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1.
J Neurosci ; 38(36): 7761-7773, 2018 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-30054393

RESUMO

Alcohol withdrawal symptoms contribute to excessive alcohol drinking and relapse in alcohol-dependent individuals. Among these symptoms, alcohol withdrawal promotes hyperalgesia, but the neurological underpinnings of this phenomenon are not known. Chronic alcohol exposure alters cell signaling in the central nucleus of the amygdala (CeA), and the CeA is implicated in mediating alcohol dependence-related behaviors. The CeA projects to the periaqueductal gray (PAG), a region critical for descending pain modulation, and may have a role in alcohol withdrawal hyperalgesia. Here, we tested the roles of (1) CeA projections to PAG, (2) CeA melanocortin signaling, and (3) PAG µ-opioid receptor signaling in mediating thermal nociception and alcohol withdrawal hyperalgesia in male Wistar rats. Our results demonstrate that alcohol dependence reduces GABAergic signaling from CeA terminals onto PAG neurons and alters the CeA melanocortin system, that CeA-PAG projections and CeA melanocortin signaling mediate alcohol withdrawal hyperalgesia, and that µ-opioid receptors in PAG filter CeA effects on thermal nociception.SIGNIFICANCE STATEMENT Hyperalgesia is commonly seen in individuals with alcohol use disorder during periods of withdrawal, but the neurological underpinnings behind this phenomenon are not completely understood. Here, we tested whether alcohol dependence exerts its influence on pain modulation via effects on the limbic system. Using behavioral, optogenetic, electrophysiological, and molecular biological approaches, we demonstrate that central nucleus of the amygdala (CeA) projections to periaqueductal gray mediate thermal hyperalgesia in alcohol-dependent and alcohol-naive rats. Using pharmacological approaches, we show that melanocortin receptor-4 signaling in CeA alters alcohol withdrawal hyperalgesia, but this effect is not mediated directly at synaptic inputs onto periaqueductal gray-projecting CeA neurons. Overall, our findings support a role for limbic influence over the descending pain pathway and identify a potential therapeutic target for treating hyperalgesia in individuals with alcohol use disorder .


Assuntos
Alcoolismo/fisiopatologia , Tonsila do Cerebelo/fisiopatologia , Hiperalgesia/fisiopatologia , Rede Nervosa/fisiopatologia , Substância Cinzenta Periaquedutal/fisiopatologia , Alcoolismo/metabolismo , Tonsila do Cerebelo/metabolismo , Animais , Temperatura Alta , Hiperalgesia/metabolismo , Masculino , Rede Nervosa/metabolismo , Vias Neurais/metabolismo , Vias Neurais/fisiopatologia , Neurônios/metabolismo , Substância Cinzenta Periaquedutal/metabolismo , Ratos , Ratos Wistar , Receptor Tipo 4 de Melanocortina/metabolismo , Receptores Opioides mu/metabolismo , Transdução de Sinais/fisiologia
2.
Alcohol Clin Exp Res ; 40(12): 2537-2547, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27796078

RESUMO

BACKGROUND: Nicotine use increases alcohol drinking, suggesting that the combination of these drugs may produce synergistic effects in activating reward circuitry. Alternatively, use of either of these drugs may facilitate the development of cross-tolerance to the other to promote intake escalation. METHODS: In this study, adult male Wistar rats were chronically exposed to room air or chronic, intermittent nicotine vapor, which has been shown to produce symptoms of nicotine dependence as evidenced by elevated nicotine self-administration and a host of somatic and motivational withdrawal symptoms. We examined regional neuroadaptations in nicotine-experienced versus nonexperienced animals, focusing on changes in phosphorylation of the AMPA glutamate channel subunit GluA1 in reward-related brain regions as excitatory neuroadaptations are heavily implicated in both alcohol and nicotine addiction. RESULTS: During withdrawal, nicotine exposure and alcohol challenge (1 g/kg) interactively produced neuroadaptations in GluA1 phosphorylation in a brain region-dependent manner. Alcohol robustly increased protein kinase A-mediated phosphorylation of GluA1 at serine 845 in multiple regions. However, this neuroadaptation was largely absent in 3 areas (dorsomedial prefrontal cortex, dorsal striatum, and central amygdala) in nicotine-experienced animals. This interactive effect suggests a molecular tolerance to alcohol-stimulated phosphorylation of GluA1 in the context of nicotine dependence. CONCLUSIONS: Nicotine may modify the rewarding or reinforcing effects of alcohol by altering glutamate signaling in a region-specific manner, thereby leading to increased drinking in heavy smokers.


