Blood flow distribution, lymph flow, villus tissue osmolality and fluid and electrolyte transport after exposing the cat small intestine to sodium deoxycholate

Characterization of AQPs in Mouse, Rat, and Human Colon and Their Selective Regulation by Bile Acids

In normal individuals, the epithelium of the colon absorbs 1.5–2 l of water a day to generate dehydrated feces. However, in the condition of bile acid malabsorption (BAM), an excess of bile acids in the colon results in diarrhea. Several studies have attempted to address the mechanisms contributing to BAM induced by various bile acids. However, none have addressed a potential dysregulation of aquaporin (AQP) water channels, which are responsible for the majority of transcellular water transport in epithelial cells, as a contributing factor to the onset of diarrhea and the pathogenesis of BAM. In this study, we aimed to systematically analyze the expression of AQPs in colonic epithelia from rat, mouse, and human and determine whether their expression is altered in a rat model of BAM. Mass spectrometry-based proteomics, RT-PCR, and western blotting identified various AQPs in isolated colonic epithelial cells from rats (AQP1, 3, 4, 7, 8) and mice (AQP1, 4, 8). Several AQPs were also detected in human colon (AQP1, 3, 4, 7–9). Immunohistochemistry localized AQP1 to the apical plasma membrane of epithelial cells in the bottom of the crypts, whereas AQP3 (rat, human) and AQP4 (mice, human) were localized predominantly in the basolateral plasma membrane. AQP8 was localized intracellularly and at the apical plasma membrane of epithelial cells. Rats fed sodium cholate for 72 h had significantly increased fecal water content, suggesting development of BAM-associated diarrhea. Colonic epithelial cells isolated from this model had significantly altered levels of AQP3, 7, and 8, suggesting that these AQPs may be involved in the pathogenesis of bile acid-induced diarrhea.

Exercise Capacity in Chronic Obstructive Pulmonary Disease: Mechanisms of Limitation

Patients with chronic obstructive pulmonary disease (COPD) are often caught in a downward spiral that progresses from expiratory flow limitation to poor quality of life and invalidity. Within this downward spiral, exercise tolerance represents a key intermediate outcome. As recently stated by the GOLD initiative, improvement in exercise tolerance is now rec ognized as an important goal of COPD treatment. This objective will be achieved only by a comprehensive understanding of the mechanism of exercise limitation in this disease. The objective of this paper is to review the mechanisms of exercise limitation in COPD and discuss their relative contribution to exercise intolerance in patients suffering from this disease.

Intestinal bile acid physiology and pathophysiology

Bile acids (BAs) have a long established role in fat digestion in the intestine by acting as tensioactives, due to their amphipathic characteristics. BAs are reabsorbed very efficiently by the intestinal epithelium and recycled back to the liver via transport mechanisms that have been largely elucidated. The transport and synthesis of BAs are tightly regulated in part by specific plasma membrane receptors and nuclear receptors. In addition to their primary effect, BAs have been claimed to play a role in gastrointestinal cancer, intestinal inflammation and intestinal ionic transport. BAs are not equivalent in any of these biological activities, and structural requirements have been generally identified. In particular, some BAs may be useful for cancer chemoprevention and perhaps in inflammatory bowel disease, although further research is necessary in this field. This review covers the most recent developments in these aspects of BA intestinal biology.

Plasticity of muscle function in a thermoregulating ectotherm (Crocodylus porosus): biomechanics and metabolism

