Yokota Shigefumi, Kaur Satvinder, VanderHorst Veronique G, Saper Clifford B, Chamberlin Nancy L
Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, 02215; Division of Sleep Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, 02215; Department of Anatomy and Morphological Neuroscience, Shimane University School of Medicine, Izumo, 693-8501, Japan.
J Comp Neurol. 2015 Apr 15;523(6):907-20. doi: 10.1002/cne.23720. Epub 2015 Jan 14.
In patients with obstructive sleep apnea, airway obstruction during sleep produces hypercapnia, which in turn activates respiratory muscles that pump air into the lungs (e.g., the diaphragm) and that dilate and stabilize the upper airway (e.g., the genioglossus). We hypothesized that these responses are facilitated by glutamatergic neurons in the parabrachial complex (PB) that respond to hypercapnia and project to premotor and motor neurons that innervate the diaphragm and genioglossus muscles. To test this hypothesis, we combined c-Fos immunohistochemistry with in situ hybridization for vGluT2 or GAD67 or with retrograde tracing from the ventrolateral medullary region that contains phrenic premotor neurons, the phrenic motor nucleus in the C3-C5 spinal ventral horn, or the hypoglossal motor nucleus. We found that hypercapnia (10% CO2 for 2 hours) activated c-Fos expression in neurons in the external lateral, lateral crescent (PBcr), and Kölliker-Fuse (KF) PB subnuclei and that most of these neurons were glutamatergic and virtually none γ-aminobutyric acidergic. Numerous CO2 -responsive neurons in the KF and PBcr were labeled after retrograde tracer injection into the ventrolateral medulla or hypoglossal motor nuclei, and in the KF after injections into the spinal cord, making them candidates for mediating respiratory-facilitatory and upper-airway-stabilizing effects of hypercapnia.
在阻塞性睡眠呼吸暂停患者中,睡眠期间气道阻塞会导致高碳酸血症,进而激活将空气泵入肺部的呼吸肌(如膈肌)以及扩张和稳定上气道的呼吸肌(如颏舌肌)。我们推测,臂旁复合体(PB)中的谷氨酸能神经元对高碳酸血症做出反应,并投射到支配膈肌和颏舌肌的运动前神经元和运动神经元,从而促进这些反应。为了验证这一假设,我们将c-Fos免疫组织化学与vGluT2或GAD67的原位杂交相结合,或与从包含膈运动前神经元、C3-C5脊髓腹角的膈运动核或舌下运动核的延髓腹外侧区域进行逆行追踪相结合。我们发现,高碳酸血症(10%二氧化碳,持续2小时)激活了外侧、外侧新月形(PBcr)和 Kölliker-Fuse(KF)PB 亚核中神经元的c-Fos表达,并且这些神经元中的大多数是谷氨酸能的,几乎没有γ-氨基丁酸能的。在将逆行示踪剂注射到延髓腹外侧或舌下运动核后,KF和PBcr中有许多对二氧化碳反应的神经元被标记,在将示踪剂注射到脊髓后,KF中的神经元也被标记,这使得它们成为介导高碳酸血症对呼吸促进和上气道稳定作用的候选者。