Synthesis of quaternary ammonium salts of 16E-[4-(2-alkylaminoethoxy)-3-methoxybenzylidene]androstene derivatives as skeletal muscle relaxants

Synthesis of eighteen new quaternary ammonium salts of 16E-arylidene androstene derivatives as skeletal muscle relaxants is reported in the present study. The effects of possibly extended interonium distances on muscle relaxant activity are discussed. All the quaternary ammonium steroids produced reduction in the twitch responses, when screened for in vitro neuromuscular blocking activity using isolated chick biventer cervicis muscle preparation. However, the variable interonium distance, which is believed to range from 11 to 17 Å in these quaternary compounds and is associated with the built in flexibility of these structures about the single bonds on the moieties linked to ring D of the steroid skeleton, resulted in varied degrees of muscle relaxant activity. Some of the compounds also inhibited acetylcholinesterase activity in low concentrations so that they would not be directly suitable for use as muscle relaxants.     

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation

Percutaneous electrical nerve stimulation is a non-invasive method commonly used to evaluate neuromuscular function from brain to muscle (supra-spinal, spinal and peripheral levels). The present protocol describes how this method can be used to stimulate the posterior tibial nerve that activates plantar flexor muscles. Percutaneous electrical nerve stimulation consists of inducing an electrical stimulus to a motor nerve to evoke a muscular response. Direct (M-wave) and/or indirect (H-reflex) electrophysiological responses can be recorded at rest using surface electromyography. Mechanical (twitch torque) responses can be quantified with a force/torque ergometer. M-wave and twitch torque reflect neuromuscular transmission and excitation-contraction coupling, whereas H-reflex provides an index of spinal excitability. EMG activity and mechanical (superimposed twitch) responses can also be recorded during maximal voluntary contractions to evaluate voluntary activation level. Percutaneous nerve stimulation provides an assessment of neuromuscular function in humans, and is highly beneficial especially for studies evaluating neuromuscular plasticity following acute (fatigue) or chronic (training/detraining) exercise.     

Tolerance and upregulation of acetylcholine receptors follow chronic infusion of d-tubocurarine.

The hypothesis that chronic competitive antagonism of nicotinic acetylcholine receptors (nAChR), even in the absence of immobilization or paralysis, induces proliferation of the receptor and tolerance to the competitive antagonist was tested. Chronic antagonism of the nAChR was achieved in rats by an infusion of d-tubocurarine (dTC) via subcutaneously placed osmotic pumps. After 2 wk of dTC or saline, the neuromuscular pharmacodynamics and nAChR number were examined. No differences in weight gain or mobility were observed between groups. Chronic dTC infusion at 2 wk resulted in a baseline concentration of 0.41 +/- 0.07 (SE) micrograms/ml, which, if achieved acutely, would cause a depression of the twitch tension to 60% of control twitch height. Moreover the experimental group was able to develop a baseline twitch tension of 50 g, similar to that of controls. Despite the baseline dTC concentration in the experimental group, the effective doses of dTC for twitch depression were similar to those of controls. The plasma dTC concentration required for steady-state twitch inhibition was significantly (P less than 0.05) higher in the experimental group (0.83 +/- 0.04 vs. 0.50 +/- 0.15 micrograms/ml) as were the extrajunctional nAChR (19.76 +/- 1.77 vs. 13.37 +/- 1.82 fmol/mg protein). The diaphragmatic nAChR were unaltered. This study confirms that chronic doses of dTC cause tolerance to its effects and proliferation of nAChR even in the absence of immobilization. The absence of nAChR changes in the diaphragm may be due to the higher margin of safety of the diaphragm for muscle relaxants than for peripheral muscles. Intensive Care Unit patients receiving chronic infusions of dTC to facilitate mechanical ventilation will require increased doses with time.     

