptors. Such a pathway would provide an anatomical framework for purinergic neurotransmission to influence the tonic generation of sympathetic nerve activity. In light of this, the aim of the present study was to examine whether P2X1–P2X6 purinoceptors were located on the PVN neurones, which project directly to the RVLM.


    Methods
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 References
 
Animals and housing

Twenty-four male Sprague–Dawley rats (Monash University Animal Services, Victoria, Australia) weighing 200–250 g were housed in the Animal Facility (RMIT University, Victoria, Australia), where rat chow and tap water were available ad libitum. All of the experimental protocols used in this study were performed in accordance with the Prevention of Cruelty to Animals Act 1986 and were approved by the RMIT University Animal Ethics committee. All the experiments conform to the guidelines set out by the National Health and Medical Research Council of Australia. Every attempt was made to minimize animal suffering and discomfort and to reduce the number of animals needed to obtain reliable results.

Rat retrograde tracer microinjection

The rats were anaesthetized with sodium pentobarbitone (60 mg kg–1, I.P.; Nembutal, Boehringer Ingelheim, North Ryde NSW 2123, Australia). Buscopan compositum (0.03 ml kg–1, S.C.; consisting of a mixture of hyoscine-N-butyl bromide (12.5 mg kg–1) and 0.1 mg kg–1 dipyrone, Boehringer Ingelheim) was also administered immediately prior to surgery to minimize salivary secretions.

Prior to locating the RVLM, the right femoral artery was cannulated and connected to a pressure transducer to enable arterial blood pressure (ABP) to be monitored. The rat was placed prone and its head mounted in a Kopf stereotactic frame. An incision through the scalp was made to expose the lambda and bregma and a partial craniotomy of the occipital bone performed. A burr hole, approximately 4 mm in diameter, was drilled into the skull overlying the RVLM on the left side and the dura mater cleared. The stereotactic coordinates of the RVLM were 1.8–2.2 mm left of the sagittal suture, 2.5–3.5 mm caudal to the lambdoid suture and 8.9 mm ventral to the dural surface (Paxinos & Watson, 1986; Kantzides & Badoer, 2003). The pressor region of the RVLM was then located by injecting 25–50 nl ofL-glutamate (0.1 M, Sigma, St Louis, MO, USA) using a glass micropipette. An increase of approximately 20 mmHg in the ABP identified the region of the RVLM. The micropipette was carefully removed from the brain, emptied and then filled with the retrogradely transported tracer, rhodamine-tagged microspheres (1:1 dilution with 0.9% sterile saline; LumaFluor, Naples, FL, USA), and then reinserted into the pressor region of the RVLM. A unilateral injection of 250 nl of the tracer solution was made over 10 min, and the micropipette was left in place for several minutes following completion of the injection to avoid tracer leakage along the route of the pipette. Upon the removal of the micropipette, the scalp was sutured and the arterial cannula removed. Oxytetracycline (200 mg kg–1S.C.; Terramycin, Provet, Melbourne, Victoria, Australia) was administered to prevent infection and buprenorphine hydrochloride (15 µg I.P.; Temgesic, Reckitt and Colman Pharmaceuticals, Sydney, NSW, Australia) was administered for analgesia.

Rats were housed for 2 weeks following the surgical procedure to allow for the transport of the retrograde tracer before they were deeply anaesthetized with sodium pentobarbitone (60 mg kg–1, I.P.) and transcardially perfused with approximately 350–400 ml of heparinized phosphate-buffered saline (PBS), followed by 4% paraformaldehyde (PFA) in phosphate buffer (PB) (0.1 M, pH 7.4). The perfusion pressure was maintained at about 100–120 mmHg. Brains were then carefully removed and postfixed in 4% PFA–PB solution for 2 h, then transferred into 20% sucrose in PB overnight.

The following day, hypothalamic sections, of 40 µm thickness, were cut on a cryostat and alternate serial sections encompassing the PVN were collected from each rat. For this study, a maximum of three P2X purinoceptor subtypes were studied in each rat and seven rats were used for the group data for each P2X purinoceptor subtype.

Immunohistochemistry

Sections of the PVN from the rats injected with rhodamine-tagged microspheres underwent three 5 min washes in PB and were incubated with 10% normal horse serum (NHS) in PBS for 60 min at room temperature. The sections were incubated free-floating and processed using standard immunohistochemical procedures as previously described (Kantzides & Badoer, 2003). Primary antibodies of sheep anti-P2X1, P2X3, P2X4, P2X5 and P2X6, and rabbit anti-P2X2, were diluted 1:1000 in PB containing 2% NHS and 0.3% Triton X-100, and the free-floating sections incubated for 24 h at room temperature.

