Nitric oxide production, oxidative stress, and inflammation in the rat adrenal medulla during chronic and intermittent hypoxia

Abstract

Adrenal gland, as an important effector tissue of the sympathetic nervous system, has critical roles in cardiovascular system under both chronic hypoxia (CH) and intermittent hypoxia (IH) conditions. Nitric oxide (NO), synthesized by nitric oxide synthases (NOS), is the most important intracellular signaling molecule, as well as free radical in response to hypoxia. Yet the regulation and effects of endogenous NO production mediated in the adrenal medulla induced by hypoxia remains largely unknown.

We first studied how endogenous NO production were regulated by different NOS in rat adrenal medulla in response to CH or IH. After CH, elevated levels of endogenous NO production, eNOS expression, and apoptotic chromaffin cells were observed in the adrenal medulla. However, a remarkable decreased endogenous NO production and nNOS expression were shown in the IH-treated adrenal medulla. These results suggested that, in the rat adrenal medulla, the elevation of NO production through increased protein level of eNOS may play a protective role in the adaptive response to CH; the reduction of NO production through decreased expression of nNOS is important for the pathophysiological response to IH.

The oxidative stress and cellular injury in the adrenal medulla under chronic intermittent hypoxia (CIH) condition is undefined. We tested the hypothesis that melatonin, a potent antioxidant, is protective against CIH-induced oxidative stress and local inflammation in the rat adrenal medulla. Results showed that levels of oxidative stress, lipid peroxidation, and inflammatory mediators were significantly increased after CIH treatment. Also, the protein levels of antioxidant enzymes were significantly lowered in the hypoxic group. Co-treatment of melatonin with hypoxia significantly reduced oxidative stress and inflammatory responses in the adrenal medulla. Moreover, the amount of apoptotic cells in the hypoxic groups was significantly less in the melatonin-treated group. Thus, melatonin may act as a protective agent against adrenal damages in patients with severe obstructive sleep apnea syndrome.

Previous studies have shown that CIH associated with recurrent apnea induced oxidative stress and pathophysiological changes in the cardiovascular system. Yet the mechanism of the CIH-induced oxidative stress and local inflammation in the adrenal medulla was undefined. We therefore determined whether the up-regulation of the expression of NADPH oxidase (NOX) mediated by renin-angiotensin system (RAS) may take part in the injuries caused by CIH in the rat adrenal medulla. We found that CIH treatment dramatically induced marker levels of adrenal oxidative stress, inflammation, macrophage infiltration, and apoptosis in rats. Co-treatment with NOX inhibitor, apocynin, counteracted such reactions. Furthermore, the mRNA levels of NOX subunits (p22PHOX, NOX2, and NOX4) and RAS components (ATG, AT1, and AT2) were increased significantly in the CIH group, but reduced in apocynin-treated CIH group, supporting the involvement of NOX and RAS in CIH-induced adrenal injury. In conclusion, we defined the roles of NO production, NOX, and RAS in the rat adrenal injury during hypoxic conditions. We also found that melatonin can protect adrenal medulla from hypoxia-induced damages in rat.