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Hajj‐Boutros G, Sonjak V, Faust A, Balram S, Lagacé J, St‐Martin P, Divsalar DN, Sadeghian F, Liu‐Ambrose T, Blaber AP, Dionne IJ, Duchesne S, Kontulainen S, Theou O, Morais JA. Myths and Methodologies: Understanding the health impact of head down bedrest for the benefit of older adults and astronauts. Study protocol of the Canadian Bedrest Study. Exp Physiol 2024; 109:812-827. [PMID: 38372420 PMCID: PMC11061626 DOI: 10.1113/ep091473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/23/2024] [Indexed: 02/20/2024]
Abstract
Weightlessness during spaceflight can harm various bodily systems, including bone density, muscle mass, strength and cognitive functions. Exercise appears to somewhat counteract these effects. A terrestrial model for this is head-down bedrest (HDBR), simulating gravity loss. This mirrors challenges faced by older adults in extended bedrest and space environments. The first Canadian study, backed by the Canadian Space Agency, Canadian Institutes of Health Research, and Canadian Frailty Network, aims to explore these issues. The study seeks to: (1) scrutinize the impact of 14-day HDBR on physiological, psychological and neurocognitive systems, and (2) assess the benefits of exercise during HDBR. Eight teams developed distinct protocols, harmonized in three videoconferences, at the McGill University Health Center. Over 26 days, 23 participants aged 55-65 underwent baseline measurements, 14 days of -6° HDBR, and 7 days of recovery. Half did prescribed exercise thrice daily combining resistance and endurance exercise for a total duration of 1 h. Assessments included demographics, cardiorespiratory fitness, bone health, body composition, quality of life, mental health, cognition, muscle health and biomarkers. This study has yielded some published outcomes, with more forthcoming. Findings will enrich our comprehension of HDBR effects, guiding future strategies for astronaut well-being and aiding bedrest-bound older adults. By outlining evidence-based interventions, this research supports both space travellers and those enduring prolonged bedrest.
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Affiliation(s)
- Guy Hajj‐Boutros
- Research Institute of McGill University Health CentreMcGill UniversityMontréalQuebecCanada
| | - Vita Sonjak
- Research Institute of McGill University Health CentreMcGill UniversityMontréalQuebecCanada
| | - Andréa Faust
- Research Institute of McGill University Health CentreMcGill UniversityMontréalQuebecCanada
| | - Sharmila Balram
- Research Institute of McGill University Health CentreMcGill UniversityMontréalQuebecCanada
| | - Jean‐Christophe Lagacé
- Faculté des Sciences de l'activité physique, Centre de recherche sur le VieillissementUniversité de SherbrookeSherbrookeQuebecCanada
| | - Philippe St‐Martin
- Faculté des Sciences de l'activité physique, Centre de recherche sur le VieillissementUniversité de SherbrookeSherbrookeQuebecCanada
| | - Donya Naz Divsalar
- Department of Biomedical Physiology and KinesiologySimon Fraser UniversityGreater VancouverBritish ColumbiaCanada
| | - Farshid Sadeghian
- Department of Biomedical Physiology and KinesiologySimon Fraser UniversityGreater VancouverBritish ColumbiaCanada
| | - Teresa Liu‐Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Health Research InstituteVancouverBritish ColumbiaCanada
- Centre for Hip Health and MobilityVancouver Coastal Health Research InstituteVancouverBritish ColumbiaCanada
| | - Andrew P. Blaber
- Department of Biomedical Physiology and KinesiologySimon Fraser UniversityGreater VancouverBritish ColumbiaCanada
| | - Isabelle J. Dionne
- Faculté des Sciences de l'activité physique, Centre de recherche sur le VieillissementUniversité de SherbrookeSherbrookeQuebecCanada
| | - Simon Duchesne
- Department of Radiology and Nuclear MedicineUniversité LavalQuebec CityQuebecCanada
- CERVO Brain Research CenterQuebec CityQuebecCanada
| | - Saija Kontulainen
- College of KinesiologyUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - Olga Theou
- Physiotherapy and Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | - José A. Morais
- Division of Geriatric Medicine, McGill University Health CentreMcGill UniversityMontréalQuebecCanada
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2
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Barkaszi I, Ehmann B, Tölgyesi B, Balázs L, Altbäcker A. Are head-down tilt bedrest studies capturing the true nature of spaceflight-induced cognitive changes? A review. Front Physiol 2022; 13:1008508. [PMID: 36582360 PMCID: PMC9792854 DOI: 10.3389/fphys.2022.1008508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/26/2022] [Indexed: 12/15/2022] Open
Abstract
Although a number of studies have examined cognitive functions in space, the reasons behind the observed changes described by space research and anecdotal reports have not yet been elucidated. A potential source of cognitive changes is the cephalad fluid shift in the body caused by the lack of hydrostatic pressure under microgravity. These alterations can be modeled under terrestrial conditions using ground-based studies, such as head-down tilt bedrest (HDBR). In this review, we compare the results of the space and HDBR cognitive research. Results for baseline and in-flight/in-HDBR comparisons, and for baseline and post-flight/post-HDBR comparisons are detailed regarding sensorimotor skills, time estimation, attention, psychomotor speed, memory, executive functions, reasoning, mathematical processing, and cognitive processing of emotional stimuli. Beyond behavioral performance, results regarding brain electrical activity during simulated and real microgravity environments are also discussed. Finally, we highlight the research gaps and suggest future directions.
