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The Journal of Neuroscience, December 15, 2002, 22(24):10847-10855
Rostral Ventromedial Medulla Neurons That Project to the Spinal
Cord Express Multiple Opioid Receptor Phenotypes
Silvia
Marinelli1,
Christopher W.
Vaughan1, 2,
Stephen A.
Schnell3,
Martin
W.
Wessendorf3, and
MacDonald J.
Christie1
1 Department of Pharmacology and The Medical
Foundation, The University of Sydney, Sydney, New South Wales
2006 Australia, 2 Department of Anaesthesia and Pain
Management, Royal North Shore Hospital New South Wales, New South Wales
2065 Australia, and 3 Department of Neuroscience,
University of Minnesota, Minneapolis, Minnesota 55455
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ABSTRACT |
The rostral ventromedial medulla (RVM) forms part of a descending
pathway that modulates nociceptive neurotransmission at the level of
the spinal cord dorsal horn. However, the involvement of descending RVM
systems in opioid analgesia are a matter of some debate. In the present
study, patch-clamp recordings of RVM neurons were made from rats that
had received retrograde tracer injections into the spinal cord. More
than 90% of identified spinally projecting RVM neurons responded to
opioid agonists. Of these neurons, 53% responded only to the
µ-opioid agonist D-Ala2, N-Me-Phe4, Gly-ol5 enkephalin, 14% responded only to the -opioid
agonist U-69593, and another group responded to both µ and opioids (23%). In unidentified RVM neurons, a larger proportion
of neurons responded only to µ opioids (75%), with smaller
proportions of - (4%) and µ/ -opioid (13%) responders. These
RVM slices were then immunostained for tryptophan hydroxylase (TPH), a
marker of serotonergic neurons. Forty-percent of spinally projecting
neurons and 11% of unidentified neurons were TPH positive. Of the
TPH-positive spinally projecting neurons, there were similar
proportions of µ- (33%), - (25%), and µ/ -opioid (33%)
responders. Most of the TPH-negative spinally projecting neurons were
µ-opioid responders (67%). These findings indicate that functional
opioid receptor subtypes exist on spinally projecting serotonergic and
nonserotonergic RVM neurons. The proportions of µ- and -opioid
receptors expressed differ between serotonergic and nonserotonergic
neurons and between retrogradely labeled and unlabeled RVM neurons. We
conclude that important roles exist for both serotonergic and
nonserotonergic RVM neurons in the mediation of opioid effects.
Key words:
rostral ventromedial medulla; spinal cord; opioid
receptor; analgesia; serotonergic; patch clamp; immunohistochemistry
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INTRODUCTION |
The rostral ventromedial medulla
(RVM) is a crucial site for the supraspinal antinociceptive actions of
opioids (Fields et al., 1991 ). The RVM, particularly the nucleus raphe
magnus, forms a component of a descending inhibitory network that
modulates nociceptive neurotransmission at the level of the spinal cord dorsal horn. Whole-animal electrophysiological experiments have identified three classes of neurons within the RVM, including ON-,
OFF-, and NEUTRAL-cells that display, respectively, increases, decreases, and no changes in action potential activity associated with
nociceptive tail-flick responses (Fields et al., 1988 ). Microinjection of antinociceptive doses of µ opioids into the RVM inhibits ON-cells and excites OFF-cells (Heinricher et al., 1992 , 1994 , 1999 );
microinjection of opioids reduces the antinociceptive effect of µ agonists (Pan et al., 1997 ). In vitro electrophysiological
experiments have identified secondary cells that are directly inhibited
by µ opioids and primary cells that are directly inhibited by opioids and receive µ-opioid-sensitive GABAergic inputs (Pan et al.,
1990 , 1997 ; Ackley et al., 2001 ).
It has been proposed that µ-opioid agonists activate a descending
antinociceptive pathway originating within the RVM by reducing the
inhibitory influence of GABAergic neurons (disinhibition) onto
bulbospinal neurons (Fields et al., 1991 ; Fields and Basbaum, 1999 ;
Heinricher et al., 1999 ). This hypothesis suggests that the
µ-opioid-responsive secondary cells (which appear similar to ON-cells
in vivo) are pronociceptive GABAergic neurons and the
-opioid-responsive primary cells (which appear similar to OFF-cells)
are antinociceptive spinal projection neurons (Pan et al., 1997 ). At
least some ON- and OFF-cells project to the spinal cord (Vanegas et
al., 1984 ) and dorsal horn (Fields et al., 1995 ); however, to date, the
projections of primary and secondary cells have not been studied.