Following three 5 min washes in PB, the tissue was incubated for 1 h at room temperature with the appropriate biotinylated secondary antibody (biotinylated antigoat for P2X1, P2X3, P2X4, P2X5 and P2X6 or biotinylated antirabbit for P2X2, Sigma-Aldrich, Australia) diluted to 1:600. After washing off unbound secondary antibodies in three 5 min washes in PB, the sections were incubated for 1 h at room temperature using Extravidin (1:400 in 0.1 M PB, Sigma-Aldrich, Australia).

Following three 5 min washes in 0.05 M Tris buffer (pH 7.6), the sections were incubated for 10 min at room temperature with 0.05% 3,3'-diaminobenzidine hydrochloride (DAB) and 40 mg nickel ammonium sulphate aqueous crystals in 100 ml 0.05 M Tris buffer). The reaction was initiated by the addition of 5 µl of 17.5% hydrogen peroxide (H2O2) (Biotech Pharm P/l, Australia) and terminated by washes with fresh 0.05 M Tris buffer. Sections were then washed, dried, dipped in xylene (Analar, Merck Pty Ltd, Australia) and mounted onto gelatine-subbed slides and coverslipped using DePex mounting medium (BDH, Poole, UK).

Microscopy of P2X purinoceptors and RVLM-projecting neurones

All sections processed immunohistochemically for P2X were examined under normal bright field illumination and fluorescence microscopy using a Leica DMLB microscope. Double-labelled neurones (P2X purinoceptor subtype + fluorescent tracer) were detected by rapidly switching between the two light sources. The PVN was determined according to the morphology and histology of the area and confirmed by the location of the RVLM-projecting neurones, which approximately delineate the boundaries of the PVN (Shafton et al. 1998).

Quantification

The RVLM-projecting neurones and double-labelled neurones for each P2X purinoceptor subtype were counted in each section. These sections represented five different levels that encompassed the full rostral–caudal extent of the PVN. The numbers of double-labelled neurones were expressed as a percentage of the total number of RVLM-projecting neurones in each section and the means ±S.E.M. were determined for each level of the PVN. The overall percentage of double-labelled neurones in the PVN for each of the P2X purinoceptor subtypes was also determined.

Statistical analysis

Comparisons between the percentages of double-labelled neurones were performed using completely randomized one-way ANOVA. The statistical software package used was GB-STAT version 7.0 (Dynamic Microsystems Inc., Silver Spring, MD, USA), and the level of significance was set at P < 0.05.

Mapping

For accurate illustration of the different levels of the PVN, maps were drawn from each of the five rostral to caudal levels. Digital files were generated using the software package MD Plot (version 4.0) and an MD3 microscope digitizer stage (Minnesota Datametric Corporation, Shoreview, MN, USA) attached to a Leica DMLB microscope.

Photomicroscopy

Images were acquired using a digital camera (Sensi Cam, PCO CCD Imaging, Kelheim, Germany) on an Olympus BX60 microscope. The digital images obtained were imported into Metamorph Imaging version 4.6 (Universal Imaging Corp., Downingtown, PA, USA), and only the contrast and lightness were modified for presentation purposes.


    Results
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 Abstract
 Introduction
 Methods
 Results
 Discussion
 References
 
Distribution of P2X purinoceptors

Immunohistochemical staining for P2X1–P2X6 purinoceptor subtypes revealed a widespread distribution throughout the rostral–caudal levels of the PVN (Fig. 1). Although the number of P2X immunoreactive neurones was not quantified, it was apparent that the major proportion of the P2X purinoceptors was present in the parvocellular regions of the PVN, including the dorsal, medial and lateral subnuclei, where neurones that project to the RVLM are known to be abundantly located (Fig. 1).


Figure 1
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Figure 1.  Photomicrographs of the hypothalamic PVN
A, photomicrograph taken at low magnification, showing the distribution of P2X5 purinoceptor-positive neurones using bright field illumination. B, photomicrograph of the distribution of PVN neurones that project to the RVLM (i.e. contain the fluorescent marker) in the same section as that shown in A. C, high power photomicrograph of P2X5 purinoceptor-positive neurones (arrowed) illustrated in the rectangle shown in A. D, higher power magnification of fluorescent neurones in the PVN (i.e. neurones that project to the RVLM) found in the rectangle shown in B. E, P2X5 purinceptor staining of PVN neurones in the same field as shown in D. In D and E, double-labelled neurones are shown by the twin arrows, and single arrows highlight neurones containing only a single label. Scale bar respresents 100 µm in A and B; 50 µm in C, D and E. Abbreviations: 3V, third ventricle; PVN, paraventricular nucleus.

