Central actions of nitric oxide in regulation of autonomic functions.

The identification of nitric oxide (NO) as a gaseous, nonconventional neurotransmitter in the central nervous system has led to an explosion of studies aimed at learning about the roles of NO, not only at a cellular level, but also in regulating the activity of specific physiological systems that are coordinated by the brain. In the 1980s, publications began to appear which pointed to a role for NO in regulating peripheral autonomic function. In the 1990s, it became apparent that NO also acts centrally to affect autonomic responses. In this review, I will discuss the state of the current knowledge about the central role of NO in physiological functions which are related specifically to the control of sympathetic output. Studies which do not differentiate a central from a peripheral role for NO in these functions have not been included. After a brief discussion about the cellular events in which NO is involved, the distribution of NO-producing neurons in central autonomic areas of the brain will be presented. The more general actions of central NO in regulating sympathetic activity, as assessed with i.c.v. injections of pharmacological agents, will be followed by more specific sites of action achieved with microinjections into discrete brain areas. The review will be concluded with discussions about central NO in two physiological states of sympathetic imbalance, hypertension and stress. Copyright 1999 Elsevier Science B.V.