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Department of Anesthesiology and Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York
Address correspondence and reprint requests to Lena S. Sun, MD, Ph 5-544, 630 West 168th St., New York, NY 10032. Address e-mail to LSS4{at}columbia.edu
| Abstract |
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Implications: This study shows that maternal cocaine use during pregnancy impairs the ß-adrenoceptor signaling pathway in the rat during the first week of life. Abnormal cardiac function in the cocaine-exposed neonate may be related to a defect in ß-adrenoceptors, because they regulate cardiac function.
| Introduction |
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Fetal cocaine exposure is associated with both presynaptic and postsynaptic changes in the central monoaminergic receptor pathways (68). Peripheral autonomic dysfunction and disruption of ontogeny of cardiovascular autonomic control have been implicated as possible mechanisms for the cardiovascular functional abnormalities (7), although very few studies have specifically examined the peripheral monoaminergic receptor pathway.
The two arms of autonomic control of cardiac function involve stimulation by the sympathetic nervous system and inhibition by the parasympathetic nervous system. Sympathetic stimulation involves the neural release of catecholamines, which in turn stimulate postsynaptic myocardial ß-adrenoceptors (ßAR) to couple to the stimulatory G protein, Gs, and activate adenylyl cyclase, leading to increased intracellular cAMP accumulation (9). In the heart, the stimulation of sympathetic activity is modulated by the parasympathetic nervous system. The release of acetylcholine from vagal nerve endings stimulate postsynaptic muscarinic receptors that are coupled to the inhibitory G proteins, Gi, and inhibit adenylyl cyclase to reduce intracellular cAMP accumulation (9). Although chronic cocaine exposure has been documented to change G-protein expression and the cAMP signaling pathway in the adult central nervous system (CNS) (1013), little is known regarding the effect of prenatal cocaine exposure on G proteins and cAMP signaling in the neonatal CNS, and even less is known about the peripheral nervous system.
The hypothesis of this study is that chronic perinatal cocaine exposure reduces the myocardial (ßAR)-G protein-cAMP signaling pathway in the neonatal rat. An established pregnant rat model of perinatal drug exposure was used to determine myocardial adenylyl cyclase activity, ßAR density, and G-protein expression in neonatal rats on Postnatal Day 1 or day 7. The results indicate that perinatal cocaine exposure significantly impairs the myocardial ßAR-cAMP signaling pathway on Postnatal Days 1 and 7.
| Methods |
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Saline (control) or cocaine 20 mg/kg (C20) or 60 mg/kg (C60) in equal volume was given once a day beginning on Gestational Day 2 by intragastric administration. These doses and the intragastric route of administration simulate the plasma and tissue concentrations achieved in human cocaine abusers (14). Moreover, these doses cause minimal changes in maternal weight gain and fetal wastage (14). After birth, neonatal animals were divided into two groups: those that were nursed by mothers that continued to receive drug treatment until Postnatal Day 7 and those that were nursed by mothers that were not receiving cocaine. Animals were killed on Day 1 (D1) or Day 7 (D7) of postnatal life. The experimental protocol is outlined in Table 1.
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Adenylyl Cyclase Assay
For adenylyl cyclase assays, membranes (10 µg of protein) were incubated in triplicate at 37°C for 15 min in a final volume of 100 µL containing the following reaction mixture (final concentration): 1 mM IBMX, 3 mM MgSO4, 50 mM Tris (pH 7.5), 0.2 mM ATP, an ATP regenerating system (creatine phosphate 10 mM and 50 U/mL CPK), with and without isoproterenol (ISO), and/or 200 µM GTP. For basal activity, GTP was deleted. The reaction was stopped by the addition of 50 µL of 1% sodium dodecyl sulfate (SDS). After centrifugation at 1000g for 15 min., the cAMP generated was determined by radioimmunoassay. Separate groups of adenylyl cyclase assays were performed to evaluate ßAR- and GTP-stimulated adenylyl cyclase activity. Three different concentrations of ISO were used0.1, 1, and 10 µMto evaluate the response to ßAR stimulation. GTP 200 µM was used to assess postreceptor-mediated, G-proteinstimulated adenylyl cyclase activity.
