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Xia Y, Cui K, Alonso A, Lowenstein ED, Hernandez-Miranda LR. Transcription factors regulating the specification of brainstem respiratory neurons. Front Mol Neurosci 2022; 15:1072475. [PMID: 36523603 PMCID: PMC9745097 DOI: 10.3389/fnmol.2022.1072475] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/14/2022] [Indexed: 11/12/2023] Open
Abstract
Breathing (or respiration) is an unconscious and complex motor behavior which neuronal drive emerges from the brainstem. In simplistic terms, respiratory motor activity comprises two phases, inspiration (uptake of oxygen, O2) and expiration (release of carbon dioxide, CO2). Breathing is not rigid, but instead highly adaptable to external and internal physiological demands of the organism. The neurons that generate, monitor, and adjust breathing patterns locate to two major brainstem structures, the pons and medulla oblongata. Extensive research over the last three decades has begun to identify the developmental origins of most brainstem neurons that control different aspects of breathing. This research has also elucidated the transcriptional control that secures the specification of brainstem respiratory neurons. In this review, we aim to summarize our current knowledge on the transcriptional regulation that operates during the specification of respiratory neurons, and we will highlight the cell lineages that contribute to the central respiratory circuit. Lastly, we will discuss on genetic disturbances altering transcription factor regulation and their impact in hypoventilation disorders in humans.
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Affiliation(s)
- Yiling Xia
- The Brainstem Group, Institute for Cell Biology and Neurobiology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ke Cui
- The Brainstem Group, Institute for Cell Biology and Neurobiology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Antonia Alonso
- Functional Genoarchitecture and Neurobiology Groups, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
- Department of Human Anatomy and Psychobiology, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Elijah D. Lowenstein
- Developmental Biology/Signal Transduction, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Luis R. Hernandez-Miranda
- The Brainstem Group, Institute for Cell Biology and Neurobiology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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52
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Sanchez-Azofra A, Villafuerte FC, DeYoung PN, Gilbertson D, Gu W, Moya EA, Vizcardo-Galindo G, Figueroa-Mujíca R, Anza-Ramirez C, Macarlupú JL, Pham LV, Wagner P, Malhotra A, Simonson TS, Mesarwi OA. Isovolemic hemodilution in chronic mountain sickness acutely worsens nocturnal oxygenation and sleep apnea severity. J Clin Sleep Med 2022; 18:2423-2432. [PMID: 35855526 PMCID: PMC9516589 DOI: 10.5664/jcsm.10136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Chronic mountain sickness (CMS) is commonly observed among Andean and other highland populations. Sleep-disordered breathing (SDB) is highly prevalent at high altitude, and SDB and nocturnal hypoxemia have been observed in CMS. Phlebotomy is commonly performed to treat CMS, but it is unknown whether reducing hematocrit improves SDB. We hypothesized that isovolemic hemodilution (IVHD) in CMS would reduce SBD severity and improve sleep efficiency. METHODS Six participants with CMS and 8 without CMS, all residents of Cerro de Pasco, Peru (altitude 4340 m), completed baseline nocturnal sleep studies. CMS participants then underwent IVHD, and nocturnal sleep studies were repeated 24-48 hours after IVHD. We analyzed sleep apnea severity, nocturnal oxygenation, and sleep quality in those with CMS relative to those without CMS, and the effects of IVHD in CMS participants. RESULTS Participants with CMS did not have altered sleep architecture, sleep apnea severity, or nocturnal oxygenation relative to non-CMS participants. However, IVHD in CMS increased apnea-hypopnea index (40.9 ± 6.9 events/h to 61.5 ± 7.7 events/h, P = .009). IVHD increased oxyhemoglobin desaturation index (P = .008) and the percentage of sleep time spent with oxyhemoglobin saturation at or below 80% (P = .012). There was no effect of IVHD on sleep efficiency, arousal index, or sleep staging. CONCLUSIONS In this cohort, CMS was not associated with worsened SDB or changes in sleep architecture. IVHD, a putative therapeutic option for participants with CMS, appears to worsen nocturnal oxygenation and SDB within 48 hours post-IVHD. CITATION Sanchez-Azofra A, Villafuerte FC, DeYoung PN, et al. Isovolemic hemodilution in chronic mountain sickness acutely worsens nocturnal oxygenation and sleep apnea severity. J Clin Sleep Med. 2022;18(10):2423-2432.
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Affiliation(s)
- Ana Sanchez-Azofra
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
- Servicio de Neumología, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, España
| | - Francisco C. Villafuerte
- Laboratorio de Fisiología Comparada, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Pamela N. DeYoung
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
| | - Dillon Gilbertson
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
| | - Wanjun Gu
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
| | - Esteban A. Moya
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
| | - Gustavo Vizcardo-Galindo
- Laboratorio de Fisiología Comparada, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Rómulo Figueroa-Mujíca
- Laboratorio de Fisiología Comparada, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Cecilia Anza-Ramirez
- Laboratorio de Fisiología Comparada, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Jose L. Macarlupú
- Laboratorio de Fisiología Comparada, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Luu V. Pham
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Peter Wagner
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
| | - Atul Malhotra
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
- Center for Physiological Genomics of Low Oxygen, University of California, San Diego, California
| | - Tatum S. Simonson
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
- Center for Physiological Genomics of Low Oxygen, University of California, San Diego, California
| | - Omar A. Mesarwi
- Division of Pulmonary, Critical Care, & Sleep Medicine and Physiology, Department of Medicine, University of California, San Diego, California
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53
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Sörmann J, Schewe M, Proks P, Jouen-Tachoire T, Rao S, Riel EB, Agre KE, Begtrup A, Dean J, Descartes M, Fischer J, Gardham A, Lahner C, Mark PR, Muppidi S, Pichurin PN, Porrmann J, Schallner J, Smith K, Straub V, Vasudevan P, Willaert R, Carpenter EP, Rödström KEJ, Hahn MG, Müller T, Baukrowitz T, Hurles ME, Wright CF, Tucker SJ. Gain-of-function mutations in KCNK3 cause a developmental disorder with sleep apnea. Nat Genet 2022; 54:1534-1543. [PMID: 36195757 PMCID: PMC9534757 DOI: 10.1038/s41588-022-01185-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/09/2022] [Indexed: 11/07/2022]
Abstract
Sleep apnea is a common disorder that represents a global public health burden. KCNK3 encodes TASK-1, a K+ channel implicated in the control of breathing, but its link with sleep apnea remains poorly understood. Here we describe a new developmental disorder with associated sleep apnea (developmental delay with sleep apnea, or DDSA) caused by rare de novo gain-of-function mutations in KCNK3. The mutations cluster around the 'X-gate', a gating motif that controls channel opening, and produce overactive channels that no longer respond to inhibition by G-protein-coupled receptor pathways. However, despite their defective X-gating, these mutant channels can still be inhibited by a range of known TASK channel inhibitors. These results not only highlight an important new role for TASK-1 K+ channels and their link with sleep apnea but also identify possible therapeutic strategies.
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Affiliation(s)
- Janina Sörmann
- Clarendon Laboratory, Department of Physics, University of Oxford, Oxford, UK
- Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford, UK
| | - Marcus Schewe
- Institute of Physiology, Faculty of Medicine, Kiel University, Kiel, Germany
| | - Peter Proks
- Clarendon Laboratory, Department of Physics, University of Oxford, Oxford, UK
- Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford, UK
| | - Thibault Jouen-Tachoire
- Clarendon Laboratory, Department of Physics, University of Oxford, Oxford, UK
- Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford, UK
- Department of Pharmacology, University of Oxford, Oxford, UK
- OXION Initiative in Ion Channels and Disease, University of Oxford, Oxford, UK
| | - Shanlin Rao
- Department of Biochemistry, University of Oxford, Oxford, UK
| | - Elena B Riel
- Institute of Physiology, Faculty of Medicine, Kiel University, Kiel, Germany
| | | | | | - John Dean
- Department of Medical Genetics, NHS Grampian, Aberdeen, UK
| | - Maria Descartes
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jan Fischer
- Institute for Clinical Genetics, Universitätsklinikum, Technischen Universität Dresden, Dresden, Germany
| | - Alice Gardham
- North West Thames Regional Genetics Service, London North West Healthcare NHS Trust, London, UK
| | | | - Paul R Mark
- Spectrum Health Medical Genetics, Grand Rapids, MI, USA
| | | | | | - Joseph Porrmann
- Institute for Clinical Genetics, Universitätsklinikum, Technischen Universität Dresden, Dresden, Germany
| | - Jens Schallner
- Department of Neuropediatrics, Universitätsklinikum, Technischen Universität Dresden, Dresden, Germany
| | - Kirstin Smith
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Volker Straub
- Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, UK
| | - Pradeep Vasudevan
- University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester, UK
| | | | - Elisabeth P Carpenter
- OXION Initiative in Ion Channels and Disease, University of Oxford, Oxford, UK
- Centre for Medicines Discovery, University of Oxford, Oxford, UK
| | | | - Michael G Hahn
- Bayer AG, Research & Development, Pharmaceuticals, Wuppertal, Germany
| | - Thomas Müller
- Bayer AG, Research & Development, Pharmaceuticals, Wuppertal, Germany
| | - Thomas Baukrowitz
- Institute of Physiology, Faculty of Medicine, Kiel University, Kiel, Germany
| | - Matthew E Hurles
- Human Genetics Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Caroline F Wright
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK.
| | - Stephen J Tucker
- Clarendon Laboratory, Department of Physics, University of Oxford, Oxford, UK.
- Kavli Institute for Nanoscience Discovery, University of Oxford, Oxford, UK.
- OXION Initiative in Ion Channels and Disease, University of Oxford, Oxford, UK.
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54
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Peng Y, Nanduri J, Wang N, Khan SA, Pamenter M, Prabhakar NR. Carotid body responses to O 2 and CO 2 in hypoxia-tolerant naked mole rats. Acta Physiol (Oxf) 2022; 236:e13851. [PMID: 35757963 PMCID: PMC9787741 DOI: 10.1111/apha.13851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 02/02/2023]
Abstract
AIM Naked mole rats (NMRs) exhibit blunted hypoxic (HVR) and hypercapnic ventilatory responses (HCVR). The mechanism(s) underlying these responses are largely unknown. We hypothesized that attenuated carotid body (CB) sensitivity to hypoxia and hypercapnia contributes to the near absence of ventilatory responses to hypoxia and CO2 in NMRs. METHODS We measured ex vivo CB sensory nerve activity, phrenic nerve activity (an estimation of ventilation), and blood gases in urethane-anesthetized NMRs and C57BL/6 mice breathing normoxic, hypoxic, or hypercapnic gases. CB morphology, carbon monoxide, and H2 S levels were also determined. RESULTS Relative to mice, NMRs had blunted CB and HVR. Morphologically, NMRs have larger CBs, which contained more glomus cells than in mice. Furthermore, NMR glomus cells form a dispersed pattern compared to a clustered pattern in mice. Hemeoxygenase (HO)-1 mRNA was elevated in NMR CBs, and an HO inhibitor increased CB sensitivity to hypoxia in NMRs. This increase was blocked by an H2 S synthesis inhibitor, suggesting that interrupted gas messenger signaling contributes to the blunted CB responses and HVR in NMRs. Regarding hypercapnia, CB and ventilatory responses to CO2 in NMRs were larger than in mice. Carbonic anhydrase (CA)-2 mRNA is elevated in NMR CBs, and a CA inhibitor blocked the augmented CB response to CO2 in NMRs, indicating CA activity regulates augmented CB response to CO2 . CONCLUSIONS Consistent with our hypothesis, impaired CB responses to hypoxia contribute in part to the blunted HVR in NMRs. Conversely, the HCVR and CB are more sensitive to CO2 in NMRs.