Assuntos
Tolerância a Medicamentos , Etanol/farmacologia , Nicotina/efeitos adversos , Receptores de AMPA/metabolismo , Síndrome de Abstinência a Substâncias/metabolismo , Administração por Inalação , Animais , Encéfalo/metabolismo , Interações Medicamentosas , Masculino , Nicotina/administração & dosagem , Fosforilação/efeitos dos fármacos , Ratos , Ratos Wistar
3.
Neuropsychopharmacology ; 41(10): 2463-72, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27013358

RESUMO

Hyperalgesia is an exaggerated response to noxious stimuli produced by peripheral or central plasticity. Stress modifies nociception, and humans with post-traumatic stress disorder (PTSD) exhibit co-morbid chronic pain and amygdala dysregulation. Predator odor stress produces hyperalgesia in rodents. Systemic blockade of corticotropin-releasing factor (CRF) type 1 receptors (CRFR1s) reduces stress-induced thermal hyperalgesia. We hypothesized that CRF-CRFR1 signaling in central amygdala (CeA) mediates stress-induced hyperalgesia in rats with high stress reactivity. Adult male Wistar rats were exposed to predator odor stress in a conditioned place avoidance paradigm and indexed for high (Avoiders) and low (Non-Avoiders) avoidance of predator odor-paired context, or were unstressed Controls. Rats were tested for the latency to withdraw hindpaws from thermal stimuli (Hargreaves test). We used pharmacological, molecular, and immunohistochemical techniques to assess the role of CRF-CRFR1 signaling in CeA in stress-induced hyperalgesia. Avoiders exhibited higher CRF peptide levels in CeA that did not appear to be locally synthesized. Intra-CeA CRF infusion mimicked stress-induced hyperalgesia. Avoiders exhibited thermal hyperalgesia that was reversed by systemic or intra-CeA injection of a CRFR1 antagonist. Finally, intra-CeA infusion of tetrodotoxin produced thermal hyperalgesia in unstressed rats and blocked the anti-hyperalgesic effect of systemic CRFR1 antagonist in stressed rats. These data suggest that rats with high stress reactivity exhibit hyperalgesia that is mediated by CRF-CRFR1 signaling in CeA.


Assuntos
Núcleo Central da Amígdala/metabolismo , Hiperalgesia/patologia , Receptores de Hormônio Liberador da Corticotropina/metabolismo , Transdução de Sinais/fisiologia , Estresse Psicológico/fisiopatologia , Análise de Variância , Animais , Aprendizagem da Esquiva/efeitos dos fármacos , Núcleo Central da Amígdala/patologia , Condicionamento Psicológico/efeitos dos fármacos , Hormônio Liberador da Corticotropina/genética , Hormônio Liberador da Corticotropina/metabolismo , Hormônio Liberador da Corticotropina/farmacologia , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Hiperalgesia/fisiopatologia , Masculino , Neurônios/efeitos dos fármacos , Neurônios/patologia , Odorantes , Medição da Dor , Limiar da Dor/efeitos dos fármacos , Pirimidinas/farmacologia , RNA Mensageiro/metabolismo , Ratos , Ratos Wistar , Receptores de Hormônio Liberador da Corticotropina/antagonistas & inibidores , Receptores de Hormônio Liberador da Corticotropina/genética , Transdução de Sinais/efeitos dos fármacos
4.
Stress ; 19(1): 69-77, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26482332

RESUMO

Individuals with post-traumatic stress disorder (PTSD) avoid trauma-related stimuli and exhibit blunted hypothalamic-pituitary-adrenal (HPA) axis activation at the time of stress. Our rodent model of stress mimics the avoidance symptom cluster of PTSD. Rats are classified as "Avoiders" or "Non-Avoiders" post-stress based on the avoidance of a predator-odor paired context. Previously, we found Avoiders exhibit an attenuated HPA stress response to predator odor. We hypothesized that corticosterone administration before stress would reduce the magnitude and incidence of stress-paired context avoidance. Furthermore, we also predicted that Avoiders would exhibit altered expression of glucocorticoid receptor (GR) signaling machinery elements, including steroid receptor co-activator (SRC)-1. Male Wistar rats (n = 16) were pretreated with corticosterone (25 mg/kg) or saline and exposed to predator-odor stress paired with a context and tested for avoidance 24 h later. A second group of corticosterone-naïve rats (n = 24) were stressed (or not), indexed for avoidance 24 h later, and killed 48 h post-odor exposure to measure phosphorylated GR, FKBP51 and SRC-1 levels in the paraventricular nucleus (PVN), central amygdala (CeA) and ventral hippocampus (VH), all brain sites that highly express GRs and regulate HPA function. Corticosterone pretreatment reduced the magnitude and incidence of avoidance. In Avoiders, predator-odor exposure led to lower SRC-1 expression in the PVN and CeA, and higher SRC-1 expression in the VH. SRC-1 expression in PVN, CeA and VH was predicted by prior avoidance behavior. Hence, a blunted HPA stress response may contribute to stress-induced neuroadaptations in central SRC-1 levels and behavioral dysfunction in Avoider rats.


