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Vol. 54, Issue 2, 285-322, June 2002

The Tachykinin Peptide Family

Cinzia Severini, Giovanna Improta, Giuliana Falconieri-Erspamer, Severo Salvadori and Vittorio Erspamerdagger

Consiglio Nazionale delle Ricerche-Institute of Neurobiology and Molecular Medicine, Rome, Italy (C.S.); Department of Human Physiology and Pharmacology "Vittorio Erspamer", University "La Sapienza", Rome, Italy (G.I., G.F.-E., V.E.); and Department of Pharmaceutical Sciences, Università degli Studi, Ferrara, Italy (S.S.)

Abstract
I. Introduction
II. Occurrence and Species Distribution of Tachykinin-Like Peptides
    A. Invertebrate Tachykinin-Like Peptides
    B. Prevertebrate Tachykinin-Like Peptides
        1. Amphioxus lanceolatus.
        2. Tunicata (Protocordata).
    C. Submammalian Vertebrate Tachykinins
        1. Amphibian Skin Tachykinins.
        2. Brain and Gut Tachykinins.
    D. Mammalian Tachykinins
        1. Mammalian Tachykinins and Their Biosynthesis.
III. Localization of Tachykinin-Like Peptides
    A. Non-Neuronal Localization
        1. Amphibian Skin.
        2. Invertebrate Salivary Glands.
        3. Normal Mammalian Tissues.
    B. Neuronal Localization
IV. Relationships between Structure/Activity Receptor Selectivity
    A. Residue Occupying Position 7 from the C Terminus
    B. Residue Occupying Position 4 from the C Terminus
    C. Residue Occupying Position 6 from the C Terminus
    D. Amino Acid Substitutions in the C-Terminal Tripeptide
    E. Pro Residue in the N-Terminal Sequence
V. Tachykinin-Like Peptides: Pharmacological Actions
    A. Cardiovascular System
        1. Systemic Arterial Blood Pressure
        2. Regional Circulation.
    B. Gastrointestinal Tract
        1. Motility.
        a. In Vitro Experiments.
        b. In Vivo Experiments.
        2. Secretions.
    C. Airways System
    D. Urogenital Tract
    E. Immune System
    F. Central Nervous System
        Action on discrete selected brain areas.
    G. Pain
    H. Neurogenic Inflammation
    I. Miscellaneous Pharmacological Actions
        1. Lachrymal Secretion.
        2. Histamine Release.
VI. Tachykinins in Human Diseases and Therapeutics
    A. Tachykinin Receptor Agonists
    B. Tachykinin Receptor Antagonists
VII. General Conclusions
References


    Abstract
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The tachykinin peptide family certainly represents one of the largest peptide families described in the animal organism. So far, more than 40 tachykinins have been isolated from invertebrate (insects, worms, and molluscs), protochordate, and vertebrate (skin, gastrointestinal tract, peripheral and central nervous system) tissues. Substance P (SP), first identified by bioassay as early as 1931 but sequenced only in 1971, several years after the elucidation of the structure of eledoisin from molluscan tissues and of physalaemin from amphibian skin, may be considered as a prototype of the tachykinins. Hitherto, as many as 19 tachykinins have been isolated from amphibian integument, and eight additional peptides have been isolated from amphibian gut and brain. Counterparts of skin tachykinins in mammalian tissues are SP, neurokinin A, and neurokinin B. Three main receptor subtypes for the tachykinins have been identified (NK1, NK2, and NK3), but their number is probably destined to increase. It is obvious that the peripheral and central effects of the tachykinins may substantially vary depending on the activation of different receptor subtypes. Matters are further complicated by the frequent capacity of the single tachykinins to bind, although with different affinity, to more receptors. It has been recognized that tachykinins have a variety of effects in physiological and pathological conditions, and there is evidence suggesting intrinsic neuroprotective and neurodegenerative properties of these neuropeptides. This review provides an update on the current body of knowledge regarding tachykinin occurrence and distribution in the animal kingdom, from the lowest invertebrates to man, and the physiological and pharmacological actions of tachykinins outlining the pregnant importance of this large peptide family.


    I. Introduction
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Seventy years ago, von Euler and Gaddum described an unidentified substance present in alcoholic extracts of equine brain and intestine that in the rabbit displayed a potent stimulant action on the jejunum and a hypotensive action that was distinct from all compounds then known to stimulate the gut and that was referred to as "P" on the tracings and the protocols.

Using semipurified preparations, numerous biological studies of its activity were carried out, but many efforts have been made to isolate the active substance. After some unsuccessful attempts on horse intestine, substance P (SP) was isolated in a pure form from bovine hypothalamus, and 40 years later, its structure was established by Chang and Leeman (1970). SP was then isolated in a pure form and sequenced also from horse intestine (Studer et al., 1973). SP was one of the most extensively studied active substances during the half-century since its discovery, and for many years, it was believed to be the only mammalian tachykinin considered to be a neuropeptide. This belief was firmly put to rest only in 1983 with the discovery of neurokinin A (NKA) and neurokinin B (NKB) (Kangawa et al., 1983; Kimura et al., 1983) that differ from SP in their pharmacological activity, both peripheral and central, and in their preference for different tachykinin receptor subtypes.

The story of the identification of SP was very similar to that leading to the discovery of nonmammalian tachykinins. In 1947, while investigating the occurrence of biogenic amines, especially serotonin in the posterior salivary glands of a Mediterranean octopod, Eledone moschata, an unidentified substance was found that again lowered blood pressure in rabbits and dogs, stimulated isolated preparations of intestinal smooth muscle, and caused profuse salivation in dogs and rats (Erspamer, 1949). The structure of this substance, first called moschatin and then eledoisin, was established in 1962 (Anastasi and Erspamer, 1962; Erspamer and Falconieri Erspamer, 1962). In the same year, it was found that extracts of the skin of the South American leptodactylid frog Physalaemus biligonigerus (formerly fuscumaculatus) also displayed eledoisin-like activity. Also the elucidation of the structure of physalaemin (Anastasi et al., 1964; Erspamer et al., 1964) recalled that of eledoisin and similarly was followed in rapid succession by the identification of a number of other related peptides in the skin, in the brain and gut of amphibians, and in brain and gut of submammalian species (from birds to agnata).

These peptides, all called tachykinins, represent the largest known peptide family, including members occurring in different animal species from low invertebrates to mammals. The possible occurrence of authentic tachykinins in invertebrates was confirmed by the isolation of two tachykinins from the salivary glands of a mosquito (Champagne and Ribeiro, 1994) and by the occurrence in nervous structures of the insect Locusta migratoria of four related peptides (the locustatachykinins) having structure homology with the vertebrate tachykinins (Schoofs et al., 1990a,b).

The identification of the locustatachykinins was soon followed by the isolation of similar peptides in other insects and in crabs, echinoid worms, and molluscs. It will be shown that locustatachykinin-like peptides, the number of which is destined to grow, have full citizenship right in the tachykinin peptide family, which with more than 40 members represents one of the largest, if not the largest, family in the peptide world.

The purpose of this review is, first, to keep the reader up to date on the different occurrences, species distributions, and localizations of the numerous members of the tachykinin peptide family. Second, because the identification and study of nonmammalian tachykinins has contributed conspicuously to the explosive progress of knowledge in the field of mammalian active tachykinins, we put in evidence the extensive pharmacological studies on the nonmammalian tachykinins (TKs) (eledoisin, physalaemin, and kassinin) whose availability preceded by years that of the corresponding mammalian peptides.


    II. Occurrence and Species Distribution of Tachykinin-Like Peptides
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At present among the numerous families of neuropeptides, which are evolutionarily the oldest neurotransmitters, perhaps even older than acetylcholine and catecholamines, four tachykinin-like peptides seem to occupy a very important position.