 
Distribution of RVLM-projecting neurones

The RVLM-projecting neurones were found distributed throughout the rostral–caudal extent of the PVN. The number of RVLM-projecting neurones and their distribution were quantified in five rostral–caudal levels of the PVN (Fig. 2). The distribution profile of RVLM-projecting neurones appeared as a bell-shaped curve, with the maximum number in the mid-rostral–caudal level of the PVN (Figs 3 and 4). The distribution pattern of the retrogradely labelled neurones was similar for each of the different P2X purinoceptor subtypes analysed. The total number of RVLM-projecting neurones counted in each series of sections ranged from 147 ± 14 for the P2X1 subtype to 255 ± 22 for the P2X5 subtype. A summary of these data is shown in Table 1. There were no significant differences found in the number of RVLM-projecting neurones in each group (Table 1).


Figure 2
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Figure 2.  Representative schematic maps of the five different rostral to caudal levels of the PVN (outlined by the dashed line) examined
Each level is separated by approximately 240 µm. The levels shown (AE) coincide with levels 1–5, respectively, shown in Figs 3 and 4. Abbreviations: 3V, third ventricle; OT, optic tract; Fx, fornix.

 

Figure 3
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Figure 3.  Distribution profiles in five rostral–caudal levels (1–5, respectively) of the hypothalamic PVN
A, C and E represent the average number of PVN neurones per section that project to the RVLM, i.e. fluorescent neurones. B, D and F demonstrate the average number of PVN neurones projecting to the RVLM per section that also contain P2X1 (B), P2X2 (D) and P2X3 purinoceptor subtypes (F), i.e. double-labelled neurones. Data for each of the P2X purinoceptor subtypes were obtained from 7 rats. Abbreviations: RVLM, rostral ventrolateral medulla.

 

Figure 4
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Figure 4.  Distribution profiles in five rostral–caudal levels of the hypothalamic PVN
A, C and E represent the average number of PVN neurones per section that project to the RVLM, i.e. fluorescent neurones. B, D and F demonstrate the average number of PVN neurones projecting to the RVLM per section that also contain P2X4 (B), P2X5 (D) and P2X6 purinoceptor subtypes (F), i.e. double-labelled neurones. Data for each of the P2X purinoceptor subtypes were obtained from 7 rats. Abbreviations: RVLM, rostral ventrolateral medulla.

 

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Table 1. Quantification of hypothalamic PVN neurones projecting to the RVLM containing P2X purinoceptors
 
Distribution of double-labelled neurones

In general, retrogradely labelled neurones that were positive for a particular P2X purinoceptor subtype were observed throughout the rostral–caudal extent of the PVN. The distribution profile for double-labelled neurones for each P2X purinoceptor subtype followed a bell-shaped curve, with the peak occurring in the mid-rostral–caudal level of the PVN, and was similar to the distribution profile of the RVLM-projecting neurones (Figs 3 and 4).

The average proportion of RVLM-projecting neurones in the PVN that contained a particular P2X purinoceptor subtype ranged from 14% for P2X1 to 29% for P2X3 (Table 1). Overall, there was a significant difference in the proportion of RVLM-projecting neurones containing a specific P2X purinoceptor subtype (P < 0.05, overall one-way ANOVA). Comparison of the means and adjusting for multiple comparisons indicated that the overall difference was due primarily to a significant difference between neurones containing P2X1 and those containing P2X3 (P < 0.05, comparison of means adjusted with Bonferroni's correction, Table 1).


    Discussion
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 References
 
In the present study, we have shown several important and novel findings. The most significant finding is that we have shown that: (i) PVN neurones projecting to the RVLM contain purinoceptors; and (ii) the proportions of these neurones containing a particular purinoceptor subtype varies significantly. In these studies, we also showed that the P2X1–P2X6 purinoceptors are distributed throughout the rostral to caudal levels of the PVN.

Distribution of P2X purinoceptors in the hypothalamic PVN

In the present work, P2X1–P2X6 purinoceptor subtypes were detected throughout the PVN, including the dorsal parvocellular and medial parvocellular PVN, areas known to contain PVN neurones that project to the RVLM. The most important finding of the present study was the discovery of the presence of P2X purinoceptors on neurones in the PVN that project to the RVLM. The rostral–caudal distribution profiles of the double-labelled neurones were found to be a broad bell-shaped pattern that was similar to the distribution profile of the RVLM-projecting neurones in the PVN. However, we found that varying proportions of P2X purinoceptor subtypes were present on the PVN neurones projecting to RVLM. The proportions of these PVN neurones that contained each purinoceptor subtype varied from 14% for P2X1 to 29% for P2X3, and this difference was statistically significant. These results suggest that there is a distinct distribution of the different P2X purinoceptor subtypes in the PVN regions that contain neurones projecting to the RVLM. Furthermore, when the average percentages of double-labelled neurones for each of the P2X subtypes were added together, their sum exceeded 100%. This indicates that more than one P2X purinoceptor subtype must be present on a PVN neurone that projects to the RVLM. This may be explained by observations that P2X purinoceptor subtypes can operate as heteromers (e.g. P2X2 and P2X3) as well as homomers (Balcar et al. 1995; Worthington et al. 1999a,b).

