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J Appl Physiol 95: 1315-1324, 2003. First published May 16, 2003; doi:10.1152/japplphysiol.00107.2003
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HIGHLIGHTED TOPICS
Airway Hyperresponsiveness: From Molecules to Bedside

Selected Contribution: Hypersensitivity of pulmonary C fibers induced by adenosine in anesthetized rats

Qihai Gu,1 Ting Ruan,1 Ju-Lun Hong,1 Nausherwan Burki,2 and Lu-Yuan Lee1

Departments of 1Physiology and 2Medicine, University of Kentucky Medical Center, Lexington, Kentucky 40536

Submitted 31 January 2003 ; accepted in final form 12 May 2003


    ABSTRACT
 TOP
 ABSTRACT
 METHODS
 RESULTS
 DISCUSSION
 DISCLOSURES
 ACKNOWLEDGMENTS
 REFERENCES
 
Compelling clinical evidence implicates the potential role of adenosine in development of airway hyperresponsiveness and suggests involvement of pulmonary sensory receptors. This study was carried out to determine the effect of a low dose of adenosine infusion on sensitivity of pulmonary C-fiber afferents in anesthetized open-chest rats. Infusion of adenosine (40 µg · kg-1 · min-1 iv for 90 s) mildly elevated baseline activity of pulmonary C fibers. However, during adenosine infusion, pulmonary C-fiber responses to chemical stimulants and lung inflation (30 cmH2O tracheal pressure) were markedly potentiated; e.g., the response to right atrial injection of capsaicin (0.25 or 0.5 µg/kg) was increased by more than fivefold (change in fiber activity = 2.64 ± 0.67 and 16.27 ± 3.11 impulses/s at control and during adenosine infusion, n = 13, P < 0.05), and this enhanced response returned to control in ~10 min. The potentiating effect of adenosine infusion was completely blocked by pretreatment with 8-cyclopentyl-1,3-dipropylxanthine (100 µg/kg), a selective antagonist of the adenosine A1 receptor, but was not affected by 3,7-dimethyl-1-propargylxanthine (1 mg/kg), an A2-receptor antagonist, or 3-ethyl-5-benzyl-2-methyl-4-phenylethynyl-6-phenyl-1,4-(±)-dihydropyridine-3,5-dicarboxylate (2 mg/kg), an A3-receptor antagonist. This potentiating effect was also mimicked by N6-cyclopentyladenosine (0.25 µg·kg-1·min-1 for 90 s), a selective agonist of the adenosine A1 receptor. In conclusion, our results showed that infusion of adenosine significantly elevated the sensitivity of pulmonary C-fiber afferents in rat lungs and that this potentiating effect is likely mediated through activation of the adenosine A1 receptor.

airway hyperresponsiveness; dyspnea; lung afferents; adenosine receptor; chemical irritants


NONMYELINATED fibers (C fibers) represent ~75% of the afferent fibers in the vagal branches innervating the entire respiratory tract (1, 7). These vagal bronchopulmonary C-fiber afferents are sensitive to various inhaled irritants and certain endogenous inflammatory mediators (7, 27). Stimulation of these afferents is known to elicit a number of reflex responses mediated through the central nervous system and/or autonomic nervous system, including bronchoconstriction, mucus hypersecretion, coughing, dyspneic sensation, and bronchial vasodilatation (7, 27, 34). In addition, on activation, these C-fiber endings can release various sensory neuropeptides (e.g., tachykinins) that are known to generate potent effects on a number of effector cells in the airways and are responsible for the neurogenic inflammation resulting from sustained and/or intense stimulation of these afferents (29, 44). Increasing evidence suggests that hypersensitivity of bronchopulmonary C fibers plays a part in the development of airway hyperresponsiveness associated with airway mucosal injury and inflammation (27, 45).

