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Lindblom H, Pernett F, Schagatay E, Holmström P. Effect of exercise intensity and apnea on splenic contraction and hemoglobin increase in well-trained cross-country skiers. Eur J Appl Physiol 2024; 124:2057-2067. [PMID: 38393417 PMCID: PMC11199288 DOI: 10.1007/s00421-024-05428-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
The human spleen acts as a reservoir for red blood cells, which is mobilized into the systemic circulation during various conditions such as hypoxia and physical exertion. Cross-country (XC) skiers, renowned for their exceptional aerobic capacity, are regularly exposed to high-intensity exercise and local oxygen deficits. We investigated a putative dose-dependent relationship between splenic contraction and concomitant hemoglobin concentration ([Hb]) elevation across four exercise intensities in well-trained XC skiers. Fourteen male XC skiers voluntarily participated in a 2-day protocol, encompassing a serial apnea test and a V ˙ O2max test (day 1), followed by three submaximal exercise intensities on a roller skiing treadmill corresponding to 55, 70, and 85% of V ˙ O2max (day 2). Spleen volume was measured via ultrasonic imaging, and venous blood samples were used to determine [Hb] levels. Baseline spleen volume was similar (266(35) mL) for all conditions (NS). Notably, all conditions induced significant splenic contractions and transient [Hb] elevations. The V ˙ O2max test exhibited the most pronounced splenic contraction (35.8%, p < 0.001) and a [Hb] increase of 8.1%, while the 85% exercise intensity led to 27.1% contraction and the greatest [Hb] increase (8.3%, < 0.001) compared to baseline. The apnea test induced relatively smaller responses (splenic contraction: 20.4%, [Hb] = 3.3%, p < 0.001), akin to the response observed at the 70% exercise intensity (splenic contraction = 23%, [Hb] = 6.4%, p < 0,001) and 55% (splenic contraction = 20.0%, [Hb] = 4.8%, p < 0.001). This study shows a discernible dose-dependent relationship between splenic contraction and [Hb] increase with levels of exercise, effectively distinguishing between submaximal and maximal exercise intensity.
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Affiliation(s)
- Hampus Lindblom
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Frank Pernett
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Erika Schagatay
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Pontus Holmström
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
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Rossi A, Malvagia S, la Marca G, Parenti G, Brunetti-Pierri N. Biomarkers for gene therapy clinical trials of lysosomal storage disorders. Mol Ther 2024:S1525-0016(24)00385-X. [PMID: 38850023 DOI: 10.1016/j.ymthe.2024.06.003] [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: 01/12/2024] [Revised: 04/29/2024] [Accepted: 06/04/2024] [Indexed: 06/09/2024] Open
Abstract
Lysosomal storage disorders (LSDs) are multisystemic progressive disorders caused by defects in proteins involved in lysosomal function. Different gene therapy strategies are under clinical investigation in several LSDs to overcome the limitations of available treatments. However, LSDs are slowly progressive diseases that require long-term studies to establish the efficacy of experimental treatments. Biomarkers can be reliable substitutes for clinical responses and improve the efficiency of clinical trials, especially when long-term disease interventions are evaluated. In this review, we summarize both available and future biomarkers for LSDs and discuss their strengths and weaknesses.
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Affiliation(s)
- Alessandro Rossi
- Department of Translational Medicine, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Sabrina Malvagia
- Newborn Screening, Clinical Chemistry and Pharmacology Lab, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Giancarlo la Marca
- Newborn Screening, Clinical Chemistry and Pharmacology Lab, Meyer Children's Hospital IRCCS, Florence, Italy; Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Giancarlo Parenti
- Department of Translational Medicine, Section of Pediatrics, University of Naples Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy; School of Advanced Studies, Genomics and Experimental Medicine Program, University of Naples Federico II, Naples, Italy
| | - Nicola Brunetti-Pierri
- Department of Translational Medicine, Section of Pediatrics, University of Naples Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy; School of Advanced Studies, Genomics and Experimental Medicine Program, University of Naples Federico II, Naples, Italy.