Although many spinally projecting RVM neurons are serotonergic, their
role in antinociception is controversial (Christie, 1998 ; Huang, 1998 ;
Mason and Gao, 1998 ; Wessendorf, 1998 ). Functional studies have
demonstrated that intra-RVM morphine-induced analgesia is blocked by
systemic serotonergic antagonists and that RVM stimulation-induced analgesia is blocked by intrathecal serotonergic antagonists (Azami et
al., 1982 ; Hammond and Yaksh, 1984 ; Yaksh et al., 1988 ). In addition,
primary, but not secondary, cells recorded in vitro are
reported to be serotonergic on the basis of immunohistochemistry and
action potential shape (Pan et al., 1990 , 1993 ). However, most
serotonergic RVM cells recorded in vivo are not ON- or
OFF-cells (Potrebic et al., 1994 ), and do not respond to periaqueductal gray matter stimulation or morphine (Gao et al., 1997 ; 1998 ). In
addition, it has been reported that spinally projecting serotonergic RVM neurons express both µ- and -opioid receptors (Kalyuzhny et
al., 1996 ; Kalyuzhny and Wessendorf, 1999 ).
In the present study, we have used a combination of in vitro
electrophysiological and anatomical techniques to characterize the
opioid responses and neurochemical identity of RVM neurons that project
to the spinal cord. We find that the responses to opioids of both
serotonergic and nonserotonergic neurons are consistent with our
previous anatomical findings.
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MATERIALS AND METHODS |
Injections of retrograde tracer.
Microinjection of rhodamine-conjugated latex microspheres
(Molecular Probes, Eugene, OR) into the spinal cord dorsal horn was
performed in 8- to 11-d-old male Sprague Dawley rats. The animals were
anesthetized (1-2% halothane vaporized in 100%
O2), and the spinal cord was exposed by
performing a laminectomy over one lumbar segment (between L3 and L5).
The dura was cut, and a glass micropipette (tip diameter 20-50 µm)
was advanced into the dorsal horn of the spinal cord at an angle of
45o to the rostrocaudal axis. Between two
and four injections (10 nl each) were made bilaterally using a
calibrated injection system (Drummond Nanoject, Broomall, PA). The
incision was then closed, and a topical antibiotic was applied. Animals
were allowed to recover from anesthesia in a warmed box before being
returned to holding cages with their mother and litter. Between 2 and
5 d after surgery, animals were used for in vitro
experiments. The spinal cord was fixed, and coronal sections were cut
to verify the location of the injection sites (see Fig. 1).
Brain slice preparation and recordings.
Sprague Dawley rats, 10-18 d old, with and without previous spinal
cord tracer injections, were anesthetized with halothane and
decapitated. Four to five coronal brain slices (250 µm thick) were
cut beginning at the level of the rostral end of the fourth ventricle
and proceeding caudally. The slices were cut in ice-cold artificial CSF
(ACSF) of the following composition (in mM): 126 NaCl, 2.5 KCl, 1.4 NaH2PO4, 1.2 MgCl2, 2.4 CaCl2, 11 glucose, 25 NaHCO3. Slices were maintained at
34°C in a submerged chamber containing ACSF equilibrated with a
mixture of 5% CO2 and 95%
O2. The brain slices were then transferred to a
chamber and superfused continuously (2 ml/min) with ACSF (34°C).
Recordings were made from RVM neurons in three types of
experiments: (1) those in which we recorded retrogradely labeled
neurons that were identified (under fluorescence illumination) by the presence of fluorescent microspheres in their cell bodies, (2) those in
which we recorded randomly selected neurons from animals that had
received spinal cord tracer injections, and (3) those in which we
recorded randomly selected neurons from animals that had not received
spinal cord tracer injections. In all experiments, RVM neurons were
visualized in the triangular midline region dorsal to the pyramidal
tracts using infrared Nomarski optics on an upright microscope (Olympus
BX50). Whole-cell patch-clamp recordings of transmembrane currents
(holding potential 60 mV) were performed using patch electrodes (2-5
M ) filled with an internal solution containing (in mM):
115 K-gluconate, 25 KCl, 15 NaCl, 1 MgCl2, 10 HEPES, 11 EGTA, 2 MgATP, 0.25 NaGTP, and 0.01% biocytin, pH 7.3, osmolarity 280-285 mOsm/l. Series resistance (< 15 M ) was compensated by 80% and monitored continuously during experiments with
an Axopatch 1D amplifier (Axon Instruments, Foster City, CA). Liquid
junction potentials of 10 mV were corrected. Postsynaptic currents were filtered (50 Hz low-pass filter) and sampled (100 Hz) for later analysis (Axograph 4, Axon Instruments). All numerical data are expressed as means ± SEM, and statistical comparisons were made using 2 tests for differences
among proportions.
Immunohistochemistry. Recordings lasted 20 min, at most. Immediately after, slices containing biocytin-filled
cells were fixed for 30 min in a phosphate-buffered
paraformaldehyde/picric acid solution [75 mM
KH2PO4, 85 mM
Na2HPO4, 4% (w/v)
paraformaldehyde, 14% (v/v) saturated aqueous picric acid, pH 6.9].
