Yan B, Li L, Harden SW, Gozal D, Lin Y, Wead WB, Wurster RD, Cheng ZJ. Chronic intermittent hypoxia impairs heart rate responses to AMPA and NMDA and induces loss of glutamate receptor neurons in nucleus ambiguus of F344 rats. Am J Physiol Regul Integr Comp Physiol 296: R299 -R308, 2009. First published November 19, 2008 doi:10.1152/ajpregu.90412.2008.-Chronic intermittent hypoxia (CIH), as occurs in sleep apnea, impairs baroreflex-mediated reductions in heart rate (HR) and enhances HR responses to electrical stimulation of vagal efferent. We tested the hypotheses that HR responses to activation of ␣-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AMPA) and N-methyl-D-aspartate (NMDA) receptors in the nucleus ambiguus (NA) are reduced in CIH-exposed rats and that this impairment is associated with degeneration of glutamate receptor (GluR)-immunoreactive NA neurons. Fischer 344 rats (3-4 mo) were exposed to room air (RA) or CIH for 35-50 days (n ϭ 18/group). At the end of the exposures, AMPA (4 pmol, 20 nl) and NMDA (80 pmol, 20 nl) were microinjected into the same location of the left NA (Ϫ200 m to ϩ200 m relative to caudal end of area postrema; n ϭ 6/group), and HR and arterial blood pressure responses were measured. In addition, brain stem sections at the level of Ϫ800, Ϫ400, 0, ϩ400, and ϩ800 m relative to obex were processed for AMPA and NMDA receptor immunohistochemistry. The number of NA neurons expressing AMPA receptors and NMDA receptors (NMDARs) was quantified. Compared with RA, we found that after CIH 1) HR responses to microinjection of AMPA into the left NA were reduced (RA Ϫ290 Ϯ 30 vs. CIH Ϫ227 Ϯ 15 beats/min, P Ͻ 0.05); 2) HR responses to microinjection of NMDA into the left NA were reduced (RA Ϫ302 Ϯ 16 vs. CIH Ϫ238 Ϯ 27 beats/min, P Ͻ 0.05); and 3) the number of NMDAR1, AMPA GluR1, and AMPA GluR2/3-immunoreactive cells in the NA was reduced (P Ͻ 0.05). These results suggest that degeneration of NA neurons expressing GluRs contributes to impaired baroreflex control of HR in rats exposed to CIH. brain stem; parasympathetic efferent; heart; baroreflex; sleep apnea CHRONIC INTERMITTENT HYPOXIA (CIH) during sleep is now routinely used as a representative model for sleep apnea syndromes (20,36,43). In patients with obstructive sleep apnea, baroreflex control of heart rate (HR) is reduced (3, 4). In CIH-exposed rats and mice, CIH significantly reduced baroreflex control of HR (25,30,33). In addition, CIH decreased the central mediation of baroreflex bradycardia and conversely augmented the baroreceptor afferent function and the HR responses to electrical stimulation of the vagus nerve (25). These findings suggest that the impairment with CIH occurs within the brain stem and not in sensory or efferent premotor fibers.A substantial body of evidence indicates that the baroreflex control of HR is mediated through glutamate transmission in the nucleus ambiguus (NA) (46). Furthermore, the NA cardiac motoneurons express the ionotropic glutamate receptors ␣-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AM...