Burn injury to trunk of rat causes denervation-like responses in the gastrocnemius muscle

Thermal injury results in dystropic changes in skeletal muscle and abnormal pharmacological responses to neuromuscular relaxants, each of which suggests a denervation-like phenomenon. In the rat thermal injury model we examined whether, as in denervation states, increases in nicotinic acetylcholine receptors (AChR) and hyposensitivity to d-tubocurarine (dTc) are found. While anesthetized, thermal injury was imposed to trunk only. At 10, 14, and 21 days after injury the effective doses of dTc for left gastrocnemius tension suppression to 95% of control tension (ED95) were 0.213 +/- 0.039, 0.305 +/- 0.070, and 0.214 +/- 0.032 mg/kg, respectively. These values were significantly higher (P less than 0.05) than control values (0.155 +/- 0.006 mg/kg). The AChR concentrations in the left gastrocnemius, quantitated by 125I-alpha-bungarotoxin binding, increased at 10, 14, and 21 days to 182 +/- 20% (P less than 0.001), 166 +/- 22% (P less than 0.03), and 164 +/- 18% (P less than 0.001) of control, respectively. AChR concentrations in the right gastrocnemius also increased subsequent to thermal injury. Changes in effective dose of dTc for 50 and 95% twitch suppression in the left gastrocnemius correlated significantly with changes in AChR concentrations for the same muscle (r = 0.73 and 0.81, P less than 0.001, respectively). This study confirms the hypothesis that the systemic effects of thermal injury include an increase in AChR at sites distant from thermal injury, which may account for the skeletal muscle dysfunction and aberrant responses to neuromuscular relaxants.     

Ultrastructural features of neuromuscular junctions in the stapedius muscle of Gallus gallus

The ultrastructure of neuromuscular junctions in the twitch fibers of the stapedius muscle of Gallus gallus (domesticus) was investigated as part of a series of neurophysiological studies. Among the morphological features observed were elongated end-plates with numerous large and clear synaptic vesicles mixed with larger dense core vesicles and irregular or aperiodic “active sites” in the presynaptic membrane where synaptic vesicles were focused. The most remarkable features of these junctions were large synaptic clefts (50-80 nm) and the absence of junctional folds in the sarcolemmal surface. Unlike the large periodic junctional folds seen in the neuromuscular junctions of frogs and in the fast twitch fibers of the mammalian stapedius, the preparations studied only show small aperiodic invaginations (primitive folds) in the postsynaptic membranes. This morphological feature remains essentially constant from newly hatched to adult chickens. While these smooth junctions are consistent with earlier findings of inconspicuous junctional folds in the twitch fibers of the chicken posterior latissimus dorsi they are unlike those seen in the fast twitch fibers of the mammalian stapedius muscle, or other twitch fibers in general. The morphological findings of the present study may also suggest that the simple, unmodified neuromuscular junctions in the stapedius of Gallus may be a useful preparation for studies of synaptic membrane structures that employ the freeze-fracture technique.     

Anti-curare effect of plasma from patients with thermal injury

Following severe thermal injury, patients are resistant to non-depolarizing muscle relaxants. Although this resistance has been well documented clinically, little is known about its etiology. We have tested the hypothesis that circulating factors contribute to the decreased potency of neuromuscular blockers following burns. The potencies of d-tubocurarine (2 microM) or pancuronium (2 microM) dissolved in plasma from either burned or control human subjects were tested on the indirectly stimulated (0.2 Hz) rat phrenic nerve-hemidiaphragm preparation. The muscle relaxants produced less neuromuscular blockade when dissolved in plasma from burned patients than when they were dissolved in plasma from controls. Thus, circulating factors are involved in the decreased potency of non-depolarizing neuromuscular blocking drugs.     

Chronic exposure to a 60-Hz electric field: Effects on neuromuscular function in the rat

Neuromuscular function in adult male rats was studied following 30 days of exposure to a 60-Hz electric field at 100 kV/m (unperturbed field strength). Isometric force transducers were attached to the tendons of the plantaris (predominantly fast twitch), and soleus (predominantly slow twitch) muscles in the urethan-anesthetized rat. Square-wave stimuli were delivered to the distal stump of the transected sciatic nerve. Several measurements were used to characterize neuromuscular function, including twitch characteristics, chronaxie, tetanic and posttetanic potentiation, and fatigue and recovery. The results from three independent series of experiments are reported. Only recovery from fatigue in slow-twitch muscles was consistently and significantly affected (enhanced) by electrifield exposure. This effect does not appear to be mediated by field-induced changes in either neuromuscular transmission, or in the contractile mechanism itself. It is suggested that the effect may be mediated secondary to an effect on mechanisms regulating muscle blood flow or metabolism.     