Assuntos
Aprendizagem da Esquiva/efeitos dos fármacos , Comportamento Animal/efeitos dos fármacos , Encéfalo/metabolismo , Corticosterona/farmacologia , Coativador 1 de Receptor Nuclear/metabolismo , Receptores de Glucocorticoides/metabolismo , Estresse Psicológico/metabolismo , Proteínas de Ligação a Tacrolimo/metabolismo , Tonsila do Cerebelo/metabolismo , Animais , Aprendizagem da Esquiva/fisiologia , Comportamento Animal/fisiologia , Hipocampo/metabolismo , Sistema Hipotálamo-Hipofisário/fisiopatologia , Masculino , Núcleo Hipotalâmico Paraventricular/metabolismo , Sistema Hipófise-Suprarrenal/fisiopatologia , Ratos , Ratos Wistar , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Estresse Psicológico/fisiopatologia
5.
Physiol Behav ; 147: 16-22, 2015 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-25824191

RESUMO

Individuals with trauma- and stress-related disorders exhibit increases in avoidance of trauma-related stimuli, heightened anxiety and altered neuroendocrine stress responses. Our laboratory uses a rodent model of stress that mimics the avoidance symptom cluster associated with stress-related disorders. Animals are classified as 'Avoiders' or 'Non-Avoiders' post-stress based on avoidance of predator-odor paired context. Utilizing this model, we are able to examine subpopulation differences in stress reactivity. Here, we used this predator odor model of stress to examine differences in anxiety-like behavior and hypothalamo-pituitary adrenal (HPA) axis function in animals that avoid a predator-paired context relative to those that do not. Rats were exposed to predator odor stress paired with a context and tested for avoidance (24h and 11days), anxiety-like behavior (48h and 5days) and HPA activation following stress. Control animals were exposed to room air. Predator odor stress produced avoidance in approximately 65% of the animals at 24h that persisted 11days post-stress. Both Avoiders and Non-Avoiders exhibited a heightened anxiety-like behavior at 48h and 5days post-stress when compared to unstressed Controls. Non-Avoiders exhibited significant increases in circulating adrenocorticotropin hormone (ACTH) and corticosterone (CORT) concentrations immediately following predator odor stress compared to Controls and this response was significantly attenuated in Avoiders. There was an inverse correlation between circulating ACTH/CORT concentrations and avoidance, indicating that lower levels of ACTH/CORT predicted higher levels of avoidance. These results suggest that stress effects on HPA stress axis activation predict long-term avoidance of stress-paired stimuli, and build on previous data showing the utility of this model for exploring the neurobiological mechanisms of trauma- and stress-related disorders.


Assuntos
Ansiedade/sangue , Ansiedade/etiologia , Sistema Hipotálamo-Hipofisário/fisiologia , Odorantes , Sistema Hipófise-Suprarrenal/fisiologia , Estresse Psicológico/complicações , Hormônio Adrenocorticotrópico , Análise de Variância , Animais , Ansiedade/patologia , Aprendizagem da Esquiva/fisiologia , Encéfalo/patologia , Condicionamento Operante , Corticosterona , Modelos Animais de Doenças , Comportamento Exploratório , Masculino , Aprendizagem em Labirinto , Radioimunoensaio , Ratos , Ratos Wistar , Estresse Psicológico/etiologia , Fatores de Tempo
6.
Behav Pharmacol ; 25(5-6): 398-409, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25083568

RESUMO

Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress-induced and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often-observed combination of PTSD and comorbid conditions such as alcohol use disorder. Future studies will continue to refine preclinical PTSD models in hope of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders.


Assuntos
Encéfalo/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Animais , Modelos Animais de Doenças , Humanos
7.
Physiology (Bethesda) ; 29(3): 203-15, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24789985

RESUMO

Alcohol abuse; the most common and costly form of drug abuse, is a major contributing factor to many disease categories. The alcohol-attributable disease burden is closely related to the average volume of alcohol consumption, with dose-dependent relationships between amount and duration of alcohol consumption and the incidence of diabetes mellitus, hypertension, cardiovascular disease, stroke, and pneumonia. The frequent occurrence of alcohol use disorders in the adult population and the significant and widespread detrimental organ system effects highlight the importance of recognizing and further investigating the pathophysiological mechanisms underlying alcohol-induced tissue and organ injury.


