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1
Departments of
* Neurology and
Neurosciences, Case Western Reserve University School of Medicine, Louis Stokes Cleveland Veterans Affairs Medical Center, University Hospitals of Cleveland, Cleveland, Ohio 44106, USA
1Correspondence: Department of Neurology, University Hospitals of Cleveland, 11100 Euclid Ave., Cleveland, OH, 44106, USA. E-mail: hjk3{at}po.cwru.edu
| ABSTRACT |
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Key Words: extraocular muscle nitric oxide muscle contractility neuronal nitric oxide synthase
| INTRODUCTION |
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The EOMs are anatomically divided. A global region lies adjacent
to the eye and the orbital region is next to the bony orbit. The global
layer inserts directly on the eye, whereas the orbital layer was
appreciated recently to insert not on the globe, as always thought, but
on a fibroelastic tissue pulley system within the orbit
(5)
. At least for the rectus muscles, the global layer
serves to rotate the globe whereas the orbital layer inserts on its
pulley to position it linearly and thus influence the EOMs rotational
axis. This arrangement appears to account for various aspects of ocular
dynamics and kinematics.
The traditional classification schemes used for skeletal muscle fibers
cannot be applied to EOM (Table 1
) (3
, 6)
. EOM fibers are best categorized into six distinct
fiber types based on anatomic location, innervational pattern, and
mitochondrial/oxidative enzyme contents. Eighty percent of EOM fibers
are singly innervated fibers (SIFs), similar to those typical of other
skeletal muscles. The orbital region contains a specific type of SIF,
whereas the global region contains three types of SIFs. The orbital SIF
fiber has a high oxidative capacity and is similar to typical type 2A
fibers, but expresses embryonic/neonatal, an EOM-specific, as well as
type 2A myosin isoforms (7
, 8)
. The global SIFs were
categorized by Spencer and Porter (3)
into three distinct
fiber types. The global red SIF expresses only the 2A myosin isoform
and in that sense is similar to type 2A fibers of other skeletal
muscle, but has a higher mitochondrial content. The global intermediate
SIF expresses the 2B myosin isoform and moderate levels of oxidative
and anaerobic enzymes, whereas the global pale SIF is most similar to
type 2B fibers with few mitochondria and a fast myofibrillar ATPase.
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The remainder of EOM fibers are multiply innervated fibers (MIFs),
which are rarely found in other mammalian skeletal muscles. The global
MIFs contract in a graded or tonic fashion; the orbital MIFs can
undergo graded contractions at their ends, but have twitch properties
at their center (1
, 2
, 9)
. The role of each of the fiber
types in generation of eye movements is not known, and current theories
suggest that each fiber contributes to all movements.
Nitric oxide (NO) is a free radical gas generated by nitric oxide
synthases (NOS). In skeletal muscle, the neuronal isoform is the
predominant form expressed as a splice variant from that found in the
brain and is concentrated to the sarcolemma of fast-twitch fibers
(10
, 11)
. Since the majority of EOM fibers are similar to
fast-twitch fibers, EOM would be expected to have a high percentage of
neuronal NOS (nNOS) -containing fibers. Endothelial NOS is abundant in
skeletal muscle vasculature, but otherwise is present only at low
levels in fast- and slow-twitch skeletal muscle fibers, colocalizing
with mitochondrial markers (12)
. The inducible NOS isoform
is present at low levels in rodent and human muscles, and its
expression is induced by inflammatory conditions (13
, 14)
.
EOM contracts against a relatively small mechanical load consisting of
the globe and connective tissue, and it is not surprising that studies
of a variety of species find that EOM generates a low level of
total force (15
16
17)
. EOM fibers across species are
smaller than those of other skeletal muscle, with diameters of the
orbital MIFs averaging 20 µm and the largest global SIF 46 µm
(3
, 4)
. This is in contrast to limb and diaphragm fibers,
which have mean diameters ranging from 35 to 75 µm (18)
.
However, even when normalized for their small size, EOM fibers generate
low levels of force (4
, 16)
.
NO reduces muscle contractile force and has a short diffusion
range estimated in tissue to be at most 50 µm (14
, 19)
.