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Affiliation(s)
- Ying‐Jie Peng
- Institute for Integrative Physiology and Center for Systems Biology of O2 SensingUniversity of ChicagoChicagoIllinoisUSA
| | - Jayasri Nanduri
- Institute for Integrative Physiology and Center for Systems Biology of O2 SensingUniversity of ChicagoChicagoIllinoisUSA
| | - Ning Wang
- Institute for Integrative Physiology and Center for Systems Biology of O2 SensingUniversity of ChicagoChicagoIllinoisUSA
| | - Shakil A. Khan
- Institute for Integrative Physiology and Center for Systems Biology of O2 SensingUniversity of ChicagoChicagoIllinoisUSA
| | - Matthew E. Pamenter
- Department of BiologyUniversity of OttawaOttawaOntarioCanada,University of Ottawa Brain and Mind Research InstituteOttawaOntarioCanada
| | - Nanduri R. Prabhakar
- Institute for Integrative Physiology and Center for Systems Biology of O2 SensingUniversity of ChicagoChicagoIllinoisUSA
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55
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Silva TM, Wasinski F, Flor KC, List EO, Kopchick JJ, Takakura AC, Donato J, Moreira TS. The effect of central growth hormone action on hypoxia ventilatory response in conscious mice. Brain Res 2022; 1791:147995. [PMID: 35779583 PMCID: PMC10938300 DOI: 10.1016/j.brainres.2022.147995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/23/2022] [Accepted: 06/26/2022] [Indexed: 11/29/2022]
Abstract
Growth hormone (GH)-responsive neurons regulate several homeostatic behaviors including metabolism, energy balance, arousal, and stress response. Therefore, it is possible that GH-responsive neurons play a role in other responses such as CO2/H+-dependent breathing behaviors. Here, we investigated whether central GH receptor (GHR) modulates respiratory activity in conscious unrestrained mice. First, we detected clusters of GH-responsive neurons in the tyrosine hydroxylase-expressing cells in the rostroventrolateral medulla (C1 region) and within the locus coeruleus (LC). No significant expression was detected in phox2b-expressing cells in the retrotrapezoid nucleus. Whole body plethysmography revealed a reduction in the tachypneic response to hypoxia (FiO2 = 0.08) without changing baseline breathing and the hypercapnic ventilatory response. Contrary to the physiological findings, we did not find significant differences in the number of fos-activated cells in the nucleus of the solitary tract (NTS), C1, LC and paraventricular nucleus of the hypothalamus (PVH). Our finding suggests a possible secondary role of central GH action in the tachypneic response to hypoxia in conscious mice.
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Affiliation(s)
- Talita M Silva
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo (USP), 05508-000 São Paulo/SP, Brazil
| | - Frederick Wasinski
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo (USP), 05508-000 São Paulo/SP, Brazil
| | - Karine C Flor
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo (USP), 05508-000 São Paulo/SP, Brazil
| | - Edward O List
- Edison Biotechnology Institute and Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
| | - John J Kopchick
- Edison Biotechnology Institute and Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
| | - Ana C Takakura
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo (USP), 05508-000 São Paulo/SP, Brazil
| | - Jose Donato
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo (USP), 05508-000 São Paulo/SP, Brazil
| | - Thiago S Moreira
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo (USP), 05508-000 São Paulo/SP, Brazil.
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56
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Winter A, McMurray KMJ, Ahlbrand R, Allgire E, Shukla S, Jones J, Sah R. The subfornical organ regulates acidosis-evoked fear by engaging microglial acid-sensor TDAG8 and forebrain neurocircuits in male mice. J Neurosci Res 2022; 100:1732-1746. [PMID: 35553084 PMCID: PMC9812228 DOI: 10.1002/jnr.25059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 04/06/2022] [Accepted: 04/23/2022] [Indexed: 01/07/2023]
Abstract
An important role of pH homeostasis has been suggested in the physiology of panic disorder, with acidosis as an interoceptive trigger leading to fear and panic. Identification of novel mechanisms that can translate acidosis into fear will promote a better understanding of panic physiology. The current study explores a role of the subfornical organ (SFO), a blood-brain barrier compromised brain area, in translating acidosis to fear-relevant behaviors. We performed SFO-targeted acidification in male, wild-type mice and mice lacking microglial acid-sensing G protein-coupled receptor-T-cell death-associated gene 8 (TDAG8). Localized SFO acidification evoked significant freezing and reduced exploration that was dependent on the presence of acid-sensor TDAG8. Acidosis promoted the activation of SFO microglia and neurons that were absent in TDAG8-deficient mice. The assessment of regional neuronal activation in wild-type and TDAG8-deficient mice following SFO acidification revealed significant acidosis and genotype-dependent alterations in the hypothalamus, amygdala, prefrontal cortex, and periaqueductal gray nuclei. Furthermore, mapping of interregional co-activation patterns revealed that SFO acidosis promoted positive hypothalamic-cortex associations and desynchronized SFO-cortex and amygdala-cortex associations, suggesting an interplay of homeostatic and fear regulatory areas. Importantly, these alterations were not evident in TDAG8-deficient mice. Overall, our data support a regulatory role of subfornical organ microglial acid sensing in acidosis-evoked fear, highlighting a centralized role of blood-brain barrier compromised nodes in interoceptive sensing and behavioral regulation. Identification of pathways by which humoral information can modulate fear behavior is relevant to panic disorder, where aberrant interoceptive signaling has been reported.
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Affiliation(s)
- Andrew Winter
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, Ohio, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio, USA
| | - Katherine M. J. McMurray
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, Ohio, USA
- VA Medical Center, Cincinnati, Ohio, USA
| | - Rebecca Ahlbrand
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, Ohio, USA
- VA Medical Center, Cincinnati, Ohio, USA
| | - Emily Allgire
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, Ohio, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio, USA
| | - Sachi Shukla
- Neuroscience Undergraduate Program, University of Cincinnati, Cincinnati, Ohio, USA
| | - James Jones
- Neuroscience Undergraduate Program, University of Cincinnati, Cincinnati, Ohio, USA
| | - Renu Sah
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, Ohio, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio, USA
- VA Medical Center, Cincinnati, Ohio, USA
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Oku Y. Temporal variations in the pattern of breathing: techniques, sources, and applications to translational sciences. J Physiol Sci 2022; 72:22. [PMID: 36038825 DOI: 10.1186/s12576-022-00847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022]
Abstract
The breathing process possesses a complex variability caused in part by the respiratory central pattern generator in the brainstem; however, it also arises from chemical and mechanical feedback control loops, network reorganization and network sharing with nonrespiratory motor acts, as well as inputs from cortical and subcortical systems. The notion that respiratory fluctuations contain hidden information has prompted scientists to decipher respiratory signals to better understand the fundamental mechanisms of respiratory pattern generation, interactions with emotion, influences on the cortical neuronal networks associated with cognition, and changes in variability in healthy and disease-carrying individuals. Respiration can be used to express and control emotion. Furthermore, respiration appears to organize brain-wide network oscillations via cross-frequency coupling, optimizing cognitive performance. With the aid of information theory-based techniques and machine learning, the hidden information can be translated into a form usable in clinical practice for diagnosis, emotion recognition, and mental conditioning.
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Affiliation(s)
- Yoshitaka Oku
- Division of Physiome, Department of Physiology, Hyogo Medical University, Nishinomiya, Hyogo, 663-8501, Japan.
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58
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Vicka V, Januskeviciute E, Krauklyte J, Aleknaviciene A, Ringaitiene D, Jancoriene L, Sipylaite J. Determinants of Increased Effort of Breathing in Non-Intubated Critical COVID-19 Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081133. [PMID: 36013600 PMCID: PMC9413697 DOI: 10.3390/medicina58081133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/28/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022]
Abstract
Background and objectives: Acute respiratory distress syndrome (ARDS) is the most common complication occurring in COVID-19 patients admitted to the ICU. Given the increased respiratory work of these patients, it is necessary to evaluate their actual breathing efforts. The aim of this study is to report the incidence and determinants of increased effort of breathing (EOB) in critical COVID-19 patients. Materials and Methods: This was a retrospective study of COVID-19 patients admitted to the ICU during the year of 2020. Respiratory rate (RR) was chosen as an indicator of EOB. The cut-off value was set at more than 20 breaths per minute. ROC-AUC analysis was performed to identify the accuracy of the PaO2 and PaCO2 to determine increased EOB. Furthermore, multivariate regression analysis was performed to reveal the determinants of increased EOB. Results: 213 patients were included in the study. Mean RR in the population was 24.20 ± 6.28. 138 (64.8%) of the patients had increased EOB. The ROC-AUC analysis revealed the PaO2 (0.656 (CI 95%: 0.579−0.734, p < 0.001) as more accurate predictor of EOB than PaCO2 (0.584 (CI 95%: 0.505−0.662, p = 0.043). In the final multivariate model, the SpO2 (exp(B) = 0.922, CI 95%: 0.874−0.97 p = 0.033), PaO2/FiO2 ratio (exp(B) = 0.996, CI 95%: 0.922−1.000, p = 0.003) and PaO2 (exp(B) = 0.989 CI 95%: 0.982−0.996 p = 0.003) prevailed as independent predictors of increased EOB. Conclusions: To conclude, PaO2 was revealed as a more accurate predictor of increased EOB than PaCO2. Further investigation revealed the independent determinants of EOB: blood oxygen saturation, PaO2 and PaO2/FiO2 ratio.
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Affiliation(s)
- Vaidas Vicka
- Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania
| | - Elija Januskeviciute
- Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania
- Correspondence: ; Tel.: +370-60887381
| | - Justina Krauklyte
- Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania
| | - Aiste Aleknaviciene
- Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania
| | - Donata Ringaitiene
- Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania
| | - Jurate Sipylaite
- Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Ciurlionio st. 21, LT-03101 Vilnius, Lithuania
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Takakura AC. A new neuromodulatory mechanism in the lateral hypothalamus regulating the hypercapnic ventilatory response in conscious rats. Exp Physiol 2022; 107:1212-1213. [PMID: 35969214 DOI: 10.1113/ep090733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/11/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Ana C Takakura
- Department of Pharmacology, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, São Paulo, SP, 05508-000, Brazil
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60
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Zha XM, Xiong ZG, Simon RP. pH and proton-sensitive receptors in brain ischemia. J Cereb Blood Flow Metab 2022; 42:1349-1363. [PMID: 35301897 PMCID: PMC9274858 DOI: 10.1177/0271678x221089074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/28/2022] [Indexed: 01/01/2023]
Abstract
Extracellular proton concentration is at 40 nM when pH is 7.4. In disease conditions such as brain ischemia, proton concentration can reach µM range. To respond to this increase in extracellular proton concentration, the mammalian brain expresses at least three classes of proton receptors. Acid-sensing ion channels (ASICs) are the main neuronal cationic proton receptor. The proton-activated chloride channel (PAC), which is also known as (aka) acid-sensitive outwardly rectifying anion channel (ASOR; TMEM206), mediates acid-induced chloride currents. Besides proton-activated channels, GPR4, GPR65 (aka TDAG8, T-cell death-associated gene 8), and GPR68 (aka OGR1, ovarian cancer G protein-coupled receptor 1) function as proton-sensitive G protein-coupled receptors (GPCRs). Though earlier studies on these GPCRs mainly focus on peripheral cells, we and others have recently provided evidence for their functional importance in brain injury. Specifically, GPR4 shows strong expression in brain endothelium, GPR65 is present in a fraction of microglia, while GPR68 exhibits predominant expression in brain neurons. Here, to get a better view of brain acid signaling and its contribution to ischemic injury, we will review the recent findings regarding the differential contribution of proton-sensitive GPCRs to cerebrovascular function, neuroinflammation, and neuronal injury following acidosis and brain ischemia.
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Affiliation(s)
- Xiang-ming Zha
- Division of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Zhi-Gang Xiong
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Roger P Simon
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, GA, USA
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Oliveira LM, Fernandes-Junior SA, Cabral LMC, Miranda NCS, Czeisler CM, Otero JJ, Moreira TS, Takakura AC. Regulation of blood vessels by ATP in the ventral medullary surface in a rat model of Parkinson's disease. Brain Res Bull 2022; 187:138-154. [PMID: 35777704 DOI: 10.1016/j.brainresbull.2022.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/26/2022] [Accepted: 06/25/2022] [Indexed: 11/17/2022]
Abstract
Parkinson's disease (PD) patients often experience impairment of autonomic and respiratory functions. These include conditions such as orthostatic hypotension and sleep apnea, which are highly correlated with dysfunctional central chemoreception. Blood flow is a fundamental determinant of tissue CO2/H+, yet the extent to which blood flow regulation within chemoreceptor regions contributes to respiratory behavior during neurological disease remains unknown. Here, we tested the hypothesis that 6-hydroxydopamine injection to inducing a known model of PD results in dysfunctional vascular homeostasis, biochemical dysregulation, and glial morphology of the ventral medullary surface (VMS). We show that hypercapnia (FiCO2 = 10%) induced elevated VMS pial vessel constriction in PD animals through a P2-receptor dependent mechanism. Similarly, we found a greater CO2-induced vascular constriction after ARL67156 (an ectonucleotidase inhibitor) in control and PD-induced animals. In addition, we also report that weighted gene correlational network analysis of the proteomic data showed a protein expression module differentially represented between both groups. This module showed that gene ontology enrichment for components of the ATP machinery were reduced in our PD-model compared to control animals. Altogether, our data indicate that dysfunction in purinergic signaling, potentially through altered ATP bioavailability in the VMS region, may compromise the RTN neuroglial vascular unit in a PD animal model.