Assuntos
Transtornos Relacionados ao Uso de Álcool/etiologia , Transtornos Relacionados ao Uso de Álcool/patologia , Alcoolismo/complicações , Alcoolismo/patologia , Consumo de Bebidas Alcoólicas/patologia , Animais , Efeitos Psicossociais da Doença , Humanos
8.
Neuropharmacology ; 79: 83-9, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24269607

RESUMO

Humans with stress-related anxiety disorders exhibit increases in arousal and alcohol drinking, as well as altered pain processing. Our lab has developed a predator odor stress model that produces reliable and lasting increases in alcohol drinking. Here, we utilize this predator odor stress model to examine stress-induced increases in arousal, nociceptive processing, and alcohol self-administration by rats, and also to determine the effects of corticotropin-releasing factor-1 receptors (CRF1Rs) in mediating these behavioral changes. In a series of separate experiments, rats were exposed to predator odor stress, then tested over subsequent days for thermal nociception in the Hargreaves test, acoustic startle reactivity, or operant alcohol self-administration. In each experiment, rats were systemically injected with R121919, a CRF1R antagonist, and/or vehicle. Predator odor stress increased thermal nociception (i.e., hyperalgesia) and acoustic startle reactivity. Systemic administration of R121919 reduced thermal nociception and hyperarousal in stressed rats but not unstressed controls, and reduced operant alcohol responding over days. Stressed rats exhibited increased sensitivity to the behavioral effects of R121919 in all three tests, suggesting up-regulation of brain CRF1Rs number and/or function in stressed rats. These results suggest that post-stress alcohol drinking may be driven by a high-nociception high-arousal state, and that brain CRF1R signaling mediates these stress effects.


Assuntos
Reação de Fuga/efeitos dos fármacos , Reação de Fuga/fisiologia , Odorantes , Receptores de Hormônio Liberador da Corticotropina/metabolismo , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/fisiopatologia , Consumo de Bebidas Alcoólicas/tratamento farmacológico , Consumo de Bebidas Alcoólicas/fisiopatologia , Animais , Nível de Alerta/efeitos dos fármacos , Nível de Alerta/fisiologia , Condicionamento Operante , Temperatura Alta , Hiperalgesia/tratamento farmacológico , Hiperalgesia/fisiopatologia , Masculino , Percepção Olfatória/efeitos dos fármacos , Percepção Olfatória/fisiologia , Percepção da Dor/efeitos dos fármacos , Percepção da Dor/fisiologia , Pirimidinas/farmacologia , Ratos , Ratos Wistar , Receptores de Hormônio Liberador da Corticotropina/antagonistas & inibidores , Reflexo de Sobressalto/efeitos dos fármacos , Reflexo de Sobressalto/fisiologia , Filtro Sensorial/efeitos dos fármacos , Filtro Sensorial/fisiologia
9.
Neuropharmacology ; 77: 217-23, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24107576

RESUMO

Because tobacco use has a large negative health and financial impact on society, it is critical to identify the factors that drive excessive use. These factors include the aversive withdrawal symptoms that manifest upon cessation of tobacco use, and may include increases in nociceptive processing. Corticotropin-releasing factor (CRF) signalling in the central amygdala (CeA) has been attributed an important role in: (1) central processing of pain, (2) excessive nicotine use that results in nicotine dependence, and (3) in mediating the aversive symptoms that manifest following cessation of tobacco exposure. Here, we describe three experiments in which the main hypothesis was that CRF/CRF1 receptor (CRF1R) signalling in the CeA mediates nicotine withdrawal-induced increases in nociceptive sensitivity in rats that are dependent on nicotine. In Experiment 1, nicotine-dependent rats withdrawn from chronic intermittent (14-h/day) nicotine vapor exhibited decreased hind paw withdrawal latencies in response to a painful thermal stimulus in the Hargreaves test, and this effect was attenuated by systemic administration of the CRF1R antagonist, R121919. In Experiment 2, nicotine-dependent rats withdrawn from nicotine vapor exhibited robust increases in mRNA for CRF and CRF1Rs in CeA. In Experiment 3, intra-CeA administration of R121919 reduced thermal nociception only in nicotine-dependent rats. Collectively, these results suggest that nicotine dependence increases CRF/CRF1R signalling in the CeA that mediates withdrawal-induced increases in sensitivity to a painful stimulus. Future studies will build on these findings by exploring the hypothesis that nicotine withdrawal-induced reduction in pain thresholds drive excessive nicotine use via CRF/CRF1R signalling pathways.


