支配心脏的交感神经含有脑啡肽

曾有报道,在交感神经节、内脏大神经及迷走神经中发现脑啡肽;但在心脏及支配心脏的交感神经中是否有脑啡肽,尚未见报告。作者应用高压液相色谱和放射免疫法测定豚鼠心脏组织中的脑啡肽含量,发现每克湿重的全心心脏组织含亮啡肽1.43ng、甲啡肽5.43ng,两者的比值约为1:4。将心房与心室分别测定,心房组织中亮啡肽含量约为心室的10倍。腹腔注射化学性交感神经切断剂6—羟多巴胺,使心脏组织内     

交感神经节在支配心脏中的作用研究进展

交感神经可支配心脏,并在心脏传导、调节心率、心肌收缩和舒张等方面具有重要作用。目前对支配心脏的交感神经的研究多数集中在心肌组织中分布的交感神经,实际上支配心脏的远端交感神经节(颈部神经节和星状神经节)也发挥着重要作用。文中简要介绍了交感神经节对心脏的支配情况,总结了交感神经节阻滞在心脏疾病治疗中的作用,讨论了交感神经节支配心脏的作用机制方面的研究现况,提出了可以应用细胞电生理、免疫组化分析、分子生物学等技术,对支配心脏的远端交感神经节在心脏疾病、药物及物理因子作用下的机制进行研究。这将对深层次揭示心脏疾病的发病机制及相关治疗药物和物理方法的研制提供一定的理论及实验参考。     

迷走神经背核对胃机能调控的研究进展

神经解剖学和生理学的研究证明,迷走神经背核（dorsal motor nucleus of the vagus,DMV）是调控胃机能的重要副交感初级中枢。支配胃的迷走神经纤维主要发自于延髓的DMV。就DMV的细胞构筑和突触联系、DMV对胃的神经支配、电刺激DMV对胃机能的影响以及DMV内的神经递质和受体对胃机能的调控进行综述。     

迷走神经功能调节与心肌缺血保护

心血管系统的生理活动受自主神经系统(autonomic nervous system,ANS)调节.已有研究表明,自主神经功能紊乱,尤其是迷走神经功能低下,与心血管疾病(cardiovascular disease,CVD)的发生、发展及预后密切相关.本文结合国内外研究现状,就本研究室在迷走神经对心脏不同部位的调控及其对心肌的保护作用机制方面的研究成果进行阐述.通过收缩功能检测及标准玻璃微电极细胞内记录技术,发现迷走神经递质--乙酰胆碱对哺乳动物心室肌有直接作用,可抑制细胞收缩力及动作电位时程;通过组织化学染色及分子生物学方法进一步证明心室有毒蕈碱受体分布;通过膜片钳技术显示在部分动物心室肌上存在乙酰胆碱激活的内向整流钾通道(acetylcholine-activated potassium channel,KACh),并且其电流(IK·ACh)和心房肌一样具有衰减现象.前期研究证明心房肌IK·ACh的衰减与毒蕈碱受体、G蛋白或钾通道磷酸化有关;而心室肌的IK·ACh还有待于进一步研究.我们建立了相关动物模型,结合心率变异性分析等自主神经评价方法,探讨ANS在健康和疾病状态下的变化情况,证明了迷走神经对心脏调节的增龄性改变及代偿效应.通过提高迷走张力(乙酰胆碱缺血预/后适应、有氧运动、β受体阻断剂),研究改善自主神经平衡对缺血心肌的保护作用以及胆碱能抗炎通路防御缺血,再灌注诱导的炎症损伤机制.综合评价心脏自主神经调节,改善交感和迷走张力平衡,将为CVD防治的基础研究提供重要的理论依据.     