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Affiliation(s)
- Luiz M Oliveira
- Departamento de Farmacologia, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, 05508-000, Brazil
| | - Silvio A Fernandes-Junior
- Departamento de Farmacologia, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, 05508-000, Brazil; The Ohio State University College of Medicine, Department of Pathology, USA
| | - Laís M C Cabral
- Departamento de Farmacologia, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, 05508-000, Brazil
| | - Nicole C S Miranda
- Departamento de Farmacologia, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, 05508-000, Brazil
| | | | - José J Otero
- The Ohio State University College of Medicine, Department of Pathology, USA
| | - Thiago S Moreira
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, 05508-000, Brazil
| | - Ana C Takakura
- Departamento de Farmacologia, Instituto de Ciencias Biomedicas, Universidade de Sao Paulo, SP, 05508-000, Brazil.
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Gu L, Yu Q, Shen Y, Wang Y, Xu Q, Zhang H. The role of monoaminergic neurons in modulating respiration during sleep and the connection with SUDEP. Biomed Pharmacother 2022; 150:112983. [PMID: 35453009 DOI: 10.1016/j.biopha.2022.112983] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 11/25/2022] Open
Abstract
Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death among epilepsy patients, occurring even more frequently in cases with anti-epileptic drug resistance. Despite some advancements in characterizing SUDEP, the underlying mechanism remains incompletely understood. This review summarizes the latest advances in our understanding of the pathogenic mechanisms of SUDEP, in order to identify possible targets for the development of new strategies to prevent SUDEP. Based on our previous research along with the current literature, we focus on the role of sleep-disordered breathing (SDB) and its related neural mechanisms to consider the possible roles of monoaminergic neurons in the modulation of respiration during sleep and the occurrence of SUDEP. Overall, this review suggests that targeting the monoaminergic neurons is a promising approach to preventing SUDEP. The proposed roles of SDB and related monoaminergic neural mechanisms in SUDEP provide new insights for explaining the pathogenesis of SUDEP.
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Affiliation(s)
- LeYuan Gu
- Department of Anesthesiology, The Fourth Clinical School of Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, China; Department of Anesthesiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Qian Yu
- Department of Anesthesiology, The Fourth Clinical School of Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, China; Department of Anesthesiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Yue Shen
- Department of Anesthesiology, The Fourth Clinical School of Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, China; Department of Anesthesiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - YuLing Wang
- Department of Anesthesiology, The Fourth Clinical School of Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, China; Department of Anesthesiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Qing Xu
- Department of Anesthesiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - HongHai Zhang
- Department of Anesthesiology, The Fourth Clinical School of Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, China; Department of Anesthesiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China; Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310006, China.
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Toledo C, Díaz-Jara E, Diaz HS, Schwarz KG, Pereyra KV, Las Heras A, Rios-Gallardo A, Andrade DC, Moreira T, Takakura A, Marcus NJ, Del Rio R. Medullary astrocytes mediate irregular breathing patterns generation in chronic heart failure through purinergic P2X7 receptor signalling. EBioMedicine 2022; 80:104044. [PMID: 35533501 PMCID: PMC9097632 DOI: 10.1016/j.ebiom.2022.104044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/05/2022] Open
Abstract
Background Breathing disorders (BD) (apnoeas/hypopneas, periodic breathing) are highly prevalent in chronic heart failure (CHF) and are associated with altered central respiratory control. Ample evidence identifies the retrotrapezoid nucleus (RTN) as an important chemosensitivity region for ventilatory control and generation of BD in CHF, however little is known about the cellular mechanisms underlying the RTN/BD relationship. Within the RTN, astrocyte‐mediated purinergic signalling modulates respiration, but the potential contribution of RTN astrocytes to BD in CHF has not been explored. Methods Selective neuron and/or astrocyte-targeted interventions using either optogenetic and chemogenetic manipulations in the RTN of CHF rats were used to unveil the contribution of the RTN on the development/maintenance of BD, the role played by astrocytes in BD and the molecular mechanism underpinning these alterations. Findings We showed that episodic photo-stimulation of RTN neurons triggered BD in healthy rats, and that RTN neurons ablation in CHF animals eliminates BD. Also, we found a reduction in astrocytes activity and ATP bioavailability within the RTN of CHF rats, and that chemogenetic restoration of normal RTN astrocyte activity and ATP levels improved breathing regularity in CHF. Importantly, P"X/ P2X7 receptor (P2X7r) expression was reduced in RTN astrocytes from CHF rats and viral vector-mediated delivery of human P2X7 P2X7r into astrocytes increases ATP bioavailability and abolished BD. Interpretation Our results support that RTN astrocytes play a pivotal role on BD generation and maintenance in the setting CHF by a mechanism encompassing P2X7r signalling. Funding This study was funded by the National Research and Development Agency of Chile (ANID).
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Hypoxic and Hypercapnic Responses in Transgenic Murine Model of Alzheimer’s Disease Overexpressing Human AβPP: The Effects of Pretreatment with Memantine and Rivastigmine. Int J Mol Sci 2022; 23:ijms23116004. [PMID: 35682682 PMCID: PMC9180806 DOI: 10.3390/ijms23116004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 12/03/2022] Open
Abstract
Despite the severe respiratory problems reducing the quality of life for Alzheimer’s disease (AD) patients, their causes are poorly understood. We aimed to investigate hypoxic and hypercapnic respiratory responses in a transgenic mouse model of AD (AβPP V717I) overexpressing AβPP and mimicking early-onset AD. The cholinesterase inhibitor rivastigmine and the NMDA receptor antagonist memantine were used to investigate the effects of drugs, used to treat AD cognitive dysfunction, on breathing in hypoxia and hypercapnia. We found a significant increase in the respiratory response to hypercapnia and no difference in the hypoxic response in APP+ mice, compared with the control group (APP−). Memantine had no effect on respiration in either group, including responses to hypoxia and hypercapnia. Rivastigmine depressed resting ventilation and response to hypercapnia irrespective of the mice genotype. Reduction in hypoxia-augmented ventilation by rivastigmine was observed only in APP+ mice, which exhibited lower acetylcholinesterase activity in the hippocampus. Treatment with rivastigmine reduced the enzyme activity in both groups equally in the hippocampus and brainstem. The increased ventilatory response to hypercapnia in transgenic mice may indicate alterations in chemoreceptive respiratory nuclei, resulting in increased CO2 sensitivity. Rivastigmine is a potent reductant of normoxic and hypercapnic respiration in APP+ and APP− mice.
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Jeton F, Perrin-Terrin AS, Yegen CH, Marchant D, Richalet JP, Pichon A, Boncoeur E, Bodineau L, Voituron N. In Transgenic Erythropoietin Deficient Mice, an Increase in Respiratory Response to Hypercapnia Parallels Abnormal Distribution of CO 2/H +-Activated Cells in the Medulla Oblongata. Front Physiol 2022; 13:850418. [PMID: 35514353 PMCID: PMC9061944 DOI: 10.3389/fphys.2022.850418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/21/2022] [Indexed: 12/03/2022] Open
Abstract
Erythropoietin (Epo) and its receptor are expressed in central respiratory areas. We hypothesized that chronic Epo deficiency alters functioning of central respiratory areas and thus the respiratory adaptation to hypercapnia. The hypercapnic ventilatory response (HcVR) was evaluated by whole body plethysmography in wild type (WT) and Epo deficient (Epo-TAgh) adult male mice under 4%CO2. Epo-TAgh mice showed a larger HcVR than WT mice because of an increase in both respiratory frequency and tidal volume, whereas WT mice only increased their tidal volume. A functional histological approach revealed changes in CO2/H+-activated cells between Epo-TAgh and WT mice. First, Epo-TAgh mice showed a smaller increase under hypercapnia in c-FOS-positive number of cells in the retrotrapezoid nucleus/parafacial respiratory group than WT, and this, independently of changes in the number of PHOX2B-expressing cells. Second, we did not observe in Epo-TAgh mice the hypercapnic increase in c-FOS-positive number of cells in the nucleus of the solitary tract present in WT mice. Finally, whereas hypercapnia did not induce an increase in the c-FOS-positive number of cells in medullary raphe nuclei in WT mice, chronic Epo deficiency leads to raphe pallidus and magnus nuclei activation by hyperacpnia, with a significant part of c-FOS positive cells displaying an immunoreactivity for serotonin in the raphe pallidus nucleus. All of these results suggest that chronic Epo-deficiency affects both the pattern of ventilatory response to hypercapnia and associated medullary respiratory network at adult stage with an increase in the sensitivity of 5-HT and non-5-HT neurons of the raphe medullary nuclei leading to stimulation of fR for moderate level of CO2.
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Affiliation(s)
- Florine Jeton
- Laboratoire "Hypoxie et Poumons", UMR INSERM U1272, Université Paris 13, UFR SMBH, Bobigny, France.,Laboratory of Excellence (Labex) GR-Ex, PRES Sorbonne Paris Cité, Paris, France
| | - Anne-Sophie Perrin-Terrin
- Laboratoire "Hypoxie et Poumons", UMR INSERM U1272, Université Paris 13, UFR SMBH, Bobigny, France.,Inserm, UMR_S1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, France
| | - Celine-Hivda Yegen
- Laboratoire "Hypoxie et Poumons", UMR INSERM U1272, Université Paris 13, UFR SMBH, Bobigny, France
| | - Dominique Marchant
- Laboratoire "Hypoxie et Poumons", UMR INSERM U1272, Université Paris 13, UFR SMBH, Bobigny, France
| | - Jean-Paul Richalet
- Laboratoire "Hypoxie et Poumons", UMR INSERM U1272, Université Paris 13, UFR SMBH, Bobigny, France.,Laboratory of Excellence (Labex) GR-Ex, PRES Sorbonne Paris Cité, Paris, France
| | - Aurélien Pichon
- Laboratoire "Hypoxie et Poumons", UMR INSERM U1272, Université Paris 13, UFR SMBH, Bobigny, France.,Laboratory of Excellence (Labex) GR-Ex, PRES Sorbonne Paris Cité, Paris, France
| | - Emilie Boncoeur
- Laboratoire "Hypoxie et Poumons", UMR INSERM U1272, Université Paris 13, UFR SMBH, Bobigny, France
| | - Laurence Bodineau
- Inserm, UMR_S1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, France
| | - Nicolas Voituron
- Laboratoire "Hypoxie et Poumons", UMR INSERM U1272, Université Paris 13, UFR SMBH, Bobigny, France.,Laboratory of Excellence (Labex) GR-Ex, PRES Sorbonne Paris Cité, Paris, France
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Pho H, Amorim MR, Qiu Q, Shin M, Kim LJ, Anokye‐Danso F, Jun JJ, Ahima RS, Branco LGS, Kuhn DM, Mateika JH, Polotsky VY. The effect of brain serotonin deficiency on breathing is magnified by age. Physiol Rep 2022; 10:e15245. [PMID: 35581741 PMCID: PMC9114658 DOI: 10.14814/phy2.15245] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/25/2022] [Accepted: 03/13/2022] [Indexed: 11/24/2022] Open
Abstract
Serotonin is an important mediator modulating behavior, metabolism, sleep, control of breathing, and upper airway function, but the role of aging in serotonin-mediated effects has not been previously defined. Our study aimed to examine the effect of brain serotonin deficiency on breathing during sleep and metabolism in younger and older mice. We measured breathing during sleep, hypercapnic ventilatory response (HCVR), CO2 production (VCO2 ), and O2 consumption (VO2 ) in 16-18-week old and 40-44-week old mice with deficiency of tryptophan hydroxylase 2 (Tph2), which regulates serotonin synthesis specifically in neurons, compared to Tph2+/+ mice. As expected, aging decreased VCO2 and VO2 . Tph2 knockout resulted in an increase in both metabolic indexes and no interaction between age and the genotype was observed. During wakefulness, neither age nor genotype had an effect on minute ventilation. The genotype did not affect hypercapnic sensitivity in younger mice. During sleep, Tph2-/- mice showed significant decreases in maximal inspiratory flow in NREM sleep, respiratory rate, and oxyhemoglobin saturation in REM sleep, compared to wildtype, regardless of age. Neither serotonin deficiency nor aging affected the frequency of flow limited breaths (a marker of upper airway closure) or apneas. Serotonin deficiency increased the amount and efficiency of sleep only in older animals. In conclusion, younger Tph2-/- mice were able to defend their ventilation and phenotypically did not differ from wildtype during wakefulness. In contrast, both young and old Tph2-/- mice showed sleep-related hypoventilation, which was manifested by hypoxemia during REM sleep.