A. Invertebrate Tachykinin-Like Peptides

It is possible separate the tachykinin-like peptides in invertebrates into three groups: a) tachykinins identified by RIA and/or immunohistochemistry, occasionally accompanied by HPLC separation, but not isolated or sequenced; b) tachykinin-related peptides of the locustatachykinin type, isolated and sequenced, which have a C-terminal Arg-NH2 residue instead of the usual Met-NH2 residue present in all of the classical vertebrate tachykinins; and c) authentic tachykinins having structure and biological activity identical with those of the vertebrate tachykinins.

a. Substance P-like immunoreactivity (SP-LI) was localized in the primitive nervous system of Hydra (Taban and Cathieni, 1979; Grimmelikhuijzen et al., 1981; Pierobon et al., 1989), in the cerebral ganglion of the locust (Benedeczky et al., 1982), in the central nervous system of the cockroach Periplaneta americana (Verhaert and De Loof, 1985), in the retina and eyestalk neurones of the lobster Palinurus interruptus (Mancillas et al., 1981), in the eye stalk of the fiddler crab Uca pugilator (Fingerman et al., 1985), in the somatogastric system of the crab Cancer borealis and the lobster P. interruptus and Homarus americanus (Goldberg et al., 1988), in tissues of the earthworm Lumbricus terrestris (Aros et al., 1980; Kaloustian and Edmands, 1986), in the adult nervous system of the fly Sarcophaga bullata (Sivasubramanian, 1990), in the cricket Teleogryllus communis (Lembeck et al., 1985), in the brain and central ganglia of the bowfly Calliphora vomitoria and of Drosophila (Lundquist et al., 1994), in the brain, corpora cardiaca, and corpora allata of the insect Leucophaea madeirae (El-Salhy et al., 1983), in the central nervous system of the mollusc Limulus polyphemus (Mancillas and Selverstone, 1985), and in the nervous system of several parasitic trematode worms (Bush and Gupta, 1988) including Schistosoma mansoni (Gustafsson, 1987), Diphyllobathrium dendriticum (Gustafsson et al., 1986), Fasciola hepatica (Magee et al., 1989), and Diclidophora merlangi (Maule et al., 1989).

In a large number of invertebrate phyla from coelenterates to molluscs, in addition to the usual SP-like tachykinin, an NKA-like peptide has also been found. However, it is highly improbable that authentic SP or authentic NKA is present in invertebrates. First, because retention time of the invertebrate tachykinins in elution from reverse-phase HPLC columns never coincided with retention time of the mammalian tachykinins; and second, because authentic SP and/or NKA was never found, even in lower submammalian species (amphibian, fish, and agnata). It has also been shown that radioimmunoassay and immunohistochemical techniques are often insufficient to distinguish between structurally related peptides because of frequent lack of selectivity of the pertinent antisera. Callitachykinin II, for example, was recognized not only by an antiserum to the locustatachykinin (in both peptides the C-terminal residue is Arg-NH2) but also by an antiserum to the amphibian kassinin having, like all other classical tachykinins, the C-terminal residue Met-NH2 (Lundquist et al., 1994). Moreover, preincubation of locustatachykinin antibody with SP and preincubation of SP antibody with locustatachykinin blocked subsequent immunolabeling of the somatogastric nervous system in C. borealis, indicating that a member of the locustatachykinins is likely to be the source of the previously identified SP in the nervous system (Blitz et al., 1995).

b. Schoofs et al. (1990a,b) first described the occurrence in insects, more precisely in extracts of brain, corpora cardiaca-corpora allata, and suboesophageal ganglion of Locusta migratoria of five peptides, the locustatachykinins, which exhibited sequence homologies (up to 45%) with the vertebrate tachykinins, especially with amphibian and fish tachykinins. The locustatachykinins were completely inactive in all bioassay preparations used for the vertebrate tachykinins but showed a myotropic action in the insect intestine, eliciting a potent contraction of the cockroach hindgut (Winther et al., 1998).

The prediction of Schoofs' group in their first paper (Scoofs et al., 1990b) that "the peptides discovered in this study may be just the first in a whole series of substances from arthropod species to be identified as tachykinin family peptides" was correct even beyond any expectation. Up to the present, as many as 20 locustatachykinin-like peptides were isolated not only from various other arthropods, but also from an echinoid worm and from molluscs (Nassel, 1999). Table 1, reporting the present, probably provisional situation, shows that invertebrate tachykinin-like peptides are linear peptides with 8 to 15 amino acid residues and that, with the exception of the Leucophaea tachykinin-related peptide LemTRP10, they have at their C terminus an amidated Arg residue instead of the amidated Met residue, which is peculiar without exception to all classical tachykinins, including the invertebrate tachykinins (eledoisin and sialokinin I and II). Lem TRP1 is present also in two elongated forms with 17 (LemTRP2) and 19 (LemTRP3) amino acid residues, respectively (Winther et al., 1999).


                              
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TABLE 1
Amino acid sequence of invertebrate tachykinin-related peptides

In the light of appearance on the screen of the locustatachykinins and of the fact that locustatachykinin antisera may cross-react with SP, it is probable that in several and perhaps in most cases, the SP-LI described in a variety of invertebrates must be ascribed to locustatachykinin-like peptides. Thus, the locustatachykinin-like peptides of invertebrates must be considered authentic tachykinins, being either the primitive representatives of the tachykinin peptide family from which the vertebrate tachykinins have evolved by simple substitution of the C-terminal residue Arg-NH2 with Met-NH2 or an evolutionary adaptation for the invertebrates of a common ancestral tachykinin prototype already possessing the C-terminal Met-NH2 residue.

c. Authentic tachykinins with the classical C-terminal pentapeptide sequence Phe-(Tyr/Ile)-Gly-Leu-Met-NH2 occur in non-neuronal, epithelial cells of the posterior salivary glands of the Mediterranean octopods E. moschata and Eledone aldovrandi (eledoisin, up to 100 nmol/g wet tissue) (Erspamer and Falconieri Erspamer, 1962) and in the salivary glands of the mosquito Aedes aegypti (sialokinins I and II) (Champagne and Ribeiro, 1994): eledoisin, pGlu-Pro-Ser-Lys-Asp-Ala-Phe-Ile-Gly-Leu-Met-NH2; sialokinin I, Asn-Thr-Gly-Asp-Lys-Phe-Tyr-Gly-Leu-Met-NH2; sialokinin II, Asp-Thr-Gly-Asp-Lys-Phe-Tyr-Gly-Leu-Met-NH2.

These peptides display the full spectrum of activity of the mammalian tachykinins and bind to the same receptors. It is remarkable that eledoisin occurs only in Eledone but not in the strictly related Octopus vulgaris. Yet, the salivary glands of both Eledone and Octopus contain large amounts of biogenic amines: serotonin (up to 2 µmol/g), octopamine, tyramine, and histamine.

B. Prevertebrate Tachykinin-Like Peptides

1. Amphioxus lanceolatus. Radioimmunoassay combined with HPLC suggests the occurrence of small amount of SP-LI in brain and spinal cord of this prevertebrate species (Lembeck et al., 1985).

2. Tunicata (Protocordata). Using immunohistochemical techniques only, the presence of an antigen related to substance P has been demonstrated in the neuronal ganglion (Fritsch et al., 1979), gill epithelium (Fritsch et al., 1980), and alimentary tract (Fritsch et al., 1982) of the ascidian Ciona intestinalis. More recently, the occurrence of tachykinins in C. intestinalis tissues was re-examined by O'Neil et al. (1987) using specific antisera for the C terminus (C) of SP and the N terminus (N) of mammalian SP and NKA, completed with immunohistochemistry and reverse-phase HPLC of the tissue extracts. It was found that only C-SP-LI (not N-SP-LI) occurs both in cells of the ganglia and in peripheral neurons, together with but separately from N-NKA-LI. Only C-SP-LI was found in endocrine cells of the pharynx. However, we conclude that already at the prevertebrate stage of chordate evolution, the tachykinin family is represented by at least two distinct members that are provided by separate cell populations, none of which was identical with either mammalian SP or mammalian NKA.