One of the endogenous chemical mediators possibly involved in the development of airway hyperresponsiveness is adenosine (27, 33). Adenosine is a naturally occurring purine nucleoside generated by the degradation of ATP in all metabolically active cells (4). Its production increases in response to insufficient energy supply, as during tissue ischemia or hypoxia (4, 13). Aside from having important functions as a constituent of nucleic acid and an essential component of intracellular messengers (38), adenosine is known to be a critical modulator of a vast array of physiological functions through its action on one or more of the four known receptor subtypes: A1, A2A, A2B, and A3 (20). The activation of these cell surface adenosine receptors generally functions in a protective role by decreasing energy demand and/or increasing energy supply (3, 4). Mainly because of these properties, adenosine is commonly used as a drug for the treatment of supraventricular tachycardia (10, 42). However, intravenous bolus injection of adenosine has been reported to cause dyspnea, chest discomfort, and bronchospasm in patients (42); these effects are believed to be signs of activation of bronchopulmonary C fibers (16, 27, 39). The adenosine-induced bronchoconstriction can be attenuated by muscarinic-receptor antagonists (8, 35), suggesting that it is mediated through the cholinergic reflex and that pulmonary afferent stimulation is probably involved (7, 27). Indeed, a recent study reported from our laboratory has shown that right atrial bolus injection of a therapeutic dose of adenosine evokes a consistent stimulatory effect on vagal pulmonary C-fiber terminals in rats (18). The response showed a long latency (3-18 s) and was frequently followed by a recurrent stimulation. This pattern of response suggests a distinct possibility of sensitization of these afferents.

In light of the existing background information and unanswered questions, this study was carried out to determine 1) whether the sensitivity of single pulmonary C fibers is altered by intravenous infusion of a low dose of adenosine and, 2) if so, which subtype(s) of adenosine receptor is involved.


    METHODS
 TOP
 ABSTRACT
 METHODS
 RESULTS
 DISCUSSION
 DISCLOSURES
 ACKNOWLEDGMENTS
 REFERENCES
 
The procedures were performed in accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals [DHEW Publication No. (NIH) 86-23, Revised 1985, Office of Science and Health Reports, DRR/NIH, Bethesda, MD 20892] and were approved by the University of Kentucky Institutional Animal Care and Use Committee.

Animal preparation. Male Sprague-Dawley rats (330-435 g) were initially anesthetized with an intraperitoneal injection of {alpha}-chloralose (100 mg/kg) and urethane (500 mg/kg); smaller (~1/10th of the initial dose) supplemental doses of the same anesthetics were given intravenously, whenever necessary, to maintain abolition of the pain reflex elicited by paw pinch. The right femoral artery, left jugular vein, and right femoral vein were cannulated for recording arterial blood pressure (ABP) and injecting and infusing various chemical agents, respectively. The tip of the femoral arterial catheter was advanced into the abdominal aorta; the jugular venous catheter was advanced until its tip was slightly above the right atrium. The trachea was cannulated just below the larynx, and the lungs were artificially ventilated with a respirator (model 7025, UGO Basile, Comerio-Varese, Italy). Tidal volume (VT) and respiratory frequency were set at 8-10 ml/kg and 44-50 breaths/min, respectively, to mimic those of unilaterally vagotomized rats. Tracheal pressure (Ptr) was measured via a side port of the tracheal cannula. The expiratory outlet of the respirator was placed under 3 cmH2O pressure to maintain a near-normal functional residual capacity. Body temperature was maintained at ~36°C throughout the experiment by a heating pad placed under the animal lying in a supine position. Animals were killed at the end of the experiments by an intravenous injection of an overdose of pentobarbital sodium.

Recording of pulmonary C-fiber activity. Single-unit pulmonary C-fiber activity was recorded as previously described (18). Briefly, the right cervical vagus nerve was separated from the carotid artery and sectioned rostrally. The caudal end of the cut vagus nerve was placed on a small dissection platform and desheathed; a thin filament was teased away from the nerve trunk and placed on a platinum-iridium hook electrode. Action potentials were amplified (model P511K, Grass), monitored by an audio monitor (model AM8RS, Grass), and displayed on an oscilloscope (model 2211, Tektronix). The thin filament was further split until the afferent activity from a single unit was electrically isolated. Both vagi were ligated just above the diaphragm to eliminate the electrical signals arising from abdominal visceras. The afferent activity of a single unit was first sought by hyperinflation (3-4 times VT) and then identified by the immediate (<1-s delay) response to bolus injection of capsaicin (0.5-1 µg/kg) into the right atrium. Finally, the general locations of pulmonary C fibers were identified by their responses to gentle pressure on the lungs with a blunt-ended glass rod. The signals of the afferent activities, Ptr (model MP 45-28, Validyne), and ABP (model P23AA, Statham) were recorded on a thermal writer (model TW11, Gould) and on a videocassette recorder (model 500H, Vetter). Fiber activity (FA) was analyzed continuously by a computer for each 0.5-s interval.