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Brutsaert TD, Harman TS, Bigham AW, Kalker A, Jorgensen KC, Zhu KT, Steiner BC, Hawkins E, Day TA, Kunwar AJ, Thakur N, Dhungel S, Sherpa N, Holmström PK. Larger spleens and greater splenic contraction during exercise may be an adaptive characteristic of Nepali Sherpa at high-altitude. Am J Hum Biol 2024:e24090. [PMID: 38741522 DOI: 10.1002/ajhb.24090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES The Sherpa ethnic group living at altitude in Nepal may have experienced natural selection in response to chronic hypoxia. We have previously shown that Sherpa in Kathmandu (1400 m) possess larger spleens and a greater apnea-induced splenic contraction compared to lowland Nepalis. This may be significant for exercise capacity at altitude as the human spleen responds to stress-induced catecholamine secretion by an immediate contraction, which results in transiently elevated hemoglobin concentration ([Hb]). METHODS To investigate splenic contraction in response to exercise at high-altitude (4300 m; Pb = ~450 Torr), we recruited 63 acclimatized Sherpa (29F) and 14 Nepali non-Sherpa (7F). Spleen volume was measured before and after maximal exercise on a cycle ergometer by ultrasonography, along with [Hb] and oxygen saturation (SpO2). RESULTS Resting spleen volume was larger in the Sherpa compared with Nepali non-Sherpa (237 ± 62 vs. 165 ± 34 mL, p < .001), as was the exercise-induced splenic contraction (Δspleen volume, 91 ± 40 vs. 38 ± 32 mL, p < .001). From rest to exercise, [Hb] increased (1.2 to 1.4 g.dl-1), SpO2 decreased (~9%) and calculated arterial oxygen content (CaO2) remained stable, but there were no significant differences between groups. In Sherpa, both resting spleen volume and the Δspleen volume were modest positive predictors of the change (Δ) in [Hb] and CaO2 with exercise (p-values from .026 to .037 and R2 values from 0.059 to 0.067 for the predictor variable). CONCLUSIONS Larger spleens and greater splenic contraction may be an adaptive characteristic of Nepali Sherpa to increase CaO2 during exercise at altitude, but the direct link between spleen size/function and hypoxia tolerance remains unclear.
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Affiliation(s)
- Tom D Brutsaert
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
| | | | - Abigail W Bigham
- Department of Anthropology, University of California, Los Angeles, CA, USA
| | - Anne Kalker
- Department of Anesthesiology, Raboud Medical Center, Nijmegen, Netherlands
| | - Kelsey C Jorgensen
- Department of Anthropology, University of California, Los Angeles, CA, USA
| | - Kimberly T Zhu
- Department of Anthropology, University of California, Los Angeles, CA, USA
| | - Bethany C Steiner
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
| | - Ella Hawkins
- Department of Anthropology, Syracuse University, Syracuse, NY, USA
| | - Trevor A Day
- Department of Biology, Mount Royal University, Calgary, Canada
| | - Ajaya J Kunwar
- Kathmandu Center for Genomics and Research Laboratory, Global Hospital, Gwarko, Nepal
| | - Nilam Thakur
- Kathmandu Center for Genomics and Research Laboratory, Global Hospital, Gwarko, Nepal
| | - Sunil Dhungel
- College of Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Nima Sherpa
- Local collaborator without institutional affiliation
| | - Pontus K Holmström
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
- Department of Health Sciences, Mid-Sweden University, Östersund, Sweden
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Holmström PK, Harman TS, Kalker A, Steiner B, Hawkins E, Jorgensen KC, Zhu KT, Kunwar AJ, Thakur N, Dhungel S, Sherpa N, Day TA, Schagatay EK, Bigham AW, Brutsaert TD. Differential splenic responses to hyperoxic breathing at high altitude in Sherpa and lowlanders. Exp Physiol 2024; 109:535-548. [PMID: 38180087 PMCID: PMC10988702 DOI: 10.1113/ep091579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024]
Abstract
The human spleen contracts in response to stress-induced catecholamine secretion, resulting in a temporary rise in haemoglobin concentration ([Hb]). Recent findings highlighted enhanced splenic response to exercise at high altitude in Sherpa, possibly due to a blunted splenic response to hypoxia. To explore the potential blunted splenic contraction in Sherpas at high altitude, we examined changes in spleen volume during hyperoxic breathing, comparing acclimatized Sherpa with acclimatized individuals of lowland ancestry. Our study included 14 non-Sherpa (7 female) residing at altitude for a mean continuous duration of 3 months and 46 Sherpa (24 female) with an average of 4 years altitude exposure. Participants underwent a hyperoxic breathing test at altitude (4300 m; barrometric pressure = ∼430 torr;P O 2 ${P_{{{\mathrm{O}}_{\mathrm{2}}}}}$ = ∼90 torr). Throughout the test, we measured spleen volume using ultrasonography and monitored oxygen saturation (S p O 2 ${S_{{\mathrm{p}}{{\mathrm{O}}_{\mathrm{2}}}}}$ ). During rest, Sherpa exhibited larger spleens (226 ± 70 mL) compared to non-Sherpa (165 ± 34 mL; P < 0.001; effect size (ES) = 0.95, 95% CI: 0.3-1.6). In response to hyperoxia, non-Sherpa demonstrated 22 ± 12% increase in spleen size (35 ± 17 mL, 95% CI: 20.7-48.9; P < 0.001; ES = 1.8, 95% CI: 0.93-2.66), while spleen size remained unchanged in Sherpa (-2 ± 13 mL, 95% CI: -2.4 to 7.3; P = 0.640; ES = 0.18, 95% CI: -0.10 to 0.47). Our findings suggest that Sherpa and non-Sherpas of lowland ancestry exhibit distinct variations in spleen volume during hyperoxia at high altitude, potentially indicating two distinct splenic functions. In Sherpa, this phenomenon may signify a diminished splenic response to altitude-related hypoxia at rest, potentially contributing to enhanced splenic contractions during physical stress. Conversely, non-Sherpa experienced a transient increase in spleen size during hyperoxia, indicating an active tonic contraction, which may influence early altitude acclimatization in lowlanders by raising [Hb].