肾脏去交感神经支配术在心衰治疗中的作用

心脏和肾脏通过一系列神经体液调节机制相互作用,这种作用维持正常状态下的循环稳态.然而,调节机制在充血性心衰时变的异常,充血性心衰患者中,肾功能不全常常会进一步进展.肾交感传出神经激活引起肾素释放,钠水潴留,以及肾血流量减少,都是充血性心衰时肾脏表现.由肾脏部分调节释放的血管紧张素Ⅱ水平增加,作用于中枢神经系统后可增加全身交感神经活性,临床上肾脏交感神经活性可通过去甲肾上腺素分泌进行评估,充血性心衰时去甲肾上腺素分泌增加提示预后不良.除传出交感神经激活外,心衰时肾脏传入神经的激活可反射性引起交感神经活性的增加,进而引起外周血管阻力增加、血管重塑、心室重塑及左室功能障碍.在心衰动物模型中,外科肾脏去交感神经支配术可以改善肾脏和心室功能,但有创性操作过程以及相关并发症限制了其应用.近期出现的经导管射频消融去肾脏交感神经支配术可特异性阻断肾传出、传入神经,已成功应用于顽固性高血压的治疗.目前评估心衰患者肾脏去交感神经支配术安全性及有效性的临床试验正在进行中.     

环核苷酸与心脏功能的神经调节

心脏接受交感与副交感双重植物性神经支配,二者分别通过其末梢释放去甲肾上腺素(NE)和乙酰胆碱(ACh)等神经递质,并由它们作用于心肌细胞膜上相应的β和M受体而引起心肌发生一系列电的、代谢的和机械的变化,从而产生四种相互拮抗的作用(变时性、变力性、变兴奋性、变传导性)。因为心脏神经分布以交感神经占优势,所以心脏在很大程度上受NE与β受体相互反应的控制。自从Sutherland等发现了环核苷酸这一类重要的细胞内调节物质后,对心脏神经调节的认识便向亚细胞水平和分子水平深入了一步。     

神经肽Y对心脏的作用

神经肽Y（NPY）广泛分布于心脏各个部位,主要与去甲肾上腺素共存于交感神经。当交感神经兴奋时,由末梢释放。NPY对心脏具有直接的变力、变时和电生理作用,可影响细胞的信号转导,调制心脏自主神经递质的释放,并参与心脏的自主神经调节。NPY在心脏的生理学和病理生理学上具有重要意义。     

迷走神经和乙酰胆碱对缺血心肌保护作用的研究新进展

缺血性心脏病是危害人类健康的主要疾病之一。新近研究发现,心肌缺血与迷走神经活性降低及交感神经活性升高密切相关。本文从缺血性心脏病时心脏迷走神经调控的改变、迷走神经及其递质乙酰胆碱对缺血心肌的保护作用和其在缺血预适应、缺血后适应中可能的信号转导途径等方面,对迷走神经及其递质保护缺血心肌的作用机制研究的新进展予以综述,将有助于深入理解缺血性心脏病的发病机制及防治措施,为该疾病的防治开辟新思路。     

心经经脉、心因性牵涉痛与心脏相关联系的机制

采用神经示踪剂荧光素三标记法研究了上肢内侧面(心经经脉循行线)、外侧面(肺经经脉循行线)与心脏的神经联系.结果表明,脊神经节的小量细胞的外周轴突有双分支现象,其一支分布于心脏,另一支分布于上肢;心经循行线与心脏之间的脊神经节细胞外周轴突分支支配现象更明显.与肺经穴位相比,刺激心经穴位引起更大的心交感神经兴奋,心经穴位通过心交感神经对心功能起调节作用.心交感神经刺激可引起心经穴位的最大反射性肌电反应,表明心脏功能异常的传入活动可能在心经循行线出现肌紧张反应.结果提示,心经与心脏特异性联系的基础是神经节段的相同性和神经纤维分布相对密集性;心脏传入神经与心经穴位神经支配的重叠性及反射的循经性是心因性牵涉痛的基础.     

