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Measuring blood flow through intrapulmonary and intracardiac shunts: a technical labyrinth 通过肺内和心内分流测量血流量:一个技术迷宫
Pub Date : 2019-11-01 DOI: 10.1113/JP278820
G. Foster
Intracardiac and intrapulmonary pathways permitting the right-to-left shunting of venous blood can impair pulmonary gas exchange efficiency and provide passageways for the arterialization of venous blood clots. Intrapulmonary arteriovenous anastomoses (IPAVAs) are recruited with increasing exercise intensity, acute hypoxia, and when cardiac output is increased by physiological or pharmacological stress. Whether IPAVA recruitment is sufficient in magnitude to impair pulmonary gas exchange efficiency has been a matter of great debate. As with most fields of research, settling this debate probably requires the development of novel methodology. In this case, methodology is needed to permit the accurate measurement of blood flow and gas exchange through shunt pathways that may be susceptible to pre-capillary gas exchange. This is a void remaining to be filled; yet, several tools have been used separately to approximate blood flow through IPAVAs or gas exchange deficits due to shunt. Measuring blood flow through either pathway is technically challenging and typically relies on the lung’s ability to filter blood. It is reasoned that if particles larger in diameter than the pulmonary capillaries are injected into a peripheral vein and subsequently observed in the systemic arterial circulation, they must have travelled by way of cardiac or pulmonary shunt. In animal models, solid 25-μm-diameter microspheres can be injected into a peripheral vein and physically collected in the arterial circulation. Anatomical shunt fraction can be calculated using the fraction of microspheres collected and measures of cardiac output. In humans, shunt fraction can be assessed by injecting radiolabelled macroaggregates and using nuclear medicine to count the particles that have bypassed the lung. Agitated saline contrast echocardiography, another approach, uses a mixture of small air bubbles injected into a peripheral vein; detection of saline contrast in the left ventricle is a sure sign of intracardiac or intrapulmonary shunt. Saline contrast is more feasible, and, therefore, frequently used in humans, but it provides little detail with respect to the magnitude of shunted blood owing to methodological limitations (Hackett et al. 2016; Boulet et al. 2017). Finally, the multiple inert gas elimination technique (MIGET) provides an assessment of gas exchange through the infusion of six inert gases of varying blood solubilities. Measurements of gas retained in the blood and excreted from the lung are mathematically modelled to approximate the lung’s ventilation– perfusion distribution, including an estimated shunt fraction. MIGET is a highly complex technique successfully used by just a few worldwide. In this issue of The Journal of Physiology, Stickland et al (2019) conducted a highly technical study involving the combination of three techniques for measuring intracardiac/intrapulmonary shunt in anaesthetized canines. Measurements were made at rest, with dopamine and dobutami
允许静脉血从右向左分流的心内和肺内通路会损害肺气体交换效率,并为静脉血凝块的动脉化提供通道。肺内动静脉吻合术(IPAVAs)在运动强度增加、急性缺氧以及心输出量因生理或药理学应激增加时发生。IPAVA的吸收是否足以影响肺气体交换效率一直是一个有争议的问题。与大多数研究领域一样,解决这一争论可能需要开发新的方法。在这种情况下,需要一种方法来精确测量可能易受毛细血管前气体交换影响的分流途径的血流和气体交换。这是一个有待填补的空白;然而,已经分别使用了几种工具来估计通过IPAVAs的血流量或由于分流引起的气体交换缺陷。测量这两种途径的血流量在技术上具有挑战性,而且通常依赖于肺部过滤血液的能力。由此推断,如果直径大于肺毛细血管的颗粒被注入外周静脉,并随后在全身动脉循环中观察到,它们一定是通过心脏或肺分流的方式传播的。在动物模型中,可以将直径为25 μm的固体微球注射到外周静脉中,并在动脉循环中物理收集。解剖分流分数可以通过收集的微球分数和心输出量的测量来计算。在人类中,分流分数可以通过注射放射性标记的大聚集体来评估,并使用核医学来计数已经绕过肺部的颗粒。激动生理盐水对比超声心动图是另一种方法,将混合的小气泡注入外周静脉;左心室生理盐水造影剂的检测是心内或肺内分流的明确标志。盐水对比更可行,因此经常用于人类,但由于方法限制,它提供的关于分流血液大小的细节很少(Hackett et al. 2016;Boulet et al. 2017)。最后,多重惰性气体消除技术(MIGET)通过输注六种不同血液溶解度的惰性气体来评估气体交换。测量血液中保留的气体和从肺中排出的气体,用数学模型来近似肺的通气-灌注分布,包括估计的分流分数。MIGET是一种高度复杂的技术,全世界只有少数人成功使用。在这一期的《生理学杂志》上,Stickland等人(2019)进行了一项高度技术性的研究,涉及三种技术的结合,用于测量麻醉犬的心内/肺内分流。静息时测量,用多巴胺和多巴酚丁胺增加IPAVA招募,最后用手术诱导的心房分流。分流幅度采用以下方法量化:(1)搅拌盐水和微球的左心室超声对比评分(0-5序数);(2)收集的25 μm微球的分数;(3)MIGET近似的气体交换分流分数。在所有条件下,微球测量的分流分数的幅度为2.3±7.4%,与MIGET测量的结果相当相似。然而,当排除少数心内分流研究时,分流率要小得多(n = 4,2项观察)。在这种情况下,微球测量的平均分流分数为3可能反映了肺泡与动脉氧差的扩大(Elliott et al. 2014)。生理盐水造影剂极不稳定,其快速衰减对环境、血压、血气、温度和经肺转运时间敏感(Hackett et al. 2016;Boulet et al. 2017)。显然需要在如何量化搅拌生理盐水造影剂检测方面进行技术改进,以提高其特异性。此外,左心室造影剂的出现并不是一个有限的事件,但超声造影剂评分系统将其视为有限事件。利用整个超声视频回路和来自左右心室的声强,可以根据指标稀释理论计算分流分数(Hackett et al. 2016)。随着方法学的这些和其他改进,使用搅拌生理盐水对比超声心动图可能提高了测量通过小、大心脏和肺内分流的血流的特异性。
