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视前正中核神经元调节睡眠-觉醒的研究进展

2015-01-08王典茹综述黄志力曲卫敏审校

复旦学报(医学版) 2015年6期
关键词:核团下丘脑组胺

王典茹(综述) 黄志力,2,3 曲卫敏,2△(审校)

视前正中核神经元调节睡眠-觉醒的研究进展

王典茹1(综述) 黄志力1,2,3曲卫敏1,2△(审校)

(1复旦大学基础医学院药理学系,2脑科学研究院和脑科学协同创新中心,3医学神经生物学国家重点实验室 上海 200032)

视前正中核(median preoptic nucleus,MnPO)位于下丘脑视前区,主要由GABA能和谷氨酸能神经元组成。研究显示,MnPO在睡眠时大部分细胞放电增加;动物睡眠剥夺后,睡眠张力增高,MnPO区c-Fos表达量增多;毁损大鼠MnPO,睡眠量减少,觉醒量增加。MnPO与脑内多个调控睡眠觉醒的核团有神经纤维联系。在MnPO区微注射GABAA受体激动剂,抑制MnPO神经元,导致觉醒相关脑区神经元去抑制,引起觉醒,提示MnPO区GABA能神经可通过抑制觉醒核团来维持睡眠。本文综述MnPO调节睡眠-觉醒作用的研究进展。

视前正中核; 睡眠; 觉醒

Advanecs in slccp-wakc rcgulation of thc mcdian prcoptie ncuelcus

WANG Dian-ru1,HUANG Zhi-li1,2,3,QU Wei-min1,2△

(1Department of Pharmacology,School of Basic Medical Sciences,2Institutes of Brain Science and Collaborative Innovation Center for Brain Science,3State Key Laboratory of Medical Neurobiology,Fudan University,Shanghai 200032,China)

【Abstraet】 The median preoptic nucleus(MnPO)located in the hypothalamus preoptic area,mainly consists of GABAergic and glutamatergic neurons.It has been reported that most MnPO neurons are activated during sleep.Sleep deprived rats exhibit an increase in c-Fos expression in the MnPO with the increase of sleep propensity.Lesion of rat MnPO decreases the amount of sleep with an increase in wakefulness.Furthermore,MnPO innervates most of sleep-wake regulatory nuclei.Microinjection of GABAAreceptor agonist into the MnPO inhibits the MnPO neurons,and results in the disinhibition of wake-related nuclei projected from the MnPO and induces wakefulness.These findings indicate that the activation of MnPO neurons contributes to the suppression of wake-promoting systems and promotes sleep.In this review,we summarized the advances in the roles of MnPO in sleep-wake regulation.

【Kcy words】 median preoptic nucleus; sleep; wake

*This work was supportcd by thc National Kcy Dcvclopmcnt Plan of Foundamcntal Rcscareh of China(2011CB711000,2015CB856401)and thc National Natural Seicnec Foundation of China(31171010,31271164,31471064,81420108015).

研究发现,位于下丘脑视前区的2个核团——腹外侧视前区(ventrolateral preoptic nucleus,VLPO)和视前正中核(median preoptic nucleus, MnPO)参与睡眠调节。自1996年以来,大量研究显示VLPO与睡眠调节密切相关[1]。多数报道认为MnPO参与调节水盐摄取、体温等生理活动,但也有研究提示MnPO在睡眠调节中发挥重要作用。电生理及免疫组化实验发现,MnPO神经元在非快动眼(non-rapid eye movement,NREM)睡眠时活性增强[2-3]。MnPO神经元与脑内多个调控睡眠-觉醒的核团有神经纤维联系,通过抑制觉醒核团或兴奋睡眠中枢,维持睡眠[4-5]。本文从神经电生理、药理学和神经化学等方面综述Mn PO调节睡眠-觉醒作用研究进展。

MnPO的神经解剖学和基本功能视前正中核是位于下丘脑视前区中缝上的核团,它在前连合上形成一个盖帽结构,位于第3脑室前壁,被前连合分为背侧和喙侧。MnPO区主要存在2种神经元:谷氨酸能神经元和γ-氨基丁酸(γ-aminobutyric acid,GABA)能神经元[6]。MnPO对机体内稳态调节具有重要作用,例如水盐平衡、血压、渴觉[7]、体温以及睡眠[8]等。