Because EOM fibers are small, the influence of NO on contractility may
be more prominent than on other muscles with NO affecting the fiber
expressing nNOS, but also neighboring fibers, and offers a mechanism by
which EOM force generation may be reduced. In this investigation we
characterize nNOS expression in EOM and the influence of NO on EOM
force generation.
| MATERIALS AND METHODS |
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For contractile studies, one lateral rectus muscle was used for each experiment. The lateral rectus was removed by lateral orbitotomy after removal of the brain. The posterior orbital processes of the frontal and zygomatic bones were cut. The eyelid was detached and the tissues surrounding the eye were removed. The lateral rectus muscle was identified and part of the sclera on either side of the muscle attachment was cut; the muscle was separated with its attachment to the sphenoid bone. The muscle was kept moist with 37°C oxygenated saline. The physiological saline solution was composed of (mM): 135 NaCl, 5 KCl, 2.5 CaCl2, 1 MgSO4,1 NaH2PO4, 15 NaHCO3, and 11 glucose with pH adjusted to pH 7.4. The saline was maintained at 37°C and oxygenated with 95% O2 and 5% CO2. Incisions were made around the attachment of the muscles to the orbital rim. This separated and isolated all the EOMs with their attachments to the sphenoid bone on one end and the eye on the other. The EOMs, eyeball, and part of the sphenoid bone were transferred to a tissue bath containing physiological saline solution, maintained at 37°C, and oxygenated with 95% O2 and 5% CO2. The eye, all other muscles, and connective tissues (except the lateral rectus) were trimmed, leaving the lateral rectus muscle with portions of sclera on one end and sphenoid bone attached to the other end. The muscle was placed vertically in a double-jacketed, tissueorgan bath containing an oxygenated, physiological saline solution at 37°C. The muscle was placed between a pair of platinum electrodes (Radnoti Glass Technology, Monrovia, CA) and stimulated by an electrical field generated between these electrodes. The sphenoid attachment was tied by silk suture (6/0) to an immobile hook at the lower end of the electrode. The other end with the scleral part was attached to an isometric transducer (Radnoti Glass Technology). The transducer was connected to a computer through an Axon Instruments Digidata 1200 series A/D interface for recording the contractile force produced during electrical stimulations.
nNOS catalytic activity
Neuronal NOS activity was determined by measuring the
conversion of 3H arginine to
3H citrulline at 23 ± 1°C, as described
previously (20
, 21)
. Muscles were homogenized on ice in 25
mM Tris-HCl, 1 mM EDTA, 1 mM EGTA. The homogenate was assayed using a
kit produced by Stratagene (La Jolla, CA) that specifically measures
neuronal nNOS activity. The isolated 3H
citrulline was quantitated by liquid scintillation spectroscopy.
Protein concentrations of the extracts were determined using the
Bio-Rad protein assay (Hercules, CA). Activity was expressed as
picamoles of citrulline conversion min-1
mg-1 of protein (20)
. Each sample
was measured in triplicate and results combined for analysis from three
animals.
NADPH diaphorase histochemistry
Using only EOM, nNOS expression was localized by NADPH
diaphorase histochemistry (22)
and EOM fibers were
classified into the six types described by Spencer and Porter
(3)
. NADPH diaphorase staining is a marker of nNOS and was
performed by the method of Dawson et al. (23)
with
modifications (24)
. Serial 8 µm-thick cryostat sections
were fixed at 4°C for 10 min in 4% paraformaldehyde in
phosphate-buffered saline (PBS), pH 7.4. After three rinses in PBS for
10 min, the sections were incubated in 0.2% Triton X-100 for 10 min at
37°C. The reaction was performed in a dark, humidified chamber at
37°C for 40 min in 0.2% Triton X-100, 0.1 mM NADPH, and 0.16 mg
ml-1 nitro blue tetrazolium chloride. The
reaction was terminated by a water wash and the sections were mounted
with Immu-mount (Shandon, Pittsburgh, PA). Intense sarcolemmal staining
that rings the fiber readily identifies positive fibers. A modified
trichrome staining procedure was performed on serial sections to
identify EOM fiber types (25)
. Only sections from the
midbelly of the muscle were used to correlate fiber type and NADPH
diaphorase staining. Six EOM fiber types are readily differentiated by
the trichrome stain and anatomic location (Table 1)
(3
, 26)
. In cross section, a narrow C-shaped region outlines the
muscle, which is the orbital region that contains an orbital SIF (type
1) with a coarse appearance with the trichrome stain and an orbital MIF
(type 2) with a fine, granular appearance. The larger global
region contains three SIFs (types 35) and a global MIF (type 6). Each
has a distinct trichrome staining pattern (3)
.