Experimental protocols. Four series of experiments were carried out. In study series 1, the effect of intravenous infusion of adenosine on pulmonary C-fiber responses to chemical stimuli was examined. To minimize potential cumulative effects of adenosine, a low dose of adenosine was infused for a relatively short duration (40 µg · kg-1 · min-1 iv for 90 s). Two chemical stimulants of C-fiber afferents, capsaicin (0.25 or 0.5 µg/kg) and lactic acid (9 or 18 mg/kg), were applied separately during the last 10 s of the adenosine infusion. In study series 2, the effect of adenosine infusion at the same dose on the pulmonary C-fiber response to lung inflation was examined. The lungs were inflated (30 cmH2O Ptr for 10 s) during the last 10 s of adenosine infusion. In study series 3, the effects of adenosine were compared before and after pretreatments with the selective antagonists of adenosine A1, A2, and A3 receptors, 8-cyclopentyl-1,3-dipropylxanthine (DPCPX), 3,7-dimethyl-1-propargylxanthine (DMPX), and 3-ethyl-5-benzyl-2-methyl-4-phenylethynyl-6-phenyl-1,4-(±)-dihydropyridine-3,5-dicarboxylate (MRS-1191), respectively. In three separate groups of animals, pulmonary C-fiber responses to capsaicin before and during infusion of adenosine were established. Then DPCPX (100 µg/kg), DMPX (1 mg/kg), or MRS-1191 (2 mg/kg) was slowly injected (~2 min) intravenously as a bolus. C-fiber responses to capsaicin before and during adenosine infusion were repeated at ~10 and 20 min after pretreatment of these adenosine receptor antagonists. The doses of these antagonists were selected on the basis of the following observations reported in anesthetized rats: 1) DPCPX blocks A1-receptor-mediated bradycardia without affecting A2-receptor-mediated hypotension (22); 2) DMPX abolishes the A2-receptor agonist-induced hypotension (23); and 3) MRS-1191 produces a high degree of antagonistic effect on the A3 receptor without exhibiting any of the A1-receptor antagonistic properties (28). In study series 4, the effect of N6-cyclopentyladenosine (CPA, 0.25 µg · kg-1 · min-1 for 90 s), a selective adenosine A1-receptor agonist, on the pulmonary C-fiber response to capsaicin was determined. This dose of CPA was chosen on the basis of our preliminary observation that CPA at a higher dose (0.5-2 µg · kg-1 · min-1 for 90 s) markedly elevated the baseline FA and decreased the baseline heart rate (HR) and ABP. In study series 1-4, >=10 min elapsed between administrations of chemical stimuli.

Materials. All chemicals were obtained from Sigma Chemical (St. Louis, MO). A mixture of 2% {alpha}-chloralose and 10% urethane was dissolved in a 2% borax solution. Capsaicin was dissolved in a stock solution at 250 µg/ml in a vehicle of 10% Tween 80, 10% ethanol, and 80% isotonic saline. The hemisulfate salt of adenosine was chosen over adenosine free base because of its higher solubility in saline, whereas adenosine in both forms at the same molar dose produced very similar cardiovascular and C-fiber responses (18). CPA and DMPX were dissolved in saline at 1 and 0.8 mg/ml, respectively. MRS-1191 was dissolved in DMSO at 5 mg/ml. DPCPX was first dissolved in DMSO and then diluted in saline to a concentration of 0.1 mg/ml before use; the final concentration of DMSO was 2%, and the total volume of DMSO used in each rat was <10 µl. L(+)-Lactic acid (30% solution, wt/vol) was diluted with distilled water, and other chemical agents were diluted with saline to the desired concentration just before the experiments. No detectable effect of the vehicles of these chemical agents on pulmonary C fibers was found in our preliminary experiments.

Statistical analysis. A one- or two-way repeated-measures analysis of variance was used for the statistical analysis. When the two-way analysis of variance showed a significant interaction, pairwise comparisons were made with a post hoc analysis (Newman-Keuls test). Values are means ± SE. P < 0.05 was considered significant.


