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Volume 17, Number 9,
Issue of May 1, 1997
pp. 3234-3238
Copyright ©1997 Society for Neuroscience
Negative Feedback Neuroendocrine Control of Inflammatory Response
in the Rat is Dependent on the Sympathetic Postganglionic Neuron
Paul G. Green3, 4,
Wilfrid Jänig5, and
Jon D. Levine1, 2, 3, 4
1 Departments of Anatomy, 2 Medicine, and
3 Oral Surgery, and 4 Division of Neurobiology,
University of California, San Francisco, California 94143 and
5 Physiologisches Institut,
Christian-Albrechts-Universität, 24098 Kiel, Germany
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
FOOTNOTES
REFERENCES
ABSTRACT
Negative feedback control of inflammation is mediated by activation
of nociceptive afferents that in turn activates the
hypothalamic-pituitary-adrenal axis to release corticosteroids. Plasma
extravasation (PE) produced by the potent inflammatory mediator,
bradykinin (BK), but not that induced by another potent inflammatory
mediator, platelet-activating factor (PAF), is inhibited by released
corticosterone. Because bradykinin, but not PAF, produces PE by a
mechanism that is, in part, dependent on the sympathetic postganglionic
neuron (SPGN) terminal, we tested the hypothesis that the negative
feedback control of inflammation is dependent on the SPGN terminal in
the inflamed tissue. In sympathectomized rats, the residual (i.e., SPGN-independent) PE in the knee joint produced by BK was not inhibited
by noxious electrical stimulation. Furthermore, intravenous administration of corticosterone potently inhibited, with a similar time-course, the SPGN-dependent, but not the SPGN-independent, component of BK-induced PE. Neither electrical stimulation nor corticosterone inhibited PAF-induced PE. Finally, corticosterone's actions do not appear to be mediated by release of norepinephrine from
the SPGN terminal, because neither the -adrenergic receptor antagonist phentolamine nor the 2-adrenergic receptor
antagonist ICI 118,551 antagonized the inhibition of BK-induced PE by
corticosterone. We conclude that in the rat knee joint, negative
feedback control of the inflammatory response is dependent on the
presence of the SPGN terminal. Further, our data suggest that a
significant component of corticosteroid-induced inhibition of PE
produced by inflammatory mediators is SPGN-dependent.
Key words:
neurogenic inflammation;
sympathetic postganglionic
neuron;
sympathectomy;
noxious electrical stimulation;
hypothalamic-pituitary-adrenal axis;
bradykinin;
platelet activating
factor;
corticosterone;
inflammation;
negative feedback control
INTRODUCTION
Inflammation can induce negative feedback control
of plasma extravasation (PE), a component of inflammation, at a second
site. This negative feedback control of inflammation is mediated by a
pathway involving activation of C-fiber afferents, ascending tracts in
the spinal cord, and the hypothalamic-pituitary-adrenal (HPA) axis
(Green et al., 1995 ). This feedback circuit inhibits PE produced by one
potent inflammatory mediator, bradykinin (BK), but not that produced by
another, platelet-activating factor (PAF). Because a component
(60-70%) of the PE response produced by BK, unlike that produced by
PAF, requires the presence of the sympathetic terminal (Coderre et al.,
1989 ; Green et al., 1993b ; Miao et al., 1996a ,b ), we tested the
hypothesis that feedback inhibition is dependent on the sympathetic
postganglionic neuron (SPGN) terminal at the site of PE. We have tested
this hypothesis by showing that the negative feedback circuit acts only
on the BK-induced PE that is dependent on the sympathetic terminals and
not on BK-induced PE that is independent of the sympathetic terminals,
and that corticosterone, the final common mediator of the HPA-axis,
acts similarly.
MATERIALS AND METHODS
Animals. The experiments were performed on 90 male
(300-400 gm) Sprague Dawley rats (Bantin and Kingman, Fremont, CA).
The rats were housed in a temperature- and humidity-controlled
environment and were maintained on a 12 hr light/dark cycle (lights on
at 06 A.M.). Food and water were available ad libitum.