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Affiliation(s)
- Irén Barkaszi
- Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
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3
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Tamma G, Di Mise A, Ranieri M, Centrone M, Venneri M, D'Agostino M, Ferrulli A, Šimunič B, Narici M, Pisot R, Valenti G. Early Biomarkers of Altered Renal Function and Orthostatic Intolerance During 10-day Bedrest. Front Physiol 2022; 13:858867. [PMID: 35514354 PMCID: PMC9065601 DOI: 10.3389/fphys.2022.858867] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Exposure to actual or simulated microgravity results in alterations of renal function, fluid redistribution, and bone loss, which is coupled to a rise of urinary calcium excretion. We provided evidence that high calcium delivery to the collecting duct reduces local Aquaporin 2 (AQP2)-mediated water reabsorption under vasopressin action, thus limiting the maximal urinary concentration to reduce calcium saturation. To investigate early renal adaptation into simulated microgravity, we investigated the effects of 10 days of strict bedrest in 10 healthy volunteers. We report here that 10 days of inactivity are associated with a transient, significant decrease (day 5) in vasopressin (copeptin) paralleled by a decrease in AQP2 excretion, consistent with an increased central volume to the heart, resulting in reduced water reabsorption. Moreover, bedrest caused a significant increase in calciuria secondary to bone demineralization paralleled by a decrease in PTH. Urinary osteopontin, a glycoprotein exerting a protective effect on stone formation, was significantly reduced during bedrest. Moreover, a significant increase in adrenomedullin (day 5), a peptide with vasodepressor properties, was observed at day 5, which may contribute to the known reduced orthostatic capacity post-bedrest. We conclude that renal function is altered in simulated microgravity and is associated with an early increase in the risk of stone formation and reduced orthostatic capacity post-bedrest within a few days of inactivity.
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Affiliation(s)
- Grazia Tamma
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Annarita Di Mise
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Marianna Ranieri
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Mariangela Centrone
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Maria Venneri
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Mariagrazia D'Agostino
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Angela Ferrulli
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Boštjan Šimunič
- Institute of Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Marco Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Rado Pisot
- Institute of Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Giovanna Valenti
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
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4
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Le Roux E, De Jong NP, Blanc S, Simon C, Bessesen DH, Bergouignan A. Physiology of physical inactivity, sedentary behaviours and non-exercise activity: insights from the space bedrest model. J Physiol 2022; 600:1037-1051. [PMID: 33501660 PMCID: PMC10895929 DOI: 10.1113/jp281064] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/08/2021] [Indexed: 01/08/2023] Open
Abstract
Physical inactivity, i.e. not reaching the recommended level of physical activity (PA), and sedentary behaviours (SB), i.e. sitting time, have been associated with increased risk for common metabolic diseases. Recent epidemiological data suggest that high volumes of SB are detrimental to metabolic health, even in the presence of regular exercise, i.e. moderate/vigorous PA. This suggests that the health effects of SB are independent from those of exercise. However, experimentally testing this hypothesis is complicated because of the difficulty in disassociating SB from PA. Bedrest studies, a traditional space science model, can offer new insights. In some bedrest studies, an exercise training protocol has been used to counteract the harmful effects of inactivity. While bedrest induces an inactive and sedentary state, exercise with bedrest represents a unique model of sedentary yet physically active people. Here, we review bedrest studies with and without exercise training. Although exercise training prevents the loss of muscle mass and function, even large volumes of exercise are not sufficient to fully counteract the negative metabolic adaptations triggered by inactivity. This observation supports the existence of independent adverse health effects of SB, but also the potential benefits of non-exercise activity, i.e. daily living light PA. We gathered available data to examine the complex relationships between exercise, non-exercise activity, SB and health outcomes. Given the large amount of SB in modern societies, the sole promotion of exercise, i.e. moderate/vigorous PA may be insufficient, and promotion of light PA may be a complimentary approach to improve health.