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引用次数: 0
New molecular motif contributes to NKCC2 trafficking 新的分子基序有助于NKCC2的转运
Pub Date : 2019-11-01 DOI: 10.1113/JP278896
Keyona N King-Medina, Cesar A Romero
One of the most important functions of the kidney is the formation of urine and the maintenance of electrolyte and water homeostasis. The Na+–K+–2Cl− cotransporter (NKCC2) is a major contributor to this process by actively reabsorbing Na+, K+ and Cl− in the kidney’s loop of Henle. The properties of this transporter are the subject of a recent article in The Journal of Physiology by Marcoux et al. (2019) in which they report that variants of this protein alter trafficking of NKCC2, which ultimately influences the reabsorption of sodium chloride (NaCl) along the thick ascending limb of the loop of Henle (TAL). The TAL is one segment of the nephron and is of particular interest since approximately 25% of the Na+ in the glomerular filtrate is reabsorbed from it back into the circulation (Castrop & Schnermann, 2008; Ares et al. 2011; Marcoux et al. 2019). The magnitude of the reabsorption implies that this segment (and NKCC2) is important in the control of blood pressure and total body sodium homeostasis. In humans, NKCC2 is the major determinant of ion movement from the lumen of the TAL, across the tubular epithelium and back into the blood. NKCC2 is a membrane protein that has 12 transmembrane (TM) domains and a large intracellular loop near the middle of the molecule, a structure that is similar to other related membrane ion transporters
肾脏最重要的功能之一是形成尿液和维持电解质和水的平衡。Na+ -K + -2Cl -共转运体(NKCC2)是这一过程的主要贡献者,通过在肾的Henle环中主动重吸收Na+, K+和Cl -。这种转运体的特性是Marcoux等人(2019)最近在《生理学杂志》上发表的一篇文章的主题,他们在文章中报告说,这种蛋白质的变体改变了NKCC2的运输,最终影响了沿着Henle环(TAL)厚升臂的氯化钠(NaCl)的重吸收。TAL是肾元的一个部分,由于肾小球滤液中大约25%的Na+被它重新吸收回循环中,因此它是特别有趣的(Castrop & Schnermann, 2008;Ares et al. 2011;Marcoux et al. 2019)。重吸收的大小表明,这一段(和NKCC2)在控制血压和全身钠稳态中很重要。在人类中,NKCC2是TAL管腔离子运动的主要决定因素,穿过小管上皮并返回血液。NKCC2是一种膜蛋白,具有12个跨膜(TM)结构域和靠近分子中间的大胞内环,其结构与其他相关的膜离子转运蛋白相似
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引用次数: 1
From atoms to physiology: what it takes to really understand inflammasomes 从原子到生理学:如何才能真正理解炎性小体
Pub Date : 2019-11-01 DOI: 10.1113/JP277027
F. Schmidt
Rapid inflammatory responses to cytosolic threats are mediated by inflammasomes – large macromolecular signalling complexes that control the activation of the pro‐inflammatory cytokines interleukin (IL)‐1β and IL‐18, as well as cell death by pyroptosis. Different inflammasome sensors are activated by diverse direct and indirect signals, and subsequently nucleate the polymerization of the adaptor molecule ASC to form signalling platforms macroscopically observed as ASC specks. Caspase‐1 is autocatalytically activated at these sites and subsequently matures pro‐inflammatory cytokines and the pore‐forming effector molecule gasdermin D. While most molecules and basic assembly principles have been deduced from reductionist experimental systems, we still lack fundamental information on the structure and regulation of these complexes in their physiological environment and in the interplay with other signalling pathways. In this review, novel experimental approaches are proposed, including some that rely on nanobodies and single domain antibodies, to understand inflammasome assembly and regulation in the context of the relevant tissues or cells.