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Affiliation(s)
- Huy Pho
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Mateus R. Amorim
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Qingchao Qiu
- Department of PhysiologyWayne State UniversityDetroitMichiganUSA
| | - Mi‐Kyung Shin
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Lenise J. Kim
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Frederick Anokye‐Danso
- Division of Endocrinology, Diabetes, and MetabolismDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jonathan J. Jun
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Rexford S. Ahima
- Division of Endocrinology, Diabetes, and MetabolismDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Luiz G. S. Branco
- Dental School of Ribeirão PretoUniversity of São PauloSão PauloBrazil
| | - Donald M. Kuhn
- Department of Psychiatry and Behavioral NeurosciencesWayne State University School of MedicineDetroitMichiganUSA
- John D. Dingell Veterans Affairs Medical CenterDetroitMichiganUSA
| | - Jason H. Mateika
- Department of PhysiologyWayne State UniversityDetroitMichiganUSA
- John D. Dingell Veterans Affairs Medical CenterDetroitMichiganUSA
- Department of Internal MedicineWayne State University School of MedicineDetroitMichiganUSA
| | - Vsevolod Y. Polotsky
- Division of Pulmonary and Critical Care MedicineDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Osorio-Forero A, Cherrad N, Banterle L, Fernandez LMJ, Lüthi A. When the Locus Coeruleus Speaks Up in Sleep: Recent Insights, Emerging Perspectives. Int J Mol Sci 2022; 23:ijms23095028. [PMID: 35563419 PMCID: PMC9099715 DOI: 10.3390/ijms23095028] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 12/03/2022] Open
Abstract
For decades, numerous seminal studies have built our understanding of the locus coeruleus (LC), the vertebrate brain’s principal noradrenergic system. Containing a numerically small but broadly efferent cell population, the LC provides brain-wide noradrenergic modulation that optimizes network function in the context of attentive and flexible interaction with the sensory environment. This review turns attention to the LC’s roles during sleep. We show that these roles go beyond down-scaled versions of the ones in wakefulness. Novel dynamic assessments of noradrenaline signaling and LC activity uncover a rich diversity of activity patterns that establish the LC as an integral portion of sleep regulation and function. The LC could be involved in beneficial functions for the sleeping brain, and even minute alterations in its functionality may prove quintessential in sleep disorders.
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68
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Zoccal DB. Past questions, present results, future perspectives: interacting chemosensitive areas and the hypercapnic ventilatory response. J Physiol 2022; 600:2549-2550. [DOI: 10.1113/jp283142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 04/21/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Daniel B. Zoccal
- Department of Physiology and Pathology School of Dentistry of Araraquara São Paulo State University (UNESP)
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Betka S, Adler D, Similowski T, Blanke O. Breathing control, brain, and bodily self-consciousness: Toward immersive digiceuticals to alleviate respiratory suffering. Biol Psychol 2022; 171:108329. [PMID: 35452780 DOI: 10.1016/j.biopsycho.2022.108329] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 01/19/2023]
Abstract
Breathing is peculiar among autonomic functions through several characteristics. It generates a very rich afferent traffic from an array of structures belonging to the respiratory system to various areas of the brain. It is intimately associated with bodily movements. It bears particular relationships with consciousness as its efferent motor control can be automatic or voluntary. In this review within the scope of "respiratory neurophysiology" or "respiratory neuroscience", we describe the physiological organisation of breathing control. We then review findings linking breathing and bodily self-consciousness through respiratory manipulations using virtual reality (VR). After discussing the currently admitted neurophysiological model for dyspnea, as well as a new Bayesian model applied to breathing control, we propose that visuo-respiratory paradigms -as developed in cognitive neuroscience- will foster insights into some of the basic mechanisms of the human respiratory system and will also lead to the development of immersive VR-based digital health tools (i.e. digiceuticals).
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Affiliation(s)
- Sophie Betka
- Laboratory of Cognitive Neuroscience, Brain Mind Institute and Center for Neuroprosthetics, Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, (EPFL), Geneva 1202, Switzerland.
| | - Dan Adler
- Division of Lung Diseases, University Hospital and Geneva Medical School, University of Geneva, Switzerland
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département R3S (Respiration, Réanimation, Réhabilitation respiratoire, Sommeil), F-75013 Paris, France
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Brain Mind Institute and Center for Neuroprosthetics, Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, (EPFL), Geneva 1202, Switzerland; Department of Clinical Neurosciences, University Hospital and Geneva Medical School, University of Geneva, Switzerland
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70
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Rico-Díaz J, Río-Rodríguez D, Gómez-Varela J, Martín-Acero R. Handball Training and Competition With Facemasks in Galicia: The FISICOVID-DXTGALEGO Protocols Experience. Front Psychol 2022; 13:851732. [PMID: 35465546 PMCID: PMC9022707 DOI: 10.3389/fpsyg.2022.851732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
Objective COVID-19 caused a complete stop in non-professional sports. The use of face masks for team sports is not a widely used measure in non-professional sports. The study aimed to evaluate the perception about using the mask and the adaptation difficulties related to training and competition in team sports following the FISICOVID-DXTGALEGO protocol. Methods Seven hundred eighty-seven handball players from the Galician Handball Federation were followed during their return to participation after months of confinement through an electronic questionnaire of perception and experience on the use of a mask. Results There is an excellent adaptation to the mask in training and competition with medium and high correlations. The 86,41% of players reported an adaptation to the mask in 3 weeks with a three times a week training frequency. The negative opinion on the mask was drastically reduced (-66.86%) after use. The 80,44% of players considered the use of a mask as an essential measure to resume competitions. Conclusions It is very feasible to adapt to training and compete with a mask (hygienic or surgical) in a short period. The use of a mask following these protocols changed previous opinions on the disadvantages of the mask during training and competition.
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Affiliation(s)
- Javier Rico-Díaz
- Facultade de Ciencias da Educación, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Dan Río-Rodríguez
- Grupo de Aprendizaje y Control del Movimiento Humano, Facultade de Ciencias do Deporte e a Educación Física, Universidade da Coruña, A Coruña, Spain
- ATP Entrenamiento Personal, A Coruña, Spain
| | - Joaquín Gómez-Varela
- Grupo de Aprendizaje y Control del Movimiento Humano, Facultade de Ciencias do Deporte e a Educación Física, Universidade da Coruña, A Coruña, Spain
| | - Rafael Martín-Acero
- Grupo de Aprendizaje y Control del Movimiento Humano, Facultade de Ciencias do Deporte e a Educación Física, Universidade da Coruña, A Coruña, Spain
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Shi Y, Sobrinho CR, Soto-Perez J, Milla BM, Stornetta DS, Stornetta RL, Takakura AC, Mulkey DK, Moreira TS, Bayliss DA. 5-HT7 receptors expressed in the mouse parafacial region are not required for respiratory chemosensitivity. J Physiol 2022; 600:2789-2811. [PMID: 35385139 PMCID: PMC9167793 DOI: 10.1113/jp282279] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract A brainstem homeostatic system senses CO2/H+ to regulate ventilation, blood gases and acid–base balance. Neurons of the retrotrapezoid nucleus (RTN) and medullary raphe are both implicated in this mechanism as respiratory chemosensors, but recent pharmacological work suggested that the CO2/H+ sensitivity of RTN neurons is mediated indirectly, by raphe‐derived serotonin acting on 5‐HT7 receptors. To investigate this further, we characterized Htr7 transcript expression in phenotypically identified RTN neurons using multiplex single cell qRT‐PCR and RNAscope. Although present in multiple neurons in the parafacial region of the ventrolateral medulla, Htr7 expression was undetectable in most RTN neurons (Nmb+/Phox2b+) concentrated in the densely packed cell group ventrolateral to the facial nucleus. Where detected, Htr7 expression was modest and often associated with RTN neurons that extend dorsolaterally to partially encircle the facial nucleus. These dorsolateral Nmb+/Htr7+ neurons tended to express Nmb at high levels and the intrinsic RTN proton detectors Gpr4 and Kcnk5 at low levels. In mouse brainstem slices, CO2‐stimulated firing in RTN neurons was mostly unaffected by a 5‐HT7 receptor antagonist, SB269970 (n = 11/13). At the whole animal level, microinjection of SB269970 into the RTN of conscious mice blocked respiratory stimulation by co‐injected LP‐44, a 5‐HT7 receptor agonist, but had no effect on CO2‐stimulated breathing in those same mice. We conclude that Htr7 is expressed by a minor subset of RTN neurons with a molecular profile distinct from the established chemoreceptors and that 5‐HT7 receptors have negligible effects on CO2‐evoked firing activity in RTN neurons or on CO2‐stimulated breathing in mice. Key points Neurons of the retrotrapezoid nucleus (RTN) are intrinsic CO2/H+ chemosensors and serve as an integrative excitatory hub for control of breathing. Serotonin can activate RTN neurons, in part via 5‐HT7 receptors, and those effects have been implicated in conferring an indirect CO2 sensitivity. Multiple single cell molecular approaches revealed low levels of 5‐HT7 receptor transcript expression restricted to a limited population of RTN neurons. Pharmacological experiments showed that 5‐HT7 receptors in RTN are not required for CO2/H+‐stimulation of RTN neuronal activity or CO2‐stimulated breathing. These data do not support a role for 5‐HT7 receptors in respiratory chemosensitivity mediated by RTN neurons.
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Affiliation(s)
- Yingtang Shi
- Department of Pharmacology, University of Virginia, Charlottesville, VA, USA
| | - Cleyton R Sobrinho
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Jaseph Soto-Perez
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
| | - Brenda M Milla
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
| | - Daniel S Stornetta
- Department of Pharmacology, University of Virginia, Charlottesville, VA, USA
| | - Ruth L Stornetta
- Department of Pharmacology, University of Virginia, Charlottesville, VA, USA
| | - Ana C Takakura
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Daniel K Mulkey
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
| | - Thiago S Moreira
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
| | - Douglas A Bayliss
- Department of Pharmacology, University of Virginia, Charlottesville, VA, USA
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72
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Kaczyńska K, Orłowska ME, Andrzejewski K. Respiratory Abnormalities in Parkinson's Disease: What Do We Know from Studies in Humans and Animal Models? Int J Mol Sci 2022; 23:ijms23073499. [PMID: 35408858 PMCID: PMC8998219 DOI: 10.3390/ijms23073499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
Parkinson’s disease (PD) is the second most common progressive neurodegenerative disease characterized by movement disorders due to the progressive loss of dopaminergic neurons in the ventrolateral region of the substantia nigra pars compacta (SNpc). Apart from the cardinal motor symptoms such as rigidity and bradykinesia, non-motor symptoms including those associated with respiratory dysfunction are of increasing interest. Not only can they impair the patients’ quality of life but they also can cause aspiration pneumonia, which is the leading cause of death among PD patients. This narrative review attempts to summarize the existing literature on respiratory impairments reported in human studies, as well as what is newly known from studies in animal models of the disease. Discussed are not only respiratory muscle dysfunction, apnea, and dyspnea, but also altered central respiratory control, responses to hypercapnia and hypoxia, and how they are affected by the pharmacological treatment of PD.
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73
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Mitrouska I, Bolaki M, Vaporidi K, Georgopoulos D. Respiratory system as the main determinant of dyspnea in patients with pulmonary hypertension. Pulm Circ 2022; 12:e12060. [PMID: 35506092 PMCID: PMC9053013 DOI: 10.1002/pul2.12060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ioanna Mitrouska
- Department of Pulmonary Medicine, University Hospital of Heraklion, Medical School University of Crete Heraklion Crete Greece
| | - Maria Bolaki
- Department of Intensive Care Medicine, University Hospital of Heraklion, Medical School University of Crete Heraklion Crete Greece
| | - Katerina Vaporidi
- Department of Intensive Care Medicine, University Hospital of Heraklion, Medical School University of Crete Heraklion Crete Greece
| | - Dimitris Georgopoulos
- Department of Intensive Care Medicine, University Hospital of Heraklion, Medical School University of Crete Heraklion Crete Greece
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74
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Feinstein JS, Gould D, Khalsa SS. Amygdala-driven apnea and the chemoreceptive origin of anxiety. Biol Psychol 2022; 170:108305. [PMID: 35271957 DOI: 10.1016/j.biopsycho.2022.108305] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 02/09/2022] [Accepted: 03/03/2022] [Indexed: 12/13/2022]
Abstract
Although the amygdala plays an important part in the pathogenesis of anxiety and generation of exteroceptive fear, recent discoveries have challenged the directionality of this brain-behavior relationship with respect to interoceptive fear. Here we highlight several paradoxical findings including: (1) amygdala lesion patients who experience excessive fear and panic following inhalation of carbon dioxide (CO2), (2) clinically anxious patients who have significantly smaller (rather than larger) amygdalae and a pronounced hypersensitivity toward CO2, and (3) epilepsy patients who exhibit apnea immediately following stimulation of their amygdala yet have no awareness that their breathing has stopped. The above findings elucidate an entirely novel role for the amygdala in the induction of apnea and inhibition of CO2-induced fear. Such a role is plausible given the strong inhibitory connections linking the central nucleus of the amygdala with respiratory and chemoreceptive centers in the brainstem. Based on this anatomical arrangement, we propose a model of Apnea-induced Anxiety (AiA) which predicts that recurring episodes of apnea are being unconsciously elicited by amygdala activation, resulting in transient spikes in CO2 that provoke fear and anxiety, and lead to characteristic patterns of escape and avoidance behavior in patients spanning the spectrum of anxiety. If this new conception of AiA proves to be true, and activation of the amygdala can repeatedly trigger states of apnea outside of one's awareness, then it remains possible that the chronicity of anxiety disorders is being interoceptively driven by a chemoreceptive system struggling to maintain homeostasis in the midst of these breathless states.