Assuntos
Tonsila do Cerebelo/metabolismo , Hiperalgesia/induzido quimicamente , Nicotina/efeitos adversos , Receptores de Hormônio Liberador da Corticotropina/metabolismo , Síndrome de Abstinência a Substâncias/metabolismo , Tabagismo/complicações , Tonsila do Cerebelo/efeitos dos fármacos , Animais , Hormônio Liberador da Corticotropina/metabolismo , Hiperalgesia/metabolismo , Masculino , Limiar da Dor/efeitos dos fármacos , Pirimidinas/farmacologia , Ratos , Ratos Wistar , Receptores de Hormônio Liberador da Corticotropina/antagonistas & inibidores , Tabagismo/metabolismo
10.
Addict Biol ; 19(4): 587-92, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23240929

RESUMO

Humans escalate their cigarette smoking over time, and a major obstacle in the field of pre-clinical nicotine addiction research has been the inability to produce escalated nicotine self-administration in rats. In experiment 1, male Wistar rats were trained to respond for nicotine in 2-hour operant sessions, then exposed to chronic intermittent (12 hours/day) nicotine vapor and repeatedly tested for nicotine self-administration at 8-12 hours of withdrawal. Rats were tested intermittently on days 1, 3 and 5 of the vapor exposure procedure, then tested with nicotine vapor exposure on 6-15 consecutive days. Rats exhibited transient increases in operant nicotine responding during intermittent testing, regardless of vapor condition, and this responding returned to baseline levels upon resumption of consecutive-days testing (i.e. nicotine deprivation effect). Nicotine vapor-exposed rats then escalated nicotine self-administration relative to both their own baseline (∼200% increase) and non-dependent controls (∼3× higher). In experiment 2, rats were exposed or not exposed to chronic intermittent nicotine vapor, then tested for spontaneous and precipitated somatic signs of nicotine withdrawal. Eight hours following removal from nicotine vapor, rats exhibited robust mecamylamine-precipitated somatic signs of withdrawal. There was a strong correlation between nicotine flow rate and air-nicotine concentration, and the air-nicotine concentrations used in experiments 1 and 2 resemble concentrations experienced by human smokers. Collectively, these results suggest that chronic intermittent nicotine vapor inhalation produces somatic and motivational signs of nicotine dependence, the latter of which is evidenced by escalation of nicotine self-administration.


Assuntos
Comportamento Animal/efeitos dos fármacos , Nicotina/farmacologia , Tabagismo/fisiopatologia , Análise de Variância , Animais , Condicionamento Operante , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Masculino , Mecamilamina , Dados de Sequência Molecular , Nicotina/administração & dosagem , Antagonistas Nicotínicos , Ratos , Ratos Wistar , Autoadministração , Síndrome de Abstinência a Substâncias/fisiopatologia , Volatilização
11.
Life Sci ; 93(17): 623-9, 2013 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-24002017

RESUMO

AIMS: Acute ethanol intoxication (AEI) attenuates the arginine vasopressin (AVP) response to hemorrhage leading to impaired hemodynamic counter-regulation and accentuated hemodynamic stability. Previously we identified that the ethanol-induced impairment of circulating AVP concentrations in response to hemorrhage was the result of augmented central nitric oxide (NO) inhibition. The aim of the current study was to examine the mechanisms underlying ethanol-induced up-regulation of paraventricular nucleus (PVN) NO concentration. Angiotensin (ANG) (1-7) is an important mediator of NO production through activation of the Mas receptor. We hypothesized that Mas receptor inhibition would decrease central NO concentration and thus restore the rise in circulating AVP levels during hemorrhagic shock in AEI rats. MAIN METHODS: Conscious male Sprague-Dawley rats (300-325 g) received a 15 h intra-gastric infusion of ethanol (2.5 g/kg+300 mg/kg/h) or dextrose prior to a fixed-pressure (~40 mm Hg) 60 min hemorrhage. The Mas receptor antagonist A-779 was injected through an intracerebroventricular (ICV) cannula 15 min prior to hemorrhage. KEY FINDINGS: PVN NOS activity and NO were significantly higher in AEI compared to DEX-treated controls at the completion of hemorrhage. ICV A-779 administration decreased NOS activity and NO concentration, partially restoring the rise in circulating AVP level at completion of hemorrhage in AEI rats. SIGNIFICANCE: These results suggest that Mas receptor activation contributes to the NO-mediated inhibitory tone of AVP release in the ethanol-intoxicated hemorrhaged host.