脾神经与脾脏免疫功能研究进展

脾脏是人体外周最大的免疫器官,其与细胞免疫以及体液免疫关系密切,对脾内及外周血内的免疫活性细胞的量和比例有重要的调节作用,近年来随着对脾脏免疫功能的研究愈来愈深入,尤其是神经对脾脏免疫的调控研究方面取得了较大进展.支配脾脏的神经主要是腹腔交感神经节后纤维,其既参与调节脾脏免疫功能,同时也受到免疫应答系统的影响,二者相互作用,共同完成脾脏功能.明确相互之间作用机制,对临床某些疾病发病机理以及治疗都有一定的指导意义.     

Innervation patterns of autonomic axons in the human endocrine pancreas

The autonomic nervous system regulates hormone secretion from the endocrine pancreas, the islets of Langerhans, thus impacting glucose metabolism. The parasympathetic and sympathetic nerves innervate the pancreatic islet, but the precise innervation patterns are unknown, particularly in human. Here we demonstrate that the innervation of human islets is different from that of mouse islets and does not conform to existing models of autonomic control of islet function. By visualizing axons in three dimensions and quantifying axonal densities and contacts within pancreatic islets, we found that, unlike mouse endocrine cells, human endocrine cells are sparsely contacted by autonomic axons. Few parasympathetic cholinergic axons penetrate the human islet, and the invading sympathetic fibers preferentially innervate smooth muscle cells of blood vessels located within the islet. Thus, rather than modulating endocrine cell function directly, sympathetic nerves may regulate hormone secretion in human islets by controlling local blood flow or by acting on islet regions located downstream.     

Reflex regulation of airway smooth muscle tone.

Autonomic nerves in most mammalian species mediate both contractions and relaxations of airway smooth muscle. Cholinergic-parasympathetic nerves mediate contractions, whereas adrenergic-sympathetic and/or noncholinergic parasympathetic nerves mediate relaxations. Sympathetic-adrenergic innervation of human airway smooth muscle is sparse or nonexistent based on histological analyses and plays little or no role in regulating airway caliber. Rather, in humans and in many other species, postganglionic noncholinergic parasympathetic nerves provide the only relaxant innervation of airway smooth muscle. These noncholinergic nerves are anatomically and physiologically distinct from the postganglionic cholinergic parasympathetic nerves and differentially regulated by reflexes. Although bronchopulmonary vagal afferent nerves provide the primary afferent input regulating airway autonomic nerve activity, extrapulmonary afferent nerves, both vagal and nonvagal, can also reflexively regulate autonomic tone in airway smooth muscle. Reflexes result in either an enhanced activity in one or more of the autonomic efferent pathways, or a withdrawal of baseline cholinergic tone. These parallel excitatory and inhibitory afferent and efferent pathways add complexity to autonomic control of airway caliber. Dysfunction or dysregulation of these afferent and efferent nerves likely contributes to the pathogenesis of obstructive airways diseases and may account for the pulmonary symptoms associated with extrapulmonary disorders, including gastroesophageal reflux disease, cardiovascular disease, and rhinosinusitis.     

Thematic review series: adipocyte biology. Sympathetic and sensory innervation of white adipose tissue

During our study of the reversal of seasonal obesity in Siberian hamsters, we found an interaction between receptors for the pineal hormone melatonin and the sympathetic nervous system (SNS) outflow from brain to white adipose tissue (WAT). This ultimately led us and others to conclude that the SNS innervation of WAT is the primary initiator of lipid mobilization in these as well as other animals, including humans. There is strong neurochemical (norepinephrine turnover), neuroanatomical (viral tract tracing), and functional (sympathetic denervation-induced blockade of lipolysis) evidence for the role of the SNS in lipid mobilization. Recent findings suggest the presence of WAT sensory innervation based on strong neuroanatomical (viral tract tracing, immunohistochemical markers of sensory nerves) and suggestive functional (capsaicin sensory denervation-induced WAT growth) evidence, the latter implying a role in conveying adiposity information to the brain. By contrast, parasympathetic nervous system innervation of WAT is characterized by largely negative neuroanatomical evidence (viral tract tracing, immunohistochemical and biochemical markers of parasympathetic nerves). Functional evidence (intraneural stimulation and in situ microdialysis) for the role of the SNS innervation in lipid mobilization in human WAT is convincing, with some controversy regarding the level of sympathetic nerve activity in human obesity.     