Coexistence of twitch potentiation and tetanic force decline in rat hindlimb muscle

An experimental protocol designed to assess fatigability in motor units has been applied to two hindlimb muscles of anesthetized adult rats to study the effects of whole-muscle fatigue on the isometric twitch. Both soleus and extensor digitorum longus exhibited a linear relationship between fatigability (i.e., force decline after a 360-s fatigue test) and the magnitude of the twitch force following the fatigue test. Twitch force after the fatigue test was potentiated (i.e., greater than the value before the fatigue test) in many muscles, despite the development of considerable fatigue. This coexistence of fatigue and twitch potentiation was observed in 7% (5/70) of soleus and 48% (31/64) of extensor digitorum longus muscles. The coexistence was exhibited only by the least fatigable muscles of the fast-contracting extensor digitorum longus. The extensor digitorum longus muscles that did not exhibit twitch potentiation probably experienced a higher proportion of muscle-fiber inactivation, such as due to failure of neuromuscular propagation, that was induced by the fatigue regimen.     

Determining sample size for the morphological assessment of sperm

Morphologic assessment of spermatozoa is an integral component in the analysis of semen. Whether a technician rapidly screening semen quality at a commercial stud, a veterinarian performing breeding soundness examinations, a clinician at a reference andrology laboratory providing auditing or diagnostic services, or a researcher evaluating morphology as a part of a fertility study, it is important to make an informed decision regarding the number of spermatozoa to include in the morphology assessment. Application of basic statistical principles such as the nature of proportions, level of confidence in an observed value, and the interaction of sample size with precision, can and should be used in the decision process. This paper outlines in detail the application of these statistical principles in relation to the morphologic assessment of spermatozoa. Guidelines on how these principles can be utilized in practical situations are discussed. Additionally, methodologies for comparison of results within and between laboratories (an area easily prone to misinterpretation) are reviewed. It is hoped that through the use of these fundamental statistical principles, this paper will bring clarity and delineation to the science of quantifying the morphology of spermatozoa.     

Muscle fibrillation caused by cytochalasin-B applied to the motor nerve.

Cytochalasin-B, a drug known to interfere with axoplasmic transport, evoked fibrillary potentials in the geniohyoid muscle when applied to its motor nerve. Despite this denervation-like effect, neuromuscular transmission remained normal. Some contractile characteristics of the muscle were studied. It was found that contraction time, isometric twitch tension, and half-relaxation time were not altered by the drug treatment. The present findings show that neurogenic molecular factors conveyed by axoplasmic transport to the nerve terminal are involved in the regulation of some muscle membrane characteristics but do not modify the muscle contractile features.     

An integrated model for the interaction of muscle relaxants with their antagonists

An integrated model describing the interaction of nondepolarizing neuromuscular blocking agents with reversible anticholinesterase agents is derived and compared with a naive model using experimental data obtained from four anesthetized dogs. Three consecutive but separate steady-state d-tubocurarine blocks (approximately 50, 70, and 90%) were induced in each of the four dogs and reversed by short edrophonium infusions. Edrophonium arterial concentrations and twitch tension of the anterior tibialis muscle were measured. Both the integrated and the naive model were fit to the twitch tension data using a model with a hypothetical "effect" compartment. The integrated model consistently fit the twitch tension data better than the naive model; the sum of squared deviations was lower by 46, 45, 87, and 69%, respectively, with the integrated model than with the naive model. Also, in contrast to the naive model, the integrated model is capable of describing the interaction of the anticholinesterase agent and the neuromuscular blocking agent when the concentration of either varies with time.     

