Sympathetic Motor Neuron Dysfunction is a Missing Link in Age-Associated Sympathetic Overactivity

Reviewer #1 (Public Review):

Summary:
The authors study age-related changes in the excitability and firing properties of sympathetic neurons, which they ascribe to age-related changes in the expression of KCNQ (Kv7, "M-type") K+ currents in rodent sympathetic neurons, whose regulation by GPCRs has been most thoroughly studied for over 40 years. The authors suggest the ingestion of rapamycin may partially reverse the age-related decrease in M-channel expression. With the rapamycin part included, it is unclear how this work will impact the field of age-related neuronal dysfunction, as the mechanistic information is not strong.

Strengths:
The strengths include the rigor of the current-clamp and voltage-clamp experiments, the lovely, crisp presentation of the data, and the expert statistics. The separation of neurons into tonic, phasic, and adapting classes is also interesting, and informative. The writing is also elegant, and crisp. The above is especially true of the manuscript up until the part dealing with the effects of rapamycin, which becomes less compelling.

Weaknesses:
Where the manuscript becomes less compelling is in the rapamycin section, which does not provide much in the way of mechanistic insights. As such, the effect is more of an epi-phenomenon of unclear insight, and the authors cannot ascribe a signaling mechanism to it that is supported by data. Thus, this latter part rather undermines the overall impact and central advance of the manuscript. The problem is exacerbated by the controversial and anecdotal nature of the entire mTor/aging field, some of whose findings have very unfortunately had to be recently retracted.

I would strongly recommend to the authors that they end the manuscript with their analysis of the role of M current/KCNQ channels in the numerous age-related changes in sympathetic neuron function that they elegantly report, and save the rapamycin, and possible mTor action, for a separate line of inquiry that the authors could develop in a more thorough and scholarly way.

Reviewer #2 (Public Review):

Summary:
This research shows compelling and detailed evidence showing that aging influences intrinsic membrane properties of peripheral sympathetic motor neurons such that they become more excitable. Furthermore, the authors present convincing evidence that the oral administration of the anti-aging drug Rapamycin partially reversed hyperexcitability in aged neurons. This study also investigates the molecular mechanisms underlying age-associated hyperexcitability in mouse sympathetic motor neurons. In that regard, the authors found an age-associated reduction of an outward current having properties similar to KCNQ2/Q3 potassium current. They suggested a reduction of KCNQ2/Q3 current density in aged neurons as a potential mechanism behind their overactivity.

Strengths:
Detailed and rigorous analysis of electrical responses of peripheral sympathetic motor neurons using electrophysiology (perforated patch and whole-cell recordings). Most of the conclusions of this paper are well supported by the data.

Weaknesses:

1. The identity of the age-associated reduced current as KCNQ2/Q3 is not corroborated by pharmacology (blocking the current with the specific blocker XE-991).
2. The manuscript does not include a direct test of the reduction of KCNQ current as the mechanism behind age-induced hyperexcitability.

Reviewer #3 (Public Review):

This is a descriptive study of membrane excitability and Na+ and K+ current amplitudes of sympathetic motor neurons in culture. The main findings of the study are that neurons isolated from aged animals show increased membrane excitability manifested as increased firing rates in response to electrical stimulation and changes in related membrane properties including depolarized resting membrane potential, increased rheobase, and spontaneous firing. By contrast, neuron cultures from young mice show little to no spontaneous firing and relatively low firing rates in response to current injection. These changes in excitability correlate with significant reductions in the magnitude of KCNQ currents in aged neurons compared to young neurons. Treating cultures with the immunosuppressive drug, rapamycin, which has known antiaging effects in model animals appears to reverse the firing rates in aged neurons and enhance KCNQ current. The authors conclude that aging promotes hyperexcitability of sympathetic motor neurons.

The electrophysiological cataloging of the neuronal properties is generally well done, and the experiments are performed using perforated patch recordings which preserve the internal constituents of neurons, providing confidence that the effects seen are not due to washout of regulators from the cells. The main weakness is that this study is a descriptive tabulation of changes in the electrophysiology of neurons in culture, and the effects shown are correlative rather than establishing causality. It is difficult to know from the data presented whether the changes in KCNQ channels are in fact directly responsible for the observed changes in membrane excitability. Furthermore, a notable omission seems to be the analysis of Ca2+ currents which have been widely linked to alterations in membrane properties in aging. As well, additional experiments in slice cultures would provide greater significance on the potential relevance of the findings for intact preparations. Finally, experiments using KCNQ blockers and activators could provide greater relevance that the observed changes in KCNQ are indeed connected to changes in membrane excitability.