    RESULTS
 TOP
 ABSTRACT
 METHODS
 RESULTS
 DISCUSSION
 DISCLOSURES
 ACKNOWLEDGMENTS
 REFERENCES
 
A total of 67 pulmonary C fibers were studied in 46 anesthetized open-chest rats. The distribution of receptor locations was as follows: 18 in the upper lobe, 22 in the middle lobe, 23 in the lower lobe, and 4 in the accessory lobe. These pulmonary C fibers had no baseline activity during eupneic breathing (0.01 ± 0.01 impulses/s, n = 67; Fig. 1). During adenosine infusion (40 µg · kg-1 · min-1 iv for 90 s), there was a small, but significant, increase in the baseline activity of these C fibers (0.11 ± 0.06 impulses/s, n = 59, P < 0.05). Adenosine also induced a slight decrease in the baseline mean ABP (MABP) in 24 of the 40 rats studied, although the difference was not statistically significant (84.4 ± 1.8 and 80.3 ± 2.1 mmHg at control and during infusion, respectively, n = 40, P > 0.05). In addition to the hypotension, there was also a mild decrease in the baseline HR in 24 of the 40 rats (300.4 ± 5.9 and 286.2 ± 7.1 beats/min at control and during adenosine infusion, respectively, n = 40, P > 0.05). MABP and HR returned to control in these 24 animals in a short time (<30 s) after termination of adenosine infusion.



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Fig. 1. Effect of intravenous infusion of adenosine on afferent responses of a pulmonary C fiber arising from an ending in the right middle lobe to right atrial injection of capsaicin in an anesthetized open-chest rat (360 g). A: control response. B: response during infusion of adenosine (Ado, 40 µg · kg-1 · min-1 iv for 90 s). C: recovery (10 min after termination of adenosine infusion). Capsaicin (Cap, 0.5 µg/kg) solution (volume = 0.2 ml) was slowly injected into the catheter (dead space = 0.3 ml) and then flushed into the right atrium (arrow) as a bolus with saline. AP, action potential; Ptr, tracheal pressure; ABP, arterial blood pressure.

 

At control, the right atrial bolus injection of a low dose of capsaicin (0.25 or 0.5 µg/kg) abruptly evoked a mild and short burst of discharge (Fig. 1); the difference between the peak FA averaged over a 2-s duration after capsaicin injection and the baseline FA averaged over a 10-s duration ({Delta}FA) was 2.64 ± 0.67 impulses/s. During adenosine infusion, the stimulatory effect of the same dose of capsaicin on these C fibers was augmented by more than fivefold ({Delta}FA = 16.27 ± 3.11 impulses/s, n = 13, P < 0.05). Peak activity and duration of firing of the C fibers increased (Fig. 2). The responses to capsaicin returned toward control levels ({Delta}FA = 1.44 ± 0.52 impulses/s) when the fibers were tested again ~10 min after termination of the adenosine infusion (Fig. 1).



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Fig. 2. Effect of adenosine infusion on averaged pulmonary C-fiber and cardiovascular responses to capsaicin injection in anesthetized open-chest rats. Fiber activity (FA) was measured in 0.5-s intervals in each fiber. Capsaicin (0.25 or 0.5 µg/kg) was injected into the right atrium at time 0. HR, heart rate; MABP, mean ABP; imp, impulses. Adenosine was infused at 40 µg · kg-1 · min-1 iv for 90 s. Values are means ± SE of 13 fibers from 11 rats.

 

Bolus injection of capsaicin (0.25 or 0.5 µg/kg) triggered an immediate bradycardia ({Delta}HR = 134.2 ± 26.8 beats/min) and a lower blood pressure ({Delta}MABP = 23.1 ± 4.2 mmHg). We previously demonstrated that these cardiovascular responses could be completely eliminated in intact animals by vagotomy or selective inactivation of C-fiber afferents after perineural capsaicin treatment of both vagi (23), suggesting that these responses were probably elicited by capsaicin stimulation of bronchopulmonary C-fiber afferents in the contralateral lung. During adenosine infusion, these cardiovascular depressor responses to the same dose of capsaicin were also significantly augmented ({Delta}HR = 260.6 ± 14.5 beats/min, n = 11, P < 0.05; {Delta}MABP = 51.2 ± 7.1 mmHg, n = 11, P < 0.05; Fig. 2) and prolonged (Fig. 1).