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Affiliation(s)
- Justin S Feinstein
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA, 74136; University of Tulsa, Oxley College of Health Sciences, Tulsa, Oklahoma, USA, 74104; University of Iowa, Department of Neurology, Iowa City, Iowa, USA, 52242.
| | - Dylan Gould
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA, 74136
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA, 74136; University of Tulsa, Oxley College of Health Sciences, Tulsa, Oklahoma, USA, 74104
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75
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Imenez Silva PH, Wagner CA. Physiological relevance of proton-activated GPCRs. Pflugers Arch 2022; 474:487-504. [PMID: 35247105 PMCID: PMC8993716 DOI: 10.1007/s00424-022-02671-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 12/12/2022]
Abstract
The detection of H+ concentration variations in the extracellular milieu is accomplished by a series of specialized and non-specialized pH-sensing mechanisms. The proton-activated G protein–coupled receptors (GPCRs) GPR4 (Gpr4), TDAG8 (Gpr65), and OGR1 (Gpr68) form a subfamily of proteins capable of triggering intracellular signaling in response to alterations in extracellular pH around physiological values, i.e., in the range between pH 7.5 and 6.5. Expression of these receptors is widespread for GPR4 and OGR1 with particularly high levels in endothelial cells and vascular smooth muscle cells, respectively, while expression of TDAG8 appears to be more restricted to the immune compartment. These receptors have been linked to several well-studied pH-dependent physiological activities including central control of respiration, renal adaption to changes in acid–base status, secretion of insulin and peripheral responsiveness to insulin, mechanosensation, and cellular chemotaxis. Their role in pathological processes such as the genesis and progression of several inflammatory diseases (asthma, inflammatory bowel disease), and tumor cell metabolism and invasiveness, is increasingly receiving more attention and makes these receptors novel and interesting targets for therapy. In this review, we cover the role of these receptors in physiological processes and will briefly discuss some implications for disease processes.
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Affiliation(s)
- Pedro H Imenez Silva
- Institute of Physiology, University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland. .,National Center of Competence in Research NCCR Kidney.CH, Zurich, Switzerland.
| | - Carsten A Wagner
- Institute of Physiology, University of Zurich, Winterthurerstrasse 190, CH-8057, Zurich, Switzerland. .,National Center of Competence in Research NCCR Kidney.CH, Zurich, Switzerland.
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76
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Severs L, Vlemincx E, Ramirez JM. The psychophysiology of the sigh: I: The sigh from the physiological perspective. Biol Psychol 2022; 170:108313. [DOI: 10.1016/j.biopsycho.2022.108313] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 12/30/2022]
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77
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Kinkead R, Gagnon M, Carrier MC, Fournier S, Ambrozio-Marques D. Amygdala-driven apnea: a breath of fresh air in respiratory neurobiology. Biol Psychol 2022; 170:108307. [DOI: 10.1016/j.biopsycho.2022.108307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/16/2022] [Accepted: 03/03/2022] [Indexed: 11/02/2022]
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78
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Prescott SL, Liberles SD. Internal senses of the vagus nerve. Neuron 2022; 110:579-599. [PMID: 35051375 PMCID: PMC8857038 DOI: 10.1016/j.neuron.2021.12.020] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/30/2021] [Accepted: 12/11/2021] [Indexed: 12/16/2022]
Abstract
The vagus nerve is an indispensable body-brain connection that controls vital aspects of autonomic physiology like breathing, heart rate, blood pressure, and gut motility, reflexes like coughing and swallowing, and survival behaviors like feeding, drinking, and sickness responses. Classical physiological studies and recent molecular/genetic approaches have revealed a tremendous diversity of vagal sensory neuron types that innervate different internal organs, with many cell types remaining poorly understood. Here, we review the state of knowledge related to vagal sensory neurons that innervate the respiratory, cardiovascular, and digestive systems. We focus on cell types and their response properties, physiological/behavioral roles, engaged neural circuits and, when possible, sensory receptors. We are only beginning to understand the signal transduction mechanisms used by vagal sensory neurons and upstream sentinel cells, and future studies are needed to advance the field of interoception to the level of mechanistic understanding previously achieved for our external senses.
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79
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Disordered breathing in severe cerebral illness - towards a conceptual framework. Respir Physiol Neurobiol 2022; 300:103869. [PMID: 35181538 DOI: 10.1016/j.resp.2022.103869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/26/2022] [Accepted: 02/11/2022] [Indexed: 12/16/2022]
Abstract
Despite potentially life-threatening symptoms of disordered breathing in severe cerebral illness, there are no clear recommendations on diagnostic and therapeutic strategies for these patients. To identify types of breathing disorders observed in severely neurological comprised patients, to direct further research on classification, pathophysiology, diagnosis and treatment for disordered breathing in cerebral disease. Data including polygraphy, transcutaneous capnometry, blood gas analysis and radiological examinations of patients with severe cerebral illness and disordered breathing admitted to the neurological intensive care were analyzed. Patients (15) presented with acquired central hypoventilation syndrome (ACHS), central bradypnea, central tachypnea, obstructive, mixed and central apneas and hypopneas, Cheyne Stokes respiration, ataxic (Biot's) breathing, cluster breathing and respiration alternans. Severe cerebral illness may result in an ACHS and in a variety of disorders of the respiratory rhythm. Two of these, abrupt switches between breathing patterns and respiration alternans, suggest the existence of a rhythmogenic respiratory network. Polygraphy, transcutaneous capnometry, blood gas analysis and MRI are promising tools for diagnosis and research alike.
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80
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Lusk SJ, McKinney A, Hunt PJ, Fahey PG, Patel J, Chang A, Sun JJ, Martinez VK, Zhu PJ, Egbert JR, Allen G, Jiang X, Arenkiel BR, Tolias AS, Costa-Mattioli M, Ray RS. A CRISPR toolbox for generating intersectional genetic mouse models for functional, molecular, and anatomical circuit mapping. BMC Biol 2022; 20:28. [PMID: 35086530 PMCID: PMC8796356 DOI: 10.1186/s12915-022-01227-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 01/06/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The functional understanding of genetic interaction networks and cellular mechanisms governing health and disease requires the dissection, and multifaceted study, of discrete cell subtypes in developing and adult animal models. Recombinase-driven expression of transgenic effector alleles represents a significant and powerful approach to delineate cell populations for functional, molecular, and anatomical studies. In addition to single recombinase systems, the expression of two recombinases in distinct, but partially overlapping, populations allows for more defined target expression. Although the application of this method is becoming increasingly popular, its experimental implementation has been broadly restricted to manipulations of a limited set of common alleles that are often commercially produced at great expense, with costs and technical challenges associated with production of intersectional mouse lines hindering customized approaches to many researchers. Here, we present a simplified CRISPR toolkit for rapid, inexpensive, and facile intersectional allele production. RESULTS Briefly, we produced 7 intersectional mouse lines using a dual recombinase system, one mouse line with a single recombinase system, and three embryonic stem (ES) cell lines that are designed to study the way functional, molecular, and anatomical features relate to each other in building circuits that underlie physiology and behavior. As a proof-of-principle, we applied three of these lines to different neuronal populations for anatomical mapping and functional in vivo investigation of respiratory control. We also generated a mouse line with a single recombinase-responsive allele that controls the expression of the calcium sensor Twitch-2B. This mouse line was applied globally to study the effects of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) on calcium release in the ovarian follicle. CONCLUSIONS The lines presented here are representative examples of outcomes possible with the successful application of our genetic toolkit for the facile development of diverse, modifiable animal models. This toolkit will allow labs to create single or dual recombinase effector lines easily for any cell population or subpopulation of interest when paired with the appropriate Cre and FLP recombinase mouse lines or viral vectors. We have made our tools and derivative intersectional mouse and ES cell lines openly available for non-commercial use through publicly curated repositories for plasmid DNA, ES cells, and transgenic mouse lines.
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Affiliation(s)
- Savannah J Lusk
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Andrew McKinney
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Patrick J Hunt
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Paul G Fahey
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Jay Patel
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Andersen Chang
- Department of Statistics, Rice University, Houston, TX, USA
| | - Jenny J Sun
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Vena K Martinez
- Department of Pharmacology, Baylor College of Medicine, Houston, TX, USA
| | - Ping Jun Zhu
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Jeremy R Egbert
- Department of Cell Biology, University of Connecticut, Farmington, CT, USA
| | - Genevera Allen
- Department of Statistics, Computer Science, and Electrical and Computer Engineering, Rice University, Houston, TX, USA
- Neurological Research Institute, Baylor College of Medicine, Houston, TX, USA
| | - Xiaolong Jiang
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Benjamin R Arenkiel
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
- McNair Medical Institute, Houston, TX, USA
| | - Andreas S Tolias
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | | | - Russell S Ray
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA.
- McNair Medical Institute, Houston, TX, USA.
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81
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do Prado DML, Silvino VO, Motta-Santos D, Dos Santos MAP. The effect of the protective face mask on cardiorespiratory response during aerobic exercise. Clin Exp Pharmacol Physiol 2022; 49:453-461. [PMID: 35090062 DOI: 10.1111/1440-1681.13624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 11/10/2021] [Accepted: 11/20/2021] [Indexed: 11/29/2022]
Abstract
Protective face mask (PFM) has been widely used for safety purposes and, after the advent of the COVID-19 pandemic, its use is growing steadily, not only among healthcare personnel but also the general population. While PFM is important to preserve the wearer from contaminating agents present in the airflow, they are well known to increase the subjective perception of breathing difficulty. Although some studies demonstrated that PFM use worsens exercise tolerance, there are several studies stating that there is no such limitation with the use of PFM. Moreover, no serious adverse effects during physical exercise have been found in the literature. Physical exercise represents a significant challenge to the human body through a series of integrated changes in function that involve most of its physiologic systems. In this respect, cardiovascular and respiratory systems provide the capacity to sustain physical tasks over extended periods. Within this scenario, both convective oxygen (O2 ) transport (product of arterial O2 content x blood flow) to the working locomotor muscles and O2 diffusive transport from muscle capillaries to mitochondria are of paramount importance to endurance performance. Interestingly, the effects of PFM on cardiorespiratory response during aerobic exercise depends on the type of mask and exercise (i.e., walking, running, or cycling), including decrease in ventilatory demands, arterial oxygen levels, maximal oxygen consumption, and endurance performance. The purpose of this review was to elucidate the effect of protective face mask-wearing on 1) cardiorespiratory responses during aerobic exercise and 2) endurance performance.
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Affiliation(s)
| | - Valmir Oliveira Silvino
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health, Federal University of Piaui, PI, Brazil
| | - Daisy Motta-Santos
- School of Physical Education, Physiotherapy, and Occupational Therapy, Federal University Minas Gerais, MG, Brazil
| | - Marcos Antônio Pereira Dos Santos
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health, Federal University of Piaui, PI, Brazil
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82
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Winczewska-Wiktor A, Hirschfeld AS, Badura-Stronka M, Wojsyk-Banaszak I, Sobkowiak P, Bartkowska-Śniatkowska A, Babak V, Steinborn B. Central Apneas Due to the CLIFAHDD Syndrome Successfully Treated with Pyridostigmine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020775. [PMID: 35055596 PMCID: PMC8776169 DOI: 10.3390/ijerph19020775] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/12/2021] [Accepted: 01/06/2022] [Indexed: 02/05/2023]
Abstract
NALCN mutations lead to complex neurodevelopmental syndromes, including infantile hypotonia with psychomotor retardation and characteristic facies (IHPRF) and congenital contractures of limbs and face, hypotonia, and developmental delay (CLIFAHDD), which are recessively and dominantly inherited, respectively. We present a patient in whom congenital myasthenic syndrome (CMS) was suspected due to the occurrence of hypotonia and apnea episodes requiring resuscitation. For this reason, treatment with pyridostigmine was introduced. After starting the treatment, a significant improvement was observed in reducing the apnea episodes and slight psychomotor progress. In the course of further diagnostics, CMS was excluded, and CLIFAHDD syndrome was confirmed. Thus, we try to explain a possible mechanism of clinical improvement after the introduction of treatment with pyridostigmine in a patient with a mutation in the NALCN gene.