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Affiliation(s)
- Elisa Le Roux
- CNRS, IPHC UMR 7178, Université de Strasbourg, Strasbourg, France
| | - Nathan P De Jong
- Division of Endocrinology, Metabolism and Diabetes, Anschutz Health & Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Stéphane Blanc
- CNRS, IPHC UMR 7178, Université de Strasbourg, Strasbourg, France
| | - Chantal Simon
- CarMen Laboratory, INSERM 1060, INRA 1397, University of Lyon, Oullins, France
- Human Nutrition Research Centre of Rhône-Alpes, Hospices Civils de Lyon, Lyon, France
| | - Daniel H Bessesen
- Division of Endocrinology, Metabolism and Diabetes, Anschutz Health & Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Audrey Bergouignan
- CNRS, IPHC UMR 7178, Université de Strasbourg, Strasbourg, France
- Division of Endocrinology, Metabolism and Diabetes, Anschutz Health & Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
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5
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Cahill T, Cope H, Bass JJ, Overbey EG, Gilbert R, da Silveira WA, Paul AM, Mishra T, Herranz R, Reinsch SS, Costes SV, Hardiman G, Szewczyk NJ, Tahimic CGT. Mammalian and Invertebrate Models as Complementary Tools for Gaining Mechanistic Insight on Muscle Responses to Spaceflight. Int J Mol Sci 2021; 22:ijms22179470. [PMID: 34502375 PMCID: PMC8430797 DOI: 10.3390/ijms22179470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 02/07/2023] Open
Abstract
Bioinformatics approaches have proven useful in understanding biological responses to spaceflight. Spaceflight experiments remain resource intensive and rare. One outstanding issue is how to maximize scientific output from a limited number of omics datasets from traditional animal models including nematodes, fruitfly, and rodents. The utility of omics data from invertebrate models in anticipating mammalian responses to spaceflight has not been fully explored. Hence, we performed comparative analyses of transcriptomes of soleus and extensor digitorum longus (EDL) in mice that underwent 37 days of spaceflight. Results indicate shared stress responses and altered circadian rhythm. EDL showed more robust growth signals and Pde2a downregulation, possibly underlying its resistance to atrophy versus soleus. Spaceflight and hindlimb unloading mice shared differential regulation of proliferation, circadian, and neuronal signaling. Shared gene regulation in muscles of humans on bedrest and space flown rodents suggest targets for mitigating muscle atrophy in space and on Earth. Spaceflight responses of C. elegans were more similar to EDL. Discrete life stages of D. melanogaster have distinct utility in anticipating EDL and soleus responses. In summary, spaceflight leads to shared and discrete molecular responses between muscle types and invertebrate models may augment mechanistic knowledge gained from rodent spaceflight and ground-based studies.
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Affiliation(s)
- Thomas Cahill
- School of Biological Sciences & Institute for Global Food Security, Queens University Belfast, Belfast BT9 5DL, UK; (T.C.); (W.A.d.S.); (G.H.)
| | - Henry Cope
- Nottingham Biomedical Research Centre (BRC), School of Computer Science, University of Nottingham, Nottingham NG7 2QL, UK;
| | - Joseph J. Bass
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham NG7 2QL, UK; (J.J.B.); (N.J.S.)
| | - Eliah G. Overbey
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA;
| | - Rachel Gilbert
- NASA Ames Research Center, Space Biosciences Division, Moffett Field, CA 94035, USA; (R.G.); (A.M.P.); (S.S.R.); (S.V.C.)