Assuntos
Intoxicação Alcoólica/metabolismo , Angiotensina I/farmacologia , Arginina Vasopressina/efeitos dos fármacos , Óxido Nítrico/metabolismo , Núcleo Hipotalâmico Paraventricular/metabolismo , Fragmentos de Peptídeos/farmacologia , Choque Hemorrágico/metabolismo , Intoxicação Alcoólica/sangue , Intoxicação Alcoólica/complicações , Angiotensina II/administração & dosagem , Angiotensina II/análogos & derivados , Angiotensina II/farmacologia , Animais , Arginina Vasopressina/sangue , Inibidores Enzimáticos/farmacologia , Hemodinâmica/efeitos dos fármacos , Injeções Intraventriculares , Masculino , Óxido Nítrico Sintase/metabolismo , Núcleo Hipotalâmico Paraventricular/efeitos dos fármacos , Fragmentos de Peptídeos/administração & dosagem , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas/antagonistas & inibidores , Ratos , Receptores Acoplados a Proteínas G/antagonistas & inibidores , Sistema Renina-Angiotensina/efeitos dos fármacos , Choque Hemorrágico/sangue , Choque Hemorrágico/classificação , Regulação para Cima
12.
Shock ; 39(3): 240-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23416555

RESUMO

Traumatic injury ranks as the number one cause of death for the younger than 44 years age group and fifth leading cause of death overall (www.nationaltraumainstitute.org/home/trauma_statistics.html). Although improved resuscitation of trauma patients has dramatically reduced immediate mortality from hemorrhagic shock, long-term morbidity and mortality continue to be unacceptably high during the postresuscitation period particularly as a result of impaired host immune responses to subsequent challenges such as surgery or infection. Acute alcohol intoxication (AAI) is a significant risk factor for traumatic injury, with intoxicating blood alcohol levels present in more than 40% of injured patients. Severity of trauma, hemorrhagic shock, and injury is higher in intoxicated individuals than that of sober victims, resulting in higher mortality rates in this patient population. Necessary invasive procedures (surgery, anesthesia) and subsequent challenges (infection) that intoxicated trauma victims are frequently subjected to are additional stresses to an already compromised inflammatory and neuroendocrine milieu and further contribute to their morbidity and mortality. Thus, dissecting the dynamic imbalance produced by AAI during trauma is of critical relevance for a significant proportion of injured victims. This review outlines how AAI at the time of hemorrhagic shock not only prevents adequate responses to fluid resuscitation but also impairs the ability of the host to overcome a secondary infection. Moreover, it discusses the neuroendocrine mechanisms underlying alcohol-induced hemodynamic dysregulation and its relevance to host defense restoration of homeostasis after injury.


Assuntos
Alcoolismo/complicações , Choque Hemorrágico/etiologia , Ferimentos e Lesões/etiologia , Alcoolismo/fisiopatologia , Sistema Nervoso Autônomo/fisiopatologia , Etanol/intoxicação , Hemodinâmica/fisiologia , Humanos , Neurofisinas/fisiologia , Sistemas Neurossecretores/fisiopatologia , Precursores de Proteínas/fisiologia , Ressuscitação/métodos , Choque Hemorrágico/fisiopatologia , Choque Hemorrágico/terapia , Vasopressinas/fisiologia , Ferimentos e Lesões/fisiopatologia
13.
J Trauma Acute Care Surg ; 74(1): 196-202, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23147176

RESUMO

BACKGROUND: Acute alcohol intoxication (AAI) impairs the hemodynamic and arginine vasopressin (AVP) counter-regulation to hemorrhagic shock (HS) and lactated Ringer's solution (LR) fluid resuscitation (FR). The mechanism of AAI-induced suppression of AVP release in response to HS involves accentuated nitric oxide (NO) inhibitory tone. In contrast, AAI does not prevent AVP response to increased osmolarity produced by hypertonic saline (HTS) infusion. We hypothesized that FR with HTS during AAI would enhance AVP release by decreasing periventricular nucleus NO inhibitory tone, subsequently improving mean arterial blood pressure (MABP) and organ perfusion. METHODS: Male Sprague-Dawley rats received a 15-hour alcohol infusion (2.5 g/kg + 0.3 g/kg/h) or dextrose (DEX) before HS (40 mm Hg × 60 minutes) and FR with HTS (7.5%, 4 ml/kg) or LR (2.4 × blood volume removed). Organ blood flow was determined, and brains were collected for NO content at 2 hours after FR. RESULTS: HTS improved MABP recovery in AAI (109 vs. 80 mm Hg) and DEX (114 vs. 83 mm Hg) animals compared with LR. This was associated with higher (>60%) circulating AVP levels at 2 hours after FR compared with those detected in LR animals in both groups. Neither AAI alone nor HS in DEX animals resuscitated with LR altered organ blood flow. In AAI animals, HS and FR with LR reduced blood flow to the liver (72%), small intestine (65%), and large intestine (67%) compared with shams. FR with HTS improved liver (threefold) and small intestine (twofold) blood flow compared with LR in AAI-HS animals. The enhanced MABP response to HTS was prevented by pretreatment with a systemic AVP V1a receptor antagonist. HTS decreased periventricular nucleus NO content in both groups 2 hours after FR. CONCLUSION: These results suggest that FR with HTS in AAI results in the removal of central NO inhibition of AVP, restoring AVP levels and improving MABP and organ perfusion in AAI-HS.