C. Submammalian Vertebrate Tachykinins

The formidable enlargement of the tachykinin peptide family is consequent to systematic studies conducted on the one side on the amphibian skin and on the other side on the brain and intestines of submammalian vertebrates, mainly in their cold-blooded classes: reptiles, amphibians, fish, and agnata. The story of the group of the amphibian skin peptides began in 1964 with isolation and structure elucidation of physalaemin (Erspamer et al., 1964), followed by the systematic screening of peptide contents in the skin of as many as 600 amphibian species from all over the world, which resulted in the discovery and isolation of numerous neuropeptides, belonging to a dozen distinct families, among which is that of the tachykinins (with 21 members).

The fruitful search for tachykinin peptides in brain and gut of submammalian vertebrates started in 1986 with the isolation and structure elucidation of scyliorhinins I and II from dogfish intestine (Conlon et al., 1986a). At the end of 1998, a list of as many as 24 novel tachykinins was available, 12 from brain and 12 from gut. Skin tachykinins and brain/gut tachykinins will be discussed separately.

1. Amphibian Skin Tachykinins. Table 2 summarizes the present situation. The great majority of amphibian skin peptides have the classical C-terminal pentapeptide sequence: Phe-X-Gly-Leu-Met-NH2. However, important exceptions are represented by: 1) some tachykinins from the skin of the Australian frog Agalychnis callidryas, namely AC-AR1, -AR2, and -AR3 with the C-terminal pentapeptide sequence Phe-Tyr-Pro-Gly-Met-NH2 and AC-AR4 with sequence Phe-Tyr-Pro-Val-Met-NH2; and 2) hylambatin from the skin of the South-African frog Hylambates maculatus with the C-terminal pentapeptide sequence Phe-Tyr-Gly-Met-Met-NH2. It is evident that in the C-terminal pentapeptide only the Phe residue at position 5 from the C terminus and Met-NH2 are immutable.


                              
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TABLE 2
Amino acid sequence of natural amphibian skin tachykinins

All of the amphibian skin peptides have a non-neuronal origin, being synthesized in the syncytial cells dressing the wall of the granular glands. These cells are capable of cosynthesizing, costoring, and cosecreting not only peptides belonging to different families, but also amines and alkaloids belonging to various classes and families. The amphibian syncytial cells behave like some mammalian endocrine cells, e.g., the enterochromaffin cells, which may contain both biogenic amines and peptides (substance P, guanylin), and like a number of central and peripheral neurons in which amine messengers coexist with peptide messengers.

2. Brain and Gut Tachykinins. Table 3 summarizes the present situation. All of the tabulated tachykinins, with the exception of ranatachynin D, show the classical C-terminal pentapeptide Phe-X-Gly-Leu-Met-NH2. Of considerable interest is the fact that in goldfish, cod, and trout NKA-like peptides, the usual acidic Asp residue at position 7 from the C terminus, crucial for receptor NK2/NK3 selectivity, is replaced by the neutral Asn residue.


                              
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TABLE 3
Amino acid sequence of submammalian vertebrate tachykinins

The list of tachykinins shown in the Table 3 should be completed by authentic NKA occurring in the intestine of the chicken and of the alligator and in the brain of the python, and by authentic NKB found only in the brain of Rana esculenta.

Moreover, NKA is present in as many as six submammalian species also by its elongated form, the gamma -neuropeptides, as shown in Table 4. From the above sequences, it is evident that none of the submammalian gamma -neuropeptides is identical with the corresponding mammalian peptide. Substantial differences in the amino acid composition may be seen not only in the flanking sequence but in all examined fish, even in the NKA-like C-terminal decapeptides.


                              
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TABLE 4
Amino acid sequence of submammalian vertebrate gamma -neuropeptides

D. Mammalian Tachykinins

1. Mammalian Tachykinins and Their Biosynthesis. Until now, only three tachykinins have been isolated and sequenced from mammalian tissues: SP, NKA (neuromedin L, neurokinin, and substance k), and NKB (neurokinin and neuromedin k). NKA is present also in two elongated forms, neuropeptide K and neuropeptide-gamma (Table 5).


                              
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TABLE 5
Amino acid sequence of mammalian tachykinins

It is hardly conceivable, but of course it is possible, that mammalian tissues contain only three members of the tachykinin family. As a matter of fact, the number of mammalian species in which tachykinin peptides have been isolated is very scanty: horse and guinea pig intestine, porcine spinal cord, and in some additional species (rat and man) preprotachykinins have been detected. RIA or immunohistochemistry, again in a limited number of species and especially in the rat, has detected all other tachykinin locations. This is all. Yet fish present five different tachykinins in the brain and six in the gut, and the four examined amphibian species exhibit as many as nine different tachykinins altogether in the brain and the gut. It is evident that the occurrence even in mammalian tissues of tachykinins other than the three classical ones is likely. Lazarus group (Lazarus and Di Augustine, 1980; Lazarus et al., 1980), using an antiserum specifically recognizing the N-terminal region of physalaemin, was able to detect a physalaemin-LI in a number of tissues of three mammalian species (guinea pig, mouse, and rat) with peaks in guinea pig and mouse gastric fundus, pylorus, and duodenum (up to 18 pmol/g lyophilized tissue). Moreover, physalaemin antiserum caused a clear-cut immunostaining in a population of cells of the Brunner's gland of the guinea pig duodenum, and several other examples of the expression of physalaemin-, eledoisin-, and kassinin-LI may be found in carcinoids (see Section III.A.4.).

Mammalian tachykinins are derived from two preprotachykinin genes: the PPT-A gene, which encodes the sequences of SP, NKA, and neuropeptide K and neuropeptide-gamma , and the PPT-B gene, which encodes the sequence of NKB (Nawa et al., 1983; Kotani et al., 1986; Bonner et al., 1987; Krause et al., 1987).

The precursor RNA from PPT-A is alternatively processed to yield three different mRNAs (Nawa et al., 1984). The three precursor proteins from which the mRNA codes are designated alpha -, beta -, and gamma -PPT; alpha -PPT, which generates SP; beta -PPT, which generates SP, NKA, and neuropeptide K; and gamma -PPT, which generates SP, NKA, and neuropeptide-gamma . The biological significance of the alternative splicing of PPT-A is unknown. The relative proportion of alpha -, beta -, and gamma -PPT mRNAs is markedly species dependent. For example, beta -PPT is the predominant form expressed in human basal ganglia (Bannon et al., 1992), whereas alpha -PPT prevails in the bovine brain (Nawa et al., 1984).

alpha -PPT mRNA is abundant in the brain, whereas beta - and gamma -PPT mRNAs are found mainly in peripheral tissues (Nakanishi, 1987). PPT-B mRNA is found in the brain (hypothalamus) and intestine (Kotani et al., 1986). Tachykinins are liberated from their precursors by the action of specific processing proteases. Typical cleavage points are Lys-Arg, Arg-Arg, and Arg-Lys doublets and the cleavage is carried out by six groups of proteolytic enzymes called convertases (Chretien et al., 1989; Steiner et al., 1992; Marcinkiewicz et al., 1993). COOH-terminal amidation after cleavage is generated from the precursor sequence, Gly-Leu-Met-Gly-Lys-Arg, in which Gly acts as the amide donor.

As with all known neurotransmitters, neuronal tachykinins are also released from the nerve ending after a calcium-dependent mechanism in response to application of physiological and nonphysiological stimuli (electrical stimulation, potassium, or capsaicin depolarization) (Maggi et al., 1993). Concerning release, two points are firmly established.

First, like that of biogenic amines, which are considered "rapid transmitters" and which under certain conditions may be released massively, release of neuropeptides, considered "slow" transmitters or modulators, is probably discrete and long lasting. Second, at the nerve terminals, especially in brain and in the autonomic nervous system, a release of a single transmitter is improbable, and, at any rate, must represent an exception. The concept of co-release of different peptides, amines, amino acids, and purines is now generally accepted after the immunohistochemical demonstration of the costorage in the granular material of single neurones of more active substances (Hokfelt et al., 1986).