The slices were then washed six to eight times and stored in a
phosphate-buffered sucrose solution [30 mM
KH2PO4, 70 mM
Na2HPO4, 10% sucrose
(w/v), 0.01% (w/v) sodium azide, 0.032% (w/v) bacitracin, pH 7.2].
Brainstem slices and spinal cords were shipped by courier from Sydney
to Minneapolis for the anatomical portion of the experiments.
Biocytin-filled cells were visualized by incubation with Cy5-labeled
streptavidin (Jackson ImmunoResearch, West Grove, PA). Tryptophan
hydroxylase immunoreactivity (TPH-ir) was visualized using a sheep
anti-TPH antiserum (Chemicon, Temecula, CA) followed by Cy2-conjugated donkey anti-sheep IgG (Jackson ImmunoResearch). Because fluorescent microspheres can be dissolved by xylene-based mounting media, slices
were mounted with coverslips using 85% (w/v) aqueous sucrose. Images
of filled cells were collected using an MRC 1000 or MRC 1024 confocal
microscope (Bio-Rad, Hercules, CA), and we identified the
brainstem level at which filled cells occurred by reference to the
pontine gray matter, the trapezoid body/superior olivary complex, and
the facial nucleus. Spinal cord segments were sectioned at a nominal
thickness of 100 µm using a freezing microtome. Spinal sites at which
the fluorescent microspheres were injected were examined using
conventional fluorescence microscopy, and reconstructions of the
extents of injection sites were made from digital images.
Drugs, reagents, and solutions. All stock
solutions for in vitro experiments were made in distilled
water except for U-69593, which was made in 0.1% HCl. These solutions
were diluted at working concentrations in the extracellular solution
immediately before use and applied by superfusion.
D-Ala2, N-Me-Phe4, Gly-ol5 enkephalin (DAMGO), methionine-enkephalin (met-enkephalin), and
Phe-Gly-Gly-Phe-Thr-Gly-Ala-Arg-Lys-Ser-Ala-Arg-Lys-Leu-Ala-Asn-Gln (nociceptin) were obtained from Auspep (Melbourne, Australia). Nor-binaltorphimine dihydrochloride (nor-BNI) and U-69593 were from
Research Biochemicals (Natick, MA). 5-Hydroxytryptamine and biocytin
were from Sigma (Sydney, Australia).
D-Phe-Cys-Tyr-D-Trp-Arg-Pen-Thr-NH2 (CTAP) was from Phoenix Pharmaceuticals (Mountain View, CA).
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RESULTS |
Opioid responses of spinally projecting RVM neurons
We first characterized the opioid responses of RVM neurons that
were identified as projecting to the spinal cord. After injection of
the fluorescent microspheres into the spinal cord, many neurons in the
RVM were observed to contain retrograde tracer. Whole-cell voltage-clamp recordings (holding potential 60 mV) were made from 73 retrogradely labeled neurons throughout the RVM with varying cell size
and morphology. Post hoc imaging of the biocytin-filled neurons confirmed the presence of fluorescent microspheres within the
recorded neurons (Fig. 1).

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Figure 1.
Electrophysiologically characterized serotonergic
RVM cell that was retrogradely labeled from the dorsal spinal cord.
This cell responded to both µ- and -opioid receptors.
A, Low-magnification image of the cell on the midline of
the brainstem, ~600 µm dorsal to the pyramidal tract.
B, High-magnification image of the biocytin-filled cell.
C, High-magnification image of the fluorescent
microspheres present within the cell. Inset, Extent in
the coronal plane of the spinal injection site of the fluorescent
microspheres. D, High-magnification image of TPH-ir in
the biocytin-filled cell. The high-magnification images were all
collected at the same optical plane using confocal microscopy. Scale
bars: A, 100 µm; B-D,
10 µm.
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Four types of spinally projecting RVM neurons were identified on the
basis of their membrane current responses to µ- and -opioid receptor activation. The first group of spinally projecting RVM neurons
responded only to µ-opioid receptor activation (Fig.
2a). In these neurons,
superfusion of the selective µ-opioid agonist DAMGO (1-3
µM) produced a reversible outward current
(38 ± 6 pA; n = 25), whereas the -opioid
agonist U-69593 (1-3 µM) was without effect
(n = 39). The DAMGO-induced current was reversed by
addition of the µ-opioid antagonist CTAP (300 nM-1 µM;
n = 15). The endogenous opioid ligand met-enkephalin
(10 µM) also produced an outward current in
these neurons (41 ± 3 pA; n = 31). The second
group of spinally projecting RVM neurons responded only to -opioid receptor activation (Fig. 2b). In these neurons, U-69593
(300 nM-1 µM) produced an
outward current (65 ± 15 pA) that was reversed by the -opioid
antagonist nor-BNI (300 nM-1
µM), whereas DAMGO (1-3
µM) produced no change in membrane current
(n = 10). The third group of spinally projecting RVM
neurons responded to both µ- and -opioid receptor activation (Fig.