White adipose tissue lacks significant vagal innervation and immunohistochemical evidence of parasympathetic innervation

Converging evidence indicates that white adipose tissue (WAT) is innervated by the sympathetic nervous system (SNS) based on immunohistochemical labeling of a SNS marker (tyrosine hydroxylase [TH]), tract tracing of WAT sympathetic postganglionic innervation, pseudorabies virus (PRV) transneuronal labeling of WAT SNS outflow neurons, and functional evidence from denervation studies. Recently, WAT para-SNS (PSNS) innervation was suggested because local surgical WAT sympathectomy (sparing hypothesized parasympathetic innervation) followed by PRV injection yielded infected cells in the vagal dorsomotor nucleus (DMV), a traditionally-recognized PSNS brain stem site. In addition, local surgical PSNS WAT denervation triggered WAT catabolic responses. We tested histologically whether WAT was parasympathetically innervated by searching for PSNS markers in rat, and normal (C57BL) and obese (ob/ob) mouse WAT. Vesicular acetylcholine transporter, vasoactive intestinal peptide and neuronal nitric oxide synthase immunoreactivities were absent in WAT pads (retroperitoneal, epididymal, inguinal subcutaneous) from all animals. Nearly all nerves innervating WAT vasculature and parenchyma that were labeled with protein gene product 9.5 (PGP9.5; pan-nerve marker) also contained TH, attesting to pervasive SNS innervation. When Siberian hamster inguinal WAT was sympathetically denervated via local injections of catecholaminergic toxin 6-hydroxydopamine (sparing putative parasympathetic nerves), subsequent PRV injection resulted in no central nervous system (CNS) or sympathetic chain infections suggesting no PSNS innervation. By contrast, vehicle-injected WAT subsequently inoculated with PRV had typical CNS/sympathetic chain viral infection patterns. Collectively, these data indicate no parasympathetic nerve markers in WAT of several species, with sparse DMV innervation and question the claim of PSNS WAT innervation as well as its functional significance.     

Distribution of vasoactive intestinal polypeptide-like immunoreactivity in the mammalian heart

Summary The distribution of vasoactive intestinal polypeptide (VIP) immunoreactivity has been studied in the mammalian heart and compared with that of neurotensin and substance P by use of light-microscopic peroxidase-antiperoxidase immunohistochemistry. VIP-immunoreactive cell bodies are present in intracardiac ganglia in various locations. VIP-immunoreactive nerve fibers predominate in the atria and the conduction system but are rare in the ventricles and occur in cardiac ganglia, endocardium, and epicardium. VIP-ergic nerves supply the coronary vasculature having a preference for the microvasculature and the nodal cells of the sinuatrial node. The large vessels of the heart and periarterial cardiac glomera also receive a VIP-immunoreactive nerve supply. There is partial co-distribution with neurotensin- and substance P-immunoreactive nerve fibers but no co-location in identical nerve fibers is detectable. The VIP-ergic cardiac innervation, which is probably predominantly intrinsic, may stem from postganglionic parasympathetic neurons and is less substantial than the more homogeneous neurotensin-ergic and substance P-ergic nervous supply which is probably extrinsic. The occurrence of an extrinsic VIP-ergic cardiac innervation cannot be excluded however. The differential histotopography of the multitarget cardiac nerves containing the cardiovascular active peptides VIP, neurotensin and substance P may suggest multiple and complex peptide-peptide and peptide-classical transmitter interactions. These may contribute to the regulation of various cardiac functions.     