Plasma extravasation. Rats were anesthetized with sodium
pentobarbital (Anthony Products, Arcadia, CA; 65 mg/kg). Skin overlying the knee was excised to expose the joint capsule, and rats were then
given an intravenous injection of Evans blue dye (50 mg/kg, in a volume
of 2.5 ml/kg). A 30 gauge hypodermic needle was then inserted for the
inflow of perfusion fluid (250 µl/min), controlled by a syringe pump
(Sage Instruments, model 341B), and after perfusion of 100-200 µl of
fluid, a second needle (25 gauge) was inserted into the joint cavity
for outflow of the perfusion fluid (250 µl/min) (syringe pump, Sage
Instruments, model 351). Samples of perfusion fluid were collected over
5 min intervals for 70 min. Samples were analyzed for Evans blue dye
concentration by spectrophotometric measurement of absorbance at 620 nm. Absorbance is linearly related to dye concentration (Carr and
Wilhelm, 1964 ). After collection of the first three samples (to
establish baseline PE levels), BK (150 nM; 160 ng/ml) was
added to the perfusing fluid and remained present in the fluid for the
duration of the experiment. Other drugs were added to the perfusion
fluid as indicated in Results, and they remained in the perfusion fluid
for the duration of the experiment.
Surgical removal of the lumbar sympathetic chain
(sympathectomy). The lumbar sympathetic chains were removed using
a lateral retroperitoneal approach, as described previously (Baron et
al., 1988 ; Miao et al., 1995 ). Briefly, after cutting the skin and abdominal muscles on the left side of the abdomen, the lumbar sympathetic chains were fully exposed bilaterally by excising part of
the left erector spinae and transversospinalis muscles of lumbar
vertebrae L2-5, the left quadratus lumborum, the psoas minor and
major, as well as the upper part of the iliacus muscles. The lumbar
sympathetic chain was then exposed from paravertebral ganglia L2 to L4,
and the ganglia were excised (Miao et al., 1996b ). The wound was closed
separately in layers. Rats recovered 1 week postsurgery before being
used in the PE experiments. The paravertebral ganglia L2-L4 contain
the cell bodies of the postganglionic neurons projecting to the rat
hindlimb, only a small number of which are in the more rostral
paravertebral ganglia and in the L5 ganglion (Baron et al., 1988 ).
Neurons in the L5 ganglion are unlikely to innervate the knee joint,
because the sympathetic supply to the knee joint has a more rostral
representation. In a parallel study, we found that the temperature on
the plantar paw had increased by 2°-3°C 4 min after sympathectomy,
indicating vasodilation caused by removal of sympathetic control (Miao
et al., 1996b ). The residual 30-40% PE produced by BK in
sympathectomized rats is presumably caused by an action of BK on other
target(s), such as endothelial cells and primary afferent neurons
(Majno et al., 1969 ; Northover, 1989 ; Morel et al., 1990 ; Khalil and
Helme, 1992 ; Geppetti, 1993 ; Cambridge and Brain, 1995 ). Whereas
surgical procedures presumably activate C-fibers and therefore might be
expected to engage the negative feedback system, this does not appear
to be the case, because we have shown previously that acute
interruption of the sympathetic chain (during perfusion) and
decentralization of the lumbar sympathetic chain (preganglionic
sympathectomy) performed 1 week before perfusion did not affect the
feedback inhibitory circuit (Green et al., 1995 ).
Electrical stimulation of the hindpaw. Two stainless steel
electrodes were placed transversely in the plantar area of the hindpaw
contralateral to the perfused knee joint (~10 mm apart). Stimulus
intensities necessary to excite C-fibers have been determined previously electrophysiologically (Green et al., 1995 ). Noxious (C-fiber strength) electrical stimulation was applied to the hindpaw during the assessment of BK-induced PE. Twenty-five minutes after the
initiation of BK perfusion in the knee joint, rats received noxious
electrical stimulation (25 mA, 0.25 msec duration pulses, 3 Hz) via the
two stimulating electrodes, which continued throughout the
experiment.
Materials. Evans blue dye, BK triacetate, and PAF were
obtained from Sigma Chemical (St. Louis, MO); phentolamine mesylate was
obtained from Ciba-Geigy (Summit, NJ); and ICI 118,551 was obtained
from Research Biochemicals International (Natick, MA). PAF was
dissolved in 0.2% BSA (in 0.9% saline), and all other drugs were
dissolved in 0.9% saline.