2c). In these neurons, U-69593 (300 nM-3 µM) produced an
outward current (35 ± 7 pA; n = 17), which was
reversed by nor-BNI (1 µM; n = 13). In addition, DAMGO (1-3 µM; 32 ± 7 pA; n = 13) and/or met-enkephalin (10 µM; 48 ± 10 pA; n = 14)
produced an outward current. The fourth group of spinally projecting
RVM neurons did not respond to µ- or -opioid agonists
(n = 7; data not shown). However, subsequent
application of 5-hydroxytryptamine (3 µM;
47 ± 10 pA; n = 3) or nociceptin (300 nM; 88 ± 29 pA; n = 4)
produced an outward current, confirming that these neurons were
responsive to activation of other
Gi/o-protein-coupled receptors.

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Figure 2.
Three distinct categories of opioid-responding
bulbospinal cells in RVM. Typical current traces of µ-
(a), - (b), and µ/ -
(c) opioid-responding RVM neurons. The membrane
current was recorded in RVM neurons during the superfusion of the
opioid agonists U69593 (U69) (1 µM), DAMGO
(3 µM), and met-enkephalin (ME) (10 µM). The effects of DAMGO and U69593 were reversed by the
µ- and -opioid-selective antagonists CTAP (1 µM) and
nor-BNI (300 nM). Current traces
a-c are from different neurons that were
voltage clamped at 60 mV. The action potential traces
for d-f are from different
neurons in current-clamp mode that are typical of the opioid-responding
types in a-c, respectively.
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The proportions of these three opioid responsive types differed (Fig.
3). The majority of spinally projecting
neurons responded only to µ-opioid receptor activation (53%;
n = 39 of 73). Smaller proportions of projection
neurons responded either only to -opioid receptor activation (14%;
n = 10 of 73) or to both µ- and -opioid receptor
activation (23%; n = 17 of 73). The other neurons did not respond to either µ- or -opioid receptor activation (10%; n = 7 of 73).

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Figure 3.
The proportion of opioid-responding subtypes
differs between spinally projecting and randomly selected RVM neurons.
Bar charts display the percentage of µ-, -,
µ/ -opioid-responding neurons in recordings from retrogradely
labeled neurons using fluorescence illumination
(Retro-labelled) and from randomly sampled neurons with
the fluorescence illumination off (Random). Both groups
of neurons are from animals that had received previous spinal
injections of fluorescent microspheres. *p < 0.05.
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In some experiments the shapes of action potentials were studied in
current-clamp mode. We found that opioid-responsive neurons had
distinctive action potential shapes (Fig. 2d-f). The
majority of µ-responsive neurons had short-duration action potentials
(width at half-amplitude = 0.9 ± 0.1 msec; n = 36 of 39). The majority of -opioid responsive neurons had
long-duration action potentials (width at half-amplitude = 2.2 ± 0.6 msec; n = 7 of 9). The majority of
µ/ -responsive neurons had short-duration action potentials (width
at half-amplitude = 1.1 ± 0.1 msec; n = 7 of 8).
Examination of the spinal cords of pups that had received injections of
fluorescent microspheres showed that in all cases injections of
microspheres were made into the dorsal horn of the spinal cord. In no
cases were the injections restricted entirely to the dorsal horn, and
they generally extended into the intermediate gray and sometimes the
ventral horn. In 5 of 17 animals, injection sites were more restricted
to the dorsal horn with additional labeling extending only into small
portions of the intermediate gray immediately adjacent to the base of
the dorsal horn. The proportion of µ, , and µ/ responders in
the five animals with more restricted injected sites (42, 25, and 25%;
n = 12) was similar to that observed in the 12 animals
with larger injection sites that spread into the intermediate gray and
the ventral horn (55, 18, and 18%; n = 38)
(p = 0.7; 2 = 0.7; df = 2).
Opioid responses of RVM neurons not identified as
projecting to the spinal cord
We then attempted to characterize the opioid responses of RVM
neurons that did not project to the spinal cord by recording from
randomly selected RVM neurons. Whole-cell voltage-clamp recordings were
made from 52 randomly selected RVM neurons (without first establishing
whether they were retrogradely labeled) from animals that had received
lumbar spinal cord tracer injections (n = 14 animals).