对细胞质威胁的快速炎症反应是由炎症小体介导的,炎症小体是一种大型大分子信号传导复合物,控制促炎细胞因子白介素(IL) - 1β和IL - 18的激活,以及细胞焦亡。不同的炎性小体传感器被不同的直接和间接信号激活,随后使适配器分子ASC聚合成核,形成宏观上观察到的ASC斑点信号平台。Caspase‐1在这些位点被自动催化激活,随后成熟促炎细胞因子和成孔效应分子gasdermin D.虽然大多数分子和基本组装原理已经从还原主义实验系统中推导出来,但我们仍然缺乏关于这些复合物在生理环境中的结构和调节以及与其他信号通路相互作用的基本信息。在这篇综述中,提出了一些新的实验方法,包括一些依赖于纳米体和单域抗体的方法,以了解炎症小体在相关组织或细胞中的组装和调节。
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引用次数: 2
The organization of the sympathetic nervous system: shining new light on historic views 交感神经系统的组织:为历史观提供新的视角
Pub Date : 2019-11-01 DOI: 10.1113/JP278898
A. Incognito, N. Jendzjowsky
The organization and spatial distribution of neurons within the sympathetic nervous system (SNS) have been long-standing questions in autonomic neuroscience, particularly concerning the functional innervation of target organs. First understood as an ‘alarm reaction’ system turned on en masse, advancements in nerve recording techniques have revealed sympathetic outflow to be differentially controlled to distinct functional subunits within (DiBona 2000; Incognito et al. 2019) and between (Rundqvist et al. 1997) organ systems. Our modern understanding of sympathetic control is now regionand function-specific, governed by an intricate topography within central autonomic nuclei (e.g. rostral ventrolateral medulla; RVLM). Despite intensive efforts to elucidate the regulation of sympathetic outflow, a consensus amongst investigators regarding how topographic arrangements mediate unique activation patterns remains to be reached. Expanding the organizational framework of the SNS is crucial for understanding pathophysiological manifestations. Specifically, cardiovascular disease states present with hallmark sympathetic overactivation, predictive of disease severity (Rundqvist et al. 1997), and with characteristic region-specific alterations in sympathetic outflow to morphologically distinct target organs (e.g. heart, kidney, muscle; Rundqvist et al. 1997). Thus, investigating how the central autonomic circuitry mediates sympathoexcitatory patterns may elucidate cardiovascular (or other) disease mechanisms of neurogenic origin. In a recent article in The Journal of Physiology, Farmer & colleagues (2019) used viral vector tracing and optogenetic manipulation, in vivo, of spinally projecting RVLM neurons to test if these neurons possess the anatomical chassis and functional capacity to elicit sympathoexcitation to regionally and morphologically distinct target organs. The primary objectives were to (1) identify RVLM neurons synapsing at both rostral and caudal thoracic spine regions (i.e. axon collaterals at T2 and T10 spinal segments) and (2) identify if selective stimulation of RVLM neurons with known projections to the caudal thoracic spine (i.e. T12) elicits parallel activation of post-ganglionic nerves in regionally (i.e. rostral thoracic spine) and/or morphologically (i.e. non-vascular) distinct target organs. The authors suggest that evidence of RVLM neurons with functioning axon collaterals would revive older views of generalized/global SNS activation properties, adding an intriguing supplement to the well-established modern view of differential control. Using healthy Sprague–Dawley rats, the first objective was to define the anatomical organization of RVLM projections using retrograde viral tracing. Investigators performed bilateral pressure injections of recombinant herpes simplex retrograde viral vectors into the interomediolateral column (IML) at T2 and T10. Differences in fluorescent tags enabled neurons projecting from the two sites of injection