In the present study, we found that P2X1–P2X6 purinoceptors were abundantly distributed throughout the hypothalamus, and for this reason we did not attempt to quantify them. However, our observations support previous reports indicating the presence of purinoceptors in the brain (Bo & Burnstock, 1994; Balcar et al. 1995; Vulcanova et al. 1997; Kidd et al. 1998; Kanjhan et al. 1999; Yao et al. 2000). Early studies of the distribution of the different subtypes of purinoceptors suggested that P2X2, P2X4 and P2X6 were the predominant forms in the CNS (Collo et al. 1996; Kanjhan et al. 1999). More recent studies, however, indicate that all subtypes are present within the CNS (Yao et al. 2000). The distribution of P2X1–P2X6 purinoceptors has been extensively studied in the medulla and pons (Yao et al. 2000). By contrast, the distribution of these purinoceptors in the more rostral brain regions, including the hypothalamus, with the exception of P2X2, has not been examined in great detail (Yao et al. 2003).

Significance

Activation or inhibition of the PVN can elicit marked changes in blood pressure, heart rate and renal sympathetic nerve activity (Kannan et al. 1987; Coote, 1995; Badoer et al. 2002). The neurones in the PVN that project to the RVLM undoubtedly mediate some of the changes seen in sympathetic nerve activity. Since the RVLM is an important brain region involved in the tonic regulation of sympathetic nerve activity (Ross et al. 1984; Dampney et al. 2000), altering the activity of neuronal inputs into the RVLM could have important functional implications. Thus, activation of PVN neurones that project to the RVLM by stimulating P2X purinoceptors could contribute to the influence of the PVN on resting sympathetic nerve activity (Potter & White, 1980; Dampney, 1994; Dampney et al. 2000; Badoer et al. 2002).

The effect of stimulating or inhibiting P2X purinoceptors in the PVN has been studied in one report to date, in which ATP injected into the PVN did not affect basal blood pressure whilst injection of the P2X purinoceptor antagonist, suramin, did not affect the pressor response to peripheral chemoreceptor stimulation (Kubo et al. 1997). These experiments were performed in spinally transected, anaesthetized rats. Thus, effects on the sympathetic nervous system could not be evaluated. In light of the present work, the effects of stimulation and antagonism of purinoceptors in the PVN on the sympathetic nervous system requires further investigation.

Methodological considerations

The antibodies used in the present study have been raised against the extracellular domain of each P2X purinoceptor subtype found in the rat. The domains chosen were unique to each P2X purinoceptor subtype to ensure no cross-reactivity. The antibodies recognize a single P2X purinoceptor subtype, and antibody specificity has been described in great detail previously (Hansen et al. 1997, 1999a,b; Worthington et al. 1999a,b; Yao et al. 2000, 2001, 2003; Sluyter et al. 2001).

We injected the retrogradely transported tracer into the pressor region of the RVLM. We identified this region functionally to maximize the probability of labelling the neurones in the PVN that were involved in the regulation of sympathetic nerve activity. This injection site was confirmed histologically and the injections were similar in spread, and covered the rostral–caudal extent of the RVLM, hence the similarity in the number of fluorescent neurones between the groups.

Summary and conclusion

We have described the distribution of P2X1–P2X6 purinoceptors in the hypothalamic PVN. We determined, in detail, the rostral–caudal distribution of these P2X purinoceptor subtypes on PVN neurones that project to the pressor region of the RVLM and found significant differences between the proportion of P2X purinoceptors located on the PVN neurones. Furthermore, our quantitative analysis also indicates that there is likely to be several different P2X purinoceptor subtypes present on the same neurones in the PVN. Finally, our observations of P2X purinoceptor subtypes found on the PVN neurones projecting to the RVLM suggests that ATP may function as an important neurotransmitter in influencing neurones projecting from the PVN to RVLM; hence, ATP within the PVN may have an important role in the regulation of sympathetic nerve activity.


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 Introduction
 Methods
 Results
 Discussion
 References
 
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    Acknowledgements
 
The authors acknowledge RMIT University. N.C.O. is a Peter Doherty Fellow, NHMRC.




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