Statistical analysis. Data were analyzed using
repeated-measures ANOVA with one between-subjects factor, treatment,
with two levels (control and electrical stimulation, or control and
corticosterone) and one within-subjects factor, time, with 10 levels
(45 - 90 min, 5 min intervals). We present the results of the analysis of the main effect, treatment; differences were considered significant when p < 0.05.
RESULTS
BK induces synovial PE, in part, via a mechanism that is dependent
on the SPGN terminals, whereas PAF-induced PE is independent of the
SPGN terminals. This difference allows us to test the hypothesis that
the target of noxious stimulation-induced feedback inhibition of PE is
the SPGN terminals in the knee joint. Noxious electrical stimulation
(25 mA) was applied to the hindpaw of normal and sympathectomized rats.
This stimulation significantly inhibited BK-induced PE to a level
produced by BK in sympathectomized animals that did not receive
electrical stimulation (p < 0.001) (Fig.
1A), but did not inhibit PAF-induced
PE [ p = not significant (NS)] (Fig.
1B). To control for the possibility that feedback
inhibition was only effective at the magnitude of PE induced by 150 nM BK, the 35 nM dose of PAF, which produced
the same magnitude of PE as that produced by 150 nM BK, was
chosen (p = NS).
Fig. 1.
A, Effect of electrical stimulation on BK-induced
PE in the rat knee joint. In both groups of rats, baseline PE was
established in the first three samples. In one group, BK (150 nM; , n = 8) was then added to the
perfusion fluid (0.9% sodium chloride) and, for the remainder of the
experiment, was the only substance in the perfusion fluid. In the
second group ( , n = 6), BK was added after the first
three baseline samples, and then 40 min after beginning knee perfusion,
a noxious electrical stimulation of the hindpaw (ES, 25 mA, 0.5 msec.
pulse duration, 1 Hz) was applied continuously for the remainder of the
experiment. B, Effect of electrical stimulation on
PAF-induced PE in the rat knee joint. In both groups of rats, baseline
PE was established in the first three samples. In one group, PAF (35 nM; , n = 6) was then added to the
perfusion fluid (0.9% sodium chloride) and, for the remainder of the
experiment, was the only substance in the perfusion fluid. In the
second group ( , n = 8), PAF was added after the
first three baseline samples, and then 40 min after beginning knee
perfusion, a noxious electrical stimulation (25 mA) was applied to the
hindpaw continuously for the remainder of the experiment. In this and subsequent figures, data are presented as mean ± SEM of
n values, and ordinate is absorbance of light at 620 nm.
After a drug is added to the perfusate, it is present throughout the
experiment.
[View Larger Version of this Image (16K GIF file)]
In sympathectomized rats, maximal BK-induced PE is ~30-40% of that
produced in normal animals. Noxious electrical stimulation of the skin
did not significantly change the magnitude of BK-induced PE in these
sympathectomized animals (p = NS) (Fig.
2).
Fig. 2.
Effect of sympathectomy on noxious
stimulation-induced inhibition of BK-induced PE. For both groups in
this figure, BK (150 nM) was added to the perfusion fluid
after the first three baseline samples and remained in the perfusion
fluid for the duration of the experiment. Both groups had undergone
sympathectomy 1 week before the perfusion experiment. The first group
( , n = 15) received BK only, whereas the second
group ( , n = 14) also received continuous noxious
electrical stimulation of the hindpaw (ES, 25 mA, 0.5 msec, 1 Hz) 40 min after beginning knee perfusion.
[View Larger Version of this Image (21K GIF file)]
Because noxious stimulation-induced inhibition of PE is mediated via
activation of the HPA axis, we tested the corollary hypothesis that
electrical stimulation-induced inhibition of BK-induced PE is mimicked
by intravenously administering corticosterone. Intravenous infusion of
corticosterone at a rate of 5 µg/min inhibited BK-induced PE
(p < 0.005) over a similar time course and with
the same magnitude of inhibition as that produced by electrical
stimulation of the skin (p = NS) (Fig.
3A). Also, the SPGN-independent component of
BK-induced PE (i.e., that remaining after sympathectomy) was not
inhibited by corticosterone administration (p = NS) (Fig. 4). In addition, intravenous corticosterone
had no effect on the SPGN-independent PE induced by PAF
(p = NS) (Fig. 3B), contrasting with
the effect on BK-induced PE in normal animals.
Fig. 3.