Muscle fibrillation caused by Cytochalasin-B applied to the motor nerve

Cytochalasin-B, a drug known to interfere with axoplasmic transport, evoked fibrillary potentials in the geniohyoid muscle when applied to its motor nerve. Despite this denervation-like effect, neuromuscular transmission remained normal. Some contractile characteristics of the muscle were studied. It was found that contraction time, isometric twitch tension, and half-relaxation time were not altered by the drug treatment. The present findings show that neurogenic molecular factors conveyed by axoplasmic transport to the nerve terminal are involved in the regualtion of some muscle membrane characteristics but do not modify the muscle contractile features.     

Effect of aging on fatigue characteristics of elbow flexor muscles during sustained submaximal contraction.

The purpose of this study was to compare fatigue-related measures of central and peripheral mechanisms between young and elderly subjects for a task performed with elbow flexor muscles. Ten young and nine elderly subjects performed a sustained submaximal fatigue task at 35% of their maximum voluntary contraction torque. Measures of neuromuscular function, reflecting changes in neuromuscular propagation, voluntary activation, excitation-contraction-relaxation processes, and metabolite buildup, were taken before, during, and after the fatigue task. The main results were the absence of neuromuscular propagation failure in either young or elderly subjects, the presence of central fatigue at the end of the fatigue task in 7 of 9 elderly but only 3 of 10 young subjects, and lesser changes in twitch torque contraction-relaxation variables and electromyographic median frequency in elderly compared with young subjects. The lesser fatigue-related changes in twitch contraction speed and median frequency in elderly compared with young subjects could reflect the increase in type I-to-type II fiber area reported with old age. The presence of significant central fatigue can apparently minimize some of the potential differences present in peripheral fatigue sites.     

Effect of stretch and release on equatorial X-ray diffraction during a twitch contraction of frog skeletal muscle.

Time-resolved intensity measurements of the x-ray equatorial reflections were made during twitch contractions of frog skeletal muscles, to which stretches or releases were applied at various times. A ramp stretch applied at the onset of a twitch (duration, 15 ms; amplitude, approximately 3% of muscle length) caused a faster and larger development of contractile force than in an isometric twitch. The stretch accelerated the decrease of the 1.0 reflection intensity (I1,0). The magnitude of increase of the 1,1 reflection intensity (I1,1) was reduced by the stretch, but its time course was also accelerated. A release applied at the peak of a twitch or later (duration, 5 ms; amplitude, approximately 1.5%) caused only a partial redevelopment of tension. The release produced clear reciprocal changes of reflections toward their relaxed levels, i.e., the I1,0 increased and the I1,1 decreased. A release applied earlier than the twitch peak had smaller effects on the reflection intensities. The results suggest that a strength applied at the onset of a twitch causes a faster radial movement of the myosin heads toward actin, whereas a release applied at or later than the peak of a twitch accelerates their return to the thick filament backbone. The results are discussed in the context of the regulation of the myosin head attachment by calcium.     

Volume of the effect compartment in simulations of neuromuscular block

Background  

The study examines the role of the volume of the effect compartment in simulations of neuromuscular block (NMB) produced by nondepolarizing muscle relaxants.     

Amphetamine effects on acetylcholine release and mammalian neuromuscular transmission

The mechanisms by which (+)-amphetamine biphasically modifies neuromuscular transmission were studied in the rat phrenic nervediaphragm preparation. Low to moderate amphetamine concentrations (30–300 μM) enhanced twitch height and potentiated the nerve stimulated release of acetylcholine (ACh) by up to 4.8-fold from the phrenic nerve. Higher amphetamine concentrations depressed muscle twitch and ACh release. Using a cannulated diaphragm preparation, amphetamine enhanced the twitch response to nerve stimulation but markedly depressed the contractions elicited by a pulsed injection of ACh. Amphetamine-induced enhancement of ACh release was prevented by pretreatment of animals with α-methyl-p-tyrosine, suggesting that amphetamine may be acting indirectly by releasing catecholamines. These results support the hypothesis that amphetamine enhancement results from a presynaptic increase in ACh release and the blocking actions are mediated by a postsynaptic inhibitory effect.     

Mechanisms of depression of neuromuscular transmission by ATP and adenosine.