ß Adrenoceptor Radioligand Binding Experiments
Saturation experiments were performed in duplicate using the radiolabeled antagonist (-)-125I-iodocy-anopindolol (ICYP) to determine total ßAR density. Membranes (2540 µg of protein) were incubated with 811 concentrations of 125I-ICYP in the absence (total binding) and presence of 10 µM propranolol (nonspecific binding) in the saturation binding studies. In all experiments 125I-ICYP 2, 4, 8, 16, 32, 64, 128, and 160 pM were used. In some experiments, additional concentrations of ICYP (12, 24, and 48 pM) were included. After incubation for 1 h at 37°C, the reaction was terminated by rapid vacuum filtration over glass fiber filters, followed by three washings with 5 mL of ice-cold 50 mM Tris buffer (pH 7.5). All filters had been presoaked in 0.5% polyethylenimine. Filters were then counted in a gamma counter at 70% efficiency.
Immunoblot Analysis
Sarcolemmal membrane proteins were subjected to SDS-polyacrylamide gel electrophoresis (12%) according to the method of Laemmli, and protein was transferred electrophoretically to a nitrocellulose membrane. Gel was soaked overnight in phosphate-buffered saline containing 0.05% Tween 20 and 5% nonfat dry milk in the refrigerator. The membrane was then incubated for 90 min with the primary antibodies (anti-Gi
1&2 or anti-Gs
) at 1:1000 dilution. After four 10-min washes with phosphate-buffered saline containing 0.05% Tween 20, the gel was incubated for 45 min with horseradish peroxidase-conjugated goat anti-rabbit immunoglobin G as the secondary antibody at 1:3000 dilution. This was followed by four 15-min washes. The immunoreactive bands were visualized using a Western blot analysis reagent system. Bands obtained from the chemiluminescence films were quantified by densitometry.
Data Analysis
Adenylyl cyclase assays and ßAR binding data obtained from D7 animals were initially analyzed to assess whether there was any effect of postnatal cocaine treatment. There was no difference in animals nursed by mothers that did or did not continue to received cocaine; therefore, all of the data for D7 animals with and without postnatal cocaine exposure were combined and are reported as one group. The saturation binding experiments were analyzed by performing Scatchard analysis to determine the apparent affinity (Kd) of the ligand for the ßAR and the apparent maximal number of binding sites (Bmax) (bound versus bound/free ligand and using least square linear regression) (16). The negative reciprocal of the slope of the best fit yields the Kd, and the x intercept yields the Bmax. Bmax was used as an index of ßAR density. Analysis of variance (ANOVA) for repeated measures was used to assess the concentration-response effect of ISO within each group, followed by Bonferronis modified t-test, if needed. The interaction of cocaine exposure and dose was examined by using ANOVA (17). Significant differences in Kd, Bmax, and the amount of immunoreactive G proteins among groups were assessed by using factorial ANOVA. Data are expressed as means ± SEM. P < 0.05 was deemed significant.
Materials
Anti-Gs, anti-Gi antibodies, and creatine kinase were purchased from Calbiochem Biolabs (Beverly, MA); 125ICYP was purchased from New England (Lã Jolla, CA); Western blot analysis reagent system was purchased from Amersham (Arlington Heights, IL), and all other chemicals were purchased from Sigma Chemical Company, St. Louis, MO.