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Affiliation(s)
- Anna Winczewska-Wiktor
- Chair and Department of Developmental Neurology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland;
- Correspondence:
| | - Adam Sebastian Hirschfeld
- Chair and Department of Medical Genetics, Poznan University of Medical Sciences, 60-352 Poznan, Poland; (A.S.H.); (M.B.-S.); (V.B.)
| | - Magdalena Badura-Stronka
- Chair and Department of Medical Genetics, Poznan University of Medical Sciences, 60-352 Poznan, Poland; (A.S.H.); (M.B.-S.); (V.B.)
- Centers of Medical Genetics GENESIS, 60-529 Poznan, Poland
| | - Irena Wojsyk-Banaszak
- Department of Pulmonology, Pediatric Allergy and Clinical Immunology, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (I.W.-B.); (P.S.)
| | - Paulina Sobkowiak
- Department of Pulmonology, Pediatric Allergy and Clinical Immunology, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (I.W.-B.); (P.S.)
| | - Alicja Bartkowska-Śniatkowska
- Department of Pediatric Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, 60-572 Poznan, Poland;
| | - Valeriia Babak
- Chair and Department of Medical Genetics, Poznan University of Medical Sciences, 60-352 Poznan, Poland; (A.S.H.); (M.B.-S.); (V.B.)
| | - Barbara Steinborn
- Chair and Department of Developmental Neurology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland;
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83
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Salvati KA, Souza GMPR, Lu AC, Ritger ML, Guyenet P, Abbott SB, Beenhakker MP. Respiratory alkalosis provokes spike-wave discharges in seizure-prone rats. eLife 2022; 11:72898. [PMID: 34982032 PMCID: PMC8860449 DOI: 10.7554/elife.72898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/03/2022] [Indexed: 12/13/2022] Open
Abstract
Hyperventilation reliably provokes seizures in patients diagnosed with absence epilepsy. Despite this predictable patient response, the mechanisms that enable hyperventilation to powerfully activate absence seizure-generating circuits remain entirely unknown. By utilizing gas exchange manipulations and optogenetics in the WAG/Rij rat, an established rodent model of absence epilepsy, we demonstrate that absence seizures are highly sensitive to arterial carbon dioxide, suggesting that seizure-generating circuits are sensitive to pH. Moreover, hyperventilation consistently activated neurons within the intralaminar nuclei of the thalamus, a structure implicated in seizure generation. We show that intralaminar thalamus also contains pH-sensitive neurons. Collectively, these observations suggest that hyperventilation activates pH-sensitive neurons of the intralaminar nuclei to provoke absence seizures.
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Affiliation(s)
- Kathryn A Salvati
- Department of Pharmacology, University of Virginia, Charlottesville, United States.,Neuroscience Graduate Program, University of Virginia, Charlottesville, United States
| | - George M P R Souza
- Department of Pharmacology, University of Virginia, Charlottesville, United States
| | - Adam C Lu
- Department of Pharmacology, University of Virginia, Charlottesville, United States.,Neuroscience Graduate Program, University of Virginia, Charlottesville, United States
| | - Matthew L Ritger
- Department of Pharmacology, University of Virginia, Charlottesville, United States.,Neuroscience Graduate Program, University of Virginia, Charlottesville, United States
| | - Patrice Guyenet
- Department of Pharmacology, University of Virginia, Charlottesville, United States
| | - Stephen B Abbott
- Department of Pharmacology, University of Virginia, Charlottesville, United States
| | - Mark P Beenhakker
- Department of Pharmacology, University of Virginia, Charlottesville, United States
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84
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Abstract
Breathing (or respiration) is a complex motor behavior that originates in the brainstem. In minimalistic terms, breathing can be divided into two phases: inspiration (uptake of oxygen, O2) and expiration (release of carbon dioxide, CO2). The neurons that discharge in synchrony with these phases are arranged in three major groups along the brainstem: (i) pontine, (ii) dorsal medullary, and (iii) ventral medullary. These groups are formed by diverse neuron types that coalesce into heterogeneous nuclei or complexes, among which the preBötzinger complex in the ventral medullary group contains cells that generate the respiratory rhythm (Chapter 1). The respiratory rhythm is not rigid, but instead highly adaptable to the physic demands of the organism. In order to generate the appropriate respiratory rhythm, the preBötzinger complex receives direct and indirect chemosensory information from other brainstem respiratory nuclei (Chapter 2) and peripheral organs (Chapter 3). Even though breathing is a hard-wired unconscious behavior, it can be temporarily altered at will by other higher-order brain structures (Chapter 6), and by emotional states (Chapter 7). In this chapter, we focus on the development of brainstem respiratory groups and highlight the cell lineages that contribute to central and peripheral chemoreflexes.
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Affiliation(s)
- Eser Göksu Isik
- Brainstem Group, Institute for Cell Biology and Neurobiology, Charité Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Luis R Hernandez-Miranda
- Brainstem Group, Institute for Cell Biology and Neurobiology, Charité Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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85
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Abstract
Brain PCO2 is sensed primarily via changes in [H+]. Small pH changes are detected in the medulla oblongata and trigger breathing adjustments that help maintain arterial PCO2 constant. Larger perturbations of brain CO2/H+, possibly also sensed elsewhere in the CNS, elicit arousal, dyspnea, and stress, and cause additional breathing modifications. The retrotrapezoid nucleus (RTN), a rostral medullary cluster of glutamatergic neurons identified by coexpression of Phoxb and Nmb transcripts, is the lynchpin of the central respiratory chemoreflex. RTN regulates breathing frequency, inspiratory amplitude, and active expiration. It is exquisitely responsive to acidosis in vivo and maintains breathing autorhythmicity during quiet waking, slow-wave sleep, and anesthesia. The RTN response to [H+] is partly an intrinsic neuronal property mediated by proton sensors TASK-2 and GPR4 and partly a paracrine effect mediated by astrocytes and the vasculature. The RTN also receives myriad excitatory or inhibitory synaptic inputs including from [H+]-responsive neurons (e.g., serotonergic). RTN is silenced by moderate hypoxia. RTN inactivity (periodic or sustained) contributes to periodic breathing and, likely, to central sleep apnea. RTN development relies on transcription factors Egr2, Phox2b, Lbx1, and Atoh1. PHOX2B mutations cause congenital central hypoventilation syndrome; they impair RTN development and consequently the central respiratory chemoreflex.
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Affiliation(s)
- Patrice G Guyenet
- Department of Pharmacology, University of Virginia, Charlottesville, VA, United States.
| | - Douglas A Bayliss
- Department of Pharmacology, University of Virginia, Charlottesville, VA, United States
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86
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Abstract
Obstructive sleep apnea (OSA) is a disease that results from loss of upper airway muscle tone leading to upper airway collapse during sleep in anatomically susceptible persons, leading to recurrent periods of hypoventilation, hypoxia, and arousals from sleep. Significant clinical consequences of the disorder cover a wide spectrum and include daytime hypersomnolence, neurocognitive dysfunction, cardiovascular disease, metabolic dysfunction, respiratory failure, and pulmonary hypertension. With escalating rates of obesity a major risk factor for OSA, the public health burden from OSA and its sequalae are expected to increase, as well. In this chapter, we review the mechanisms responsible for the development of OSA and associated neurocognitive and cardiometabolic comorbidities. Emphasis is placed on the neural control of the striated muscles that control the pharyngeal passages, especially regulation of hypoglossal motoneuron activity throughout the sleep/wake cycle, the neurocognitive complications of OSA, and the therapeutic options available to treat OSA including recent pharmacotherapeutic developments.
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Affiliation(s)
- Luu V Pham
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States.
| | - Jonathan Jun
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Vsevolod Y Polotsky
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States
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87
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de Sousa Abreu RP, Bondarenko E, Feldman JL. Phase- and state-dependent modulation of breathing pattern by preBötzinger complex somatostatin expressing neurons. J Physiol 2022; 600:143-165. [PMID: 34783033 PMCID: PMC9261878 DOI: 10.1113/jp282002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/12/2021] [Indexed: 01/03/2023] Open
Abstract
As neuronal subtypes are increasingly categorized, delineating their functional role is paramount. The preBötzinger complex (preBötC) subpopulation expressing the neuropeptide somatostatin (SST) is classified as mostly excitatory, inspiratory-modulated and not rhythmogenic. We further characterized their phenotypic identity: 87% were glutamatergic and the balance were glycinergic and/or GABAergic. We then used optogenetics to investigate their modulatory role in both anaesthetized and freely moving mice. In anaesthetized mice, short photostimulation (100 ms) of preBötC SST+ neurons modulated breathing-related variables in a combinatory phase- and state-dependent manner; changes in inspiratory duration, inspiratory peak amplitude (Amp), and phase were different at higher (≥2.5 Hz) vs. lower (<2.5 Hz) breathing frequency (f). Moreover, we observed a biphasic effect of photostimulation during expiration that is probabilistic, that is photostimulation given at the same phase in consecutive cycles can evoke opposite responses (lengthening vs. shortening of the phase). These unexpected probabilistic state- and phase-dependent responses to photostimulation exposed properties of the preBötC that were not predicted and cannot be readily accounted for in current models of preBötC pattern generation. In freely moving mice, prolonged photostimulation decreased f in normoxia, hypoxia or hypercapnia, and increased Amp and produced a phase advance, which was similar to the results in anaesthetized mice when f ≥ 2.5 Hz. We conclude that preBötC SST+ neurons are a key mediator of the extraordinary and essential lability of breathing pattern. KEY POINTS: PreBötzinger complex (preBötC) SST+ neurons, which modulate respiratory pattern but are not rhythmogenic, were transfected with channelrhodopsin to investigate phase- and state-dependent modulation of breathing pattern in anaesthetized and freely behaving mice in normoxia, hypoxia and hypercapnia. In anaesthetized mice, photostimulation during inspiration increased inspiratory duration and amplitude regardless of baseline f, yet the effects were more robust at higher f. In anaesthetized mice with low f (<2.5 Hz), photostimulation during expiration evoked either phase advance or phase delay, whereas in anaesthetized mice with high f (≥2.5 Hz) and in freely behaving mice in normoxia, hypoxia or hypercapnia, photostimulation always evoked phase advance. Phase- and state-dependency is a function of overall breathing network excitability. The f-dependent probabilistic modulation of breathing pattern by preBötC SST+ neurons was unexpected, requiring reconsideration of current models of preBötC function, which neither predict nor can readily account for such responses.
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88
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Wasserman AH, Huang AR, Lewis-Israeli YR, Dooley MD, Mitchell AL, Venkatesan M, Aguirre A. Oxytocin promotes epicardial cell activation and heart regeneration after cardiac injury. Front Cell Dev Biol 2022; 10:985298. [PMID: 36247002 PMCID: PMC9561106 DOI: 10.3389/fcell.2022.985298] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Cardiovascular disease (CVD) is one of the leading causes of mortality worldwide, and frequently leads to massive heart injury and the loss of billions of cardiac muscle cells and associated vasculature. Critical work in the last 2 decades demonstrated that these lost cells can be partially regenerated by the epicardium, the outermost mesothelial layer of the heart, in a process that highly recapitulates its role in heart development. Upon cardiac injury, mature epicardial cells activate and undergo an epithelial-mesenchymal transition (EMT) to form epicardium-derived progenitor cells (EpiPCs), multipotent progenitors that can differentiate into several important cardiac lineages, including cardiomyocytes and vascular cells. In mammals, this process alone is insufficient for significant regeneration, but it might be possible to prime it by administering specific reprogramming factors, leading to enhanced EpiPC function. Here, we show that oxytocin (OXT), a hypothalamic neuroendocrine peptide, induces epicardial cell proliferation, EMT, and transcriptional activity in a model of human induced pluripotent stem cell (hiPSC)-derived epicardial cells. In addition, we demonstrate that OXT is produced after cardiac cryoinjury in zebrafish, and that it elicits significant epicardial activation promoting heart regeneration. Oxytocin signaling is also critical for proper epicardium development in zebrafish embryos. The above processes are significantly impaired when OXT signaling is inhibited chemically or genetically through RNA interference. RNA sequencing data suggests that the transforming growth factor beta (TGF-β) pathway is the primary mediator of OXT-induced epicardial activation. Our research reveals for the first time an evolutionary conserved brain-controlled mechanism inducing cellular reprogramming and regeneration of the injured mammalian and zebrafish heart, a finding that could contribute to translational advances for the treatment of cardiac injuries.