1. The effects of ATP in the presence of theophylline and imidazole were investigated on the twitch tension of a partially magnesium blocked rat phrenic nerve-diaphragm preparation. Both theophylline and imidazole facilitate the neuromuscular transmission and prevent the effects of ATP. 2. The effects of adenosine in solutions with low calcium concentrations in the frog-sartorius and in solutions with very low calcium concentrations in the rat-diaphragm were studied on the miniature end-plate potentials. Adenosine caused a similar reduction of the frequency of the miniature end-plate potentials in both low and very low calcium concentrations. 3. The results are discussed in relation to the cyclic AMP and calcium hypothesis.     

Neuromuscular fatigue of elbow flexor muscles of dominant and non-dominant arms in healthy humans.

The purpose of this study was to assess differences in fatigue-related changes in variables related to structures within the neuromuscular system, between the dominant and non-dominant elbow flexor muscles of right-handed individuals. Two experimental sessions were performed on the right arm and one on the left arm. For each session, maximum voluntary torque, level of voluntary activation, M-wave amplitude, twitch/train or twitch/doublet torque ratio and EMG median frequency were obtained before and up to 20 min after a sustained maximum isometric fatigue task. Our main results were: 1) reproducible fatigue-induced changes in all variables of interest between the two sessions performed with the right arm, 2) significantly greater failure in voluntary activation and neuromuscular propagation with sustained activity for the non-dominant compared with dominant side, and 3) no effect of dominance on MVC torque, endurance time, and fatigue-induced changes in EMG median frequency and elicited torques. These results suggest that the preferential use of elbow flexor muscles with the dominant arm leads to more fatigue resistance in certain structures/mechanisms of the neuromuscular system, but not in others.     

Reappraisal of VAChT‐Cre: Preference in slow motor neurons innervating type I or IIa muscle fibers

VAChT‐Cre.Fast and VAChT‐Cre.Slow mice selectively express Cre recombinase in approximately one half of postnatal somatic motor neurons. The mouse lines have been used in various studies with selective genetic modifications in adult motor neurons. In the present study, we crossed VAChT‐Cre lines with a reporter line, CAG‐Syp/tdTomato, in which synaptophysin‐tdTomato fusion proteins are efficiently sorted to axon terminals, making it possible to label both cell bodies and axon terminals of motor neurons. In the mice, Syp/tdTomato fluorescence preferentially co‐localized with osteopontin, a recently discovered motor neuron marker for slow‐twitch fatigue‐resistant (S) and fast‐twitch fatigue‐resistant (FR) types. The fluorescence did not preferentially co‐localize with matrix metalloproteinase‐9, a marker for fast‐twitch fatigable (FF) motor neurons. In the neuromuscular junctions, Syp/tdTomato fluorescence was detected mainly in motor nerve terminals that innervate type I or IIa muscle fibers. These results suggest that the VAChT‐Cre lines are Cre‐drivers that have selectivity in S and FR motor neurons. In order to avoid confusion, we have changed the mouse line names from VAChT‐Cre.Fast and VAChT‐Cre.Slow to VAChT‐Cre.Early and VAChT‐Cre.Late, respectively. The mouse lines will be useful tools to study slow‐type motor neurons, in relation to physiology and pathology.     

Development of tolerance to the excitatory effect of morphine and cross-tolerance to the inhibitory action of β-endorphin in the isolated rat vas deferens

In the isolated rat vas deferens, morphine caused an increase in the neuromuscular twitch evoked by electrical stimulation. In rats chronically treated with morphine, the concentration of the opiate required to cause a 50% increase in the twitch was about 3 times larger than needed to elicit the same response in vasa from rats treated with a placebo. The simultaneous administration of naloxone plus morphine partially antagonized tolerance development by about 22%. Morphine tolerance was extended to other opiate- like alkaloids such as etonitazene and a derivative of azidomorphine (CAM). In contrast to the effects of morphine, β-endorphin inhibited neuromuscular transmission. Vasa from rats chronically treated with morphine were about 10 times less sensitive to the inhibitory effect of β-endorphin as compared to paired placebo treated controls. Chronic naloxone treatment in conjuction with morphine significantly reduced the cross-opiate tolerance by 66%. Present results suggest that morphine may interact at two different sites in the nerve terminals of the rat vas deferens.