Once released, the tachykinins may be attacked, cleaved, and inactivated by a number of proteolytic enzymes, which, however, act with considerably different intensity on the different tachykinins. The most vulnerable peptide seems to be SP, whereas peptides having at their N-terminal the pGlu residue seem much more resistant to enzyme attack. In the proteolytic degradation of SP, three enzymes seem to display a predominant role: dipeptidyl-amino peptidase, postproline endopeptidase, and cathepsin D (Regoli et al., 1994a).


    III. Localization of Tachykinin-Like Peptides
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We have previously shown that tachykinins constitute one of the largest families of peptides in the world whose members are present in all animal species, from lower invertebrates to mammals. Tachykinins possess a widespread distribution in the central and peripheral nervous system that is undoubtedly the major source of these peptides. However, tachykinins have also, like numerous other peptides and like all biogenic amines, a limited and species-dependent, but not negligible, distribution in non-neuronal structures represented by the irregular and sparse localizations in which they display known and unknown functions. In the first localization (neuronal cells), the active compounds act as neurotransmitters/neuromodulators, in the second (non neuronal cells) as autocrine, paracrine, or endocrine regulators.

A. Non-Neuronal Localization

1. Amphibian Skin. The most complex and rich localization of non-neuronal tachykinins is certainly the amphibian skin, that may be considered a huge factory and storehouse of a variety of tachykinins. However, an important characteristic of the skin peptides is their extreme irregularity in occurrence and richness: some amphibian species are extremely rich in active peptides, others, even closely related species, are lacking of active peptides. These findings contribute to the incomprehension of the physiological significance of the skin tachykinins and of that of the skin biogenic amines, especially indolealkylamines that are similarly present, sometimes in enormous amounts in the skin. The occurrence in the skin of a such variety of neuropeptides and amines may perhaps be explained by the common embryogenic origin of the integument and the nervous system from the primitive ectoderm.

2. Invertebrate Salivary Glands. The significance of eledoisin, as with that of the large amounts of biogenic amines, occurring in the posterior salivary glands of E. moschata but not in the glands of any related Octopus species is again completely obscure. On the contrary, the sialokinins occurring in the salivary glands of A. aegypti may be interpreted as an evolutionary selection of the peptides as vasodilators, in connection with the habit of feeding in blood of this insect (Champagne and Ribeiro, 1994).

3. Normal Mammalian Tissues. All of the non-neuronal localizations of the tachykinins concern mainly SP, and the occurrence of the peptide was established only by immunohistochemistry, using selective SP-antisera. SP occurring (together with serotonin) in populations of argentaffin/chromaffin and argyrophil/acidophil (with no serotonin) cells of the mammalian and probably also of lower vertebrate (ascidian and fish) intestine may act either as paracrine hormone or as a true hormone after release into the blood stream. It is possible that SP found in mammalian blood originates prevalently from the SP-containing cells of the intestinal mucosa. More than 60 years ago, Vialli and Erspamer (1933) described the so-called "acidophil basigranular cells" of the dog and cat large intestine, and it would be worthwhile checking to see if they are, like the argyrophil cells of the human large intestine, SP-producing cells. The acidophil cells are, in fact, neither argentaffin nor chromaffin, that is they do not contain serotonin. Little is known as to whether and under which conditions SP is released from the endocrine cells of the gastrointestinal mucosa. For example, release of SP from the enterochromaffin cells of the rat caecum mucosa seems to be inhibited by serotonin and calcium-free medium (Simon et al., 1992). Moreover, that SP may be released from the gut endocrine cells into the blood stream is strongly suggested by the evidence that legation of all intestinal blood vessels and evisceration in the cat significantly lowered SP plasma levels (Gamse et al., 1978) and by the fact that portal venous blood contains about 4 times more SP than peripheral blood (Pernow, 1983).

At any rate, it is obvious that blood SP must display some function. The most acceptable suggestion is that the peptide acts on the blood vessels either indirectly through release of vasodilator agents from the endothelium (vasodilation) or directly on the vascular smooth muscle, causing generally constriction or even potent stimulation of phasic movements in particular vessels (e.g., rat portal vein). There are sharp species differences in the response of the vessels to tachykinins, depending not only on the vascular beds but also on animal species (see Section V.I.).

4. Endocrine Tachykinin-Secreting Tumors. Carcinoids.  Carcinoids are tumors of the diffuse endocrine system characterized by a typical growth pattern, silver affinity, and positive immunohistochemical reaction with specific markers. They can express different biogenic amines (serotonin and histamine), peptides (tachykinins, bradykinin, and enteroglucagon), and prostaglandins (Creutzfeldt, 1996). Among the amines, serotonin is always present in argentaffin/chromaffin carcinoids, originating from the malignant growth of the enterochromaffin cells. They are prevailingly present in the midgut and appendix. Serotonin, however, is lacking in argyrophil nonchromaffin carcinoids, which may be present in the foregut, hindgut, lung (mostly bronchial carcinoids) and various other organs (Creutzfeldt and Stockmann, 1987). Argyrophil carcinoids may originate in the colon and probably in other sites as well, from the population of argyrophil, serotonin-lacking cells described by Sokolski and Lechago (1984). Peptides (bradykinin, enteroglucagon, and especially tachykinins) may occur both in chromaffin (together with serotonin) and in argyrophil nonchromaffin carcinoids (Wilander et al., 1977, 1979).

Because in normal endocrine cells of the gut and other organs only SP has been detected by immunochemistry, as expected, the tachykinin most frequently identified not only in the primary carcinoid tumor but also in its metastases was SP, together with its fragment SP(5-11), both in normal and oxidized form (Gamse et al., 1981; Conlon et al., 1985; Roth et al., 1985; Theodorsson-Norheim et al., 1985; Bishop et al., 1989). However, NKA, together with its fragments NKA(4-10) and NKA(5-10) and its extended form neuropeptide K, may also frequently be present in carcinoids (Roth et al., 1985; Theodorsson-Norheim et al., 1985; Conlon et al., 1986b; Bishop et al., 1989); and, more rarely, an eledoisin-like immunoreactivity (eledoisin-LI) was observed together with a neurokinin B-LI (Theodorsson-Norheim et al., 1985) and an oxidized physalaemin-LI (Conlon et al., 1985).

SP-LI was also found, together with NKA-LI, in bronchial carcinoids (Creutzfeldt and Stockmann, 1987; Bishop et al., 1989), in ovarian carcinoids (Skrabanek et al., 1980; Strodel et al., 1984), and in a medullary carcinoma of the thyroid (Skrabanek et al., 1979).

Tachykinins (NKA-, neuropeptide K-, and eledoisin-like peptides) were produced also by carcinoid tumors in culture (Norheim et al., 1987) and both 5-HT- and SP-LI were found in cytoplasmatic granules isolated from an intestinal argentaffin carcinoid, supporting the view that in this case SP is costored with 5-HT in the granules of the enterochromaffin cells (Alumets et al., 1977).

Pheocromocytomas.  Two pheocromocytomas showed SP-LI and SP sulfoxide-LI (Gamse et al., 1981), and another pheocromocytoma showed NKB-LI (Conlon et al., 1985). After subcellular fractionation, SP-LI and catecholamines were enriched in the chromaffin granular fraction, making it unlikely that SP-LI originates from nerve terminals (Gamse et al., 1981).

Lung carcinoma.  Only a few data on the content of tachykinins in these carcinoid tumors are available: up to 2 ng/g fresh tissue of SP-like peptides, 1.2 ng/g being represented by authentic SP (Gamse et al., 1981). This content is surprisingly low, compared with the content of serotonin (from 1 µg to 2.5 mg per g fresh tissue) in argentaffin carcinoids (Stacey, 1966). Moreover, Lazarus et al. (1983) have presented evidence that a human small cell carcinoma may contain a tachykinin peptide (1-1.6 ng/g) that has structural and biological activity similar to that of the amphibian physalaemin.