- Universities Space Research Association, Columbia, MD 21046, USA
| | - Willian Abraham da Silveira
- School of Biological Sciences & Institute for Global Food Security, Queens University Belfast, Belfast BT9 5DL, UK; (T.C.); (W.A.d.S.); (G.H.)
- Department of Biological Sciences, School of Life Sciences and Education, Staffordshire University, Stoke-on-Trent ST4 2DF, UK
| | - Amber M. Paul
- NASA Ames Research Center, Space Biosciences Division, Moffett Field, CA 94035, USA; (R.G.); (A.M.P.); (S.S.R.); (S.V.C.)
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USA
- Blue Marble Space Institute of Science, Seattle, WA 98104, USA
| | - Tejaswini Mishra
- Department of Genetics, Stanford University School of Medicine, Palo Alto, CA 94305, USA;
| | - Raúl Herranz
- Centro de Investigaciones Biológicas Margarita Salas–CSIC, Ramiro de Maeztu 9, 28040 Madrid, Spain;
| | - Sigrid S. Reinsch
- NASA Ames Research Center, Space Biosciences Division, Moffett Field, CA 94035, USA; (R.G.); (A.M.P.); (S.S.R.); (S.V.C.)
| | - Sylvain V. Costes
- NASA Ames Research Center, Space Biosciences Division, Moffett Field, CA 94035, USA; (R.G.); (A.M.P.); (S.S.R.); (S.V.C.)
| | - Gary Hardiman
- School of Biological Sciences & Institute for Global Food Security, Queens University Belfast, Belfast BT9 5DL, UK; (T.C.); (W.A.d.S.); (G.H.)
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Nathaniel J. Szewczyk
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), University of Nottingham, Nottingham NG7 2QL, UK; (J.J.B.); (N.J.S.)
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
| | - Candice G. T. Tahimic
- NASA Ames Research Center, Space Biosciences Division, Moffett Field, CA 94035, USA; (R.G.); (A.M.P.); (S.S.R.); (S.V.C.)
- Department of Biology, University of North Florida, Jacksonville, FL 32224, USA
- Correspondence:
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6
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Brisendine MH, Bond JM. A glimpse into the early window of muscle unloading. J Physiol 2021; 599:4249-4251. [PMID: 34318496 DOI: 10.1113/jp282019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/26/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
- Matthew H Brisendine
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Jacob M Bond
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Graduate Program in Translational Biology, Medicine, and Health, Fralin Biomedical Research Institute at Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
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7
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Peter-Derex L, Subtil F, Lemaitre G, Ricordeau F, Bastuji H, Bridoux A, Onen F, Onen SH. Observation and Interview-based Diurnal Sleepiness Inventory for measurement of sleepiness in patients referred for narcolepsy or idiopathic hypersomnia. J Clin Sleep Med 2021; 16:1507-1515. [PMID: 32406372 DOI: 10.5664/jcsm.8574] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES First, to determine whether the 3-item Observation and Interview-based Diurnal Sleepiness Inventory (ODSI) measures the degree of excessive daytime sleepiness in patients with suspected narcolepsy or idiopathic hypersomnia (IH). Second, to assess the correlation between the ODSI and the Epworth Sleepiness Scale (ESS) as well as objective polysomnographic measurements. Third, to test the accuracy of the ODSI to detect narcolepsy or IH (narcolepsy/IH) compared with the ESS. METHODS A total of 181 patients complaining of excessive daytime sleepiness filled in the ESS and the ODSI and underwent measurements including actigraphy, full-night polysomnography, Multiple Sleep Latency Test, and 24-hour bedrest sleep recording. RESULTS Narcolepsy or IH was diagnosed in 76 patients. The ODSI found excessive daytime sleepiness in 92.3% of all patients and in 98.7% of those diagnosed with narcolepsy/IH. In the whole population, the ODSI was significantly positively correlated with the ESS (R = .547; 95% confidence interval: .436, .642; P < .001) and weakly with 24-hour total sleep time on bedrest recording (R = .208; 95% confidence interval: .056, .350; P = .047) but not with the Multiple Sleep Latency Test. The ODSI offered a higher negative (92.9%) and positive (44.9%) predictive value to detect narcolepsy/IH than did the ESS (66.7% and 43.3%, respectively). In the IH group, the ODSI's third-item score (daily sleepiness duration) was significantly higher in patients with than without increased 24-hour total sleep time (P = .023). CONCLUSIONS The ODSI is a brief, simple first-line questionnaire that explores both intensity and duration of daytime sleepiness and offers a high sensitivity to detect narcolepsy and IH.
