title: Localization of multiple neurotransmitters in surgically derived specimens of human atrial ganglia.
abstract: Dysfunction of the intrinsic cardiac nervous system is implicated in the genesis of atrial and ventricular arrhythmias. While this system has been studied extensively in animal models, far less is known about the intrinsic cardiac nervous system of humans. This study was initiated to anatomically identify neurotransmitters associated with the right atrial ganglionated plexus (RAGP) of the human heart. Biopsies of epicardial fat containing a portion of the RAGP were collected from eight patients during cardiothoracic surgery and processed for immunofluorescent detection of specific neuronal markers. Colocalization of markers was evaluated by confocal microscopy. Most intrinsic cardiac neuronal somata displayed immunoreactivity for the cholinergic marker choline acetyltransferase and the nitrergic marker neuronal nitric oxide synthase. A subpopulation of intrinsic cardiac neurons also stained for noradrenergic markers. While most intrinsic cardiac neurons received cholinergic innervation evident as punctate immunostaining for the high affinity choline transporter, some lacked cholinergic inputs. Moreover, peptidergic, nitrergic, and noradrenergic nerves provided substantial innervation of intrinsic cardiac ganglia. These findings demonstrate that the human RAGP has a complex neurochemical anatomy, which includes the presence of a dual cholinergic/nitrergic phenotype for most of its neurons, the presence of noradrenergic markers in a subpopulation of neurons, and innervation by a host of neurochemically distinct nerves. The putative role of multiple neurotransmitters in controlling intrinsic cardiac neurons and mediating efferent signaling to the heart indicates the possibility of novel therapeutic targets for arrhythmia prevention.
authors.affiliation: Department of Pharmacology, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA. hoover@etsu.edu
authors.forename: D B
authors.initials: DB
authors.lastname: Hoover
authors.forename: E R
authors.initials: ER
authors.lastname: Isaacs
authors.forename: F
authors.initials: F
authors.lastname: Jacques
authors.forename: J L
authors.initials: JL
authors.lastname: Hoard
authors.forename: P
authors.initials: P
authors.lastname: Pagé
authors.forename: J A
authors.initials: JA
authors.lastname: Armour
mesh_terms: D000109:Acetylcholine / Q000378:metabolism; D000368:Aged; D017776:Autonomic Pathways / Q000166:cytology / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002795:Choline O-Acetyltransferase / Q000378:metabolism; D002799:Cholinergic Fibers / Q000378:metabolism / Q000648:ultrastructure; D005260:Female; D005455:Fluorescent Antibody Technique; D005725:Ganglia, Autonomic / Q000166:cytology / Q000378:metabolism*; D006325:Heart Atria / Q000294:innervation*; D006329:Heart Conduction System / Q000166:cytology / Q000378:metabolism*; D006801:Humans; D008297:Male; D026901:Membrane Transport Proteins / Q000378:metabolism; D018613:Microscopy, Confocal; D008875:Middle Aged; D009474:Neurons / Q000166:cytology / Q000378:metabolism*; D009479:Neuropeptides / Q000378:metabolism; D018377:Neurotransmitter Agents / Q000378:metabolism*; D026602:Nitrergic Neurons / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D052248:Nitric Oxide Synthase Type I / Q000378:metabolism; D009638:Norepinephrine / Q000378:metabolism; D014446:Tyrosine 3-Monooxygenase / Q000378:metabolism
chemical_list: D015415:Biomarkers; D026901:Membrane Transport Proteins; D009479:Neuropeptides; D018377:Neurotransmitter Agents; C065637:choline transporter; D009569:Nitric Oxide; D052248:Nitric Oxide Synthase Type I; D014446:Tyrosine 3-Monooxygenase; D002795:Choline O-Acetyltransferase; D000109:Acetylcholine; D009638:Norepinephrine