| Results |
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Myocardial Adenylyl Cyclase Activity in Neonatal Rats
In myocardial membranes from D1 animals, basal adenylyl cyclase activity was similar in rats that had received intrauterine saline (CTL), cocaine 20 mg/kg (C20), or cocaine 60 mg/kg (C60) treatment [in pmoles] cAMP/mg protein per minute: 18.8 ± 3.1, 20 ± 2.7, or 17 ± 1.5, respectively). ISO increased adenylyl cyclase activity at all three concentrations and was comparable among the three groups (Figure 1A) (CTL n = 8; C20 n = 6; C60 n = 5 at D1). Basal adenylyl cyclase activity increased significantly from D1 to D7 in CTL (40.1 ± 7.8 pmoles cAMP/mg protein per minute), C20 (61.5 ± 6.2 pmoles cAMP/mg protein per minute), and C60 (55.6 ± 10.9 pmoles cAMP/mg protein per minute). A significant cocaine effect was observed on adenylyl cyclase activity in response to increasing concentrations of ISO in D7 hearts (P = 0.0018 by ANOVA) (Figure 1B) (CTL n = 8; C20 n = 5; C60 n = 5 for D7). Prenatal cocaine exposure attenuated the cAMP response to ISO in D7 hearts. To examine whether cocaine exposure affected postreceptor-mediated activation of adenylyl cyclase, adenylyl cyclase activity in response to stimulation by GTP at 200 µM was examined in a separate group of assays. GTP-stimulated myocardial adenylyl cyclase activity was significantly reduced in D1 C20 animals (n = 11) compared with CTL animals (n = 17), but it was comparable for CTL and C60 animals (n = 6). GTP significantly stimulated adenylyl cyclase activity in D7 hearts (CTL n = 17; C20 n = 13; C60 n = 12). Although there seemed to be less GTP-stimulated activity in the D7 C20 group, similar to the pattern observed for the D1 group, it failed to attain statistical significance (Table 2).
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| Discussion |
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ßAR regulation differs between neonatal and adult hearts. Sustained ßAR stimulation induces uncoupling of ßAR-Gs and receptor down-regulation in the adult heart, whereas, in neonatal rats, repeated agonist exposure enhances ßAR signaling (18). The reason for this paradoxical response in the developing heart is unclear but seems to be temporally related to sympathetic innervation. The observed ßAR up-regulation in the newborn D1 heart in this model of intrauterine cocaine exposure may be a "sensitization" response. A possible explanation for the findings of myocardial ßAR up-regulation at D1 is the increased circulating catecholamine levels in the mother rat, and exposure of the neonatal heart to the large amount of maternally derived catecholamines induced an increase in ßAR number.
It is likely that the up-regulation of myocardial ßAR at D1 after prenatal cocaine exposure compensated for any alteration of the downstream signaling pathway. In D7 hearts, which no longer had evidence of ßAR upregulation we observed a decrease in ISO-stimulated adenylyl cyclase activity in the cocaine-exposed groups.
Therefore, the current data seem to support the idea that prenatal cocaine exposure impaired ßAR-Gs-cAMP signaling in both D1 and D7 hearts. This impairment may be less obvious in D1 hearts because there was also an increase in ßAR number, which may have masked the defect. However, in D7 hearts, the reduction in adenylyl cyclase activity in response to ßAR stimulation was much more evident in the absence of the compensatory effects of ßAR up-regulation.
These results further suggest that the defect in the ßAR-cAMP signaling pathway clearly involved effects of prenatal cocaine exposure on G proteins. Nonreceptor-mediated myocardial adenylyl cyclase activity in response to the maximal concentration of GTP was attenuated at D1 in the cocaine-exposed animals at the small-dose cocaine treatment (20 mg/kg)the same group that also had an increase in the inhibitory G proteinwhich suggests that prenatal exposure to cocaine modified inhibitory G protein quantity and function. That GTP-stimulated adenylyl cyclase activity was unchanged after the large dose of intrauterine cocaine treatment in D1 hearts may be due to the combined effects of a more modest increase in Gi and a significant increase in Gs. These two effects might have offset each other. The effects of prenatal cocaine exposure on GTP-stimulated adenylyl cyclase activity in D7 hearts were smaller, and this also corresponded with smaller changes in the amount of immunodetectable G proteins.