Histological images were obtained using a SPOT digital camera
(Diagnostic Instruments Inc., Sterling Heights, MI) and analyzed by
Image-Pro plus software (Media Cybernetics, Silver Spring, MD). The
degree of sarcolemmal staining was graded as intense (++), moderate
(+), or absent (-).
Contractile studies
A Grass stimulator (Model S8800) was used to
stimulate the muscles. The stimulator was connected to a stimulus
isolation unit (Model SIU5, Grass Instrument Division) to minimize
artifacts. The stimulus isolation unit was connected to a stimulus
booster (Stimu-Splitter II, Med-Lab Instruments), which in turn was
connected to the stimulation electrodes. The muscle length was adjusted
so that the twitch tension was maximal. The length of the muscle
(L0) was maintained throughout the experiment.
Four or five animals were used for each drug. For baseline and drug
treatments, the following stimulation protocol was used. The voltage
and pulse duration were adjusted to obtain the maximal response from
the muscle. Six twitches and six trains were recorded from each muscle
during each experimental condition. Consecutive twitches at regular
intervals of 30 s were first recorded. A fused tetanic force
response always occurred at
200 Hz for the lateral rectus. For
tetanic contraction studies, 200 Hz stimulation was performed with a
train duration of 333 ms and a train interval of 30 s.
Muscle stimulation records were digitized using the program Axotape
(Axon Industries, Forest City, CA). The length of the muscle was
measured. The muscle was blotted and weighed after removing the bone
and tendon. Muscle area was calculated as muscle weight (grams) divided
by the product of fiber length (centimeters) times the density of the
muscle (1.06/cm (3)
(27)
. Because of the size
variability of the muscles, the force was normalized and force
generated (in grams) was converted to Newtons.
Solutions and drugs
L-NAME and spermineNONOate were purchased
from Molecular Probes (Eugene, OR). S-nitrosoacetylcysteine (SNAC) was
prepared as described by Kröncke and Kolb-Bachofen
(28)
. Cysteine HCl and NaNO2, used
for production of SNAC, were purchased from Sigma Chemical (St. Louis,
MO). Spent SNAC was prepared by leaving the SNAC solution overnight
at room temperature to react completely. The drugs were added directly
to the physiological saline solution in the tissueorgan bath. The
drugs were prepared fresh for each experiment and added to the
tissueorgan bath to achieve the desired concentrations:
L-NAME, 200 µM; SNAC, 1 mM; spermineNONOate, 2 mM.
Baseline recordings were made before the addition of the drug. Fifteen
minutes after addition of L-NAME solution, the stimulation
protocol was repeated. In experiments with SNAC, spent SNAC was added
after baseline recordings. Twitches and trains were repeated and
recorded after 45 min. Then the tissueorgan bath was flushed and
fresh physiological saline was added. Freshly prepared SNAC was added
and the stimulation protocol was repeated after 45 min. SpermineNONOate
spontaneously releases NO with a half-life of
40 min (29
, 30)
. Twitches and trains were recorded at 2 and 40 min after the
addition of spermineNONOate. After 50 min, the tissueorgan bath was
flushed and filled with fresh 37°C physiological saline solution.
Stimulations were repeated after 40 min. Twitches and trains were
recorded at 15, 30, and 60 min for studying the recovery of the
contractile force after flushing the test solution. There was a gradual
increase in the tension for up to 40 min and a decrease at 60 min.
Statistical analysis
The data were analyzed and tested for statistical significance
(P<0.05) using ANOVA and one-sample t tests.
Tables show mean values, the standard error, and the number of muscles
studied.
| RESULTS |
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nNOS catalytic activity
Results of nNOS catalytic activity are summarized in Table 2
. EOM had the highest level of nNOS activity. EDL activity was
significantly greater than diaphragm and soleus muscles
(P<0.0001), but no difference existed between diaphragm and
soleus (P<0.67).