Thermoregulation and thermal sensitivity of performance are thought to have coevolved so that performance is optimized within the selected body temperature range. However, locomotor performance in thermoregulating crocodiles (Crocodylus porosus) is plastic and maxima shift to different selected body temperatures in different thermal environments. Here we test the hypothesis that muscle metabolic and biomechanical parameters are optimized at the body temperatures selected in different thermal environments. Hence, we related indices of anaerobic (lactate dehydrogenase) and aerobic (cytochrome c oxidase) metabolic capacities and myofibrillar ATPase activity to the biomechanics of isometric and work loop caudofemoralis muscle function. Maximal isometric stress (force per muscle cross-sectional area) did not change with thermal acclimation, but muscle work loop power output increased with cold acclimation as a result of shorter activation and relaxation times. The thermal sensitivity of myofibrillar ATPase activity decreased with cold acclimation in caudofemoralis muscle. Neither aerobic nor anaerobic metabolic capacities were directly linked to changes in muscle performance during thermal acclimation, although there was a negative relationship between anaerobic capacity and isometric twitch stress in cold-acclimated animals. We conclude that by combining thermoregulation with plasticity in biomechanical function, crocodiles maximize performance in environments with highly variable thermal properties.

Involvement of enteric nerves in permeability changes due to deoxycholic acid in rat jejunum in vivo

AIM

Stress and Clostridium difficile toxin A increase epithelial permeability in the small intestine via vagus and visceral afferents, in turn activating mucosal mast cells. Bile acids also increase epithelial permeability but it is not known if nerves or mast cells are involved in this effect in the small intestine.

METHOD

In jejunum of anesthetized rats, the effects of hexamethonium and atropine on deoxycholic acid (DCA) induced fluid secretion and increase in epithelial permeability was therefore studied by determining the appearance and disappearance rates of 14C-mannitol and 51Cr-EDTA into and from a perfusion system containing 4 or 8 mm DCA and expressed as clearance.

RESULTS

DCA increased net fluid transport and appearance and to a less extent disappearance rates of the probes. Hexamethonium but not atropine, chronic denervation or the NO synthase inhibitor L-NNA did significantly decrease the appearance rate and net fluid secretion. The levels of the mast cell protease II (RMCP II) in perfusate and plasma were not increased by DCA. The clearance ratio Cr-EDTA/mannitol indicates that the plasma clearance of the permeability probes is partly secondary to net fluid transport only at higher DCA concentrations.

CONCLUSION

We conclude that the DCA effect on epithelial permeability is to a large part induced by intramural reflex(es) containing nicotinic receptors. The results also suggest that mast cell degranulation and NO release are not involved in the mechanism. This indicates that the nerve effect on intestinal paracellular permeability is not mediated by the mechanisms described for stress or Clostridium difficile toxin A.

Selected Contribution: Improved anoxic tolerance in rat diaphragm following intermittent hypoxia

Intermittent hypoxia (IH), associated with obstructive sleep apnea, initiates adaptive physiological responses in a variety of organs. Little is known about its influence on diaphragm. IH was simulated by exposing rats to alternating 15-s cycles of 5% O2 and 21% O2 for 5 min, 9 sets/h, 8 h/day, for 10 days. Controls did not experience IH. Diaphragms were excised 20-36 h after IH. Diaphragm bundles were studied in vitro or analyzed for myosin heavy chain isoform composition. No differences in maximum tetanic stress were observed between groups. However, peak twitch stress (P < 0.005), twitch half-relaxation time (P < 0.02), and tetanic stress at 20 or 30 Hz (P < 0.05) were elevated in IH. No differences in expression of myosin heavy chain isoforms or susceptibility to fatigue were seen. Contractile function after 30 min of anoxia (95% N2-5% CO2) was markedly preserved at all stimulation frequencies during IH and at low frequencies after 15 min of reoxygenation. Anoxia-induced increases in passive muscle force were eliminated in the IH animals (P < 0.01). These results demonstrate that IH induces adaptive responses in the diaphragm that preserve its function in anoxia.