Because carcinoid tumors and their metastases are authentic endocrine glands, releasing into the blood stream biogenic amines and tachykinins, levels of these compounds may increase in plasma and even in urine. TK-LI was found in 75% of the 65 carcinoid patients examined (Norheim et al., 1984). The major component in plasma eluted in ion-exchange chromatography was in a different position from that of the usual tachykinins. Similar results were obtained by Conlon et al. (1986b) in three of four carcinoid patients, with NKA-LI up to 1 nmol/ml plasma and SP-LI up to 345 fmol/ml. Moreover, in urine samples of 79% of the 48 carcinoid patients examined in another study, the TK-LI material was 8 times more elevated than in healthy subjects. The immunoreactive material was heterogeneous, with some components coeluting with oxidized NKA and neuropeptide K (Bergstrom et al., 1995). In the urine of patients with argentaffin carcinoids, the concentration of 5-hydroxyindolacetic acid, the main metabolite of serotonin, was 100 times more elevated than in healthy subjects (Stacey, 1966).

All of these findings on carcinoid tumors demonstrate that tumoral epithelial, non-neuronal cells of the mammalian intestine and other organs are capable of expressing and storing not only SP, as expected, but several other tachykinins as well, certainly NKA and its extended form neuropeptide K, but also NKB and kassinin-, eledoisin-, and physalaemin-like peptides, i.e., peptides occurring in normal tissues only in submammalian species.

Patients with argentaffin carcinoid tumors and their metastases very often exhibit a typical syndrome characterized by flushing, diarrhea, asthma, cyanosis, and right-side valvular disease. Creutzfeldt and Stockmann (1987) have considered tachykinins to be coresponsible only for vasodilation (flushing) and not of the other symptoms. Secretory diarrhea and enhanced motility, important features of the carcinoid syndrome, do not seem to be attributable to SP, but instead to NKA and to eledoisin-like peptides (Makridis et al., 1999).

We can conclude that carcinoid tumors are not pure tachykinin-secreting tumors and do not contribute, unlike other endocrine tumors (gastrinomas and vipomas), to the understanding of the physiological significance and function of the tachykinins.

B. Neuronal Localization

Nervous tissue represents by far the most important localization of the tachykinins in invertebrates and vertebrates. A more or less dense network of tachykininergic fibers, which release their content upon adequate stimulation, permeates all vertebrate tissues close upon a very rich population of different receptors located on the membrane of neuronal and non-neuronal cells. In certain cerebral areas, the concentration of tachykinins may be on the order of nanomoles.

Data on the distribution and localization of neuronal tachykinins in the CNS and periphery have been obtained by a combination of HPLC with radioimmunoassay and/or by immunohistochemistry (Hokfelt et al., 1975, 1977; Pernow, 1983; Maggio, 1985).

Regional specific antisera directed against the C-terminal region of the tachykinins have been generally used, a condition that is unfortunate for discrimination between the various tachykinins (Maggio, 1988). The low specificity of several antisera and the different tissue extraction methods (Lindefors et al., 1985; Brodin et al., 1986) may explain some differences encountered in the literature on the localization of the three mammalian tachykinins.

Central nervous system.  Distribution of the tachykinins in the CNS has been extensively studied only in the rat (Otsuka and Yoshioka, 1993). Data on other species are scanty. As expected, SP is generally cosynthesized, colocalized, and cosecreted with NKA. The values of immunoreactive SP in various areas of the rat brain are: olfactory tubercle, 300 pmol/g of wet tissue; amygdala, 383 pmol/g of wet tissue; nucleus caudatus, 247 pmol/g of wet tissue; globus pallidus, 332 pmol/g of wet tissue; septum, 116 to 405 pmol/g of wet tissue; hypothalamus, 208 to 626 pmol/g of wet tissue; habenula, 377 pmol/g of wet tissue; posterior pituitary, 489 pmol/g of wet tissue; thalamic nucleus, 25 pmol/g of wet tissue; globus pallidus, 332 pmol/g of wet tissue; substantia nigra, 1725 to 2580 pmol/g of wet tissue; periaqueoductal central gray, 590 to 994 pmol/g of wet tissue; locus caeruleus, 332 pmol/g of wet tissue; nuclei parabranchiales, 546 pmol/g of wet tissue; medulla oblungata, 95 to 436 pmol/g of wet tissue; dorsal horn of the spinal cord, 1070 pmol/g of wet tissue; and ventral horn, 134 pmol/g of wet tissue (Kanazawa and Jessell, 1976; Douglas et al., 1982). The concentration of SP may reach values as high as 2 to 3 µg/g of wet tissue.

In rats, both the density and the distribution of SP-containing neurons is changing significantly during the period just before birth, the days after birth, and into the adult period. SP-staminal cells and fibers reached maximum levels between postnatal days 5 and 15. Then density generally decreased (Inagaki et al., 1982; Sakanaka et al., 1982). The distribution of NKA is less known and in the rat brain, seems to be similar to that of SP, with clearly different locations, however, in several regions. As revealed by immunohistochemistry, NKB-containing perikarya were detected in the main and accessory olfactory bulb, some cortical regions, the olfactory tubercule, the n. accumbens, the septum, the neostriatum, several hypothalamic nuclei, the superior colliculus, the substantia nigra, the medullary reticular formation, and the external caudate nucleus (Kanazawa et al., 1984; Merchenthaler et al., 1992). NKB is also located in the spinal cord, predominantly in the dorsal horn, while it is present in negligible amounts in dorsal root ganglia and dorsal roots (Ogawa et al., 1985).

In the cat brain, kassinin-LI (NKA-LI) has a widespread distribution with the highest concentration present in substantia nigra, hypothalamus, and caudate n.; moderate levels in thalamus, brain stem, and spinal cord; and low levels in the cortex and cerebellum. Distribution of NKA-LI paralleled that of SP, although the ratio between the two peptides varied throughout the different areas (Hunter et al., 1985).

In human brain, the areas most rich in immunoreactive SP were: amygdala, 25 to 340 pmol/g of wet tissue; nucleus caudatus, 113 to 370 pmol/g of wet tissue; putamen, 81 to 380 pmol/g of wet tissue; globus pallidus, 518 to 1800 pmol/g of wet tissue; hypothalamus, 125 to 135 pmol/g of wet tissue; substantia nigra, 1264 to 4720 pmol/g of wet tissue; and locus caeruleus, 199 pmol/g of wet tissue (Gale et al., 1978; Emson et al., 1980; Cooper et al., 1981).

Data on the occurrence of SP and SP-like peptides in the frog and fish brain are presented by Inagaki et al. (1981).

Gut.  The main sources of the neuronal tachykinins in the gut are: a) the intrinsic enteric neurons of the myenteric plexus, b) the intrinsic enteric neurons of the submucosal plexus, and c) the extrinsic primary afferent fibers. The most quantitatively important source of tachykinins in the gut is the enteric nervous system, which has its cells in the wall of the intestine and supplies all gastrointestinal effector systems. The mammalian gastrointestinal tract contains both SP and NKA and various extended forms of these tachykinins.

Neurons that contain only SP (alone or with other nontachykinin transmitters) are considered to be intrinsic sensory neurons (Holzer and Holzer-Petsche, 1997a, 1997b). In addition to these neurons, extrinsic efferent nerve fibers also display a small, but distinct contribution to the SP/NKA immunoreactivity in the gut. These fibers originate from dorsal root ganglia and reach the periphery via sympathetic or parasympathetic nerves, passing through prevertebral ganglia. The extrinsic efferent nerves project predominantly to the vessels in the intestinal wall but they also supply the lamina propria of the gastrointestinal mucosa. There are considerable species-dependent quantitative differences in the location of the tachykinins in the various gut segments, in the concentration of the peptides and in the density of SP/NKA-containing fibers.