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Affiliation(s)
- Pontus K. Holmström
- Department of Health SciencesMid‐Sweden UniversityÖstersundSweden
- Department of Exercise ScienceSyracuse UniversitySyracuseNew YorkUSA
| | - Taylor S. Harman
- Department of AnthropologySyracuse UniversitySyracuseNew YorkUSA
| | - Anne Kalker
- Department of AnesthesiologyRadboud Medical CenterNijmegenNetherlands
| | - Bethany Steiner
- Department of Exercise ScienceSyracuse UniversitySyracuseNew YorkUSA
| | - Ella Hawkins
- Department of AnthropologySyracuse UniversitySyracuseNew YorkUSA
| | | | - Kimberly T. Zhu
- Department of AnthropologyUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Ajaya J. Kunwar
- Kathmandu Center for Genomics and Research LaboratoryGlobal Hospital, GwarkoLalitpurNepal
| | - Nilam Thakur
- Kathmandu Center for Genomics and Research LaboratoryGlobal Hospital, GwarkoLalitpurNepal
| | - Sunil Dhungel
- College of MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Nima Sherpa
- Local collaborator without institutional affiliation
| | - Trevor A. Day
- Department of BiologyFaculty of Science and TechnologyMount Royal UniversityCalgaryABCanada
| | | | - Abigail W. Bigham
- Department of AnthropologyUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Tom D. Brutsaert
- Department of Exercise ScienceSyracuse UniversitySyracuseNew YorkUSA
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Persson G, Lodin-Sundström A, Linér MH, Andersson SHA, Sjögreen B, Andersson JPA. Splenic contraction and cardiovascular responses are augmented during apnea compared to rebreathing in humans. Front Physiol 2023; 14:1109958. [PMID: 36960158 PMCID: PMC10028099 DOI: 10.3389/fphys.2023.1109958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/22/2023] [Indexed: 03/09/2023] Open
Abstract
The spleen contracts during apnea, releasing stored erythrocytes, thereby increasing systemic hemoglobin concentration (Hb). We compared apnea and rebreathing periods, of equal sub-maximal duration (mean 137 s; SD 30), in eighteen subjects to evaluate whether respiratory arrest or hypoxic and hypercapnic chemoreceptor stimulation is the primary elicitor of splenic contraction and cardiovascular responses during apnea. Spleen volume, Hb, cardiovascular variables, arterial (SaO2), cerebral (ScO2), and deltoid muscle oxygen saturations (SmO2) were recorded during the trials and end-tidal partial pressure of oxygen (PETO2) and carbon dioxide (PETCO2) were measured before and after maneuvers. The spleen volume was smaller after apnea, 213 (89) mL, than after rebreathing, 239 (95) mL, corresponding to relative reductions from control by 20.8 (17.8) % and 11.6 (8.0) %, respectively. The Hb increased 2.4 (2.0) % during apnea, while there was no significant change with rebreathing. The cardiovascular responses, including bradycardia, decrease in cardiac output, and increase in total peripheral resistance, were augmented during apnea compared to during rebreathing. The PETO2 was higher, and the PETCO2 was lower, after apnea compared to after rebreathing. The ScO2 was maintained during maneuvers. The SaO2 decreased 3.8 (3.1) % during apnea, and even more, 5.4 (4.4) %, during rebreathing, while the SmO2 decreased less during rebreathing, 2.2 (2.8) %, than during apnea, 8.3 (6.2) %. We conclude that respiratory arrest per se is an important stimulus for splenic contraction and Hb increase during apnea, as well as an important initiating factor for the apnea-associated cardiovascular responses and their oxygen-conserving effects.
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Affiliation(s)
- Gustav Persson
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- *Correspondence: Gustav Persson, ; Johan P. A. Andersson,
| | - Angelica Lodin-Sundström
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
- Department of Biology, Lund University, Lund, Sweden
| | - Mats H. Linér
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Samuel H. A. Andersson
- Department of Biology, Lund University, Lund, Sweden
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | | | - Johan P. A. Andersson
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- *Correspondence: Gustav Persson, ; Johan P. A. Andersson,
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