MnPO与脑内睡眠-觉醒相关核团有广泛纤维联系。MnPO神经元支配下丘脑室旁核

(paraventricular nucleus of the hypothalamus,PVH)[9]、外侧下丘脑穹窿区(perifornical-lateral hypothalamic area,PF/LH)[5]、视交叉上核(suprachiasmatic nucleus,SCN)、视上核(supraoptic nucleus,SON)[10]、中缝背核(dorsal raphe nucleus,DRN)、蓝斑(locus coeruleus,LC)[11]、VLPO[12]和下丘脑背内侧核(dorsomedial nucleus of the hypothalamus,DMH)[13]。MnPO也接受来自臂旁核(parabrachial nucleus,PB)[14]、DMH[13]、穹窿下器(subfornical organ,SFO)[15]和终板血管器(organum vasculosum lamina terminalis,OVLT)[16]的纤维传入(图1)。已证明VLPO参与睡眠的调控及维持[17],LH、MPB、LC以及DRN对于觉醒的维持发挥着关键作用[18-20]。除此之外,DRN和LC还参与调控快动眼(rapid eye movement,REM)睡眠[21],SCN和DMH可通过调节生物节律影响睡眠[22-23]。MnPO与睡眠-觉醒核团的解剖学联系提示MnPO可能参与调节睡眠-觉醒。

图1 MnPO与睡眠-觉醒核团神经网络系统Fig 1 Conncetion of MnPO with slccp-wcck rcgulation systcms

MnPO区GABA能神经元活性与睡眠相关

在体电生理记录SD大鼠的MnPO神经元放电特性发现:约75%的MnPO神经元在睡眠时放电增加,其中58%的细胞在REM睡眠和NREM睡眠时都处于活化状态,被认为是睡眠相关神经元。REM睡眠相关神经元表现出高频率的爆发式放电,脑波以θ波为主[3]。大多睡眠相关神经元在睡眠起始前出现放电频率增加,提示MnPO神经元的活动与启动睡眠过程相关。

大鼠睡眠剥夺2 h后,在体记录发现MnPO睡眠相关神经元兴奋。在随后的睡眠恢复期,MnPO 区REM睡眠相关神经元放电增加约65.6%[24]。Sakai等[25]进一步研究Mn PO神经元与睡眠的相关性及神经元类型,发现MnPO中31.9%的神经元为睡眠活性神经元,33%的为觉醒活性神经元,觉醒/REM睡眠活性神经元占23.4%,少量神经元(11.7%)与睡眠无相关性。电毁损大鼠的MnPO后,睡眠量显著减少,觉醒量增加[26]。以上提示,MnPO部分神经元活性与睡眠呈正相关。

Modirrousta等[27]发现,大鼠睡眠时MnPO区的GABA能神经元活性升高,c-Fos表达增强,其中75%以上的c-Fos阳性细胞都与谷氨酸脱羧酶(glutamic acid decarboxylase,GAD)共标。大鼠睡眠剥夺后,睡眠张力增强,MnPO区的GABA能神经元大量表达c-Fos,说明MnPO的GABA能神经元在睡眠剥夺后活化,对睡眠内稳态调节起重要作用[8,28]。猫在体研究也发现,MnPO的GABA能神经元参与维持睡眠,尤其是NREM睡眠[29]。大鼠侧脑室给予生长激素释放激素,可增加动物睡眠量和Mn PO区c-Fos表达,且大部分c-Fos阳性细胞与GAD共标[30]。因此,MnPO区的GABA能神经元参与调控睡眠。

MnPO区多数谷氨酸能神经元放电频率低于GABA能神经元,为1~5 Hz[31]。电刺激MnPO,同时记录其下游LH神经元的放电变化,观察到不同的反应[5]。Sakai[25]认为MnPO区有33%的神经元可能是谷氨酸能神经元,具有促觉醒作用。提示MnPO区的谷氨酸能神经元在睡眠-觉醒调控中的作用与GABA能神经元不同。