Vasopressin and oxytocin in the neural control of the circulation

Catecholamine innervation originating in dorsal medial and ventral lateral medulla terminates on parvocellular and magnocellular subnuclei, respectively, of the paraventricular nucleus of the hypothalamus. In turn, parvocellular pathways terminate in brain stem and spinal cord, whereas magnocellular pathways terminate in median eminence and posterior pituitary. Consistent with the neuroanatomy, we find that baroreceptor regulation of neuroendocrine (plasma vasopressin) and autonomic (blood pressure) functions can be dissociated. Further, studies indicate that sympathetic vasomotor pathways are activated by injections of vasopressin and oxytocin into the nucleus tractus solitarii and vasopressin into the lateral cerebral ventricles. Also, parasympathetic pathways to the heart and baroreflex function are activated and augmented, respectively, by i.v. administered vasopressin. These results are consistent with at least three central sites of action and suggest a complex role of vasopressin (and possibly oxytocin) in the central neural regulation of the heart and circulation.     

Peptide YY reduces effects of sympathetic nerves and neuropeptide Y on cardiac vagal action.

In anesthetized dogs intravenous injection of neuropeptide Y (NPY) or stimulation of the cardiac sympathetic nerve is followed by a period of attenuation of vagal action at the heart lasting from many minutes to over an hour. Peptide YY (PYY), a related peptide (but one not reported to occur in the heart or its autonomic innervation), also inhibits cardiac vagal action but is more powerful and has a longer duration action. In 5 of 9 dogs, cardiac sympathetic nerve stimulation inhibited vagal action on the heart in control conditions, but relieved preexisting inhibition when repeated in the presence of PYY. In 3 dogs, exogenous NPY inhibited cardiac vagal action in control conditions, but failed to augment preexisting inhibition in the presence of PYY. An explanation offered for these results is that when PYY is occupying receptors on vagal nerve terminals, nerve-released NPY or exogenous NPY is either unable to produce an effect, because it cannot gain access to the receptors, or displaces PYY from at least some receptors and, being less powerful than PYY in its inhibitory action, lessens the preexisting vagal attenuation. The results reported are consistent with the proposal that the factor released from the sympathetic nerves following their stimulation and which is responsible for cardiac vagal inhibition is NPY.     

Innervation of the proximal urethra of ovariectomized and estrogen-treated female rats

The proximal urethra plays a central role in maintaining urinary continence, and sympathetic excitatory innervation to urethral smooth muscle is a major factor in promoting tonic contraction of this organ. Elevated estrogen levels are often associated with incontinence in humans. Because elevated estrogen levels result in degeneration of sympathetic nerves from the closely related uterine smooth muscle, we examined the effects of chronic estrogen administration on proximal urethral innervation. Ovariectomized virgin female rats received either vehicle or 17 beta-estradiol for 1 week, and smooth muscle size and parasympathetic, sensory and sympathetic nerve densities were assessed quantitatively throughout the first 3 mm of the proximal urethral smooth muscle. In vehicle-infused ovariectomized rats, parasympathetic nerves immunoreactive for vesicular acetylcholine transporter were most abundant, while calcitonin gene-related peptide-immunoreactive sensory nerves and tyrosine hydroxylase-immunoreactive sympathetic nerves were less numerous. The densities of parasympathetic and sensory nerves remained constant along the proximal urethra, while sympathetic nerves showed a significant increase along a proximal-distal gradient. Administration of 17beta-estradiol for 7 days via subcutaneous osmotic pump did not change smooth muscle area in sections, and neither densities nor total innervation of any nerve population was altered. These findings reveal a rich cholinergic innervation of the proximal urethra, and a pronounced gradient in sympathetic innervation. Unlike the embryologically similar uterine smooth muscle, estrogen does not influence muscle size or composition of innervation, indicating that estrogen's actions on innervation are highly target-specific. Thus, estrogen's effects on urinary continence apparently occur independently of any significant remodeling of smooth muscle or resident innervation.