In most species, the highest concentrations of tachykinins in the gut are found in pylorus, gastric fundus, duodenum, and jejunum (Pearse and Polak, 1975; Lazarus et al., 1980; Hunter et al., 1985; Gates et al., 1989). In the guinea pig small intestine, the bulk of SP and NKA, which are stored in the same synaptic vesicles, is associated with the myenteric plexus in longitudinal muscle.

Concerning NKB, the peptide is generally considered to be absent from human, porcine, guinea pig, and rat intestine, which is consistent with the absence of PPT-B expression in the enteric nervous system of the rat but is in contrast with other results, showing that human and rat intestine contains minute amounts of NKB (Holzer and Holzer-Petsche, 1997a) and even more so with data showing that highly specific antiserum to NK3 receptors detected them in nervous myenteric and submucosal neurons (Grady et al., 1996). SP- but not NKA- and NKB-immunoreactivity is present also in the gall bladder and bile duct and in the pancreas, both around blood vessels and in the acini and the islets (Otsuka and Yoshioka, 1993).

Respiratory tract.  RIA and immunohistochemistry have demonstrated the presence of SP and NKA in the respiratory tract of various mammalian fibers. In the trachea and bronchi, SP-immunoreactive fibers have been found in the smooth muscle layer and around local ganglion cells. In the bronchial tree, most of the SP-positive fibers are of vagal origin; but in the lung, the fibers are both of vagal and thoracic spinal origin. (Nilsson et al., 1977; Lundberg et al., 1983; Saria et al., 1985; Manzini et al., 1989).

Blood vessels.  Data on the occurrence of SP-containing fibers are rather scanty and old. SP-like immunoreactivity has been observed in fibers of the adventitia and media in various blood vessels, such as feline cerebral arteries (Liu Chen et al., 1986), guinea pig intestinal vasculature (Furness et al., 1982), and rat portal vein (Barja and Mathison, 1982). The majority of SP-containing perivascular fibers are of sensory, capsaicin-sensitive origin.

Urinary system.  The distribution of SP and NKA has been extensively studied in renal pelvis and ureter and especially in the urinary bladder of several species (Sharkey et al., 1983; Gibbins et al., 1985; Maggi et al., 1987). Capsaicin treatment results in an almost complete disappearance of the tachykinin-immunoreactive fibers, suggesting that the major sources of tachykinins in the urinary bladder are sensory fibers (Maggi and Meli, 1988; Maggi et al., 1988).

Skin.  In human digital skin, SP- and NKA-immunoreactivity is present in free nerve endings in dermal papillae and epidermis (Dalsgaard et al., 1985; Bjorklund et al., 1986). SP-like immunoreactive fibers are also found in the skin of the rat and cat (Hokfelt et al., 1977). Treatment with capsaicin in rats caused a 70% depletion of SP-like immunoreactivity in various skin areas, suggesting that SP is present mainly in primary afferent C-fibers (Holzer, 1991).

Immune system.  Tachykinin-containing primary capsaicin-sensitive afferent nerves are present in lymphoid organs, such as thymus, spleen, lymph nodes, and lymphoid aggregates in the lung and nasal mucosa. Their distribution is prevalently perivascular, but some fibers penetrate within the follicles. Both SP and NKA have been detected in rat thymus, spleen, and lymph nodes by radioimmunoassay. In addition to NKA, neuropeptide K and an eledoisin-like peptide also occur in the guinea pig thymus (Geppetti et al., 1987). However, non-neuronal sources of tachykinins are also present in the immune system. Using an anti-NKA antiserum, positive immunostaining was observed in staminal cells throughout the thymic parenchyma of the rat with predominance in the medullary area (Ericsson et al., 1990).

Because endothelial cells express SP-LI (Linnik and Moskowitz, 1989; Ralevic et al., 1990), the vascular endothelium of lymphoid organs may be the source of non-neuronal tachykinins at this level. Moreover, there is evidence that certain immune cells such as eosinophils and macrophages synthesize and release SP (for review, cf. Maggi, 1997).

Blood.  Quantitative data on the concentration of immunoreactive SP in blood plasma are very variable with a wide range of values obtained by the different authors, indicating that nonspecific factors are probably interfering with the assay of immunoreactive SP. This is particularly true when unextracted plasma was used. As previously stated, the major part of circulating SP evidently originates from the intestine (Pernow, 1983). Values were as follows: man 70 to 300 and 50 to 620 fmol/ml; dog, 40 to 50 fmol/ml; and calf, 165 and 18 fmol/ml for unextracted and extracted plasma, respectively.


    IV. Relationships between Structure/Activity Receptor Selectivity
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Tachykinins, yet defined as peptides having the characteristic C-terminal pentapeptide Phe5-Xaa4-Gly-Leu-Met-NH2, are identified as "aromatic tachykinins" when Xaa is an aromatic amino acid residue (Phe or Tyr) and "aliphatic tachykinins" when Xaa is an aliphatic amino acid residue (Val or Ile). All natural tachykinins are amidated at their C terminus, and this function is crucial for biological activity. Deamidated peptides are virtually inactive (Erspamer, 1994).

Structure/activity relationship studies established that the C-terminal pentapeptide was essential but not sufficient for the biological activity of the tachykinins. In fact, the C-terminal pentapeptide of eledoisin and physalaemin (Bernardi et al., 1964; Regoli et al., 1994b) like that of all other examined tachykinins was virtually inactive. The minimum chain length required for activity was six residues. These studies also recognized the Phe residue at position 5 from the C terminus and the amidation at the C terminus to be crucial for biological activity, both occurring in all vertebrate and invertebrate tachykinins, as well as the presence of the C-terminal Arg-NH2 in the locustatachykinin-like peptides. The biological activity of the tachykinins depends on their interaction with three G protein-coupled receptors---NK1, NK2, and NK3---which share considerable structural homology, reflecting their common mechanism of action.

Receptors are small proteins of 350 to 500 amino acid residues, belonging to the family of rhodopsin-like membrane structures. The tachykinin receptor displaying higher affinity for SP was termed NK1, the receptor showing higher affinity for NKA was termed NK2, and the receptor showing higher affinity for NKB was termed NK3. It should be emphasized that, up to date, all naturally occurring tachykinins may act as agonists on all three receptor types, although sometimes with considerably different affinities (Regoli et al., 1987, 1994a; Maggi et al., 1993).

Parallel bioassay on a number of isolated and in situ test systems using the natural tachykinins and selective synthetic analogs, radioligand binding studies, and the use of antagonists with increasing potency and selectivity have led to the conclusion that all of the three main tachykinin receptors are heterogeneous entities, with NK1, NK2, and NK3 subtypes (Maggi et al., 1993; Quartara and Maggi, 1997, 1998). The main second messenger system coupled to activate the three known receptor subtypes is the stimulation of phospholipase C, leading to phosphoinositol breakdown and elevation of intracellular calcium (Guard and Watson, 1991). At high tachykinin concentrations, an adenylate cyclase stimulation and cAMP formation may also come into play (Nakajima et al., 1992).

The extracellular loops of these G-protein coupled receptors probably have the specific function of selecting a ligand, whereas the interaction of the ligand with transmembrane domains is responsible for receptor activation. Tachykinin peptides, therefore, presumably contain a sequence that interacts with the extracellular loops of the receptor and a sequence that interacts with transmembrane domains. Recent findings conclusively allowed clarifying the crucial importance for and the influence on receptor selectivity and activity of some key amino acids in the tachykinin sequence (Severini et al., 2000).