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Affiliation(s)
- Aaron H Wasserman
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI, United States.,Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, United States
| | - Amanda R Huang
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI, United States.,Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, United States
| | - Yonatan R Lewis-Israeli
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI, United States.,Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, United States
| | - McKenna D Dooley
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI, United States.,Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, United States
| | - Allison L Mitchell
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI, United States.,Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, United States
| | - Manigandan Venkatesan
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI, United States.,Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, United States
| | - Aitor Aguirre
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, MI, United States.,Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, United States
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89
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Ghosh S. Breathing disorders in neurodegenerative diseases. HANDBOOK OF CLINICAL NEUROLOGY 2022; 189:223-239. [PMID: 36031306 DOI: 10.1016/b978-0-323-91532-8.00008-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Neurodegenerative disorders are a diverse group of conditions caused by progressive degeneration of neurons resulting in cognitive, motor, sensory, and autonomic dysfunction, leading to severe disability and death. Pulmonary dysfunction is relatively common in these conditions, may be present early in the disease, and is less well recognized and treated than other symptoms. There are variable disorders of upper and lower airways, central control of ventilation, strength of respiratory muscles, and breathing during sleep which further impact daily activities and quality of life and have the potential to injure vulnerable neurons. Laryngopharyngeal dysfunction affects speech, swallowing, and clearance of secretions, increases the risk of aspiration pneumonia, and can cause stridor and sudden death. In Parkinson's disease, L-Dopa benefits some pulmonary symptoms but there are limited pharmacological treatment options for pulmonary dysfunction. Targeted treatments include strengthening of respiratory muscles, positive airway pressure in sleep and techniques to improve cough efficacy. Well-designed clinical trials are needed to evaluate the long-term benefits of these interventions. Challenges for the future include earlier identification of pulmonary dysfunction in the clinic, institution of the most effective treatments (based on clinical trials that measure long-term meaningful outcomes) and the development of neuroprotective treatment.
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Affiliation(s)
- Soumya Ghosh
- Perron Institute for Neurological and Translational Science, University of Western Australia and Department of Neurology, Sir Charles Gairdner and Perth Children's Hospitals, Nedlands, WA, Australia.
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90
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Wang X, Luo J, Huang R, Xiao Y. The Elevated Central Chemosensitivity in Obstructive Sleep Apnea Patients with Hypertension. Nat Sci Sleep 2022; 14:855-865. [PMID: 35547180 PMCID: PMC9081185 DOI: 10.2147/nss.s362319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/20/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Hypertension is a common comorbidity in obstructive sleep apnea (OSA), in which dysfunction of the autonomic nervous system plays an integral part. Chemoreflex is essential for ventilatory control and cardiovascular activity. This study aimed to determine whether central chemosensitivity was increased in OSA patients with hypertension and the potential role of the autonomic nerve activity in this relationship. PATIENTS AND METHODS A total of 77 men with OSA were included in this cross-sectional study. We measured hypercapnic ventilatory response (HCVR) by the rebreathing method under isoxic hyperoxia to test the central ventilatory chemosensitivity since hyperoxia silences the peripheral chemoreceptors' response to CO2. To elevate the autonomic nerve activity, time-domain, frequency-domain, and non-linear variables of heart rate variability were calculated over 5-min records. Univariate and multivariate linear regression analyses were used to find the determinants of HCVR. RESULTS The median HCVR was 2.3 (1.8, 3.3), 2.1 (1.6, 3.0), and 3 (2.2, 3.7) L/min/mmHg in all participants, OSA patients, and OSA patients with hypertension, respectively. Hypertension was significantly associated with elevated HCVR after adjusting for age, central obesity, OSA severity, daytime sleepiness, and diabetes mellitus. Compared with OSA patients, OSA patients with hypertension had higher body mass index, worse nocturnal hypoxia, and lower time-domain variables and frequency-domain variables. After adjusting for age, apnea-hypopnea index, central obesity, and beta-blocker usage, approximate entropy was independently negatively associated with HCVR in OSA patients with hypertension. CONCLUSION This study demonstrated elevated central chemosensitivity in OSA patients with hypertension. Compared with OSA patients, OSA patients with hypertension had attenuated parasympathetic nerve activity. This study preliminarily illustrated that elevated central chemosensitivity might be associated with weak adaptability of the cardiac autonomic nervous system in OSA patients with hypertension.
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Affiliation(s)
- Xiaona Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jinmei Luo
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Rong Huang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yi Xiao
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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91
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Gaertner VD, Waldmann AD, Bassler D, Hooper SB, Rüegger CM. Intrapulmonary Volume Changes during Hiccups versus Spontaneous Breaths in a Preterm Infant. Neonatology 2022; 119:525-529. [PMID: 35398844 DOI: 10.1159/000524194] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/16/2022] [Indexed: 11/19/2022]
Abstract
Hiccups occur at all ages but are most common during fetal development, and accordingly, they are seen regularly in preterm infants. However, the physiologic correlate of hiccups has never been established. We present the case of a preterm infant who developed a spell of hiccups and compared lung volume changes during hiccups with spontaneous breaths using electrical impedance tomography. Hiccups mostly occurred during the expiratory phase of breathing and were associated with a shorter inspiratory time and a larger tidal volume compared with spontaneous breaths. The center of ventilation was shifted toward the ventral (non-gravity-dependent) part of the lung during hiccups and volume changes were mainly restricted to the larger airways, but some gas flow also reached the lung parenchyma. Our observations shed new light on this phenomenon, which is well known but little researched, and our findings may imply a physiological impact of hiccups during fetal development.
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Affiliation(s)
- Vincent D Gaertner
- Newborn Research Zurich, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Andreas D Waldmann
- Department of Anesthesiology and Intensive Care Medicine, Rostock University Medical Center, Rostock, Germany
| | - Dirk Bassler
- Newborn Research Zurich, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Stuart B Hooper
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Victoria, Australia
| | - Christoph M Rüegger
- Newborn Research Zurich, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland
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92
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Dervieux E, Théron M, Uhring W. Carbon Dioxide Sensing-Biomedical Applications to Human Subjects. SENSORS (BASEL, SWITZERLAND) 2021; 22:188. [PMID: 35009731 PMCID: PMC8749784 DOI: 10.3390/s22010188] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 02/06/2023]
Abstract
Carbon dioxide (CO2) monitoring in human subjects is of crucial importance in medical practice. Transcutaneous monitors based on the Stow-Severinghaus electrode make a good alternative to the painful and risky arterial "blood gases" sampling. Yet, such monitors are not only expensive, but also bulky and continuously drifting, requiring frequent recalibrations by trained medical staff. Aiming at finding alternatives, the full panel of CO2 measurement techniques is thoroughly reviewed. The physicochemical working principle of each sensing technique is given, as well as some typical merit criteria, advantages, and drawbacks. An overview of the main CO2 monitoring methods and sites routinely used in clinical practice is also provided, revealing their constraints and specificities. The reviewed CO2 sensing techniques are then evaluated in view of the latter clinical constraints and transcutaneous sensing coupled to a dye-based fluorescence CO2 sensing seems to offer the best potential for the development of a future non-invasive clinical CO2 monitor.
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Affiliation(s)
- Emmanuel Dervieux
- BiOSENCY, 1137a Avenue des Champs Blancs, 35510 Cesson-Sévigné, France
| | - Michaël Théron
- ORPHY, Université de Bretagne Occidentale, 6 Avenue Victor le Gorgeu, 29238 Brest, France;
| | - Wilfried Uhring
- ICube, University of Strasbourg and CNRS, 23 rue du Loess, CEDEX, 67037 Strasbourg, France;
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93
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Peters EL, van Campen JSJA, Groepenhoff H, de Man FS, Noordegraaf AV, Bogaard HJ. Bisoprolol and/or hyperoxic breathing do not reduce hyperventilation in pulmonary arterial hypertension patients. Pulm Circ 2021; 11:20458940211057890. [PMID: 34925761 PMCID: PMC8671678 DOI: 10.1177/20458940211057890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
Hyperventilation is common in pulmonary arterial hypertension and may be related to autonomic imbalance. Patients underwent exercise testing and hyperoxic breathing before and after bisoprolol treatment. We found that neither beta blocker treatment nor hyperoxic breathing in patients reduced hyperventilation at rest and during exercise, although it reduced heart rate.
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Affiliation(s)
- Eva L Peters
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jasmijn S J A van Campen
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Herman Groepenhoff
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frances S de Man
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anton Vonk Noordegraaf
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Harm J Bogaard
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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94
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Elliot-Portal E, Arias-Reyes C, Laouafa S, Tam R, Kinkead R, Soliz J. Cerebral Erythropoietin Prevents Sex-Dependent Disruption of Respiratory Control Induced by Early Life Stress. Front Physiol 2021; 12:701344. [PMID: 34987412 PMCID: PMC8720854 DOI: 10.3389/fphys.2021.701344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022] Open
Abstract
Injuries that occur early in life are often at the root of adult illness. Neonatal maternal separation (NMS) is a form of early life stress that has persistent and sex-specific effects on the development of neural networks, including those that regulate breathing. The release of stress hormones during a critical period of development contributes to the deleterious consequences of NMS, but the role of increased corticosterone (CORT) in NMS-induced respiratory disturbance is unknown. Because erythropoietin (EPO) is a potent neuroprotectant that prevents conditions associated with hyperactivation of the stress neuroaxis in a sex-specific manner, we hypothesized that EPO reduces the sex-specific alteration of respiratory regulation induced by NMS in adult mice. Animals were either raised under standard conditions (controls) or exposed to NMS 3 h/day from postnatal days 3–12. We tested the efficacy of EPO in preventing the effects of NMS by comparing wild-type mice with transgenic mice that overexpress EPO only in the brain (Tg21). In 7-days-old pups, NMS augmented CORT levels ~2.5-fold by comparison with controls but only in males; this response was reduced in Tg21 mice. Respiratory function was assessed using whole-body plethysmography. Apneas were detected during sleep; the responsiveness to stimuli was measured by exposing mice to hypoxia (10% O2; 15 min) and hypercapnia (5% CO2; 10 min). In wild-type, NMS increased the number of apneas and the hypercapnic ventilatory response (HcVR) only in males; with no effect on Tg21. In wild-type males, the incidence of apneas was positively correlated with HcVR and inversely related to the tachypneic response to hypoxia. We conclude that neural EPO reduces early life stress-induced respiratory disturbances observed in males.
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Affiliation(s)
- Elizabeth Elliot-Portal
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada
| | - Christian Arias-Reyes
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada
| | - Sofien Laouafa
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada
| | - Rose Tam
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada
| | - Richard Kinkead
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada
| | - Jorge Soliz
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada
- High Altitude Pulmonary and Pathology Institute (HAPPI–IPPA), La Paz, Bolivia
- *Correspondence: Jorge Soliz,
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95
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Chen CR, Zhong YH, Jiang S, Xu W, Xiao L, Wang Z, Qu WM, Huang ZL. Dysfunctions of the paraventricular hypothalamic nucleus induce hypersomnia in mice. eLife 2021; 10:69909. [PMID: 34787078 PMCID: PMC8631797 DOI: 10.7554/elife.69909] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022] Open
Abstract
Hypersomnolence disorder (HD) is characterized by excessive sleep, which is a common sequela following stroke, infection, or tumorigenesis. HD is traditionally thought to be associated with lesions of wake-promoting nuclei. However, lesions of a single wake-promoting nucleus, or even two simultaneously, did not exert serious HD. Therefore, the specific nucleus and neural circuitry for HD remain unknown. Here, we observed that the paraventricular nucleus of the hypothalamus (PVH) exhibited higher c-fos expression during the active period (23:00) than during the inactive period (11:00) in mice. Therefore, we speculated that the PVH, in which most neurons are glutamatergic, may represent one of the key arousal-controlling centers. By using vesicular glutamate transporter 2 (vglut2Cre) mice together with fiber photometry, multichannel electrophysiological recordings, and genetic approaches, we found that PVHvglut2 neurons were most active during wakefulness. Chemogenetic activation of PVHvglut2 neurons induced wakefulness for 9 hr, and photostimulation of PVHvglut2→parabrachial complex/ventral lateral septum circuits immediately drove transitions from sleep to wakefulness. Moreover, lesioning or chemogenetic inhibition of PVHvglut2 neurons dramatically decreased wakefulness. These results indicate that the PVH is critical for arousal promotion and maintenance.