交感神经系统(SNS)内神经元的组织和空间分布一直是自主神经科学中长期存在的问题,特别是关于目标器官的功能神经支配。首先被理解为一种“警报反应”系统,神经记录技术的进步揭示了交感神经流出在不同的功能亚单位中受到不同的控制(DiBona 2000;Incognito et al. 2019)和(Rundqvist et al. 1997)器官系统之间。我们对交感神经控制的现代理解现在是区域和功能特异性的,受中央自主神经核内复杂的地形(例如,延髓吻侧腹外侧;RVLM)。尽管在阐明交感神经外流的调节方面做了大量的努力,但研究者们对于地形安排如何调节独特的激活模式仍未达成共识。扩大SNS的组织框架对于理解病理生理表现至关重要。具体来说,心血管疾病状态表现为交感神经过度激活,可预测疾病严重程度(Rundqvist et al. 1997),并且交感神经向形态学上不同的靶器官(如心脏、肾脏、肌肉;Rundqvist et al. 1997)。因此,研究中枢自主神经回路如何介导交感神经兴奋模式可能有助于阐明神经源性心血管(或其他)疾病机制。在《生理学杂志》(The Journal of Physiology)最近发表的一篇文章中,Farmer及其同事(2019)在体内对脊髓投射的RVLM神经元进行了病毒载体追踪和光遗传操作,以测试这些神经元是否具有解剖基础和功能能力,从而引发对区域和形态不同的靶器官的交感神经兴奋。主要目的是:(1)确定在胸椎吻侧和尾侧区域(即T2和T10脊柱节段的轴突侧枝)突触的RVLM神经元;(2)确定对胸椎尾侧(即T12)已知投射的RVLM神经元的选择性刺激是否会引起区域(即吻侧胸椎)和/或形态(即非血管)不同靶器官的节后神经的平行激活。作者认为,RVLM神经元具有功能轴突侧支的证据将恢复关于广义/全局SNS激活特性的旧观点,为已建立的差异控制的现代观点增加一个有趣的补充。使用健康的Sprague-Dawley大鼠,第一个目标是使用逆行病毒追踪来定义RVLM投影的解剖组织。研究人员在T2和T10时双侧压力注射重组单纯疱疹逆行病毒载体到中间外侧柱(IML)。荧光标记的差异使神经元从两个注射位点(T2的绿色荧光蛋白(GFP)和T10的mCherry)投射出来。在标记的RVLM神经元亚群中,53%表达GFP(突出到T2), 26%表达mCherry(突出到T10), 21%共表达GFP和mCherry(突出到T2和T10)——后者是轴突侧支的证据,因此是广义交感激活所需的底物,在脊髓突出的交感RVLM神经元亚群中。Farmer和他的同事们的第二个目的是研究来自上胸椎的节后神经是否在光遗传刺激下被激活,以响应已知投射到下胸椎的RVLM神经元。光遗传学方法采用交叉方法,将AAV-ChAR2载体注射到RVLM中,并将CAV2-CMV-Cre启动子注射到胸椎下部,以确保RVLM中的Channelrhodopsin仅在T12水平下投射到IML的神经元中表达。注射后11-50 d,同时记录节后神经配对(1)前肢肌肉交感神经活动(SNA)和后肢肌肉SNA,(2)左心SNA和后肢肌肉SNA。在光遗传刺激这些选择的RVLM神经元后,正如预期的那样,后肢肌肉SNA增加,前肢肌肉SNA和心脏SNA也增加。这些结果证明了RVLM神经元的功能能力,可以唤起远端但形态相似的靶器官(即前肢和后肢肌肉血管)的全身性交感神经兴奋,以及形态不同但潜在功能相似的靶器官(即肌肉血管和心脏)。这些发现证明了轴突侧支在脊髓投射RVLM神经元亚群中的存在,以及它们介导广义交感神经兴奋的能力。
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引用次数: 0
Moving beyond an empiric trial to using combined physiology and anatomy to predict success of oral appliances in obstructive sleep apnoea 从经验性试验到结合生理学和解剖学来预测口腔器械在阻塞性睡眠呼吸暂停中的成功
Pub Date : 2019-11-01 DOI: 10.1113/JP278922
D. Rapoport
Both diagnosis and severity of obstructive sleep apnoea (OSA) have traditionally been assessed through the apnoea–hypopnoea index, a simple count of how often obstruction occurs. However, it is now widely accepted that this metric performs poorly in predicting the success of various non-continuous positive airway pressure (CPAP) therapies; the rate of obstructive events appears to be insensitive to the cause(s) of obstruction in a particular patient. This failure has led several groups to propose that an interaction of multiple pathophysiological factors underlie OSA and that specific therapies may work best in a subset of patients. The ‘holy grail’ has been to define such subsets using this ‘phenotypic’ approach. The problem is exemplified by response to oral appliances, as there is a substantial failure rate in unselected patients. As the time to titration is often prolonged and cost of an empiric therapeutic trial is non-trivial because of needing multiple titration visits and sleep studies, it would be advantageous to be able to select patients with a higher than average success rate. The simplest, but so far unsuccessful, approach to estimating the chance of success has been to use clinical, polysomnographic (PSG) and/or anthropomorphic measures of the patient at baseline. This assumes that anatomy drives OSA and that a relatively