A. Residue Occupying Position 7 from the C Terminus

The amino acid in position seven from the C-terminal of tachykinins seems to address the peptide ligand toward the receptor. SP and tachykinins with a neutral or basic residue in this position have a preference for the NK1 receptor. Neutral residues are generally hydrophilic, and proline in position eight from the C-terminal can increase affinity for the NK1 receptor. Tachykinins with an acidic or a couple of acidic residues in position 7 or 6 and 7 from the C-terminal addressed the peptides toward the NK2 and NK3 receptors. Interestingly, the second extracellular loop has four acidic and four basic residues in the rat NK1 receptor, three acidic and two basic residues in the NK2 receptor, and one acidic and five basic residues in the NK3 receptor.

B. Residue Occupying Position 4 from the C Terminus

In all natural tachykinins, position 4 from the C terminus is occupied either by an aromatic amino acid residue (Phe, Tyr) in the aromatic tachykinins or by an aliphatic, branched amino acid residue (Val, Ile) in the aliphatic tachykinins. The presence of an aromatic residue invariably determines selectivity or increases the selectivity of the peptide for the NK1 receptor. This is true not only when a neutral or basic amino acid residue occupies position 7 from the C terminus but also when an acidic residue occupies position 7. The couple of aromatic residues (Phe-Tyr or Phe-Phe) present in the "message domain" of the tachykinins provide specific binding interactions with transmembrane domains of NK1 receptor.

C. Residue Occupying Position 6 from the C Terminus

The presence of a Pro residue in position 6 from the C terminus causes a profound decay of biological activity. The negative contribution of Pro6 could be related to a distortion in the interaction of the C-terminal sequence of the peptide (Phe-Xaa-Gly-Leu-Met-NH2) with all tachykinin receptors. In the Pseudophryne güntheri tachykinins, a Glu residue occupies position 6 from the C terminus. The couple of acidic residues Asp7-Glu6 present in PG-SP1 and PG-KII could, therefore, be responsible for the marked shift of receptor selectivity toward the NK3 receptor. This shift is quite evident for PG-KII (an aliphatic tachykinin) and much less evident for PG-SP1 (an aromatic tachykinin) in which the Phe-Tyr sequence induces NK1 receptor selectivity.

D. Amino Acid Substitutions in the C-Terminal Tripeptide

To date, six natural peptides have single or double amino acid substitutions in the C-terminal tripeptide Gly-Leu-Met-NH2: Pro (AC-AR2, AC-AR4) or Ala (ranatachykinin D) for Gly; and Val (AC-AR4) or Pro (ranatachykinin D) or Gly (AC-AR2) or Met (hylambatin) for Leu. None of these substitutions affected the peptides' receptor selectivity, only their receptor affinity or potency.

E. Pro Residue in the N-Terminal Sequence

The Pro residue is a well represented residue in the natural tachykinins. It is nearly always located in the N-terminal moiety of the peptide sequence and has a clear-cut preference for positions 8 and 10 from the C terminus. In the majority of natural NK1 receptor-preferring tachykinins, a Pro residue is present at position 8, adjacent to the crucial neutral or basic residue occupying position 7. Proline in this position could modify the conformation of the C-terminal sequence of the tachykinin peptides and helps to increase their affinity and selectivity for the NK1 receptor. Cascieri et al. (1992) have suggested that all tachykinins containing Pro at position 8 from the C terminus, for example SP, have greatly reduced affinity for NK2 and NK3 receptors, and they have attributed this behavior to the preferred conformation of the Pro-containing peptides for the NK1 receptor and unfavorable for NK2 and NK3 receptors.


    V. Tachykinin-Like Peptides: Pharmacological Actions
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The TKs display a number of potent pharmacological actions in the periphery and in the central nervous system. In the present chapter, analysis is limited essentially to the pharmacological actions of the nonmammalian TKs (eledoisin, physalaemin, and even kassinin) available in pure form several years before the structures of SP, NKA, and NKB were elucidated. As a consequence, the pharmacology of the TKs is based largely on the study of amphibian physalaemin, kassinin, and on molluscan eledoisin.

Whereas results obtained with eledoisin and kassinin, multireceptor agonists, do not exactly mimic results obtained with either NKA or NKB, results obtained with physalaemin, a selective NK1 agonist, are perfectly superimposable, with negligible quantitative differences, on those later obtained with SP, the mammalian selective NK1 receptor agonist.

A. Cardiovascular System

1. Systemic Arterial Blood Pressure Tachykinins administered to the anesthetized dog by the parenteral route are the most potent among all known hypotensive agents. On the dog blood pressure, physalaemin was 2 to 2.5 times less potent than SP, 10 to 20 times more potent than kassinin, and 3 to 4 times more potent than eledoisin (Erspamer, 1981). When administered by rapid intravenous injection, physalaemin was 200 to 1000 times more potent than bradykinin, and 600 to 2000 times more potent than histamine (Bertaccini et al., 1965). Physalaemin was very effective in antagonizing the pressor effects of noradrenaline and angiotensin II given at doses 100 and 10 times higher, respectively.

The rabbit was again extremely sensitive to physalaemin and even more so to SP. Eledoisin was approximately 10 times less active than SP; kassinin, 20 times less active; NKA and NKB, 200 and 2000 times less active, respectively (Bianchi Porro et al., 1965; Holzer-Petsche et al., 1985).

Intravenously injected in the sheep, eledoisin showed a hypertensive response of slow onset, probably attributable to some arousal of the animals (Ormas et al., 1975).

In cat and in rat, the effect of physalaemin was considerably less intense, with high variability and tachyphylaxis. Finally, in the decapitated chicken, physalaemin regularly elicited a biphasic response consisting of a brief hypotensive phase followed by a more intense and sustained dose-related pressure increase (Bertaccini et al., 1965). The rise in pressure observed in sheep and chicken was blocked by sympatholytic drugs and by pretreatment with reserpine, thus, indicating a release of cathecolamines from the adrenal medulla and/or other stores.

Conversely, the hypotensive effect of the tachykinins was not modified by any of the usual autonomic blocking agents, thus suggesting a direct effect on the vascular smooth muscle.

Physalaemin, ranakinin, SP, and NKB produced a dose-dependent decrease in arterial blood pressure in the toad, Bufo marinus. A selective NK1 antagonist had no effect on the blood pressure fall elicited by ranakinin and SP, suggesting the existence of an NK1 receptor subtype different from mammalian NK1 receptor (Courtice et al., 1993).

In the bowfin Amia calva, a teleost fish, the bolus injection into the bulbus arteriosus of 0.1 to 10 nmol/kg of the bowfin SP resulted in a significant and dose-dependent rise in vascular resistance and blood pressure and a fall in cardiac output without changes in heart rate. Those effects lasted 5 to 10 min (Waugh et al., 1995b). Similarly, in the teleost fish rainbow trout, both the trout SP and the trout NKA at intraaortic doses of 1 nmol/kg increased systemic and celiac vascular resistance leading to hypertension, bradycardia, and decrease of cardiac output. After in vitro perfusion of the aortic and celiac mesenteric vascular bed, the peptides dose dependently increased the vascular resistance. It may be concluded that in teleost fish, the fish tachykinins are potent vasoconstrictor agents (Kagstrom et al., 1996).

In the conscious, unanaesthetized dogfish Scyliorhinus canicula, intravenous injection of either dogfish SP or scyliorhinin I (up to 5 nmol) produced no change in arterial blood pressure, pulse amplitude, and heart rate. Injection of greater amounts of the peptides (10-50 nmol) produced a slight increase in blood pressure (Waugh et al., 1993). However, in the unrestrained spiny dogfish Squalus acanthia, the intravenous injection of scyliorhinin I and NKA caused hypotension, due to a general vasodilation, with transient increase in mesenteric blood flow and a prolonged increase in celiac blood flow. The peptides did not increase heart rate (Kagstrom et al., 1996).

In human volunteers, eledoisin given by rapid intravenous injection (threshold 15-20 pmol/kg) decreased blood pressure, caused spinal fluid hypertension, increased the rate of respiration and caused skin vasodilation, particularly in the head. Rise in blood pressure produced by 3 to 5 nmol/kg angiotensin or 40 to 60 nmol/kg noradrenaline was inhibited or reversed by 1 to 2 nmol/kg eledoisin injected 5 s previously (Sicuteri et al., 1963).