As observed in the above experiments, we found four types of
opioid-responsive neurons in the RVM (Fig. 3). The majority of these
neurons responded only to µ-opioid receptor activation (75%;
n = 39 of 52). Smaller proportions of neurons responded only to opioids (4%; n = 2 of 52) or to both µ and opioids (13%; n = 7 of 52), or did not respond
to µ or opioids (8%; n = 4 of 52). Of the
neurons that responded to opioids, those that were sampled randomly
from spinally injected rats differed from those obtained when
recordings were limited to spinally projecting neurons
(p < 0.05; 2 = 6.8; df = 2). In particular, the proportion of
µ-opioid-responsive neurons was higher in recordings from randomly
selected neurons (p < 0.05;
2 = 6.0; df = 1).
After recording opioid responses we then examined whether the randomly
selected neurons projected to the spinal cord. Most of these neurons
appeared not to contain fluorescent microspheres in their cell bodies
(85%; n = 44 of 52), and most of the cells without
microspheres responded only to µ opioids (82%; n = 36 of 44). As such, most of the cells described above as responding only to µ opioids were not retrogradely labeled (92%;
n = 36 of 39). The other unlabeled RVM neurons were responsive (2%; n = 1 of 44) or µ/ responsive
(7%; 3 of 44), or did not respond to any opioid agonists (9%;
n = 4 of 44).
To control for any influence of the retrograde tracing procedures on
opioid responsiveness, we then recorded randomly selected RVM neurons
from animals that had not received spinal cord tracer injections. In
these experiments, 46 biocytin-filled neurons were recovered that had
been characterized for their opioid responses. Of these, 70%
(n = 32 of 46) were µ responsive, 13%
(n = 6 of 46) were responsive, 13%
(n = 6 of 46) were µ/ responsive, and the
remaining 4% (n = 2 of 46) did not respond to opioids. The proportion of the different opioid-responsive groups was not significantly different between randomly selected neurons from animals
that had and had not received tracer injections
(p = 0.3; 2 = 2.6; df = 2). This suggests that spinal surgery and tracer injection had no effect on the opioid responses of RVM neurons.
TPH immunoreactivity
It is unclear what role raphe-spinal serotonergic neurons have in
mediating the effects of opioids (see introductory remarks). We
therefore examined whether the different groups of RVM neurons described above were immunoreactive for TPH, a marker of serotonergic neurons (Fig. 4).

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Figure 4.
TPH immunoreactivity of electrophysiologically
characterized RVM neurons. A-C, RVM
neuron that expressed TPH-ir. This cell responded to µ- and
-opioid receptor activation. A, Merged confocal
images showing both the biocytin-filled cell (red) and
TPH-ir (green). B,
C, Separate images showing TPH-ir
(B) and biocytin (C)
labeling of the filled cell. D-F, RVM
neuron that did not express TPH-ir. This cell responded to µ-opioid
receptor activation and had an action potential shape typical of µ responders. D, Merged confocal images showing both the
biocytin-filled cell (red) and TPH-ir
(green). Note the lack of double labeling.
E, F, Separate images showing TPH-ir
(E) and biocytin (F)
labeling of the filled cell. Both neurons were identified as containing
fluorescent microspheres before recording. Scale bars: 25 µm (bar in
D applies to A and D; bar
in C applies to B, C,
E, and F).
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Of the 73 retrogradely labeled RVM neurons from the first set of
experiments, 60 biocytin-filled cells were recovered. Of these, 40%
were immunoreactive for TPH (Fig. 5)
(n = 24 of 60). The proportion of µ-, -, and
µ/ -responsive groups differed between the TPH-positive and
TPH-negative spinally projecting neurons (Fig.
6) (p < 0.001;
2 = 15.8; df = 2). Of the
TPH-positive neurons, there were similar proportions of µ-responsive
(33%; n = 8 of 24), -responsive (25%; n = 6 of 24), and µ/ -responsive (33%;
n = 8 of 24) neurons. Most of the TPH-negative neurons
were µ responsive (67%; n = 24 of 36), with smaller
proportions of -responsive (3%; n = 1 of 36) and
µ/ -responsive (19%; n = 7 of 36) neurons. The
other two TPH-positive and four TPH-negative neurons did not respond to
either µ- or -opioid agonists. In addition, the proportion of
TPH-immunoreactive neurons was similar in animals with more restricted
spinal cord tracer injections (42%; n = 5 of 12) and
those with more extensive tracer injections (40%; n = 12 of 30; p = 0.9; 2 = 0.01; df = 1).

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Figure 5.
The proportion of TPH-immunoreactive neurons
differs between spinally projecting and randomly selected RVM neurons.
Bar charts display the percentage of TPH-positive neurons
(TPH+ve, filled bar) and TPH-negative
neurons (TPH ve, open
bar) in recordings from retrogradely labeled neurons using
fluorescence illumination (Retrolabeled) and from
randomly sampled neurons with the fluorescence illumination off
(Random). Both retrolabeled and random neurons are from
animals that had received previous spinal injections of fluorescent
microspheres. The proportion of TPH-positive neurons was higher for the
retrogradely labeled neurons than for the randomly selected neurons
(p < 0.005; see Results).