linear relation exists between external features, e.g. body mass index, neck size and awake visual assessment of the upper airway, and the causes of obstruction. The lack of success of these predictions in most published trials supports a competing assumption that sleep, airway mechanics and neural reflexes are as important as anatomy, and that their relative contribution is not evident without explicit testing. In this issue of The Journal of Physiology, Marques and colleagues test one such approach (Marques et al. 2019). Previous evidence, quoted by the authors, suggests that tongue position and measurement of collapsibility of the airway may individually modestly predict success of oral appliances, but their combined value has not been explored. In recent years, research techniques have been developed to assess the ‘phenotype’ of a given patient’s OSA. This is variably defined, and a recent trend is to focus on combinations of physiological ‘traits’ to define such a ‘phenotype’. Because the tools to measure the traits that contribute to the pathophysiology of obstruction require methodologies that are difficult and not suited to the clinical PSG environment, surrogates of the major components (anatomy, airway collapsibility or Pcrit, upper airway responsiveness and loop gain) are also being developed and tested for their ability to predict clinical outcomes. In their study Marques and colleagues test the utility of tongue position and Pcrit individually to predict the outcome of oral appliance therapy using state of the art techniques (sleep endoscopy and determination of Pcrit using CPAP drops). More importantl
阻塞性睡眠呼吸暂停(OSA)的诊断和严重程度传统上都是通过呼吸暂停-低通气指数来评估的,这是一种简单的阻塞发生频率计数。然而,现在被广泛接受的是,该指标在预测各种非持续气道正压(CPAP)治疗的成功方面表现不佳;在一个特定的病人中,梗阻事件的发生率似乎对梗阻的原因不敏感。这一失败导致一些研究小组提出,多种病理生理因素的相互作用是OSA的基础,特定的治疗方法可能对一部分患者最有效。“圣杯”一直是使用这种“表型”方法来定义这些子集。这个问题体现在对口腔器械的反应上,因为在未选择的患者中有很大的失败率。由于滴定的时间通常会延长,而且经验性治疗试验的成本不菲,因为需要多次滴定访问和睡眠研究,因此能够选择成功率高于平均水平的患者将是有利的。估计成功几率的最简单方法是使用临床、多导睡眠图(PSG)和/或基线患者的拟人化测量。这假设解剖驱动OSA,并且外部特征(如体重指数、颈部大小和上呼吸道清醒时的视觉评估)与阻塞原因之间存在相对线性的关系。在大多数已发表的试验中,这些预测都没有成功,这支持了一种与之相反的假设,即睡眠、气道力学和神经反射与解剖学一样重要,如果没有明确的测试,它们的相对贡献是不明显的。在本期的《生理学杂志》上,Marques及其同事测试了一种这样的方法(Marques et al. 2019)。作者引用的先前证据表明,舌头位置和气道可折叠性的测量可以单独适度地预测口腔矫形器的成功,但它们的综合价值尚未得到探讨。近年来,研究技术已经发展到评估特定患者的OSA的“表型”。这是可变的定义,最近的趋势是关注生理“特征”的组合来定义这种“表型”。由于测量导致梗阻病理生理特征的工具需要的方法困难且不适合临床PSG环境,因此也正在开发和测试主要组成部分(解剖学,气道可折叠性或Pcrit,上呼吸道反应性和环路增加)的替代品,以预测临床结果。在他们的研究中,Marques和同事分别测试了舌头位置和Pcrit的效用,以预测使用最先进技术(睡眠内窥镜和使用CPAP滴剂测定Pcrit)的口腔器械治疗的结果。比这些特征的个人效用更重要的是,它们表明,当组合在一个预测方程中时,达到了19/22的准确率,具有很高的正负预测值。如果得到证实,这意味着有可能在尝试治疗之前选择患者并预测口腔矫治器的成功和失败。然而,正如他们自己指出的那样,所使用的工具——睡眠内窥镜来确定舌头在阻塞中的作用,以及在睡眠研究中使用CPAP滴液来确定Pcrit——是侵入性的,昂贵的,不太适合临床使用。正如作者所建议的那样,这些检测方法的非侵入性替代方法是否同样具有预测性,还有待检验。本文的主要贡献是证明了从治疗前生理学预测治疗的成功是可能的,因此有了试图简化测试的强化。临床医生应该焦急地等待随访数据,表明临床PSG或其他现成的临床测试的参数也能表现良好。
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引用次数: 2
Gestational intermittent hypoxia induces endothelial dysfunction, reduces perivascular adiponectin and causes epigenetic changes in adult male offspring 妊娠期间歇性缺氧可引起成年雄性后代内皮功能障碍,降低血管周围脂联素并引起表观遗传变化
Pub Date : 2019-11-01 DOI: 10.1113/JP277936
M. Badran, Bisher Abu Yassin, David T. S. Lin, M. Kobor, N. Ayas, I. Laher