A, Effect of intravenous corticosterone on
BK-induced PE in the rat knee joint. In both groups of rats, baseline
PE was established in the first three samples. In one group, BK (150 nM; , n = 8) was then added to the
perfusion fluid (0.9% sodium chloride) and, for the remainder of the
experiment, was the only substance in the perfusion fluid. In the
second group ( , n = 12), BK was added after the
first three baseline samples, and then 40 min after knee perfusion
corticosterone was infused intravenously at a rate of 5 µg/min for
the remainder of the experiment. B, Effect of intravenous
corticosterone on PAF-induced PE. For both groups in B, PAF
(35 nM) was added to the perfusion fluid after the first three baseline samples and remained in the perfusion fluid for the
duration of the experiment. The first group ( , n = 6) were normal animals, and the second group ( , n = 7) received corticosterone (5 µg/min, i.v.) 40 min after beginning
knee perfusion.
[View Larger Version of this Image (17K GIF file)]
Fig. 4.
Effect of sympathectomy on corticosterone-induced
inhibition of BK-induced PE. For both groups in this figure, BK (150 nM) was added to the perfusion fluid after the first three
baseline samples and remained in the perfusion fluid for the duration
of the experiment. Both groups had undergone sympathectomy 1 week before perfusion experiment. The first group ( , n = 15) received BK only, whereas the second group ( , n = 9) also received corticosterone (5 µg/min, i.v.) 40 min after
beginning knee perfusion.
[View Larger Version of this Image (23K GIF file)]
To test for the possibility that corticosterone is acting directly on
the SPGN to release norepinephrine, which has been shown to inhibit
BK-induced PE (Green et al., 1993a ), we coperfused BK with a receptor
antagonist to block the inhibitory effects of norepinephrine. However,
coperfusion of BK with either the -adrenergic receptor antagonist
phentolamine (1 µM) or the 2 receptor
antagonist ICI 118,551 (100 nM) did not affect the
inhibition of BK-induced PE by intravenous corticosterone electrical
stimulation (both p = NS) (Fig. 5).
Fig. 5.
Effect of intra-articular phentolamine or ICI
118,551 on corticosterone-induced inhibition of BK-induced PE. For all
groups in this figure, bradykinin (150 nM) was added to the
perfusion fluid after the first three baseline samples and remained in
the perfusion fluid for the duration of the experiment. The first group
( , n = 8) received BK only, whereas the second group
( , n = 5) also received phentolamine (1 µM) co-perfused with BK in the knee joint. The third
group ( , n = 5) received BK with ICI 118,551 (100 nM). Corticosterone infusion (5 µg/min, i.v.) was started
40 min after beginning knee perfusion.
[View Larger Version of this Image (30K GIF file)]
DISCUSSION
The data presented here show that (1) noxious electrical
stimulation markedly inhibits BK-induced PE in the knee joint of the
rat but has no significant effect on BK-induced PE in sympathectomized animals; (2) noxious electrical stimulation reduces BK-induced PE to a
level produced by BK in sympathectomized animals that did not receive
electrical stimulation; (3) PAF-induced PE, which is sympathetic neuron
terminal-independent (Green et al., 1993b ), is not affected by
electrical stimulation of skin; (4) administration of the final
mediator of the HPA axis, intravenous corticosterone, inhibits
BK-induced PE in normal but not in sympathectomized rats; and (5)
PAF-induced PE is not affected by intravenous corticosterone.
These data taken together provide strong support for the hypothesis
that the sympathetic postganglionic terminal is necessary for the
noxious stimulus-induced feedback inhibitory system. We have shown that
because acute decentralization of the postganglionic neuron terminal
during perfusion of the knee joint cavity with BK does not affect the
attenuation of BK-induced PE by activation of the feedback system
(Green et al., 1995 ), the effect of neither noxious electrical
stimulation nor corticosterone is a result of inhibition of activity in
the SPGN originating from the CNS and propagated via preganglionic
neuron activity. Instead, we found that the electrical stimulation
induced inhibition of PE that is mediated by corticosteroids (Green et
al., 1995 ) is also dependent on the SPGN terminals at the site of
inflammation. Of note, the SPGN terminal is also known to be able to
function independently of central input in other tissues; for example,
several neurochemicals such as BK, angiotensin II, purines, and
cholinergics produce cardiac arrhythmias by a direct action on
intrinsic cardiac SPGN terminals even after decentralization (Huang et
al., 1994 ). Although we have not shown that corticosteroids act
directly on SPGN terminals in the knee joint, immunocytochemical and
electrophysiological studies have demonstrated the presence of
glucocorticoid receptors on sympathetic neurons (Bohn et al., 1984 ; Hua
and Chen, 1989 ).