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Affiliation(s)
- Laure Peter-Derex
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.,Lyon 1 University, Lyon, France.,Lyon Neuroscience Research Center, CNRS 5292, INSERM U1028, Lyon, France
| | - Fabien Subtil
- Lyon 1 University, Lyon, France.,Service de Biostatistiques, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
| | | | - François Ricordeau
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Hélène Bastuji
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.,Lyon Neuroscience Research Center, CNRS 5292, INSERM U1028, Lyon, France
| | - Agathe Bridoux
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Fannie Onen
- Centre Hospitalier Universitaire Bichat Claude Bernard, Service de gériatrie, Assistance Publique, Hôpitaux de Paris, Paris, France.,INSERM 1178 and Centre de Recherche en Epidémiologie et Santé des Populations, Université Paris Sud, Paris, France.,Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - S-Hakki Onen
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.,Lyon Neuroscience Research Center, CNRS 5292, INSERM U1028, Lyon, France
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8
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Nay K, Koechlin-Ramonatxo C, Rochdi S, Island ML, Orfila L, Treffel L, Bareille MP, Beck A, Gauquelin-Koch G, Ropert M, Loréal O, Derbré F. Simulated microgravity disturbs iron metabolism and distribution in humans: Lessons from dry immersion, an innovative ground-based human model. FASEB J 2020; 34:14920-14929. [PMID: 32918768 DOI: 10.1096/fj.202001199rr] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 01/16/2023]
Abstract
The objective of the present study was to determine the effects of dry immersion, an innovative ground-based human model of simulated microgravity and extreme physical inactivity, on iron homeostasis and distribution. Twenty young healthy men were recruited and submitted to 5 days of dry immersion (DI). Fasting blood samples and MRI were performed before and after DI exposure to assess iron status, as well as hematological responses. DI increased spleen iron concentrations (SIC), whereas hepatic iron store (HIC) was not affected. Spleen iron sequestration could be due to the concomitant increase in serum hepcidin levels (P < .001). Increased serum unconjugated bilirubin, as well as the rise of serum myoglobin levels support that DI may promote hemolysis and myolysis. These phenomena could contribute to the concomitant increase of serum iron and transferrin saturation levels (P < .001). As HIC remained unchanged, increased serum hepcidin levels could be due both to higher transferrin saturation level, and to low-grade pro-inflammatory as suggested by the significant rise of serum ferritin and haptoglobin levels after DI (P = .003 and P = .003, respectively). These observations highlight the need for better assessment of iron metabolism in bedridden patients, and an optimization of the diet currently proposed to astronauts.