Obstructive sleep apnoea (OSA) is characterized by intermittent hypoxia, which causes oxidative stress and inflammation and increases the risk of cardiovascular disease. OSA during pregnancy causes adverse maternal and fetal outcomes. The effects of pre‐existing OSA in pregnant women on cardiometabolic outcomes in the offspring are unknown. We evaluated basic metabolic parameters, as well as aortic vascular and perivascular adipose tissue (PVAT) function in response to adiponectin, and examined DNA methylation of adiponectin gene promoter in PVAT in 16‐week‐old adult offspring exposed to gestational intermittent hypoxia (GIH). GIH decreased body weights at week 1 in both male and female offspring, and caused subsequent increases in body weight and food consumption in male offspring only. Adult female offspring had normal levels of lipids, glucose and insulin, with no endothelial dysfunction. Adult male offspring exhibited dyslipidaemia, insulin resistance and hyperleptinaemia. Decreased endothelial‐dependent vasodilatation, loss of anti‐contractile activity of PVAT and low circulating PVAT adiponectin levels, as well as increased pro‐inflammatory gene expression and DNA methylation of adiponectin gene promoter, occurred in adult male offspring. Our results suggest that male offspring of women with OSA could be at risk of developing cardiometabolic disease during adulthood.
阻塞性睡眠呼吸暂停(OSA)的特点是间歇性缺氧,导致氧化应激和炎症,并增加心血管疾病的风险。妊娠期呼吸暂停会导致不良的母婴结局。孕妇先前存在的OSA对其后代心脏代谢结局的影响尚不清楚。我们评估了基本代谢参数,以及主动脉血管和血管周围脂肪组织(PVAT)功能对脂联素的响应,并检测了暴露于妊娠间歇缺氧(GIH)的16周龄成年后代PVAT中脂联素基因启动子的DNA甲基化。在第1周,GIH降低了雄性和雌性后代的体重,随后仅引起雄性后代体重和食量的增加。成年雌性后代血脂、葡萄糖和胰岛素水平正常,无内皮功能障碍。成年雄性后代表现为血脂异常、胰岛素抵抗和高瘦素血症。在成年雄性后代中,内皮依赖性血管舒张功能降低,PVAT抗收缩活性丧失,循环PVAT脂联素水平降低,促炎基因表达和脂联素基因启动子DNA甲基化增加。我们的研究结果表明,患有阻塞性睡眠呼吸暂停的女性的男性后代在成年后可能有患心脏代谢疾病的风险。
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引用次数: 31
Reproducibility and data presentation 再现性和数据表示
Pub Date : 2019-11-01 DOI: 10.1113/JP277519
I. Forsythe, Sally Howells, K. Barrett
These are interesting times! We are participating in a revolution of biological knowledge and in the manipulation of medical phenomena. But accompanying these scientific developments, there is also a realization that the pace of change and the pressure to publish may undermine scientific rigour, prompting increased scrutiny and the challenge to find ways to improve reproducibility in scientific data and publication. [Opening paragraph]
这是有趣的时刻!我们正在参与一场生物知识的革命和对医学现象的操纵。但是,伴随着这些科学发展,人们也认识到,变化的速度和发表的压力可能会破坏科学的严谨性,促使人们加强审查,并面临寻找方法提高科学数据和发表的可重复性的挑战。(开篇)
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引用次数: 5
Fatty vessels shed tonnes on programmed cardiovascular risk 脂肪血管减少了大量的程序性心血管风险
Pub Date : 2019-11-01 DOI: 10.1113/JP278732
D. Giussani
Cardiovascular disease remains one of the greatest killers in the world today, causing more than a quarter of all deaths in the UK (https://www.bhf.org.uk/for-professionals/ press-centre/facts-and-figures). It is common knowledge that cardiovascular risk is determined by the interaction between our genetic make-up and lifestyle risk factors, such as smoking, obesity and lack of exercise. There is increasing awareness that the gene–environment interaction before birth may be just as, if not more, important in setting a risk of cardiovascular disease, through a process known as developmental programming (Giussani & Davidge, 2013). In humans, the best evidence to support developmental programming comes from studies of obese women who have fallen pregnant before and after having bariatric