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Figure 6.
The proportion of opioid-responding subtypes
differs between spinally projecting TPH-positive and TPH-negative RVM
neurons. The bar chart displays the percentage of µ-, -,
µ/ -opioid-responding neurons in recordings of cells retrogradely
labeled from the spinal cord that were identified as TPH positive
(TPH+ve) or TPH negative
(TPH ve). **p < 0.0001; *p < 0.005.
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Of the 52 randomly selected RVM neurons obtained in recordings from
animals that had received tracer injections (see previous section), 37 biocytin-filled cells were recovered. Significantly fewer of the randomly selected neurons were TPH positive (Fig. 5)
(11%; n = 4 of 37), compared with the retrogradely
labeled neurons (p < 0.005;
2 = 9.5; df = 1). The proportion
of µ-, -, and µ/ -responsive groups differed between the
TPH-positive and TPH-negative neurons randomly selected from rats
injected with tracer (p = 0.001;
2 = 16.3; df = 2). Of the
TPH-negative randomly selected neurons, 79% (n = 26 of
33) were µ responsive and 21% (n = 7 of 33) were µ/ responsive. No -responsive neurons were found to be TPH
negative. The TPH-positive randomly selected neurons were all
identified post hoc as containing fluorescent microspheres
and were either -responsive (50%; n = 2 of 4) or
µ/ -responsive (50%; n = 2 of 4) neurons.
Of the randomly selected RVM neurons that were recovered in recordings
from animals that had not received tracer injections, 15%
(n = 7 of 46) were TPH positive. This proportion of
TPH-positive neurons was similar to that obtained from randomly
selected neurons from animals that had received tracer injections
(p = 0.6; 2 = 0.26; df = 1). Thus spinal cord exposure and tracer injection appear to have had no effect on the expression TPH immunoreactivity in
RVM neurons.
In current-clamp recordings of action potentials from injected and
noninjected animals, TPH-positive neurons had relatively long-duration
action potentials (half width = 2.1 ± 0.4 msec; n = 14) and always had slow afterhyperpolarizations.
The TPH-negative cells had short-duration action potentials (half
width = 0.9 ± 0.1; n = 36) and often had
fast afterhyperpolarizations.
Anatomical distribution of different RVM
neuronal types
The locations of recovered cells from which opioid responses and
TPH immunoreactivity were assessed are shown in Figure
7. Most of the retrogradely labeled
neurons or randomly selected neurons (from either injected and
noninjected animals) were found throughout the rostrocaudal axis of the
RVM. Most of the cells were concentrated in nucleus raphe magnus at the
level of the superior olivary complex (76%; n = 89 of
117), with fewer neurons at the level of the facial nucleus (18%;
n = 21 of 117). Both TPH-positive and TPH-negative cell
types and µ-, -, and µ/ -responsive cell types were present at
both levels of the RVM. However, there were insufficient numbers of
each cell type to allow statistical comparison of their relative
proportions at the two levels. A small percentage of the neurons were
located rostral to the RVM (6%; n = 7 of 117).

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Figure 7.
Distribution of characterized RVM cells.
Biocytin-filled cells were categorized by their responses to selective
µ- and -opioid agonists and by the presence of TPH-ir
(serotonergic). These cells were mapped onto drawings of caudal,
intermediate, and rostral RVM (based on the presence of the seventh
cranial nerve, the inferior olive, or the superior olive).
A, Retrogradely labeled neurons that were first
identified as containing fluorescent beads after spinal injections of
fluorescent microspheres (Retrolabeled).
B, Randomly selected cells in animals that had been
injected spinally with fluorescent microspheres [Random
(injected)]. C, Randomly selected cells in
animals that had not received spinal tracer injections [Random
(non-injected)]. A, C,
Filled circles indicate TPH positive; open
circles indicate TPH negative. B, Filled
symbols indicate TPH positive; open symbols
indicate TPH negative; stars indicate cells found post hoc to be retrogradely labeled from
the spinal cord; circles indicate cells that were not
retrogradely labeled. Scale bar, 1 mm. 6, Abducens
nucleus; 7, facial nucleus; 7n, facial
nerve; 8vn, vestibular root vestibulocochlear nerve;
CG, central gray; DR, dorsal raphe
nucleus; DT, dorsal tegmental nucleus;
g7, genu of the facial nerve; Gi,
gigantocellular reticular nucleus; LC, locus coeruleus;
Lve, lateral vestibular nucleus; mcp,
middle cerebellar peduncle; ml, medial lemniscus;
Mo5, motor trigeminal nucleus; Mve,
medial vestibular nucleus; PR5VL, principal sensory
trigeminal nucleus, ventrolateral part; Pr5, principal
sensory trigeminal nucleus; py, pyramidal tract;
RMg, raphe magnus nucleus; s5, sensory
root of the trigeminal nerve; scp, superior cerebellar
peduncle; SO, Superior olive; Sp5O,
spinal trigeminal nucleus, oral part; SPO, superior
paraolivary nucleus; tz, trapezoid body;
Tz, nucleus of the trapezoid body; VCA,
ventral cochlear nucleus, anterior part; VCP, ventral
cochlear nucleus, posterior part.
