Medullary regulation of visceral sympathetic nerve discharge at peak hyperthermia in aged F344 rats

Kidney physiology and pathophysiology during heat stress and the modification by exercise, dehydration, heat acclimation and aging

The kidneys' integrative responses to heat stress aid thermoregulation, cardiovascular control, and water and electrolyte regulation. Recent evidence suggests the kidneys are at increased risk of pathological events during heat stress, namely acute kidney injury (AKI), and that this risk is compounded by dehydration and exercise. This heat stress related AKI is believed to contribute to the epidemic of chronic kidney disease (CKD) occurring in occupational settings. It is estimated that AKI and CKD affect upwards of 45 million individuals in the global workforce. Water and electrolyte disturbances and AKI, both of which are representative of kidney-related pathology, are the two leading causes of hospitalizations during heat waves in older adults. Structural and physiological alterations in aging kidneys likely contribute to this increased risk. With this background, this comprehensive narrative review will provide the first aggregation of research into the integrative physiological response of the kidneys to heat stress. While the focus of this review is on the human kidneys, we will utilize both human and animal data to describe these responses to passive and exercise heat stress, and how they are altered with heat acclimation. Additionally, we will discuss recent studies that indicate an increased risk of AKI due to exercise in the heat. Lastly, we will introduce the emerging public health crisis of older adults during extreme heat events and how the aging kidneys may be more susceptible to injury during heat stress.

Does acute heat stress differentially-modulate expression of ionotropic neurotransmitter receptors in the RVLM of young and aged F344 rats?

The rostral ventral lateral medulla (RVLM) is a brainstem area that plays a role in regulating numerous physiological systems, especially their responsiveness to acute stress. Aging affects the responsiveness of RVLM neural circuits to acute stress. Based on the relationship between ionotropic neurotransmitter receptors in the RVLM and the physiological functions mediated via activation of these receptors, we hypothesized that in response to acute heat stress the expression of ionotropic neurotransmitter receptors in the RVLM of aged rats would be characterized by upregulation of inhibitory subunits and downregulation of excitatory subunits. The goal of the present study was to determine the effect of acute heating on the gene expression profile of RVLM inhibitory (GABA_A and Glycine) and excitatory (NMDA and AMPA) ionotropic neurotransmitter receptor subunits in young and aged F344 rats. RVLM tissue punches from young and aged F344 rats were analyzed using TaqMan qPCR and immunoblotting. When compared to age-matched controls, heat stress increased the gene expression of RVLM inhibitory receptor subunits in aged (Gabra1, Gabra2, Gabra5, Glra1) and young (Gabra1) F344 rats at mRNA level, with little change in the expression of RVLM excitatory receptor subunits. Significant age x heat interaction effects were observed with increased expression of Gabra2 and Gabrb1 inhibitory receptor subunits and decreased expression of Gria1 and Gria2 excitatory receptor subunits in the RVLM of aged F344 rats, with the most marked change observed with the Gabra2 subunit, which was validated by immunoblotting. These findings demonstrate that in response to acute heat stress there is enhanced expression of inhibitory ionotropic receptor subunits in aged compared to young rats, supporting the idea that advanced age may alter RVLM responsivity by affecting the molecular substrate of ionotropic receptors.

Microarray analysis of aging-associated immune system alterations in the rostral ventrolateral medulla of F344 rats

The rostral ventrolateral medulla (RVLM) is an area of the brain stem that contains diverse neural substrates that are involved in systems critical for physiological function. There is evidence that aging affects some neural substrates within the RVLM, although age-related changes in RVLM molecular mechanisms are not well established. The goal of the present study was to characterize the transcriptomic profile of the aging RVLM and to test the hypothesis that aging is associated with altered gene expression in the RVLM, with an emphasis on immune system associated gene transcripts. RVLM tissue punches from young, middle-aged, and aged F344 rats were analyzed with Agilent's whole rat genome microarray. The RVLM gene expression profile varied with age, and an association between chronological age and specific RVLM gene expression patterns was observed [P < 0.05, false discovery rate (FDR) < 0.3]. Functional analysis of RVLM microarray data via gene ontology profiling and pathway analysis identified upregulation of genes associated with immune- and stress-related responses and downregulation of genes associated with lipid biosynthesis and neurotransmission in aged compared with middle-aged and young rats. Differentially expressed genes associated with the complement system and microglial cells were further validated by quantitative PCR with separate RVLM samples (P < 0.05, FDR < 0.1). The present results have identified age-related changes in the transcriptomic profile of the RVLM, modifications that may provide the molecular backdrop for understanding age-dependent changes in physiological regulation.

Does aging alter the molecular substrate of ionotropic neurotransmitter receptors in the rostral ventral lateral medulla? - A short communication

Aging alters sympathetic nervous system (SNS) regulation, although central mechanisms are not well understood. In young rats the rostral ventral lateral medulla (RVLM) is critically involved in central SNS regulation and RVLM neuronal activity is mediated by a balance of excitatory and inhibitory ionotropic neurotransmitters and receptors, providing the foundation for hypothesizing that with advanced age the molecular substrate of RVLM ionotropic receptors is characterized by upregulated excitatory and downregulated inhibitory receptor subunits. This hypothesis was tested by comparing the relative mRNA expression and protein concentration of RVLM excitatory (NMDA and AMPA) and inhibitory (GABA and glycinergic) ionotropic neurotransmitter receptor subunits in young and aged Fischer (F344) rats. Brains were removed from anesthetized rats and the RVLM-containing area was micropunched and extracted RNA and protein were subsequently used for TaqMan qRT-PCR gene expression and quantitative ELISA analyses. Bilateral chemical inactivation of RVLM neurons and peripheral ganglionic blockade on visceral sympathetic nerve discharge (SND) was determined in additional experiments. The relative gene expression of RVLM NMDA and AMPA glutamate-gated receptor subunits and protein concentration of select receptor subunits did not differ between young and aged rats, and there were no age-related differences in the expression of RVLM ionotropic GABA_A and Gly receptors, or of protein concentration of select GABA_A subunits. RVLM muscimol microinjections significantly reduced visceral SND by 70±2% in aged F344 rats. Collectively these findings from this short communication support a functional role for the RVLM in regulation of sympathetic nerve outflow in aged rats, but provide no evidence for an ionotropic RVLM receptor-centric framework explaining age-associated changes in SNS regulation.