surgery (Guénard et al. 2013). These studies show that siblings born before the surgery have an increased risk of cardiovascular disease compared to those born after. Therefore, such studies highlight that changes in the environment even within the same womb can programme a differential risk of cardiovascular disease in offspring of the same family. This provides strong evidence in humans that the quality of the environment experienced during critical, early periods of development directly influences long-term cardiovascular health. Unsurprisingly, these concepts have renewed and amplified a focus on prevention rather than treatment to reduce the burden of cardiovascular disease, and for preventative medicine to start as early as possible in the developmental trajectory rather than waiting to treat disease after it has become irreversible. In this issue of The Journal of Physiology, Badran et al. (2019) investigated the effects of obstructive sleep apnoea during pregnancy on cardiometabolic function in the adult offspring using an established mouse model. Obstructive sleep apnoea is characterized by episodes of intermittent hypoxia, which promote oxidative and inflammatory stress, and increase the risk of cardiovascular dysfunction in affected patients (Badran et al. 2019). However, animal models have not addressed the effects of maternal obstructive sleep apnoea during pregnancy on the
心血管疾病仍然是当今世界上最大的杀手之一,在英国造成超过四分之一的死亡(https://www.bhf.org.uk/for-professionals/新闻中心/事实与数据)。众所周知,患心血管疾病的风险是由我们的基因构成和生活方式风险因素(如吸烟、肥胖和缺乏锻炼)之间的相互作用决定的。越来越多的人意识到,在出生前,基因与环境的相互作用,通过一个被称为发育编程的过程,在设定心血管疾病的风险方面,可能同样重要,如果不是更重要的话(Giussani & Davidge, 2013)。在人类中,支持发育规划的最佳证据来自对减肥手术前后怀孕的肥胖妇女的研究(gusamadard et al. 2013)。这些研究表明,手术前出生的兄弟姐妹比手术后出生的兄弟姐妹患心血管疾病的风险更高。因此,这些研究强调,即使在同一个子宫内,环境的变化也可能导致同一家庭后代患心血管疾病的风险差异。这为人类提供了强有力的证据,证明在发育的关键早期阶段所经历的环境质量直接影响到长期的心血管健康。毫不奇怪,这些概念更新并扩大了对预防而不是治疗的关注,以减轻心血管疾病的负担,并使预防医学在发展轨迹中尽早开始,而不是等到疾病变得不可逆转后才进行治疗。在这一期的《生理学杂志》上,Badran等人(2019)利用已建立的小鼠模型,研究了怀孕期间阻塞性睡眠呼吸暂停对成年后代心脏代谢功能的影响。阻塞性睡眠呼吸暂停的特点是间歇性缺氧发作,这会促进氧化和炎症应激,并增加患者心血管功能障碍的风险(Badran et al. 2019)。然而,动物模型并没有解决怀孕期间母亲阻塞性睡眠呼吸暂停对胎儿的影响
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引用次数: 0
HCN3 has minimal involvement in the sensation of acute, inflammatory and neuropathic pain HCN3极少参与急性、炎症性和神经性疼痛的感觉
Pub Date : 2019-11-01 DOI: 10.1113/JP278770
Mackellar Dewar
Hyperpolarization-activated cyclical nucleotide-gated (HCN) channels have recently garnered attention as drivers of chronic pain. These channels cause an inward current in response to membrane hyperpolarization, leading to the cyclical generation of action potentials. Of the four channels belonging to the HCN family (HCN1–4), HCN1 HCN2, and HCN3 are the main channels responsible for hyperpolarization-activated current in neurons. Previous research has shown that loss of HCN2 activity can eliminate thermal hyperalgesia in inflammatory pain, as well as both thermal and mechanical hyperalgesia in neuropathic pain. Additionally, HCN1 activity has been shown to regulate cold hypersensitivity and nerve injury-induced pain. Given the involvement of other HCN channels, Lainez et al. (2019) sought to determine the role of HCN3 in chronic pain. They first investigated the expression of HCN3 in sensory neurons by performing immunohistochemistry on cultured lumbar dorsal root ganglion (DRG) neurons. Staining with β3-tubulin and HCN3 