DOI QR코드

DOI QR Code

Histology and immunohistochemistry of the human carotid sinus nerve

  • Davin Bryant (Tulane University School of Medicine) ;
  • Erin McCormack (Department of Neurological Surgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine) ;
  • Juan J. Cardona (Department of Neurological Surgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine) ;
  • Arada Chaiyamoon (Department of Neurological Surgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine) ;
  • Devendra Shekhawat (Department of Neurological Surgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine) ;
  • Francisco Reina (Department of Medical Sciences, Clinical Anatomy, Embryology and Neurosciences Research Group, University of Girona) ;
  • Ana Carrera (Department of Medical Sciences, Clinical Anatomy, Embryology and Neurosciences Research Group, University of Girona) ;
  • Joe Iwanaga (Department of Neurological Surgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine) ;
  • Aaron S. Dumont (Department of Neurological Surgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine) ;
  • R. Shane Tubbs (Department of Neurological Surgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine)
  • Received : 2023.03.24
  • Accepted : 2023.07.09
  • Published : 2023.12.31

Abstract

The carotid sinus nerve (CSN) is well known as mediating baroreflexes. However, studies of its detailed histological analysis are scant in the literature. Therefore, the current anatomical study sought to better elucidate the microanatomy of the CSN. Ten fresh frozen adult cadavers underwent dissection of the CSN. Then, it was harvested and submitted for histological and immunohistochemical staining. Specimens were all shown to be nerve fibers on histology and immunohistochemistry. We identified tyrosine hydroxylase positive fibers in all CSN specimens. These fibers were always found to be within the CSN and not on its surface i.e., epineurium. Based on our findings, the majority of fibers contained in the CSN are tyrosine positive in nature. Further studies are necessary to understand the true function of this autonomic nerve fibers.

Keywords

Acknowledgement

The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude [23].