Effects of motility on epithelial transport in the human descending duodenum

The aim of the study was to determine how motility affects the balance between absorptive and secretory ion transport in the proximal human small intestine. Thirty-two healthy subjects and 16 patients (eight with villus atrophy, eight with normal duodenal biopsies) were studied. The absorptive sodium flux was estimated by measurement of bicarbonate absorption with a double-lumen perfusion technique. The secretory chloride flux was calculated from the ratio between the continuously recorded transmural potential difference (PD) and the epithelial parallel resistance, which was measured in forceps biopsies by square-wave current analysis. Graded variations in contraction frequency were obtained by recording during defined time periods before, during and after phase III of the migrating motor complex (MMC). Bicarbonate was absorbed by a process that led to CO2 formation, and both bicarbonate absorption and luminal PCO2 increased with contraction frequency. The motility-related PCO2 rise was reduced in patients with villus atrophy and by removal of bicarbonate from the perfusate. A higher motor activity was also associated with a larger PD (more lumen negative). Both the absorptive and the secretory fluxes were thus enhanced by motility. The estimated absorptive flux was approximately twice as large as the secretory flux during periods of low motor activity, and four times as large during submaximal motor activity. We conclude that motor activity affects both absorptive and secretory mucosal function in a quantifiable manner. Information about the behaviour of the respective linkage functions may make it possible to model the intestinal absorption process in vivo.

Objective effects of a 6 months' endurance and strength training program in outpatients with congestive heart failure

PURPOSE

The aim of this study was to assess the feasibility and the effects of a long-term training program with endurance and strength elements for patients with advanced congestive heart failure (CHF).

METHODS

We studied 14 patients, mean age 57 yr, mean NYHA class 2.7, mean LVEF 29%, and mean VO2max 17.2 mL x kg(-1) x min(-1). They underwent a 6 months' outpatient "in-hospital" training program (80 sessions). After an introduction period the program was subdivided into four cycles in which endurance and strength were revalued and progressively increased. Endurance was measured by spiro-ergometric exercise testing with concomitant lactate determination, while strength was measured on an isokinetic dynamometer.

RESULTS

The compliance ratio was 89% and there were no major problems during training. NYHA class improved from a mean of 2.7 to 1.5 (P = 0.0001), working capacity from 83 to 100 W (P = 0.001), VO2 from 16.7 to 18.4 mL x kg(-1) x min(-1) (P = 0.02), and maximal exercise lactate from 4.1 to 5.2 mmol x L(-1) (P = 0.01). At isokinetic testing we found a significant 18% increase in muscular endurance of knee flexors (P = 0.008) and 25% increase of knee extensors (P = 0.007). The increase of peak torque, total work, and average power reached statistical significance only for the knee extensors.

CONCLUSION

This pilot study showed that progressively adapted global strength training in association with traditional endurance training is feasible for selected patients with CHF. Additional larger studies should be done to test the effects, the safety, and the composition of such supervised "in-hospital" training programs.

Involvement of serotonin and calcium channels in the intestinal fluid secretion evoked by bile salt and cholera toxin

1. The enteric nervous system (ENS) is activated when exposing the intestinal mucosa to cholera toxin or certain bile salts. Cholera toxin stimulates ENS, at least in part, by the release of 5-hydroxytryptamine (5-HT) from the enterochromaffin cells. Calcium channel blockers of the L-type markedly attenuate the fluid secretion and the luminal release of 5-HT caused by cholera toxin. 2. The objective of the present study was to elucidate if sodium deoxycholate activated ENS in a similar manner as cholera toxin. Furthermore, the effect of several calcium channel blockers was tested on the fluid secretion caused by cholera toxin or bile salt. 3. Sodium deoxycholate (4 mM) caused a release of 5-HT into the intestinal lumen, which was inhibited by calcium channel blockade. Granisetron, a 5-HT3 receptor blocker, partly inhibited the fluid secretion caused by bile salt. 4. The effects of nifedipine, felodipine, R-felodipine, H186/86 (t-butyl analogue of felodipine) on the fluid secretion caused by cholera toxin or sodium deoxycholate were studied. Both secretory states were markedly attenuated in a dose dependent manner by all calcium channel blockers tested regardless of their effects on arterial pressure. 5. It is concluded that both cholera toxin and bile salt activate ENS, at least in part, via a release of 5-HT from the enterochromaffin cells. The antisecretory effect calcium channel blockers is partly explained by an inhibition of this release of 5-HT.