Although glucocorticoids are normally considered to produce long-term
changes in cell function by acting on cytosolic genomic glucocorticoid
receptors, glucocorticoids also act on membrane receptors to produce
more rapid effects. For example, administration of glucocorticoids,
acting in the CNS or the periphery, has been shown to acutely inhibit
sympathetic nerve activity in both human (Golczynska et al., 1995 ;
Lenders et al., 1995 ) and animal (Brown and Fisher, 1986 ) studies.
Corticosterone also potently inhibits prostaglandin synthesis (Nusing
and Ullrich, 1992 ; Masferrer and Seibert, 1994 ), and prostaglandins are
mediators of inflammatory responses (Robinson, 1989 ; Hedqvist et al.,
1990 ), including SPGN-dependent PE (Coderre et al., 1989 ). But this
effect of corticosterone is believed to be mediated via cytosolic
receptors, and so the time course would be too slow for the inhibition
we see in our study. Another acute effect of corticosterone is
inhibition of norepinephrine reuptake (uptake-2) such that the local
extracellular concentration of norepinephrine from sympathetic neurons
is increased (Parker et al., 1994 ). However, it is unlikely that
corticosterone inhibits uptake-2 in our system, because we show that
neither intra-articular phentolamine nor intra-articular ICI 118,551 administration (both of which would be expected to block the effects of
norepinephrine) affected corticosterone inhibition. Moreover, a
corticosterone concentration of ~30 µM is required to
inhibit uptake-2 (Stjarne et al., 1994 ), and our protocol produces
plasma levels of ~2.5-3.5 µM (data not shown).
In summary, our present study supports the hypothesis that activation
of the negative feedback control of PE by noxious stimulation is
mediated by release of corticosterone (Green et al., 1995 ), and
provides data to suggest that corticosterone, the final common mediator
of the HPA axis, requires the presence of the SPGN terminal to
attenuate the neurogenic (SPGN terminal-dependent) component of PE.
Because both the SPGN-independent component of BK-induced PE and
PAF-induced PE are not inhibited by corticosterone, we suggest that
this mechanism (i.e., corticosterone-induced inhibition of
SPGN-terminal-dependent PE) may play an important role in the anti-inflammatory effect of corticosterone.
FOOTNOTES
Received Dec. 23, 1996; accepted Jan. 30, 1997.
This work was supported by National Institutes of Health (NIH) Grant
AR32634 and by the Arthritis Foundation (Northern California Chapter).
We thank Dr. F.J.-P. Miao for performing surgical sympathectomies and
Professor M. Dallman for helpful discussions.
Correspondence should be addressed to Dr. Jon D. Levine, Department of
Medicine, S-1334/Box 0452A, University of California, San Francisco,
513 Parnassus Avenue, San Francisco, CA
94143-0452A.
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P. G. Green, H. J. Strausbaugh, and J. D. Levine
Annexin I Is a Local Mediator in Neural-Endocrine Feedback Control of Inflammation
J Neurophysiol,
December 1, 1998;
80(6):
3120 - 3126.
[Abstract]
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F. Marceau, J. F. Hess, and D. R. Bachvarov
The B1 Receptors for Kinins
Pharmacol. Rev.,
September 1, 1998;
50(3):
357 - 386.
[Abstract]
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S. G. Khasar, F. J.-P. Miao, W. Janig, and J. D. Levine
Vagotomy-Induced Enhancement of Mechanical Hyperalgesia in the Rat Is Sympathoadrenal-Mediated
J. Neurosci.,
April 15, 1998;
18(8):
3043 - 3049.
[Abstract]
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F. J.-P. Miao, W. Janig, P. G. Green, and J. D. Levine
Inhibition of Bradykinin-Induced Plasma Extravasation Produced by Noxious Cutaneous and Visceral Stimuli and Its Modulation by Vagal Activity
J Neurophysiol,
September 1, 1997;
78(3):
1285 - 1292.
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