药理学方法调控 MnPO活性影响睡眠腺苷(adenosine,AD)是目前已知的强效内源性促睡眠因子,可能通过激活腺苷A1和A2A受体在视前区发挥作用[32-33],与睡眠调节的内稳态过程有关[34]。采用微透析法在MnPO给予腺苷及其转运体抑制剂硝基苯硫嘌呤核苷酸[S-(4-nitrobenzyl)-6-thionosine,NBTI],均能促进睡眠[35]。侧脑室或基底前脑喙侧蛛网膜下腔给予A2A受体激动剂,可引起睡眠;且MnPO和VLPO区GABA能神经元的c-Fos表达增多,而与觉醒密切相关的组胺能神经元结节乳头体核(tuberomammillary nucleus,TMN)的c-Fos表达量下降[36-38]。相反,侧脑室给予A2A受体拮抗剂可抑制Mn PO和VLPO区GABA能神经元的c-Fos表达,并抑制睡眠剥夺后的睡眠反弹[39]。以上结果提示,腺苷通过A2A受体间接或直接活化MnPO和VLPO的GABA能神经元,促进睡眠。

大鼠侧脑室内给予IL-1β,可增加NREM睡眠达4~5 h,同时MnPO区c-Fos表达增加,而VLPO无明显变化[40]。Orexin是重要的促觉醒物质[41-42],离体电生理研究发现,Orexin可通过Orexin A和Orexin B受体增加部分MnPO神经元的活性[43]。

MnPO通过抑制觉醒核团活性,调控睡眠

MnPO神经元向觉醒相关核团广泛投射,并且大多MnPO睡眠相关神经元是GABA能[44]。MnPO的GABA能神经元投射至外侧下丘脑穹窿区(PF/ LH)的Orexin能神经元和中缝背核(dorsal raphe nucleus,DRN)的5-羟色胺能神经元。PF/LH的orexin能神经元和DRN的5-羟色胺能神经元参与觉醒的调节。在麻醉大鼠MnPO区微注射GABAA受体激动剂蝇蕈醇,抑制MnPO神经元活性。与对照组相比,PF/LH的Orexin能神经元和DRN的五羟色胺能神经元c-Fos表达量显著增加,而下丘脑中黑色素凝集激素能神经元无明显变化[45]。表明MnPO的GABA能神经元通过抑制调控觉醒的PF/LH Orexin能和DRN的5-羟色胺能神经元活性,调节睡眠。

为了研究MnPO对PH/LH的调节功能,对自由活动的大鼠MnPO进行电刺激,发现PH/LH区79%的神经元对电刺激有反应,但反应不同,大部分PH/LH神经元受到抑制,余下的一部分先抑制后兴奋,另一部分先兴奋后抑制,说明MnPO通过不同类型神经元直接调控PH/LH神经元活性[5]。在MnPO微透析给予L-谷氨酸兴奋神经元,引起了PH/LH区觉醒相关神经元放电减少;而给予蝇蕈醇(GABAA受体激动剂)抑制MnPO神经元活性,引起PH/LH区睡眠相关神经元的兴奋[5],说明MnPO睡眠活性神经元参与PF/LH的促觉醒神经元的调控,证实MnPO通过GABA能神经元抑制觉醒核团PF/LH促进睡眠。

MnPO神经元纤维也投射至中脑导水管周围灰质(periaqueductal gray,PAG)[46],其中腹外侧中脑导水管周围灰质(ventrolateral periaqueductal gray,vlPAG)参与REM睡眠和觉醒调节[47]。逆行追踪发现,睡眠完全剥夺后的睡眠恢复期,大鼠MnPO区c-Fos表达量显著高于REM睡眠剥夺后睡眠恢复组和觉醒组,并且这些投射神经元与GAD共标,表明MnPO区的GABA能神经元抑制vlPAG神经元活性,促进睡眠[48]。