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Affiliation(s)
- Kévin Nay
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS Rennes, Bruz, France.,DMEM, University of Montpellier, INRAE, Montpellier, France.,Exercise and Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | | | - Sarah Rochdi
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS Rennes, Bruz, France
| | - Marie-Laure Island
- INSERM, University of Rennes, INRAE, UMR 1241, AEM2 Platform, Nutrition Metabolisms and Cancer (NuMeCan) Institute, Rennes, France.,Department of Biochemistry, CHU Rennes, France
| | - Luz Orfila
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS Rennes, Bruz, France
| | - Loïc Treffel
- Institut NeuroMyoGène, Faculté de Médecine Lyon Est, Lyon, France
| | | | - Arnaud Beck
- Institute for Space Medicine and Physiology (MEDES), Toulouse, France
| | | | - Martine Ropert
- INSERM, University of Rennes, INRAE, UMR 1241, AEM2 Platform, Nutrition Metabolisms and Cancer (NuMeCan) Institute, Rennes, France.,Department of Biochemistry, CHU Rennes, France
| | - Olivier Loréal
- INSERM, University of Rennes, INRAE, UMR 1241, AEM2 Platform, Nutrition Metabolisms and Cancer (NuMeCan) Institute, Rennes, France
| | - Frédéric Derbré
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS Rennes, Bruz, France
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9
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Goswami N, van Loon JJWA, Roessler A, Blaber AP, White O. Editorial: Gravitational Physiology, Aging and Medicine. Front Physiol 2019; 10:1338. [PMID: 31708798 PMCID: PMC6823592 DOI: 10.3389/fphys.2019.01338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 10/08/2019] [Indexed: 01/06/2023] Open
Affiliation(s)
- Nandu Goswami
- Division of Physiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria.,Department of Health Sciences, Alma Mater Europaea Maribor, Maribor, Slovenia
| | - Jack J W A van Loon
- Department Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC, Vrije Universiteit Medical Center, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Andreas Roessler
- Division of Physiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | - Andrew P Blaber
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Olivier White
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
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10
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van Rijswijk J, Caanen MR, Mijatovic V, Vergouw CG, van de Ven PM, Lambalk CB, Schats R. Immobilization or mobilization after IUI: an RCT. Hum Reprod 2018; 32:2218-2224. [PMID: 29040538 DOI: 10.1093/humrep/dex302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 09/14/2017] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Does 15 min of immobilization after IUI improve pregnancy rates? SUMMARY ANSWER Immobilization for 15 min after IUI does not improve pregnancy rates. WHAT IS KNOWN ALREADY Prior RCTs report a beneficial effect of supine immobilization for 15 min following IUI compared to immediate mobilization, however, these studies can be criticized. Given the importance for the logistics in daily practice and the lack of biological plausibility we planned a replication study prior to potential implementation of this procedure. STUDY DESIGN, SIZE, DURATION A single centre RCT, based in an academic setting in the Netherlands, was performed. Participants were randomly assigned for 15 min of supine immobilization following IUI for a maximum of six cycles compared to the standard procedure of immediate mobilization following IUI. Participants and caregivers were not blinded to group assignment. An independent researcher used computer-generated tables to allocate treatments. Stratification occurred to the indication of IUI (unexplained or mild male subfertility). Revelation of allocation took place just before the insemination by the caregiver. The primary outcome was ongoing pregnancy rate per couple. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 498 couples diagnosed with unexplained or mild male subfertility and an indication for treatment with IUI were approached and randomized in the study, of which 244 participants were assigned to 15 min of supine immobilization and 254 participants to immediate mobilization. MAIN RESULTS AND THE ROLE OF CHANCE Participant characteristics were comparable between the groups, and 236 participants were analysed in the immobilization group, versus 245 in the mobilization group. The ongoing pregnancy rate per couple was not found to be superior in the immobilization group (one-sided P-value = 0.97) with 76/236 ongoing pregnancies (32.2%) being accomplished in the immobilization and 98/245 ongoing pregnancies (40.0%) in the immediate mobilization group (relative risk 0.81; 95% CI [0.63, 1.02], risk difference: -7.8%, 95% CI [-16.4%, 0.8%]). No difference was found in miscarriage rate, multiple gestation rate, live birth rate and time to pregnancy between the groups. LIMITATIONS, REASONS FOR CAUTION Owing to discontinuation of the planned treatment not all participants reached six IUI cycles or an ongoing pregnancy. However, this is as expected in IUI treatment and mirrors clinical practice. These participants were equally distributed across the two groups. Women with tubal pathology and endocrine disorders were excluded for this trial, and this might narrow generalizability. WIDER IMPLICATIONS OF THE FINDINGS This study shows no positive effect of 15 min of immobilization following IUI on pregnancy rates. Based on available evidence today, including our study, a possible beneficial effect of supine immobilization after IUI is at least doubtful and straightforward implementation does not seem to be justified. STUDY FUNDING/COMPETING INTEREST(S) No funding was received. All authors have nothing to disclose. TRIAL REGISTRATION NUMBER Dutch Trial Register NTR 2418. TRIAL REGISTRATION DATE 20 July 2010. DATE OF FIRST PATIENT's ENROLMENT 11 August 2010.