The potentiating effect of adenosine infusion was not limited to the response to capsaicin. The response of these pulmonary C fibers to right atrial injection of lactic acid (9 or 18 mg/kg) was also markedly enhanced during adenosine infusion ({Delta}FA = 4.54 ± 0.52 and 12.42 ± 2.02 impulses/s at control and during adenosine infusion, respectively, n = 10, P < 0.05). The augmented response to lactic acid was also reversible ~10 min after termination of the adenosine infusion (Figs. 3 and 4).



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Fig. 3. Effect of adenosine infusion on afferent responses of 2 pulmonary C fibers to right atrial injection of lactic acid (LA, 9 mg/kg; top) and lung inflation (Ptr = 30 cmH2O; bottom) in an anesthetized open-chest rat (345 g). A: control response. B: response during infusion of adenosine (40 µg · kg-1 · min-1 iv for 90 s). C: recovery (10 min after termination of adenosine infusion). These 2 fibers arose from endings located in different regions of the right upper lobe; their activities were recorded simultaneously from the same thin nerve filament and can be distinguished by their different spike heights.

 


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Fig. 4. Effects of adenosine infusion on pulmonary C-fiber responses to injections of capsaicin and lactic acid and lung inflation. In the responses to capsaicin (0.25 or 0.5 µg/kg, n = 13; A) and lactic acid (9 or 18 mg/kg, n = 10; B) injections, {Delta}FA was measured as differences between peak FA (averaged over 2-s intervals) and baseline FA (averaged over 10-s intervals) in each fiber. In the response to lung inflation (Ptr = 30 cmH2O, n = 16; C), {Delta}FA was measured as differences between FA during inflation and baseline FA (each averaged over 10-s interval). Open bar, control response; solid bar, response during infusion of adenosine (40 µg · kg-1 · min-1 iv for 90 s); hatched bar, response during recovery (~10 min after termination of adenosine). Values are means ± SE. *Significantly different (P < 0.05) from control.

 

All pulmonary C fibers had very weak or no response to lung inflation during eupneic breathing. At control, the {Delta}FA generated by lung inflation (i.e., the difference between the FA during lung inflation and baseline activity, each averaged over 10 s) was 0.70 ± 0.19 impulses/s. During adenosine infusion, the lung inflation-elicited {Delta}FA was significantly augmented to 2.44 ± 0.55 impulses/s (n = 16, P < 0.05). The potentiating response to lung inflation also completely returned to the control level ~10 min after termination of the adenosine infusion (Figs. 3 and 4).

Pretreatment with DPCPX (100 µg/kg iv), the adenosine A1-receptor antagonist, did not affect the pulmonary C-fiber response to capsaicin (0.25 or 0.5 µg/kg): {Delta}FA = 1.44 ± 0.52 and 1.28 ± 0.86 impulses/s before and after DPCPX, respectively (n = 9, P > 0.05). However, it completely blocked the potentiating effect of adenosine infusion on the C-fiber response to the same dose of capsaicin: {Delta}FA = 9.73 ± 2.44 and 1.22 ± 0.60 impulses/s before and after DPCPX, respectively (n = 9, P < 0.05; Figs. 5, 6, 7). DPCPX also completely blocked the augmenting effect of adenosine on capsaicin-induced cardiovascular depressor responses that were presumably elicited by stimulation of C-fiber afferents in the left lung (Fig. 6). In sharp contrast, pretreatment with DMPX (1 mg/kg iv, n = 6; Figs. 5 and 7), the adenosine A2-receptor antagonist, or MRS-1191 (2 mg/kg iv, n = 7; Figs. 7 and 8), the adenosine A3-receptor antagonist, had no significant effect on the potentiating effect of adenosine in all the pulmonary C fibers tested.



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Fig. 5. Responses of a pulmonary C fiber arising from the right middle lobe to capsaicin before and during adenosine infusion in an anesthetized open-chest rat (365 g). A and B: control responses to right atrial injection of capsaicin (0.5 µg/kg) before and during infusion of adenosine (40 µg · kg-1 · min-1 iv for 90 s), respectively. C and D: repeat of A and B after pretreatment with 3,7-dimethyl-1-propargylxanthine (DMPX, 1 mg/kg iv), an adenosine A2-receptor antagonist. E and F: repeat of A and B after pretreatment with 8-cyclopentyl-1,3-dipropylxanthine (DPCPX, 100 µg/kg iv), an adenosine A1-receptor antagonist.