Changes in G protein-coupled receptors, G proteins, and cAMP signaling after chronic cocaine exposure have been documented in the CNS (1013). In most chronic cocaine exposure models in adults, the effects of cocaine have only been examined in distinct brain regions and seemed to be species-dependent (1921). In rhesus monkeys that received repeated injections of cocaine, DA-1 receptor and ßAR density were both reduced in the caudate nucleus (20). In the rat, chronic cocaine use reportedly increases central ßAR binding capacity, as well as norepinephrine-stimulated cAMP accumulation (22). Studies have documented an alteration in G proteins in the CNS associated with cocaine (1013). Rats that received chronic cocaine treatment for two weeks showed a decrease in ADP-ribosylation, as well as immunoreactivity of Gi
in the nucleus accumbens (10). Other studies have reported that chronic cocaine administration causes a down-regulation in Gi mRNA in the rat hippocampus (20) and an increase in adenylyl cyclase activity in rat whole brain preparations (22). Consequently, chronic cocaine exposure in the adult animal modified the inhibitory G-protein gene expression, protein content, and the adenylyl cyclase activity modulated by the Gi.
Although prenatal chronic cocaine exposure may be considered a form of chronic cocaine exposure, the effects may be quite different due to the immaturity of the target organism and the likely contribution of indirect actions of cocaine on the maternal-fetal unit. In contrast to the down-regulation of DA-1 receptors reported after chronic exposure in adult rhesus monkeys (21), prenatal cocaine exposure causes and up-regulation of central DA-1 receptor mRNA (23). Therefore, chronic cocaine exposure in adult and fetal monkeys seemed to induce opposite changes in DA-1 receptors in the brain. The discordant effects in adult and developing animals have not been documented in the rat, nor has it been examined with regard to the ßAR system. The present data suggest that myocardial ßAR became up-regulated after cocaine exposure in the fetal rat, similar to the changes in central ßAR after chronic cocaine exposure in the adult rat.
In addition to changes in receptor number and the amount of G protein, cocaine exposure also leads to an uncoupling of receptor-effector coupling (24,25). For example, prenatal cocaine exposure in the rabbit diminishes the DA-1 receptor-mediated activation of striatal Gs proteins (26) without changes in the actual amount of Gs or Gi proteins, which indicates that DA-1 receptors were uncoupled from Gs and the cAMP signaling pathway. Moreover, the uncoupling of the central DA-1 receptor from Gs was evident from Postnatal Day 10 until Postnatal Day 100. Although whether ßAR-Gs uncoupling occurred in the neonatal myocardium was specifically examined, the changes observed could also involve additional defects at the level of receptor-G protein coupling. This will be a subject of future investigation.
In conclusion, prenatal cocaine exposure in the rat modified the myocardial ßAR-cAMP signaling pathway during the first week of postnatal life. This signaling pathway plays a very important role in the regulation of cardiac function. Abnormalities in cardiac contractile function have been reported in cocaine-exposed human neonates. The changes in the ßAR-cAMP signaling pathway documented in the neonatal rat heart after perinatal cocaine exposure may underlie the mechanism(s) for abnormal cardiac function reported in the clinical setting. The present results are the first part of a continuing investigation examining the effect of prenatal cocaine exposure in the postnatal heart. Future studies will determine whether these changes continue beyond the immediate postnatal period and the functional significance of these changes in the developing cardiovascular system.
| Acknowledgments |
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I gratefully acknowledge the technical assistance of Ms. Erlinda Samaniego, Dr. Yan Guo, and Ms. Du Fang. I also thank Dr. Yvonne Vulliemoz and Dr. Carol Hirshman for their insightful critiques of the manuscript.
| Footnotes |
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| References |
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and Go
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