In other experiments, the intravenous infusion of 0.6 nmol/kg/min eledoisin or 0.2 nmol/kg/min physalaemin produced only a 20 mm Hg pressure fall that lasted 5 min. Basal levels of pressure returned despite the continued infusion (De Caro et al., 1966).

SP also decreased blood pressure. A significant difference from the basal level was found at an infusion rate of 200 pmol/kg/min or higher (Eklund et al., 1977).

These results were substantially confirmed by Evans et al. (1988), who found that both SP (3 pmol/kg/min) and NKA (64 pmol/kg/min) did not change systolic blood pressure, whereas diastolic pressure fell significantly only after SP infusion. Moreover both peptides increased heart rate and body temperature, with skin flushing. SP was 6 to 20 times more potent than NKA.

Heart.  Electrocardiogram tracings recorded from anesthetized dogs given an intravenous infusion or a subcutaneous injection of physalaemin, at doses approximately 1000 higher than the threshold hypotensive dose, produced only moderate electrocardiographic changes mainly attributable to hypotension (Bertaccini et al., 1965). In a detailed study, the following percentage changes in a number of cardiovascular parameters have been observed in dog after intravenous injection of 4 pmol/kg physalaemin: heart rate, +17.8; mean systemic arterial pressure, -22.3; mean pulmonary arterial pressure, +1.8; mean left atrial pressure, -1; mean right atrial pressure, +0.5; myocardial contractile force, +17.5; cardiac output, +52; total peripheral resistance, -65.2; and pulmonary vascular resistance, -35.4 (Nakano et al., 1968). Similar results were obtained with eledoisin (Nakano, 1964, 1965).

The effect of SP was substantially the same as that observed with physalaemin. At infusion rates ranging from 3 to 450 pmol/kg/min, SP invariably induced a dose-dependent increase of cardiac output mostly due to a larger stroke volume. SP at concentrations up to 50 pmol/ml had no effect either on the isolated guinea pig auricles or the perfused rabbit heart, suggesting that SP has no direct effect on the heart (Burcher et al., 1977).

2. Regional Circulation. Coronary bed.  Physalaemin and, to a considerably lesser extent eledoisin and SP (Losay et al., 1977) displayed a very potent vasodilator action on the dog coronary vascular bed not only when given by intracoronary administration, but also when given by intravenous infusion. A transient, 50% increase in coronary flow was obtained by rapid intracoronary injection with 0.1 pmol/kg and a 100% increase with 1 pmol/kg of physalaemin. Eledoisin was 200 times less active and nitroglycerin, 10,000 times less active.

Eledoisin infused intracoronarily at a rate of 6 pmol/kg/min increased sinus coronary outflow by 20%, coronary sinus oxygen tension by 10%, and similarly increased stroke flow and cardiac oxygen consumption, without affecting mean arterial pressure and heart rate (Lochner and Parratt, 1966). Increase in coronary flow and decrease in coronary vascular resistance also was observed after intravenous infusion of eledoisin (Beretta Anguissola et al., 1966).

Skeletal muscle.  The vessels of the skeletal musculature of the hindlimbs of dogs were by far the most sensitive to tachykinins of any vascular bed. Doses of eledoisin as low as 10 fmol injected into the peronal artery caused an increase in blood flow, both in the intact and denervated gastrocnemius plantaris muscle. Denervation enhanced the potency of eledoisin (Bergamaschi and Glasser, 1963, 1964). Physalaemin was 50 times more potent than eledoisin and 50,000 times more potent than nitroglycerin (Bergamaschi et al., 1966; Fregnan and Glasser, 1968). In other experiments, close arterial injection of SP caused a dose-related vasodilation in adipose tissue and skeletal muscle of the dog only with doses starting from 10 nmol (Pernow and Rosell, 1975).

SP was also a potent vasodilator in humans. Infusion of 0.7 pmol/kg/min into the brachial artery significantly increased the forearm blood flow, with increases of oxygen consumption in both cutaneous and muscle blood. At the infusion rate of 70 pmol/kg/min, there was a bright red flushing of the skin, particularly in the neck and head, with a subjective feeling of warmth in the same regions, accompanied by tachycardia (Eklund et al., 1977). No effect of SP could be seen on internal carotid blood flow (Samnegard et al., 1978).

Liver.  Portal or femoral infusions of SP, eledoisin, and physalaemin (2-20 pmol/kg/min) increased blood flow in the hepatic artery and vein of the dog. Portal infusions were less effective, thus, indicating a highly inactivating capacity of the liver. Hepatic arterial and venous pressures decreased, whereas sinusoid and portal pressure increased during peptide infusion. As a consequence, hepatic arterial and outflow resistances decreased. SP was the most potent peptide, followed by physalaemin (38%) and eledoisin (10%). When given by close arterial infusion, the peptides also consistently increased blood flow in the hepatic artery (Melchiorri et al., 1977). These observations were confirmed by Takaori et al. (1989), who found that intravenous physalaemin (5 pmol/kg) caused dose-dependent increases in mesenteric arterial blood flow (70%) and portal venous blood flow (77%) in the dog.

Lung.  Intravenous eledoisin (0.1-1 nmol/kg) did not increase, and sometimes slightly reduced, pulmonary arterial pressure in the guinea pig; it always increased pressure in the rabbit. In the isolated, blood-perfused rabbit lung preparation, eledoisin produced a potent vasoconstriction from threshold doses of 0.01 to 0.1 pmol/kg. Tachyphylaxis was obvious. Bradykinin was 1000 times less effective (Hauge et al., 1966). In the dog NKA was much more potent than SP in decreasing tracheal vascular resistance (Salonen et al., 1988).

Skin.  The skin vasculature of the dog was far less sensitive than the vessels of the musculature. In man, injection of 0.2 nmol eledoisin into the brachial artery produced digital vascular responses consisting of an increase in the skin temperature and a consistent increase in total digital volume, despite a decrease in inflow volume. Responses seem to indicate a closure of the arteriovenous anastomoses (De Pasquale and Burch, 1966).

Infusion of SP into the rat femoral artery dose dependently produced vasodilation (threshold 0.1 pmol/kg/min) that was inhibited by mepyramine (Lembeck and Holzer, 1979).

Brain.  Eledoisin infused intravenously in the dog at 0.01 nmol/kg/min decreased cerebral blood flow (-22%), with an increase (+20%) in vascular resistance (Beretta Anguissola et al., 1966). In human subjects, the intravenous infusion of eledoisin (1-15 pmol/kg/min) influenced neither the cerebral blood flow and vascular resistance nor the cerebral metabolic rate of oxygen and glucose (Bianchi Porro et al., 1965).

Mechanism of vasodilation and hypotension.  All of these findings demonstrate that in some mammalian species, exogenous tachykinins display a potent dilation of regional musculature accompanied by the fall of systemic blood pressure, in other mammalian and nonmammalian species the peptides display inconstant and variable effects: hypotensive/hypertensive or even frank hypertensive responses. Thus, the intervention of endogenous tachykinins in the regulation of blood pressure and regional circulation is certainly possible but irregular and unpredictable. At any rate, it is hardly conceivable that the tachykinins display a significant role in the cardiovascular system similar to that of noradrenaline, serotonin, angiotensin, prostacyclins, etc. This does not exclude that in man the tachykinins may contribute to the control of vascular tone of the cutaneous vessels of some areas. So, it has been suggested that tachykinin (SP and NKA) release is co-involved in the pathogenesis of flushing episodes (not accompanied by edema!) occurring in the carcinoid disease. To our knowledge, tachykinin antagonists have never been used in this disease. The trial could be rewarding from both a pathogenetical and a therapeutical point of view.

The striking hypoten