Effects of previous dynamic arm exercise on power output during repeated maximal sprint cycling

This study examined the effects of elevating blood lactate concentration by arm exercise on subsequent performance during repeated 30 s sprints with the legs. Eight male students performed two 30 s cycle ergometer sprints separated by 6 min of recovery, on two occasions. On one occasion the subjects performed only the two 30 s cycle ergometer sprints ('legs'), while on the other occasion 5 min of heavy arm cranking preceded the two sprints ('arms and legs'). Blood lactate concentration was determined from capillary samples at rest, after a standardized warm-up and 3 and 5 min following each exercise bout. In the 'legs' condition, the peak power output (PPO) and mean power output (MPO) in the second sprint were 92% (P < 0.05) and 85% (P < 0.01) of the values attained during the first sprint, respectively. Prior arm exercise, which increased blood lactate to 11.0 +/- 0.6 mM, had no effect on PPO and MPO during the first cycle ergometer sprint (approximately 4% drop, N.S.). However, in the second sprint after prior arm exercise, PPO was 10% lower than the PPO attained during the corresponding sprint in the 'legs' condition (sprint 2 'arms and legs' 963 +/- 42 W, sprint 2 'legs' 1074 +/- 60 W, P < 0.05), while MPO was better maintained (sprint 2 'arms and legs' 517 +/- 17 W, sprint 2 'legs' 549 +/- 24 W, N.S.). The rate of blood lactate accumulation after both cycle ergometer sprints was considerably decreased (by approximately 50%) when blood lactate levels were pre-elevated by arm crank exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in acid-base status of marathon runners during an incremental field test. Relationship to mean competitive marathon velocity

Four top-class runners who regularly performed marathon and long-distance races participated in this study. They performed a graded field test on an artificial running track within a few weeks of a competitive marathon. The test consisted of five separate bouts of running. Each period lasted 6 min with an intervening 2-min rest bout during which arterialized capillary blood samples were taken. Blood was analysed for pH, partial pressure of oxygen and carbon dioxide (PO2 and PCO2) and lactate concentration ([la-]b). The values of base excess (BE) and bicarbonate concentration ([HCO3-]) were calculated. The exercise intensity during the test was regulated by the runners themselves. The subjects were asked to perform the first bout of running at a constant heart rate fc which was 50 beats.min-1 below their own maximal fc. Every subsequent bout, each of which lasted 6 min, was performed with an increment of 10 beats.min-1 as the target fc. Thus the last, the fifth run, was planned to be performed with fc amounting to 10 beats.min-1 less than their maximal fc. The results from these runners showed that the blood pH changed very little in the bouts performed at a running speed below 100% of mean marathon velocity (nu m). However, once nu m was exceeded, there were marked changes in acid-base status. In the bouts performed at a velocity above the nu m there was a marked increase in [la-]b and a significant decrease in pH, [HCO3-], BE and pCO2. The average marathon velocity (nu m) was 18.46 (SD 0.32) km.h-1.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of isokinetic exercise on the relationship between blood lactate and muscle fatigue

Exercise velocity may be an important variable in determining the amount of blood lactate accumulation during isokinetic exercise. The purpose of this study was to measure the effects of velocity-specific isokinetic exercise on blood lactate, muscle fatigue index, and rating of perceived exertion and to examine the relationship between blood lactate and muscle fatigue index. Ten experienced recreational weight trainers, aged 20-40 years, took part in a repeated measures design consisting of three separate treatments (constant angular velocity at 30, 120, and 300 degrees/sec performed at maximal effort for 1 minute by the right knee flexors and extensors). Rating of perceived exertion, blood lactate, and muscle fatigue index were measured in response to each treatment. Rating of perceived exertion was equal across all three speeds. Muscle fatigue and blood lactate increased significantly as the velocity of exercise increased. There was also a positive correlation coefficient (r = .82, < or = 0.01) between muscle fatigue index and blood lactate. The data suggested that the magnitude of muscle fatigue index and blood lactate responses are strongly dependent on the velocity of movement utilized during maximal isokinetic exercise, and there is a relationship between muscle fatigue index and blood lactate.