MnPO神经元不仅向觉醒核团投射,通过抑制促觉醒神经元产生促睡眠作用,同时MnPO也接受觉醒相关核团的投射。觉醒时,MnPO的GABA能神经元活性受到抑制。Modirrousta等[27]证明,大鼠夺眠后,同时表达肾上腺素α2受体和GAD的神经元兴奋性增加,提示MnPO区的GABA能神经元在觉醒时受LC释放的去甲肾上腺素所抑制。MnPO离体脑片神经元的全细胞记录结果显示,59%的细胞对去甲肾上腺素有反应,其中大部分表现为超极化,小部分表现为去极化[49]。提示MnPO 的GABA能神经元与觉醒相关核团LC之间相互作用调控睡眠。

组胺能神经系统也能调控 MnPO活性。组胺能神经元分布于下丘脑后部的TMN,其神经纤维投射至全脑。中枢组胺的释放和组胺能神经元活性与觉醒时相呈正相关[37,50]。Lundius等[51]使用单细胞反转录PCR方法,发现MnPO的GABA能神经元表达组胺H3受体,非GABA能神经元表达H1受体,而几乎无H2受体表达。离体脑片电生理研究证实,组胺可以通过 H3受体减少MnPO区GABA能神经元的放电频率,通过H1受体增加非GABA能神经元的放电频率,并使其去极化。另外,MnPO区vGlut2为标志的谷氨酸能神经元同时表达 H1受体,组胺可以通过 H1受体持续兴奋谷氨酸能神经元[31]。以上提示,TMN组胺能神经元释放的组胺,作为重要的促觉醒物质,通过H3受体抑制、H1受体兴奋MnPO神经元[51]。

MnPO区GABA能神经元与觉醒核团之间的相互联系和调控,与睡眠-觉醒调节的“跷跷板理论”[52]类似,即MnPO睡眠相关神经元兴奋时,抑制觉醒相关核团,促进睡眠;反之,诱导觉醒。

其他下丘脑视前区也是重要的体温调节中枢,这一区域包含大量的温敏和冷敏神经元,构成哺乳动物脑内的温度敏感区。MnPO作为重要的体温调节中枢,表达温度敏感的离子通道以及结节漏斗部激素、辣椒素等受体[13,53],可感受温度变化信号,整合后调控其下游通路进而启动体温调节应答反应[54]。睡眠的起始与新陈代谢和体温的降低一致。已有研究证明,基底前脑的温度调节系统参与睡眠的内稳态调节,当环境温度从27℃升至30℃时,大鼠的睡眠量随之升高,30℃时睡眠量达到最大,这一现象是由视前区的温敏神经元所介导[55],说明睡眠与温度调节密切相关。

MnPO也与生物节律相关,参与食物预期性活动。在食物预期性活动中,MnPO区时钟基因PER1大量表达[56]。在食物预期性活动期间,动物的自主活动、中心体温和觉醒量增加[57-59]。

MnPO区能够感受外周血管压力变化,参与中枢神经介导的血管紧张素Ⅱ诱导的高血压症[60]。MnPO还参与阻塞性睡眠呼吸暂停综合征中的日间高血压调节。抑制Mn PO区ΔFosB的转录活性,可使低氧血症模型动物在暗期的动脉血压降低[61]。以上提示,MnPO在生物节律调节及生命活动的维持上发挥重要作用。

结语MnPO在睡眠以及机体内稳态调节中发挥重要作用。MnPO区的GABA能神经元激活后,抑制觉醒相关核团,促进睡眠;而GABA能神经元受抑制后,使觉醒相关核团去抑制,促进觉醒。此外,MnPO区的谷氨酸能神经元可能对睡眠-觉醒也有重要的调节作用。但MnPO如何启动和维持睡眠,其神经环路机制及神经递质基础还不明确。阐明MnPO在睡眠-觉醒中的调节作用,对认识睡眠-觉醒调节机制和开发镇静催眠药等具有重要意义。

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Q 428;R 96

B

10.3969/j.issn.1672-8467.2015.06.016

2015-05-29;编辑:段佳)

国家重点基础研究发展计划(2011CB711000,2015CB856401);国家自然科学基金(31171010,31271164,31471064,81420108015)

△Corresponding author E-mail:quweimin@fudan.edu.cn

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