 


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Fig. 6. Effect of adenosine infusion on averaged pulmonary C-fiber and cardiovascular responses to capsaicin injection before (A) and after (B) pretreatment with DPCPX (100 µg/kg iv) in anesthetized open-chest rats. {circ}, Control response; {bullet}, response during infusion of adenosine (40 µg · kg-1 · min-1 iv for 90 s). Capsaicin (0.25 or 0.5 µg/kg) was injected into the right atrium at time 0. FA was measured in 0.5-s intervals in each fiber. Values are means ± SE of 9 pulmonary C fibers.

 


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Fig. 7. Effect of adenosine infusion on pulmonary C-fiber responses to injections of capsaicin before and after pretreatment with DPCPX (100 µg/kg, n = 9), DMPX (1 mg/kg, n = 6), and MRS-1191 (MRS, 2 mg/kg, n = 7). {Delta}FA was measured as differences between peak FA (averaged over 2-s intervals) and baseline FA (averaged over 10-s intervals) in each fiber. Open bars, response to capsaicin alone (0.25 or 0.5 µg/kg); solid bars, response to capsaicin during infusion of adenosine (40 µg · kg-1 · min-1 iv for 90 s). Values are means ± SE. *Significant difference (P < 0.05) between corresponding data before and during infusion of adenosine. {dagger}Significant difference (P < 0.05) between corresponding data before and after pretreatment with DPCPX.

 


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Fig. 8. Responses of a pulmonary C fiber arising from the right lower lobe to capsaicin before and during adenosine infusion in an anesthetized open-chest rat (400 g). A and B: control responses to right atrial injection of capsaicin (0.5 µg/ kg) before and during infusion of adenosine (40 µg·kg-1·min-1 iv for 90 s), respectively. C and D: repeat of A and B after pretreatment with 3-ethyl-5-benzyl-2-methyl-4-phenylethynyl-6-phenyl-1,4-(±)-dihydropyridine-3,5-dicarboxylate (MRS-1191, 2 mg/kg iv), an adenosine A3-receptor antagonist.

 

To further verify that the adenosine A1 receptor is involved in the sensitizing effect of adenosine, we investigated whether CPA, the selective agonist of the adenosine A1 receptor, affected the pulmonary C-fiber response to capsaicin. Infusion of a low dose of CPA (0.25 µg · kg-1 · min-1 iv for 90 s) had no detectable effect on the baseline activities of pulmonary C fibers, nor did it significantly affect the baseline MABP and HR. However, the {Delta}FA evoked by the same dose of capsaicin (0.25 or 0.5 µg/kg) was significantly increased from 5.2 ± 0.98 impulses/s at control to 10.6 ± 0.91 impulses/s during CPA infusion (n = 8, P < 0.05; Fig. 9). Similarly, the capsaicin-induced cardiovascular depressor responses were also augmented in four of six rats studied, but the differences were not statistically significant ({Delta}HR = 100.2 ± 45.8 and 160.5 ± 34.8 beats/min at control and during CPA infusion, respectively, P > 0.05; {Delta}MABP = 35.5 ± 5.19 and 46.2 ± 4.29 mmHg at control and during CPA infusion, respectively, P > 0.05).



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Fig. 9. Effect of N6-cyclopentyladenosine (CPA) infusion on pulmonary C-fiber response to right atrial injection of capsaicin in anesthetized open-chest rats. A: control response to capsaicin (0.25 µg/ kg). B: response to capsaicin during infusion of CPA (0.25 µg · kg-1 · min-1 iv 90 s). C: recovery (10 min after termination of adenosine infusion). Receptor location, right lower lobe; rat body weight, 395 g. D: group data showing effect of CPA on pulmonary C-fiber response to capsaicin (0.25 or 0.5 µg/kg, n = 8). Values are means ± SE. *Significantly different (P < 0.05) from control.