Phosphocreatine and pH recovery without restoration of mechanical function during prolonged activity of rat gastrocnemius muscle: an in vivo 31P NMR study

Metabolic impairment in skeletal muscle was suggested to be involved in the development of local mechanical fatigue but until now results have dealt with short activity periods whereas little data on exhaustive and prolonged exercises are available. Stimulations of rat leg muscle lasting 45 min were induced by tetanic trains delivered via sciatic nerve at five different rhythms. Energy metabolism of the stimulated gastrocnemius muscle was followed by 31P NMR spectroscopy using surface coil while mechanical function was recorded. Our data showed a decrease in the force level to very low values a few minutes after exercise onset. This mechanical impairment only induced a transient metabolic failure followed by rapid restoration of high phosphocreatine (PCr) values and intracellular pH, without mechanical recovery. In addition, at the end of exercise, the PCr content was proportional to the fatigue level. As these experiments could not have impaired neuromuscular junction, the data would indicate that fatigue was maintained by a mechanism which does not appear to depend directly on muscle cell energy stores.

Biochemical correlates of fatigue. A brief review

Muscle fatigue, defined as a decreased force generating capacity, develops gradually during exercise and is distinct from exhaustion, which occurs when the required force or exercise intensity can no longer be maintained. We have reviewed several biochemical and ionic changes reported to occur in exercising muscle, and analysed the possible effects these changes may have on the electrical and contractile properties of the muscle. There is no evidence that substrate depletion can account for the decreased force generating capacity, but this factor may be important for the rate of energy turnover and be a major determinant for endurance. Increased concentration of inorganic phosphate and hydrogen ions will depress the force generating capacity, but since fatigue can develop gradually without accumulation of these ions they can only be important when aerobic ATP production is insufficient to support the contractions. Evidence is presented showing that a disturbed balance of K+ alone might cause depolarisation block at high stimulation frequencies, but extracellular K+ accumulation does not increase gradually during prolonged dynamic or static exercise, and is therefore not closely related to fatigue. The repeated release of Ca2+ from the sarcoplasmic reticulum (SR) during muscular activity is suggested of Ca2+ by the mitochondria, increasing with stimulation frequency and duration and possibly also deteriorating mitochondrial function. We therefore speculate that decreased Ca2+ availability for release from SR might contribute to a gradual decline in force generating capacity during all types of exercise.

Bioenergetics of ice hockey: considerations for fatigue

This paper addresses the potential role of fatigue as a factor contributing to the deterioration of high level performance in ice hockey. Particularly, attention is given to the general description of different types of fatigue and the mechanisms underlying each type. Data have been presented illustrating the nature and extent of different types of fatigue in ice hockey practices and games. A bioenergetic description of ice hockey is presented and implications drawn as to the role of metabolism in causing specific fatigue patterns observed in ice hockey. The paper concludes with an overview of the inter-relationship between the characteristics of the performer, the environment and the game itself.

Influence of sodium deoxycholate on morphology, net fluid transport and motility in the small intestine of the rat

Intestinal fluid secretion and motility were induced by luminal perfusion of rat small intestine with sodium deoxycholate, a dihydroxy bile salt for 1-3 h. Changes in intestinal morphology were studied simultaneously with the changes in fluid transport and motility. The results suggest that the bile salt causes epithelial lesions which may lead to a reduced fluid absorption in the villi, thereby explaining part of the total change in net fluid transport caused by the bile salt. Pyrilamine and indomethacin did not influence the bile salt-induced secretion. Based on earlier studies, it is proposed that the major part of the bile salt-evoked secretion is mediated via activation of intramural nervous reflex(es), which also stimulate the intestinal smooth muscle cells.