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NO studies of contractility
Figure 2
shows the digitized records of 200 Hz tetanic contractions of the
lateral rectus before and after the addition of the NO modulators.
Table 3
shows the effect of NO-modulating agents on EOM twitch and tetanic
tension. The nNOS inhibitor L-NAME increased the peak
twitch tension by 28%. Peak tetanic tension showed a mean increase of
32% 15 min after addition of L-NAME.
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The NO donors SNAC and spermineNONOate both significantly reduced the
peak twitch and tetanic tensions. S-Nitrocysteine decomposes
generating NO and cystine (21
, 28)
. The effect on
contractility of a solution that had been fully reacted (spent SNAC)
was tested to assure that cystine did not contribute to alterations in
contractility. Spent SNAC decreased the peak twitch tension by 6% and
the peak tetanic tension by 12%. This reduction in the contractile
force may be due to the action of cystine or the SNAC may not have been
fully reacted or spent. SNAC produced a decrease of 33% in twitch and
22% in tetanic contractile force compared with the baseline values.
The percentage reduction in force after subtracting the reduction in
force due to the action of spent SNAC was 27% and 10%, respectively,
for twitch and tetanus. This reduction in force noticed after the
action of spent SNAC was interpreted as due to the action of NO.
SpermineNONOate produced a dramatic and rapid reduction in twitch tension. A mean decrease of 37% was observed after 2 min. The tension continued to decrease; a mean reduction of 59% occurred 40 min after addition of the drug. Mean peak tetanic contractions showed a 32% decrease after 2 min and a 38% decrease after 40 min. Flushing and addition of physiological saline resulted in an increase in contractile force, but not to predrug treatment levels.
| DISCUSSION |
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NADPH diaphorase staining was localized to the sarcolemma of all the
orbital and global SIF EOM fiber types. Although the fiber
classification used in other skeletal muscle cannot be applied to the
EOM, the EOM SIFs are most similar to the fast-twitch fibers of other
skeletal muscle based on myosin isoform expression and oxidative
capacity (26)
. A true slow-twitch fiber is not observed in
the primary EOMs. The present results are consistent with nNOS activity
and expression in other skeletal muscles being limited to fast-twitch
fibers (11
, 21)
. The type 5 global SIF had qualitatively
less NADPH diaphorase staining. The significance of this observation
cannot be determined from this examination. This fiber type has low
mitochondrial content, a fast ATPase profile, and modest levels of
oxidative enzymes, and therefore has a low fatigue resistance. Because
of this profile, the fiber type is thought to be recruited only
sporadically during eye movements (26)
. From a functional
standpoint, nNOS expression may be less important for this type of
fiber. The orbital and global MIF fibers had no NADPH diaphorase
activity. The global MIFs contract in a graded or tonic fashion whereas
the orbital MIFs have contractile characteristics intermediate to those
of twitch and tonic fibers (9)
. The degree of force
generation in tonic fibers is dependent on the rate of neuronal
stimulation. Therefore, NO generation is not expected to be a mechanism
for modulation of contractile force in MIFs.
The NO donors SNAC and spermineNONOate decreased tetanic tension and
maximum twitch, and the nNOS inhibitor L-NAME increased
force generation of isolated lateral rectus. Skeletal muscle tonically
produces NO, which functions as an endogenous modulator of muscle
function at both the tissue and cellular levels (31)
.
Using the rat diaphragm, extensor digitorum longus, and soleus, Kobzik
et al. (11)
found during submaximal tetanic contractions a
mean reduction of
1% in isometric force for the NO donor SNAC and
3% for another NO donor, sodium nitroprusside, whereas nNOS
blockade with nitro-L-arginine at a 1 mM concentration
increased contraction by
8%. Under the experimental conditions used
in this study, the effect of NO-modulating agents was much more
dramatic on EOM than observed in other skeletal muscles.
L-NAME increased force of the twitches by 28%; SNAC
reduced isometric twitch tension by 26% and spermineNONOate
produced a reduction of 60%. The more prominent reduction by
spermineNONOate may be due to its rapid generation of NO and the effect
of spermine (32)
. Flushing and the addition of fresh
physiological saline resulted in a 10% reversal in the contractile
force of twitch tension and 18% reversal in the tetanic force. This
partial reversal may be due to toxic effects of NO (33)
or
slowly reversible nitrotyrosine modification of proteins (34
, 35)
.