References

  1. Toorop RJ, Scheltinga MR, Moll FL, Bleys RL. Anatomy of the carotid sinus nerve and surgical implications in carotid sinus syndrome. J Vasc Surg 2009;50:177-82.  https://doi.org/10.1016/j.jvs.2009.03.029
  2. Shoja MM, Rai R, Lachkar S, Iboroma Akobo S, Yilmaz E, Loukas M, Binello E, Gorjaian M, Griessenauer CJ, Iwanaga J, Tubbs RS. The carotid sinus nerve and the first English translation of Hering's original research on this nerve. Cureus 2019;11:e3898. 
  3. Kikuta S, Iwanaga J, Kusukawa J, Tubbs RS. Carotid sinus nerve: a comprehensive review of its anatomy, variations, pathology, and clinical applications. World Neurosurg 2019;127:370-4.  https://doi.org/10.1016/j.wneu.2019.04.064
  4. Andrew K, Iwanaga J, Loukas M, Oskouian RJ, Tubbs RS. A variant origin of the carotid sinus nerve. Cureus 2018;10:e2883.
  5. Porzionato A, Macchi V, Stecco C, De Caro R. The carotid sinus nerve-structure, function, and clinical implications. Anat Rec (Hoboken) 2019;302:575-87.  https://doi.org/10.1002/ar.23829
  6. Tubbs RS, Wellons JC 3rd, Patwardhan RV, Oakes WJ, Wyss JM. The effectiveness of Hering's nerve stimulation in controlling penicillin-induced seizures in the rat is dependent on the amygdala. Pediatr Neurosurg 2002;37:231-4.  https://doi.org/10.1159/000066213
  7. Tubbs RS, Patwardhan RV, Wellons JC 3rd, Oakes WJ. Cortical representation of Hering's nerve: a possible anatomical pathway for seizure cessation following electrical stimulation. Pediatr Neurosurg 2002;37:235-9. https://doi.org/10.1159/000066214
  8. Iwanaga J, Singh V, Takeda S, Ogeng'o J, Kim HJ, Morys J, Ravi KS, Ribatti D, Trainor PA, Sanudo JR, Apaydin N, Sharma A, Smith HF, Walocha JA, Hegazy AMS, Duparc F, Paulsen F, Del Sol M, Adds P, Louryan S, Fazan VPS, Boddeti RK, Tubbs RS. Standardized statement for the ethical use of human cadaveric tissues in anatomy research papers: recommendations from Anatomical Journal Editors-in-Chief. Clin Anat 2022;35:526-8.  https://doi.org/10.1002/ca.23849
  9. Kawagishi K, Fukushima N, Yokouchi K, Sumitomo N, Kakegawa A, Moriizumi T. Tyrosine hydroxylase-immunoreactive fibers in the human vagus nerve. J Clin Neurosci 2008;15:1023-6.  https://doi.org/10.1016/j.jocn.2007.08.032
  10. Rees PM. Observations on the fine structure and distribution of presumptive baroreceptor nerves at the carotid sinus. J Comp Neurol 1967;131:517-48.  https://doi.org/10.1002/cne.901310409
  11. Boyd JD. Observations on the human carotid sinus and its nerve supply. Anat Anz 1937;84:386-99. 
  12. Dean C, Seagard JL. Mapping of carotid baroreceptor subtype projections to the nucleus tractus solitarius using c-fos immunohistochemistry. Brain Res 1997;758:201-8.  https://doi.org/10.1016/S0006-8993(97)00245-X
  13. Seagard JL, van Brederode JF, Dean C, Hopp FA, Gallenberg LA, Kampine JP. Firing characteristics of single-fiber carotid sinus baroreceptors. Circ Res 1990;66:1499-509. https://doi.org/10.1161/01.RES.66.6.1499
  14. Drummond HA, Price MP, Welsh MJ, Abboud FM. A molecular component of the arterial baroreceptor mechanotransducer. Neuron 1998;21:1435-41. https://doi.org/10.1016/S0896-6273(00)80661-3
  15. Finley JC, Polak J, Katz DM. Transmitter diversity in carotid body afferent neurons: dopaminergic and peptidergic phenotypes. Neuroscience 1992;51:973-87. https://doi.org/10.1016/0306-4522(92)90534-9
  16. Yokoyama T, Nakamuta N, Kusakabe T, Yamamoto Y. Vesicular glutamate transporter 2-immunoreactive afferent nerve terminals in the carotid body of the rat. Cell Tissue Res 2014;358:271-5. https://doi.org/10.1007/s00441-014-1921-x
  17. Parry SW. Should we ever pace for carotid sinus syndrome? Front Cardiovasc Med 2020;7:44. 
  18. Abdala AP, McBryde FD, Marina N, Hendy EB, Engelman ZJ, Fudim M, Sobotka PA, Gourine AV, Paton JF. Hypertension is critically dependent on the carotid body input in the spontaneously hypertensive rat. J Physiol 2012;590:4269-77. https://doi.org/10.1113/jphysiol.2012.237800
  19. Conde SV. Ablation of the carotid bodies in disease: meeting its adverse effects. J Physiol 2018;596:2955. 
  20. Conde SV, Sacramento JF, Melo BF, Fonseca-Pinto R, Romero-Ortega MI, Guarino MP. Blood pressure regulation by the carotid sinus nerve: clinical implications for carotid body neuromodulation. Front Neurosci 2022;15:725751.
  21. Epstein SE, Beiser GD, Goldstein RE, Redwood D, Rosing DR, Glick G, Wechsler AS, Stampfer M, Cohen LS, Reis RL, Braunwald NS, Braunwald E. Treatment of angina pectoris by electrical stimulation of the carotid-sinus nerves. N Engl J Med 1969;280:971-8. https://doi.org/10.1056/NEJM196905012801801
  22. Bisognano JD, Bakris G, Nadim MK, Sanchez L, Kroon AA, Schafer J, de Leeuw PW, Sica DA. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from the double-blind, randomized, placebo-controlled rheos pivotal trial. J Am Coll Cardiol 2011;58:765-73. https://doi.org/10.1016/j.jacc.2011.06.008
  23. Iwanaga J, Singh V, Ohtsuka A, Hwang Y, Kim HJ, Morys J, Ravi KS, Ribatti D, Trainor PA, Sanudo JR, Apaydin N, Sengul G, Albertine KH, Walocha JA, Loukas M, Duparc F, Paulsen F, Del Sol M, Adds P, Hegazy A, Tubbs RS. Acknowledging the use of human cadaveric tissues in research papers: recommendations from anatomical journal editors. Clin Anat 2021;34:2-4. https://doi.org/10.1002/ca.23671