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Affiliation(s)
- Chang-Rui Chen
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Yu-Heng Zhong
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Shan Jiang
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Wei Xu
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Lei Xiao
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Zan Wang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Wei-Min Qu
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Zhi-Li Huang
- Department of Pharmacology, School of Basic Medical Sciences; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
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96
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Madani A, Pitollat G, Sizun E, Cardoit L, Ringot M, Bourgeois T, Ramanantsoa N, Delclaux C, Dauger S, d'Ortho MP, Thoby-Brisson M, Gallego J, Matrot B. Obstructive Apneas in a Mouse Model of Congenital Central Hypoventilation Syndrome. Am J Respir Crit Care Med 2021; 204:1200-1210. [PMID: 34478357 DOI: 10.1164/rccm.202104-0887oc] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Congenital central hypoventilation syndrome (CCHS) is characterized by life-threatening sleep hypoventilation and is caused by PHOX2B gene mutations, most frequently the PHOX2B27Ala/+ mutation, with patients requiring lifelong ventilatory support. It is unclear whether obstructive apneas are part of the syndrome. Objectives: To determine if Phox2b27Ala/+ mice, which present the main symptoms of CCHS and die within hours after birth, also express obstructive apneas, and to investigate potential underlying mechanisms. Methods: Apneas were classified as central, obstructive, or mixed by using a novel system combining pneumotachography and laser detection of abdominal movement immediately after birth. Several respiratory nuclei involved in airway patency were examined by immunohistochemistry and electrophysiology in brainstem-spinal cord preparations. Measurements and Main Results: The median (interquartile range) of obstructive apnea frequency was 2.3 (1.5-3.3)/min in Phox2b27Ala/+ pups versus 0.6 (0.4-1.0)/min in wild types (P < 0.0001). Obstructive apnea duration was 2.7 seconds (2.3-3.9) in Phox2b27Ala/+ pups versus 1.7 seconds (1.1-1.9) in wild types (P < 0.0001). Central and mixed apneas presented similar significant differences. In Phox2b27Ala/+ preparations, the hypoglossal nucleus had fewer (P < 0.05) and smaller (P < 0.01) neurons, compared with wild-type preparations. Importantly, coordination of phrenic and hypoglossal motor activities was disrupted, as evidenced by the longer and variable delay of hypoglossal activity with respect to phrenic activity onset (P < 0.001). Conclusions: The Phox2b27Ala/+ mutation predisposed pups not only to hypoventilation and central apneas, but also to obstructive and mixed apneas, likely because of hypoglossal dysgenesis. These results thus demand attention toward obstructive events in infants with CCHS.
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Affiliation(s)
- Amélia Madani
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France
| | - Gabriel Pitollat
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, UMR5287, Université de Bordeaux, CNRS, Bordeaux, France
| | - Eléonore Sizun
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France
| | - Laura Cardoit
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, UMR5287, Université de Bordeaux, CNRS, Bordeaux, France
| | - Maud Ringot
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France
| | - Thomas Bourgeois
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France
| | | | - Christophe Delclaux
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France.,Service d'Explorations Fonctionnelles Pédiatriques and
| | - Stéphane Dauger
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France.,Service de Médecine Intensive-Réanimation Pédiatriques, Hôpital Robert Debré, AP-HP, Paris, France; and
| | - Marie-Pia d'Ortho
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France.,Service de Physiologie-Explorations Fonctionnelles, Hôpital Bichat, AP-HP, Paris, France
| | - Muriel Thoby-Brisson
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, UMR5287, Université de Bordeaux, CNRS, Bordeaux, France
| | - Jorge Gallego
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France
| | - Boris Matrot
- NeuroDiderot, FHU I2-D2, Université de Paris, Inserm, Paris, France
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97
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Carr JMJR, Caldwell HG, Carter H, Smith K, Tymko MM, Green DJ, Ainslie PN, Hoiland RL. The stability of cerebrovascular CO 2 reactivity following attainment of physiological steady-state. Exp Physiol 2021; 106:2542-2555. [PMID: 34730862 DOI: 10.1113/ep089982] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/14/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? During a steady-state cerebrovascular CO2 reactivity test, do different data extraction time points change the outcome for cerebrovascular CO2 reactivity? What is the main finding and its importance? Once steady-state end-tidal pressure of CO2 and haemodynamics were achieved, cerebral blood flow was stable, and so cerebrovascular CO2 reactivity values remained unchanged regardless of data extraction length (30 vs. 60 s) and time point (at 2-5 min). ABSTRACT This study assessed cerebrovascular CO2 reactivity (CVR) and examined data extraction time points and durations with the hypotheses that: (1) there would be no difference in CVR values when calculated with cerebral blood flow (CBF) measures at different time points following the attainment of physiological steady-state, (2) once steady-state was achieved there would be no difference in CVR values derived from 60 to 30 s extracted means, and (3) that changes in V ̇ E would not be associated with any changes in CVR. We conducted a single step iso-oxic hypercapnic CVR test using dynamic end-tidal forcing (end-tidal P C O 2 , +9.4 ± 0.7 mmHg), and transcranial Doppler and Duplex ultrasound of middle cerebral artery (MCA) and internal carotid artery (ICA), respectively. From the second minute of hypercapnia onwards, physiological steady-state was apparent, with no subsequent changes in end-tidal P C O 2 , P O 2 or mean arterial pressure. Therefore, CVR measured in the ICA and MCA was stable following the second minute of hypercapnia onwards. Data extraction durations of 30 or 60 s did not give statistically different CVR values. No differences in CVR were detected following the second minute of hypercapnia after accounting for mean arterial pressure via calculated conductance or covariation of mean arterial pressure. These findings demonstrate that, provided the P C O 2 stimulus remains in a steady-state, data extracted from any minute of a CVR test during physiological steady-state conditions produce equivalent CVR values; any change in the CVR value would represent a failure of CVR mechanisms, a change in the magnitude of the stimulus, or measurement error.
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Affiliation(s)
- Jay M J R Carr
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Hannah G Caldwell
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Howard Carter
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Kurt Smith
- Cerebrovascular Health, Exercise, and Environmental Research Sciences Laboratory (CHEERS), School of Exercise Science and Physical Health Education, Faculty of Education, University of Victoria, Victoria, British Columbia, Canada
| | - Michael M Tymko
- Neurovascular Health Laboratory, Faculty of Kinesiology, Sport, & Recreation, University of Alberta, Edmonton, Canada
| | - Daniel J Green
- Cardiovascular Research Group, School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Ryan L Hoiland
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,International Collaborations on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
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98
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Ventilatory responses during and following hypercapnic gas challenge are impaired in male but not female endothelial NOS knock-out mice. Sci Rep 2021; 11:20557. [PMID: 34663876 PMCID: PMC8523677 DOI: 10.1038/s41598-021-99922-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/24/2021] [Indexed: 11/28/2022] Open
Abstract
The roles of endothelial nitric oxide synthase (eNOS) in the ventilatory responses during and after a hypercapnic gas challenge (HCC, 5% CO2, 21% O2, 74% N2) were assessed in freely-moving female and male wild-type (WT) C57BL6 mice and eNOS knock-out (eNOS-/-) mice of C57BL6 background using whole body plethysmography. HCC elicited an array of ventilatory responses that were similar in male and female WT mice, such as increases in breathing frequency (with falls in inspiratory and expiratory times), and increases in tidal volume, minute ventilation, peak inspiratory and expiratory flows, and inspiratory and expiratory drives. eNOS-/- male mice had smaller increases in minute ventilation, peak inspiratory flow and inspiratory drive, and smaller decreases in inspiratory time than WT males. Ventilatory responses in female eNOS-/- mice were similar to those in female WT mice. The ventilatory excitatory phase upon return to room-air was similar in both male and female WT mice. However, the post-HCC increases in frequency of breathing (with decreases in inspiratory times), and increases in tidal volume, minute ventilation, inspiratory drive (i.e., tidal volume/inspiratory time) and expiratory drive (i.e., tidal volume/expiratory time), and peak inspiratory and expiratory flows in male eNOS-/- mice were smaller than in male WT mice. In contrast, the post-HCC responses in female eNOS-/- mice were equal to those of the female WT mice. These findings provide the first evidence that the loss of eNOS affects the ventilatory responses during and after HCC in male C57BL6 mice, whereas female C57BL6 mice can compensate for the loss of eNOS, at least in respect to triggering ventilatory responses to HCC.
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99
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Samaranayake CB, Warren C, Siewers K, Craig S, Price LC, Kempny A, Dimopoulos K, Gatzoulis M, Hopkinson NS, Wort SJ, Hull JH, McCabe C. Impact of cyanosis on ventilatory responses during stair climb exercise in Eisenmenger syndrome and idiopathic pulmonary arterial hypertension. Int J Cardiol 2021; 341:84-87. [PMID: 34416318 DOI: 10.1016/j.ijcard.2021.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/25/2021] [Accepted: 08/12/2021] [Indexed: 11/25/2022]
Abstract
Studies assessing exercise ventilatory responses during real-life exercise in pulmonary arterial hypertension (PAH) which include patients with cyanotic congenital heart disease are scarce. We assessed the ventilatory response to stairclimbing in patients with idiopathic PAH (IPAH) and congenital heart disease-associated PAH with Eisenmenger (EIS) physiology compared to healthy controls. Fifteen adults with IPAH, six EIS and 15 age and body mass index (BMI) matched controls were prospectively recruited. Participants completed spirometry and a self-paced stair-climb (48 steps) with portable cardiopulmonary exercise testing (CPET) equipment in-situ. Borg dyspnoea scores were measured at rest and on stair-climb cessation. Both IPAH and EIS groups had amplified ventilatory responses compared to Controls. The rate of increase in minute ventilation (VE) was exaggerated in EIS driven by an early increase in tidal volume (Tv) and more gradual increase in respiratory rate (RR). Peak Tv, RR, Tv: forced vital capacity (FVC) ratio, VE/VCO2 slope and stairclimb duration were significantly higher in EIS and IPAH compared to controls despite similar baseline spirometry and change in oxygen uptake on exercise. A decline in end-tidal carbon dioxide (CO2) and arterial oxygen saturations in early exercise distinguished EIS and IPAH patients. Significant correlations were observed between peak exercise Borg score and stair-climb time (r = 0.73, p = 0.002), peak end-tidal CO2 (r = -0.73, p = 0.001), peak VE (r = 0.53, p = 0.008), peak RR (r = 0.42, p = 0.011) and VE/VCO2 slope (r = 0.54, p = 0.001). Patients with IPAH and EIS have exaggerated ventilatory responses to stair-climbing compared to the controls with more severe levels of dyspnoea perception in Eisenmenger syndrome for equivalent oxygen uptake and work.
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Affiliation(s)
| | - Christopher Warren
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom
| | - Karina Siewers
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom
| | - Stuart Craig
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom
| | - Laura C Price
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London
| | - Aleksander Kempny
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London
| | - Konstantinos Dimopoulos
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London
| | - Michael Gatzoulis
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London
| | - Nicholas S Hopkinson
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London
| | - Stephen J Wort
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London
| | - James H Hull
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London
| | - Colm McCabe
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London.
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100
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Disordered breathing in a Pitt-Hopkins syndrome model involves Phox2b-expressing parafacial neurons and aberrant Nav1.8 expression. Nat Commun 2021; 12:5962. [PMID: 34645823 PMCID: PMC8514575 DOI: 10.1038/s41467-021-26263-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022] Open
Abstract
Pitt-Hopkins syndrome (PTHS) is a rare autism spectrum-like disorder characterized by intellectual disability, developmental delays, and breathing problems involving episodes of hyperventilation followed by apnea. PTHS is caused by functional haploinsufficiency of the gene encoding transcription factor 4 (Tcf4). Despite the severity of this disease, mechanisms contributing to PTHS behavioral abnormalities are not well understood. Here, we show that a Tcf4 truncation (Tcf4tr/+) mouse model of PTHS exhibits breathing problems similar to PTHS patients. This behavioral deficit is associated with selective loss of putative expiratory parafacial neurons and compromised function of neurons in the retrotrapezoid nucleus that regulate breathing in response to tissue CO2/H+. We also show that central Nav1.8 channels can be targeted pharmacologically to improve respiratory function at the cellular and behavioral levels in Tcf4tr/+ mice, thus establishing Nav1.8 as a high priority target with therapeutic potential in PTHS. Disordered breathing is a hallmark of Pitt-Hopkins syndrome (PTHS), yet little is known regarding how loss of Tcf4 (gene associated with PTHS) affects development and function of respiratory neurons. Here, the authors show that parafacial respiratory neurons are selectively disrupted in a mouse model of PTHS, and central Nav1.8 channels can be targeted to improve PTHS-associated behavior abnormalities.
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