The effect of NO on muscle contractility appears to be influenced by
experimental design and the muscle studied. The force of contraction of
soleus, a predominantly slow-twitch muscle, was increased by the NO
donor nitroprusside (36)
. The same group subsequently
reported (37
, 38)
that NO decreased the contractility of
the canine soleus muscle in vitro and the gastrocnemius-plantaris of
mouse in situ. They hypothesized that the differences in stimulation
parameters contributed to the opposite conclusions reached by their
studies. In the present study, the choice of NO donor significantly
influenced the effect on NO contractility. Others have observed
variations in response dependent on the choice of the NO-modulating
agent (11
, 39)
.
Peak twitch and tetanic contractile force of EOM are less than with
other skeletal muscles even when normalized to the cross-sectional area
(4
, 15
, 40
, 41)
. Loss of fiber excitability, a greater
amount of connective tissue, or low force output of the myofibrils have
been postulated to explain the low levels of force generation of EOMs.
In addition, different myofibrils may have fewer numbers of active
cross bridges. However, single, skinned rabbit EOM fibers generate
maximum isometric force levels similar to limb fibers, even though the
normalized force response of the intact muscles is low (4
, 16)
. Therefore, actomyosin cross bridge formation appears to be
similar to limb muscles. The MIFs may not generate similar amounts of
force as the SIFs and effectively reduce the total contractile force of
EOM (4)
. From the present study, the high level of NO
generation coupled with the small fiber size of EOM may also serve to
reduce force generation.
The mechanism of NO modulation of force generation in non-EOM
skeletal muscle appears to operate via several mechanisms, but
primarily by the modulation of cGMP pathways and myofibrillar adenosine
triphosphatase (ATPase) activity. Inhibition of guanylyl cyclase
increases force generation of the diaphragm, whereas cGMP analogs and
phosphodiesterase inhibition reduce force (11)
. EOM
contractility is affected in a similar fashion (unpublished
observations), but agents that modulate NO directly affect contraction
to a greater degree than cGMP modulators. NO donors also decrease
myofibrillar ATPase (42)
and creatine kinase activity
(43
, 44)
, which, if occurring in EOM, would reduce
contractility. Meszaros and Bak (45)
showed that NO
decreases the rate of Ca2+ release from
intracellular stores (like sarcoplasmic reticulum), which may lead to
diminished contractility. Galler and co-workers (42)
observed that S-nitroso-N-acetylpenicillamine depressed both mechanical
properties and myofibrillar ATPase activity of rat skeletal muscle.
They suggested that NO has a direct inhibitory effect on the
force-generating proteins in skeletal muscle. In studies of single
fibers from the mouse, Andrade et al. (46)
found that NO
impairs Ca2+ activation of the actin filaments,
which results in decreased myofibrillar Ca2+
sensitivity.
The present results suggest that NO plays a greater role in contraction
of EOM than in other skeletal muscles. NO has a short diffusion range
and interacts rapidly with its targets (47)
. The small
caliber of EOM fibers coupled with high rates of NO synthesis could
contribute to NO affecting EOM contraction to a greater extent in vivo.
During muscle contraction NO is generated by contracting muscle, which
may hasten recovery from activity by dampening muscle contractile
force, increasing glucose uptake and muscle blood flow (47
, 48)
. EOMs have a rich vascular bed and are constantly active. In
addition to effects on contraction, NO generated by contracting EOMs
may be important in matching contractile activity with the metabolic
requirements of the muscle.
In summary, nNOS is exclusively localized to the SIFs of EOM, which has high total levels of nNOS catalytic activity. In contrast to other skeletal muscles, NO-acting agents have greater effects on EOM contractility. The more prominent reduction of EOM contractile force by NO offers an additional mechanism to explain why EOM generates a low level of force compared with other skeletal muscles. This property of EOM likely is important in their specialized role in generation of eye movements and further adds to the complexity of this specialized muscle group.
| ACKNOWLEDGMENTS |
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Received for publication December 21, 2000.
Revision received April 16, 2001.
| REFERENCES |
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