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Affiliation(s)
- J van Rijswijk
- Department of Reproductive Medicine, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands
| | - M R Caanen
- Department of Reproductive Medicine, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands
| | - V Mijatovic
- Department of Reproductive Medicine, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands
| | - C G Vergouw
- Department of Reproductive Medicine, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands
| | - P M van de Ven
- Department of Epidemiology and Biostatistics, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands
| | - C B Lambalk
- Department of Reproductive Medicine, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands
| | - R Schats
- Department of Reproductive Medicine, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands
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11
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Affiliation(s)
- Philip Lewis
- Institute for Occupational Medicine, Environmental Medicine and Preventive Research, University Hospital of Cologne, Germany
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12
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Abstract
Filum terminale lipoma (FTL) causes various spinal symptoms known as tethered cord syndrome. The treatment for FTL is surgical untethering by sectioning the FTL, which can prevent symptom progression and often results in improvement of symptoms. This report describes a minimally invasive surgical strategy that we have introduced for FTL sectioning. The pediatric patients with FTL since 2007 were treated using this minimally invasive surgical strategy, which we refer to as an interlaminar approach (ILA). In summary, the surgical technique involves: minimal skin incision to expose the unilateral ligamentum flavum in the lower lumbar region; ligamentum flavum incision to expose the dural sac, and dural incision followed by identification and sectioning of the filum. Postoperatively, no bed rest was required. Prior to introducing ILA, we had used standard one level laminectomy/laminotomy (LL) with more than 1 week of postsurgical bed rest until 2007, providing an adequate control group for the benefit of the ILA. A total of 49 consecutive patients were treated using ILA. While 37 patients were treated using LL. Surgical complications that need surgery were seen only in one patient, who developed cerebrospinal fluid (CSF) leak in LL patients. No retethering or additional neurological symptoms were seen during follow-up. All patients complained of minimal postsurgical back pain, but no patients required postoperative bed rest in ILA patients, while LL patients need postsurgical bed rest because of back pain. The ILA strategy provides the advantage of a minimal tissue injury, associated with minimal postoperative pain, blood loss, and bed rest.
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Affiliation(s)
| | | | - Misaki Kohama
- Department of Neurosurgery, Miyagi Children's Hospital
| | - Reizo Shirane
- Department of Neurosurgery, Miyagi Children's Hospital
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine
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13
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Abstract
This paper provides a general overview of key physiological consequences of microgravity experienced during spaceflight and of important parallels and connections to the physiology of aging. Microgravity during spaceflight influences cardiovascular function, cerebral autoregulation, musculoskeletal, and sensorimotor system performance. A great deal of research has been carried out to understand these influences and to provide countermeasures to reduce the observed negative consequences of microgravity on physiological function. Such research can inform and be informed by research related to physiological changes and the deterioration of physiological function due to aging. For example, head-down bedrest is used as a model to study effects of spaceflight deconditioning due to reduced gravity. As hospitalized older persons spend up to 80% of their time in bed, the deconditioning effects of bedrest confinement on physiological functions and parallels with spaceflight deconditioning can be exploited to understand and combat both variations of deconditioning. Deconditioning due to bed confinement in older persons can contribute to a downward spiral of increasing frailty, orthostatic intolerance, falls, and fall-related injury. As astronauts in space spend substantial amounts of time carrying out exercise training to counteract the microgravity-induced deconditioning and to counteract orthostatic intolerance on return to Earth, it is logical to suggest some of these interventions for bed-confined older persons. Synthesizing knowledge regarding deconditioning due to reduced gravitational stress in space and deconditioning during bed confinement allows for a more comprehensive approach that can incorporate aspects such as (mal-) nutrition, muscle strength and function, cardiovascular (de-) conditioning, and cardio-postural interactions. The impact of such integration can provide new insights and lead to methods of value for both space medicine and geriatrics (Geriatrics meets spaceflight!). In particular, such integration can lead to procedures that address the morbidity and the mortality associated with bedrest immobilization and in the rising health care costs associated with an aging population demographic.