antibodies showed that 60% of small (<20 μm diameter) and medium–large (>20 μm diameter) neurons expressed HCN3. Further staining was done to determine the co-localization of HCN3 with subpopulations of DRG neurons; about 35% of small unmyelinated neurons, 86% of large myelinated neurons, and 63% of small and medium neurons with nociceptive function were found to express HCN3. Together, these experiments reveal the abundant expression of HCN3 in DRG neurons of various functions and size classes. While these findings are consistent with a previous study showing widespread expression of HCN3 in rat DRG neurons (Chaplan et al. 2003), they contradict the low HCN3 expression found by a study in mice (Moosmang et al. 2001). Next, the authors investigated whether HCN3 contributes to the hyperpolarization-activated current (Ih). Whole-cell patch clamp experiments showed that 97 of 107 neurons with HCN2 deletion had a significant Ih, providing initial evidence that other isoforms contribute to the current. Previous research has identified HCN1 as predominantly involved in large neurons, whereas HCN3 probably contributes to the Ih in small and medium neurons (Momin et al. 2008). In combination with the low expression of HCN4 in these cells (Moosmang et al. 2001; Chaplan et al. 2003), HCN2 and HCN3 appear to be the major isoforms involved in small and medium neurons. Given this information, Lainez et al. (2019) then studied the relative contribution of HCN2 and HCN3 to Ih. To do so, they measured V1/2 following forskolin-induced cAMP elevation in wild type (WT), HCN2−/− and HCN3−/− neurons. The heightened levels of cAMP led to its binding to the various HCN isoforms; HCN1 and HCN3 are relatively insensitive to this interaction, but binding to HCN2 and HCN4 will cause an increase in V1/2. In small neurons a similar increase in V1/2 was seen in both WT and HCN3−/− groups after forskolin application, whereas no shift was seen in HCN2−/− neuron
从0到60 pA,在10 pA的步骤中施加1秒的电流,显示出三种不同的放电模式:无声(无放电),相位(放电周期)和持续(连续放电)。作者选择只分析具有强直性放电模式的神经元,因为它们最有可能与慢性疼痛有关。他们发现,从WT、HCN2 - / -和HCN3 - / -小鼠中提取的小神经元之间没有差异。然而,中等HCN3−/−神经元的放电频率高于WT和HCN2−/−神经元。所有HCN3−/−神经元也显示出比WT和HCN2−/−神经元更高的相放电频率。作者接下来评估了HCN3是否在急性、炎症性和神经性疼痛中发挥作用。他们首先通过测量对机械和热刺激的反应来研究急性疼痛。在对WT和HCN3−/−小鼠进行von Frey刺激后,无差异
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引用次数: 0
Skeletal muscle nitrate storage – the missing piece of the nitrate supplementation puzzle? 骨骼肌硝酸盐储存——硝酸盐补充之谜的缺失部分?
Pub Date : 2019-11-01 DOI: 10.1113/JP278785
K. A. Wickham, J. Nyakayiru, D. G. McCarthy, Daniel T. Cervone
Over the last decade, nitrate (NO3−) supplementation – delivered as beetroot juice (BRJ) or sodium/potassium nitrate – has gained widespread attention for its potential as a therapeutic and ergogenic aid (Jones et al. 2018). Specifically, NO3− supplementation has been shown to reduce blood pressure and improve exercise performance (Jones et al. 2018). These benefits have been attributed to an increase in nitric oxide (NO) bioavailability following exogenous NO3− intake.
在过去的十年中,硝酸盐(NO3−)补充剂-以甜菜根汁(BRJ)或硝酸钠/硝酸钾的形式提供-因其作为治疗和促人体健康援助的潜力而受到广泛关注(Jones et al. 2018)。具体而言,补充NO3−已被证明可以降低血压并改善运动表现(Jones et al. 2018)。这些益处归因于外源性NO3−摄入后一氧化氮(NO)生物利用度的增加。
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引用次数: 2
期刊
The Japanese journal of physiology
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