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DISCUSSION |
The principal conclusions of this study are that spinally
projecting serotonergic and nonserotonergic RVM cells are directly inhibited by µ- and -opioid receptor activation and that
inhibition of these and other RVM neurons may mediate, at least in
part, opioid analgesia. These findings indicate that spinally
projecting populations of RVM neurons exist that are likely to modulate
nociception and have not previously been sampled
electrophysiologically. This suggests the need to redefine in
vitro models and reexamine the pharmacological properties of RVM
neurons in vivo.
RVM spinally projecting neurons
In the present study, a large proportion of the spinally
projecting neurons were identified as serotonergic (40%; on the basis of TPH immunoreactivity). This observation is consistent with previous
anatomical and electrophysiological studies in adult animals
(Wessendorf et al., 1981 ; Skagerberg and Bjorklund, 1985 ), and the
presence of serotonergic neurons in neonates agrees with previous
anatomical studies (Levitt and Moore, 1978 ; Wallace and Lauder, 1983 ;
Petko and Stunya, 1987 ). Furthermore, both serotonergic and
nonserotonergic spinally projecting RVM neurons were directly inhibited
by µ opioids or opioids, or both. This observation is consistent
with anatomical experiments in adult animals which found that µ- and
-opioid receptor mRNA and/or protein are expressed by serotonergic
and nonserotonergic bulbospinal RVM neurons (Kalyuzhny et al., 1996 ;
Kalyuzhny and Wessendorf, 1998 , 1999 ; Wang and Wessendorf, 1999 ). The
present observations support the hypothesis that some, but not all,
spinally projecting serotonergic RVM neurons respond directly to
opioids and suggests that the supraspinal circuitry necessary for
opioid antinociception is present at an early age.
Of the spinally projecting serotonergic RVM neurons, 33% were µ responsive and 25% were responsive; moreover, another 33% were
responsive to both µ and opioids. Thus it appears likely that
bulbospinal serotonergic neurons play a direct role in mediating the
effects of both µ- and -opioid agonists. These findings differ with previous in vitro neonatal animals studies in which
serotonergic neurons were suggested to be primary cells, which are
directly inhibited by opioids but not µ opioids (Pan et al.,
1990 , 1993 , 1997 ). It is unclear why previous studies of serotonergic
neurons have not reported µ-opioid responses, although this may be
related to effects of anesthesia (Leung and Mason, 1995 ), to
cancellation of direct inhibitory effects by indirect excitatory
(disinhibitory) effects, to the fact that the spinal projections of the
neurons were not examined in previous in vitro studies, or
to a combination of the above factors.
The largest proportion of RVM neurons projecting to the spinal cord
were nonserotonergic (60%) and may in part have been GABAergic (Kalyuzhny and Wessendorf, 1998 ). These neurons were mostly µ- (67%)
or µ/ -opioid (19%) responsive. Consistent with previous in
vivo studies of µ-opioid actions on nonserotonergic cells, the
present data indicate that µ-opioid responding spinally projecting nonserotonergic cells are heterogeneous. In these studies it was found
that subpopulations of nonserotonergic cells may also express functional receptors. On the basis of the in vivo
actions of opioids in RVM (Pan et al., 1997 ; Ackley et al.,
2001 ), it appears possible that the µ- and
µ/ -responsive nonserotonergic spinal projection neurons that we
have identified represent populations of ON and OFF cells, respectively
(Fig. 8). Thus we predict that nonserotonergic OFF cells projecting to the spinal cord will be directly inhibited by -opioid agonists in vivo.

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Figure 8.
Proposed model of RVM opioid actions.
Schematic diagram illustrates the opioid receptor
subtypes on the different populations of RVM neurons. Of the RVM
neurons that project to the spinal cord dorsal horn, 40% are
serotonergic. These serotonergic projection neurons
(5HT) have µ-, - and
µ/ -opioid-responding subtypes. The functional role of each of
these neuronal subtypes is unknown, and they might have distinct spinal
targets. The nonserotonergic projection neurons
(non-5HT) are composed of µ- and
µ/ -opioid-responding subtypes and may code for ON- versus
OFF-neurons, respectively. RVM neurons that were not retrogradely
labeled were nonserotonergic and mostly µ-opioid responsive. Our
model predicts that some of these nonretrogradely labeled neurons are
GABAergic interneurons (GABA) that might also correspond
to a population of ON-cells. In addition, a small population of
projection neurons (~10%) did not respond to opioids. These could
correspond to either NEUTRAL-cells or OFF-cells.