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Affiliation(s)
- Nandu Goswami
- Gravitational Physiology, Aging and Medicine Research Unit, Institute of Physiology, Medical University of Graz, Graz, Austria.,Department of Health Sciences, Alma Mater Europea University, Maribor, Slovenia
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14
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Lawley JS, Petersen LG, Howden EJ, Sarma S, Cornwell WK, Zhang R, Whitworth LA, Williams MA, Levine BD. Effect of gravity and microgravity on intracranial pressure. J Physiol 2017; 595:2115-2127. [PMID: 28092926 DOI: 10.1113/jp273557] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 12/19/2016] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Astronauts have recently been discovered to have impaired vision, with a presentation that resembles syndromes of elevated intracranial pressure on Earth. Gravity has a profound effect on fluid distribution and pressure within the human circulation. In contrast to prevailing theory, we observed that microgravity reduces central venous and intracranial pressure. This being said, intracranial pressure is not reduced to the levels observed in the 90 deg seated upright posture on Earth. Thus, over 24 h in zero gravity, pressure in the brain is slightly above that observed on Earth, which may explain remodelling of the eye in astronauts. ABSTRACT Astronauts have recently been discovered to have impaired vision, with a presentation that resembles syndromes of elevated intracranial pressure (ICP). This syndrome is considered the most mission-critical medical problem identified in the past decade of manned spaceflight. We recruited five men and three women who had an Ommaya reservoir inserted for the delivery of prophylactic CNS chemotherapy, but were free of their malignant disease for at least 1 year. ICP was assessed by placing a fluid-filled 25 gauge butterfly needle into the Ommaya reservoir. Subjects were studied in the upright and supine position, during acute zero gravity (parabolic flight) and prolonged simulated microgravity (6 deg head-down tilt bedrest). ICP was lower when seated in the 90 deg upright posture compared to lying supine (seated, 4 ± 1 vs. supine, 15 ± 2 mmHg). Whilst lying in the supine posture, central venous pressure (supine, 7 ± 3 vs. microgravity, 4 ± 2 mmHg) and ICP (supine, 17 ± 2 vs. microgravity, 13 ± 2 mmHg) were reduced in acute zero gravity, although not to the levels observed in the 90 deg seated upright posture on Earth. Prolonged periods of simulated microgravity did not cause progressive elevations in ICP (supine, 15 ± 2 vs. 24 h head-down tilt, 15 ± 4 mmHg). Complete removal of gravity does not pathologically elevate ICP but does prevent the normal lowering of ICP when upright. These findings suggest the human brain is protected by the daily circadian cycles in regional ICPs, without which pathology may occur.
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Affiliation(s)
- Justin S Lawley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lonnie G Petersen
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Erin J Howden
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Satyam Sarma
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - William K Cornwell
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Louis A Whitworth
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA
| | - Michael A Williams
- Departments of Neurology and Neurological Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
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15
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Abstract
In 1968, Saltin et al. published a landmark paper describing the alterations in VO2max resulting from two sequential interventions--20 days of bed rest and almost 8 weeks of training. They concluded that bed rest reduced VO2max through reductions in maximal cardiac output, while training enhanced VO2max by an equal combination of increased maximal cardiac output and increased arterio-venous [O2] difference (A-V Δ [O2]). At the time, A-V Δ [O2] was taken as an index of peripheral (skeletal muscle) adaptation. A key interpretive element that was not featured was consideration of how alterations in cardiac output affect the O2 extraction process secondary to changes in red cell transit time through the muscle microcirculation, even in the absence of adaptive changes in the skeletal muscles per se. For the 2015 Saltin Symposium, it was therefore thought appropriate to re-examine the 1968 O2 transport data and re-evaluate the roles central cardiovascular and peripheral muscle changes after bed rest and training allowing for their interaction. The analysis supports the conclusion that bed rest reduced VO2max mainly through reduction in cardiac output, but after training, it is proposed that the 1968 conclusions should be modified: the majority of the increase in VO2max from the control state can be attributed to an improvement in diffusive unloading of O2 from the muscle microcirculation, with a much smaller role for enhanced blood flow.
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Affiliation(s)
- P D Wagner
- Distinguished Professor of Medicine & Bioengineering, University of California, San Diego, La Jolla, California, USA
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