Assuntos
Intoxicação Alcoólica/terapia , Pressão Sanguínea , Ressuscitação , Solução Salina Hipertônica/uso terapêutico , Choque Hemorrágico/terapia , Intoxicação Alcoólica/complicações , Intoxicação Alcoólica/fisiopatologia , Animais , Arginina Vasopressina/sangue , Intestinos/irrigação sanguínea , Soluções Isotônicas , Rim/irrigação sanguínea , Fígado/irrigação sanguínea , Masculino , Óxido Nítrico/sangue , Peroxidase/sangue , Ratos , Ratos Sprague-Dawley , Fluxo Sanguíneo Regional , Lactato de Ringer , Choque Hemorrágico/complicações , Choque Hemorrágico/fisiopatologia
14.
Am J Physiol Regul Integr Comp Physiol ; 301(5): R1529-39, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21849630

RESUMO

Acute alcohol intoxication (AAI) attenuates the AVP response to hemorrhage, contributing to impaired hemodynamic counter-regulation. This can be restored by central cholinergic stimulation, implicating disrupted signaling regulating AVP release. AVP is released in response to hemorrhage and hyperosmolality. Studies have demonstrated nitric oxide (NO) to play an inhibitory role on AVP release. AAI has been shown to increase NO content in the paraventricular nucleus. We hypothesized that the attenuated AVP response to hemorrhage during AAI is the result of increased central NO inhibition. In addition, we predicted that the increased NO tone during AAI would impair the AVP response to hyperosmolality. Conscious male Sprague-Dawley rats (300-325 g) received a 15-h intragastric infusion of alcohol (2.5 g/kg + 300 mg·kg(-1)·h(-1)) or dextrose prior to a 60-min fixed-pressure hemorrhage (∼40 mmHg) or 5% hypertonic saline infusion (0.05 ml·kg(-1)·min(-1)). AAI attenuated the AVP response to hemorrhage, which was associated with increased paraventricular NO content. In contrast, AAI did not impair the AVP response to hyperosmolality. This was accompanied by decreased paraventricular NO content. To confirm the role of NO in the alcohol-induced inhibition of AVP release during hemorrhage, the nitric oxide synthase inhibitor, nitro-l-arginine methyl ester (l-NAME; 250 µg/5 µl), was administered centrally prior to hemorrhage. l-NAME did not further increase AVP levels during hemorrhage in dextrose-treated animals; however, it restored the AVP response during AAI. These results indicate that AAI impairs the AVP response to hemorrhage, while not affecting the response to hyperosmolality. Furthermore, these data demonstrate that the attenuated AVP response to hemorrhage is the result of augmented central NO inhibition.


Assuntos
Intoxicação Alcoólica/complicações , Arginina Vasopressina/metabolismo , Hemorragia/complicações , Óxido Nítrico/metabolismo , Núcleo Hipotalâmico Paraventricular/metabolismo , Intoxicação Alcoólica/sangue , Intoxicação Alcoólica/metabolismo , Intoxicação Alcoólica/fisiopatologia , Animais , Pressão Sanguínea , Volume Sanguíneo , Modelos Animais de Doenças , Regulação para Baixo , Inibidores Enzimáticos/farmacologia , Hemorragia/sangue , Hemorragia/metabolismo , Hemorragia/fisiopatologia , Masculino , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico Sintase/antagonistas & inibidores , Óxido Nítrico Sintase/metabolismo , Concentração Osmolar , Núcleo Hipotalâmico Paraventricular/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Transdução de Sinais , Núcleo Supraóptico/metabolismo , Fatores de Tempo , Regulação para Cima
15.
Neuroimmunomodulation ; 17(6): 349-58, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20516716