 


    DISCUSSION
 TOP
 ABSTRACT
 METHODS
 RESULTS
 DISCUSSION
 DISCLOSURES
 ACKNOWLEDGMENTS
 REFERENCES
 
Our results show that intravenous infusion of a low dose of adenosine caused only a mild elevation of the baseline activity of pulmonary C fibers. However, during adenosine infusion, pulmonary C-fiber responses to chemical stimulation and lung inflation were markedly potentiated. The sensitizing effect of adenosine was prevented after pretreatment with the selective adenosine A1-receptor antagonist but was unaffected by blocking the adenosine A2 or A3 receptors. This sensitizing effect was also mimicked by a considerably lower dose of CPA, a selective adenosine A1-receptor agonist. These results suggest that adenosine induces a distinct potentiating effect on the sensitivity of pulmonary C-fiber afferents in rat lungs, and this effect is likely mediated through activation of the adenosine A1 receptor.

The mechanism by which the intravenous infusion of such a low dose of adenosine dramatically enhances the sensitivity of pulmonary C-fiber responses to chemical stimulants and lung inflation is not clear. However, it is known that the physiological functions of adenosine are mediated through activation of specific cell surface-associated receptors. Several different adenosine receptor subtypes (A1, A2A, A2B, and A3) have been characterized on the basis of biochemical (21), functional (46), and receptor-cloning studies (47). It is well documented that the adenosine A1 receptor acts predominantly to inhibit adenylate cyclase and voltage-dependent Ca2+ channels via its coupling with the G proteins, most likely Gi/Go proteins, whereas adenosine A2A and A2B receptors are linked to activation of adenylate cyclase via Gs proteins (13). Middle-kauff and colleagues (31, 32) demonstrated that adenosine inhibited the slow afterhyperpolarizations (AHPs) that developed after action potentials in a large percentage (~50%) of vagal afferent C neurons and, consequently, increased the neuronal excitability of these afferents. This inhibition of AHPs by adenosine is probably caused by the adenosine A2A-receptor-mediated stimulation of cAMP production in rabbits (31) or the adenosine A1-receptor-mediated attenuation of the voltage-dependent Ca2+ currents in rats (32). In bullfrog sympathetic ganglion neurons, the slow AHP has been shown to result primarily from activation of a Ca2+-dependent K+ current (IKCa) (36); inhibition of IKCa has been suggested to be one of the mechanisms of nociceptor sensitization (40). However, whether adenosine-induced sensitization of vagal pulmonary C-fiber terminals is mediated through inhibition of IKCa remains to be determined.

Several clinical observations strongly suggest an association of adenosine and the onset of an asthmatic attack in patients. For example, increase in the mucosal concentration of adenosine and appearance of the adenosine A1 receptor have been demonstrated in the airways of asthmatic patients (43). The basal level of adenosine in the bronchoalveolar lavage fluid was also found to be significantly higher in asthmatic patients than in normal subjects (11). Consistent with these reports, the level of adenosine in plasma nearly doubles and increases in parallel with brochoconstriction after allergen challenge in asthmatic patients (30). In addition, when adenosine is administered to patients for treatment of supraventricular tachycardia, the drug is known to trigger an asthmatic attack (5, 9). Similarly, dipyridamole, a drug that increases the extracellular concentration of adenosine and is used for myocardial perfusion scintigraphy, can also cause asthmatic attacks in asthmatic patients (6, 41). In a rabbit model of asthma simulating the human condition of the disease, adenosine has been shown to cause bronchoconstriction and airway hyperresponsiveness, which are mediated via the adenosine A1 receptor (2, 12). Furthermore, in a recent study, Nyce and Metzger (33) demonstrated that the airway constriction triggered by adenosine is dramatically attenuated by using antisense oligodeoxynucleotide targeting the adenosine A1 receptor.

Although the mechanism underlying the involvement of adenosine in airway hyperresponsiveness is not clear, the data obtained in this study seem to suggest a potential role of pulmonary C-fiber activation and/or sensitization. It is well documented that stimulation of vagal pulmonary C-fiber afferents can elicit reflex bronchoconstriction mediated through the cholinergic pathways (7, 27, 34). In addition, this stimulation can also evoke local release of tachykinins from the sensory terminals, which may in turn cause smooth muscle contraction (29, 44). Our results clearly show that the sensitivity of pulmonary C fibers is markedly enhanced by adenosine. Thus a sufficient level of C-fiber stimulation by inhaled irritants (e.g., cigarette smoke) will elicit a more intense bronchoconstriction via cholinergic and tachykininergic pathways.

