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. 2023 Dec 1;325(6):H1304-H1317.
doi: 10.1152/ajpheart.00299.2023. Epub 2023 Sep 22.

Real-time in vivo thoracic spinal glutamate sensing during myocardial ischemia

Affiliations

Real-time in vivo thoracic spinal glutamate sensing during myocardial ischemia

Siamak Salavatian et al. Am J Physiol Heart Circ Physiol. .

Abstract

In the spinal cord, glutamate serves as the primary excitatory neurotransmitter. Monitoring spinal glutamate concentrations offers valuable insights into spinal neural processing. Consequently, spinal glutamate concentration has the potential to emerge as a useful biomarker for conditions characterized by increased spinal neural network activity, especially when uptake systems become dysfunctional. In this study, we developed a multichannel custom-made flexible glutamate-sensing probe for the large-animal model that is capable of measuring extracellular glutamate concentrations in real time and in vivo. We assessed the probe's sensitivity and specificity through in vitro and ex vivo experiments. Remarkably, this developed probe demonstrates nearly instantaneous glutamate detection and allows continuous monitoring of glutamate concentrations. Furthermore, we evaluated the mechanical and sensing performance of the probe in vivo, within the pig spinal cord. Moreover, we applied the glutamate-sensing method using the flexible probe in the context of myocardial ischemia-reperfusion (I/R) injury. During I/R injury, cardiac sensory neurons in the dorsal root ganglion transmit excitatory signals to the spinal cord, resulting in sympathetic activation that potentially leads to fatal arrhythmias. We have successfully shown that our developed glutamate-sensing method can detect this spinal network excitation during myocardial ischemia. This study illustrates a novel technique for measuring spinal glutamate at different spinal cord levels as a surrogate for the spinal neural network activity during cardiac interventions that engage the cardio-spinal neural pathway.NEW & NOTEWORTHY In this study, we have developed a new flexible sensing probe to perform an in vivo measurement of spinal glutamate signaling in a large animal model. Our initial investigations involved precise testing of this probe in both in vitro and ex vivo environments. We accurately assessed the sensitivity and specificity of our glutamate-sensing probe and demonstrated its performance. We also evaluated the performance of our developed flexible probe during the insertion and compared it with the stiff probe during animal movement. Subsequently, we used this innovative technique to monitor the spinal glutamate signaling during myocardial ischemia and reperfusion that can cause fatal ventricular arrhythmias. We showed that glutamate concentration increases during the myocardial ischemia, persists during the reperfusion, and is associated with sympathoexcitation and increases in myocardial substrate excitability.

Keywords: arrhythmia; glutamate neurotransmitter; myocardial ischemia; real-time biosensing; spinal cord neural network.

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Conflict of interest statement

No conflicts of interest, financial or otherwise, are declared by the authors.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Electrode design. A: graphic of the photolithography process. B: schematic of the probe design. C: schematic of how the glutamate sensors work.
Figure 2.
Figure 2.
Simultaneous in vivo spinal glutamate and cardiac electrophysiological recordings. A: after T1–T4 laminectomy, the glutamate-sensing probe was inserted in the dorsal horn region of the spinal cord at the T2–T3 level. B: myocardial ischemia was induced by ligating the suture that was placed around the left anterior descending (LAD) coronary artery. Myocardial ischemia was confirmed by observing the ST-elevated electrograms (EGMs) in the ischemic region. LV/RV, left/right ventricle. C: number of ST-elevated leads increased during myocardial ischemia (n = 6 animals before LAD vs. 6 animals during LAD; *P = 0.031, Wilcoxon test). D: after sternotomy, the 56-channel sock electrode was placed around the heart to record the electrocardiogram. The activation recovery interval (ARI) was measured by subtracting the activation time (AT) from the recovery time (RT). E: representative activation recovery interval shortening during myocardial ischemia from 1 pig. A and B were created with a licensed version of BioRender.com.
Figure 3.
Figure 3.
In vitro glutamate sensor performance. A: photo demonstrating the flexibility of the probe. B: electrochemical impedance spectroscopy (EIS) and phase angle of all 6 sites on 3 probes with high reproducibility within electrodes and between electrodes. C: cyclic voltammetry (CV) of an electrode. D: sensors in a stirred solution of PBS. Electrodes do not respond to additions of ascorbic acid (AA). Glutamate sites respond to glutamate but not to the addition of AA, whereas sentinel electrode does not respond to either glutamate or AA. All sites respond to hydrogen peroxide. E: calibration curve shows a wide range of activity for the glutamate sites and no activity for the sentinel.
Figure 4.
Figure 4.
Performance of flexible glutamate probe in ex vivo and in vivo setting. A: photo of electrode inserted into the pig’s spinal cord. B: ex vivo injections of PBS and glutamate into a spinal cord. Three individual glutamate electrodes (red, green, and blue) do not sense the PBS, but the injected glutamate is sensed by the glutamate sensor probe. C, left: photo of the stiff NeuroNexus probe. Right: photo of our developed flexible probe. D: data were recorded during motion artifacts with a stiff acute NeuroNexus probe and our flex probe, both inserted and recorded at the same time. E, left: polyethylene glycol (PEG)-assisted probe. Right: tip of an electrode assembled with sharpened tungsten. F: sharpened shuttle method results in significantly more detected glutamate in vivo because of the PEG covering the electrodes’ surface.
Figure 5.
Figure 5.
Simultaneous in vivo spinal glutamate and cardiac electrophysiological recordings. A: myocardial ischemia-reperfusion injury caused an augmentation in the percent change of glutamate from baseline (Friedman test, ****P < 0.0001). Glutamate did not change during the first 15 min of the left anterior descending (LAD) coronary artery occlusion (n = 12 electrodes pre-LAD vs. 12 electrodes during LAD15, P = 0.63). LAD between 15 and 30 min (n = 12 electrodes pre-LAD vs. 12 electrodes during LAD30, *P = 0.032), LAD between 30 and 45 min (n = 12 electrodes pre-LAD vs. 12 electrodes during LAD45, ***P = 0.0002), LAD between 45 and 60 min (n = 12 electrodes pre-LAD vs. 12 electrodes during LAD60, ****P <0.0001), and reperfusion (Rep) (n = 12 electrodes pre-LAD vs. 12 electrodes during reperfusion, ****P <0.0001) caused an increase in the percent change of glutamate from baseline. For each comparison, Dunn’s multiple comparisons test was used. B: representative glutamate (Glu), activation recovery interval (ARI), and dispersion of repolarization (DOR) response during LAD ischemia. C: glutamate and DOR increased during the LAD ischemia and reperfusion, whereas the ARIs decreased during the ischemia-reperfusion injury.

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