RESUMO

BACKGROUND: Trauma/hemorrhage (TxHem) is associated with an immediate pro-inflammatory response that, if exaggerated or prolonged, is thought to contribute to the subsequent immunosuppression that characterizes the period after injury. Previously we have demonstrated that chemical sympathectomy (SNSx) accentuates this immediate pro-inflammatory response to TxHem. These findings suggest that the noradrenergic system plays a critical role in limiting the magnitude of the inflammatory response during TxHem and preserving the integrity of the host defense response to a subsequent infectious challenge during the period after TxHem. OBJECTIVE: To examine the contribution of tissue norepinephrine to the host defense response to an infectious challenge during recovery from TxHem. METHODS: Male Sprague-Dawley rats underwent SNSx (6-hydroxydopamine, i.p. daily for 3 days) prior to vascular catheter implantation. Conscious, unrestrained rats were subjected to traumatic injury (muscle crush) prior to a fixed-pressure hemorrhage (40 mm Hg for 60 min) and fluid resuscitation followed 24 h later by cecal ligation and puncture (CLP). RESULTS: SNSx impaired the hemodynamic and thermoregulatory response to hemorrhage as indicated by decreased basal blood pressure, impaired blood pressure recovery during fluid resuscitation, and greater hypothermia after CLP. Furthermore, SNSx accentuated the TNF-alpha, IL-1, IL-6, and IL-10 response to TxHem + infection in plasma 6 h after CLP and in peritoneal lavage fluid 24 h after CLP. CONCLUSION: These results indicate that the integrity of the noradrenergic system is necessary for adequate hemodynamic, thermoregulatory, and inflammatory responses to infection during the period following TxHem.


Assuntos
Hemorragia/imunologia , Tolerância Imunológica , Imunidade Inata , Sistema Nervoso Simpático/imunologia , Animais , Modelos Animais de Doenças , Hemorragia/complicações , Hemorragia/metabolismo , Tolerância Imunológica/efeitos dos fármacos , Imunidade Inata/efeitos dos fármacos , Inflamação/imunologia , Inflamação/metabolismo , Inflamação/patologia , Ketamina/administração & dosagem , Masculino , Norepinefrina/metabolismo , Oxidopamina/administração & dosagem , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Sistema Nervoso Simpático/efeitos dos fármacos , Sistema Nervoso Simpático/patologia , Fator de Necrose Tumoral alfa/biossíntese , Fator de Necrose Tumoral alfa/fisiologia , Xilazina/administração & dosagem
16.
Shock ; 32(6): 601-7, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19197228

RESUMO

Our previous studies have shown that acute alcohol intoxication (AAI) decreases blood pressure, exacerbates hypotension after hemorrhagic shock, impairs the pressor response to fluid resuscitation, and blunts neuroendocrine activation. We hypothesized that impaired hemodynamic compensation during and after hemorrhagic shock in the acute alcohol-intoxicated host is the result of blunted neuroendocrine activation or, alternatively, of an impaired vascular responsiveness to vasoactive agents. The aim of this study was to examine the effects of AAI, AAI and hemorrhagic shock, and AAI and hemorrhagic shock and resuscitation on reactivity of isolated blood vessel rings to phenylephrine and acetylcholine. Chronically instrumented, conscious male Sprague-Dawley rats (300-350 g) received a primed continuous 15-h intragastric alcohol infusion (2.5 g x kg(-1) + 300 mg x kg(-1) x h(-1)), and time-matched controls received an isocaloric-isovolumic dextrose infusion. At completion of infusions, animals were randomized to sham, 60-min fixed-pressure hemorrhage, or hemorrhagic shock followed by resuscitation with lactated Ringer's solution. At the completion of the experimental protocols, animals were killed, and thoracic aorta and mesenteric artery ring segments (1-2 mm) were prepared and studied in myograph baths. Acute alcohol intoxication did not produce significant alterations in either pressor or dilator responses in aortic or mesenteric rings. These findings suggest that impaired hemodynamic counterregulation during hemorrhagic shock in AAI is not due to decreased vasopressor responsiveness. However, our results suggest a role for accentuated vasodilatory responses that may be central in progression to decompensatory shock.


Assuntos
Acetilcolina/farmacologia , Hemorragia/terapia , Vasodilatação/efeitos dos fármacos , Acetilcolina/metabolismo , Intoxicação Alcoólica/fisiopatologia , Animais , Aorta Torácica/patologia , Depressores do Sistema Nervoso Central , Relação Dose-Resposta a Droga , Etanol/farmacologia , Masculino , Fenilefrina/farmacologia , Ratos , Ratos Sprague-Dawley , Ressuscitação/métodos , Choque/tratamento farmacológico
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