Alternatively, it is possible that the adenosine-induced airway hyperresponsiveness is mediated through an indirect mechanism, in part via activation of adenosine receptors expressed on intermediary inflammatory cells (30, 38). For example, adenosine may cause mast cell degranulation and subsequent release of various inflammatory mediators (14, 38). Increased levels of mast cell granule-derived mediators such as histamine, prostanoids, and tryptase in bronchoalveolar lavage fluid have been reported after adenosine challenge in asthmatic patients (37). Some of these mediators (e.g., histamine and prostaglandin E2) are known to exert profound sensitizing and stimulatory effects on the pulmonary C-fiber sensory terminals (15, 17, 24, 26). The cellular mechanism underlying the hypersensitivity of the C-fiber afferent endings induced by these mediators is not totally understood but is probably related to changes in the conductance of specific ion channels and/or the resting membrane potential mediated by the activation of certain specific receptor proteins (e.g., prostanoid EP2 receptor) located on the membranes of nerve terminals (24, 25, 27). It is known that the adenosine receptor subtype involved in the modulation of mast cell activity may vary depending on the mast cell phenotype. Given this and the well-documented functional heterogeneity of mast cells from different animal species (13), a possible influence of these factors should not be overlooked in identifying the receptor subtypes and the mediators involved in the adenosine-induced sensitization of pulmonary C fibers.

Two chemical stimulants of pulmonary C fibers (capsaicin and lactic acid) and lung inflation were used in the present study to test the sensitivity of these C-fiber afferents. Capsaicin, a pungent active ingredient of hot pepper, has been used extensively as a tool for identifying C-fiber afferents arising from the respiratory tract because of its well-documented potent and selective effect on these afferent endings (7, 27). Lactic acid, a "fixed acid" produced endogenously in large quantity during anaerobic tissue metabolism, has been shown to dose dependently stimulate pulmonary C-fiber afferents in anesthetized rats (19). Under certain pathophysiological conditions such as local tissue ischemia and inflammation in the airways, excessive production of adenosine and lactic acid could occur simultaneously. Furthermore, although bronchopulmonary C fibers are usually quiescent during eupneic breathing, lung inflation provides a mild physiological stimulus of these afferent endings. Because an increase in VT occurs commonly during hyperventilation caused by hypoxia or severe exercise, a concomitant increase in adenosine production in response to these physiological stresses may then augment C-fiber stimulation and reflex responses.

In summary, this study shows that infusion of a low dose of adenosine markedly potentiates the sensitivity of pulmonary C fibers to chemical stimulants and lung inflation. This sensitizing effect is probably mediated through activation of the adenosine A1 receptor. However, whether the sensitization is caused by a direct effect of adenosine on the C-fiber sensory terminals or is secondary to an adenosine-induced release of certain inflammatory mediators that, in turn, enhance the sensitivity of C-fiber endings remains to be determined. Whatever the cause, this sensitizing effect on pulmonary C-fiber afferents probably plays a role in adenosine-induced airway hyperresponsiveness.


    DISCLOSURES
 TOP
 ABSTRACT
 METHODS
 RESULTS
 DISCUSSION
 DISCLOSURES
 ACKNOWLEDGMENTS
 REFERENCES
 
This study was supported by National Heart, Lung, and Blood Institute Grants HL-65486 and HL-67379.


    ACKNOWLEDGMENTS
 TOP
 ABSTRACT
 METHODS
 RESULTS
 DISCUSSION
 DISCLOSURES
 ACKNOWLEDGMENTS
 REFERENCES
 
The authors are grateful to Dr. You-Shuei Lin and Robert Morton for technical assistance.


    FOOTNOTES
 

Address for reprint requests and other correspondence: L.-Y. Lee, Dept. of Physiology, University of Kentucky Medical Center, 800 Rose St., Lexington, KY 40536-0298 (E-mail: lylee{at}uky.edu).

The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.


    REFERENCES
 TOP
 ABSTRACT
 METHODS
 RESULTS
 DISCUSSION
 DISCLOSURES
 ACKNOWLEDGMENTS
 REFERENCES
 

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