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The spinally projecting populations of RVM neurons are therefore
heterogeneous with respect to opioid responsiveness and TPH immunoreactivity. In addition, these neurons differ in their action potential shape as reported previously (Zagon et al., 1997 ); however, the respective functions of these neuronal types, including opioid responding and nonresponding neurons, are not certain. At least in some
cases, differential expression of opioid receptors is associated with
axonal projection to different laminas of the spinal cord
(Arvidsson et al., 1995 ). Recent studies have identified clear ON- and
OFF-cell behavior in response to different noxious stimulation, or
after inflammation, in cells characterized previously as NEUTRAL-cells
(Ellrich et al., 2000 ; Miki et al., 2002 ). Such behavior might also be
associated with the patterns of opioid responsiveness that we have
identified in serotonergic neurons.
Unlabeled RVM neurons
In contrast to the spinally projecting neurons, few of the
randomly selected RVM neurons were serotonergic (11%), which is in
agreement with previous anatomical observations (Potrebic et al.,
1994 ). Most of these randomly selected neurons were µ- (75%) or
µ/ -opioid responsive (13%), and few were identified post
hoc as retrogradely labeled. Most of these unlabeled neurons were µ-opioid responsive (92%), and none were serotonergic. These
unlabeled neurons resemble the secondary cells identified in previous
in vitro studies (Pan et al., 1990 , 1993 ). Some of these
unlabeled cells may have projected to sites that we regularly missed
with our tracer injections, such as the deep ventral horn. However, their responses were significantly different from those identified as
spinally projecting neurons, and it appears likely that at least some
of those cells were µ-opioid-responsive GABAergic interneurons that
do not project to the spinal cord (Fig. 8).
Pronociceptive RVM circuitry
In the present study, a significant proportion of spinally
projecting RVM neurons were directly inhibited by µ-opioid agonists. As mentioned above, the antinociceptive role of the RVM in opiate analgesia has been proposed to be attributable to excitation (via µ-opioid disinhibition) of bulbospinal antinociceptive neurons. It is
unclear what functional role is played at the spinal level by the
bulbospinal µ-responsive neurons that we detected, but it is possible
that these cells inhibit nociception. If so, it would suggest that the
direct inhibitory effects of µ-opioid agonists on these cells
(effects that would promote, rather than inhibit, nociception) can be
overwhelmed by the indirect disinhibitory effects that opioids
reportedly exert.
An alternative explanation is that these µ-responsive spinally
projecting neurons facilitate nociception. These neurons might represent the cells that mediate nociceptive facilitation produced by
stimulation of the RVM (Zhuo and Gebhart, 1990 , 1992 , 1997 ). This
nociceptive facilitation has been reported to be reduced by spinal
serotonergic antagonists, suggesting that it is mediated by bulbospinal
serotonergic neurons (Zhuo and Gebhart, 1991 ), although other
neurotransmitters may also be involved in these circuits (Urban et al.,
1996 ; Kovelowski et al., 2000 ). Such a pronociceptive pathway has been
proposed to mediate the increased nociception observed in various
chronic pain states. For example, activation of spinally projecting
cells facilitates both morphine tolerance and the paradoxical condition
of opioid-induced hyperalgesia (Vanderah et al., 2001 ), and the
activity of ON-cells is enhanced during some of these phenomena
(Bederson et al., 1990 ). Consistent with these findings, opiate
tolerance and withdrawal can be decreased by microinjection of
lidocaine into the RVM (Kaplan and Fields, 1991 ; Vanderah et al.,
2001 ). Similarly, the allodynia associated with peripheral neuropathy
is also reduced by blockade of the RVM (Kovelowski et al., 2000 ) and by
selective lesioning of µ-opioid receptor expressing RVM cells
(Porreca et al., 2001 ). Thus the actions of opioid analgesics may be
caused not only by disinhibition of antinociceptive bulbospinal neurons
but also by inhibition of opioid-responsive RVM bulbospinal neurons
that facilitate nociception.
 |
FOOTNOTES |
Received July 11, 2002; revised Sept. 23, 2002; accepted Sept. 30, 2002.
This work was supported by United States Public Health Service Grant
DA09642, by Medical Research Council Australia Grants 211168 and
153844, and by The Medical Foundation of The University of Sydney.
Correspondence should be addressed to Prof. MacDonald J. Christie,
Department of Pharmacology, University of Sydney, New South Wales,
2006, Australia. E-mail: macc{at}med.usyd.edu.au.
S. Marinelli's present address: Instituto di Recovera e Cura a
Carattere Scientifico Fondazione Santa Lucia, 00179 Rome, Italy.
 |
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