Days Of Chronic Intermittent Hypoxia Research Articles

Peripheral macrophages contribute to nociceptor priming in mice with chronic intermittent hypoxia.

Obstructive sleep apnea (OSA) is a prevalent sleep disorder that is associated with increased incidence of chronic musculoskeletal pain. We investigated the mechanism of this association in a mouse model of chronic intermittent hypoxia (CIH) that mimics the repetitive hypoxemias of OSA. After 14 days of CIH, both male and female mice exhibited behaviors indicative of persistent pain, with biochemical markers in the spinal cord dorsal horn and sensory neurons of the dorsal root ganglia consistent with hyperalgesic priming. CIH, but not sleep fragmentation alone, induced an increase in macrophage recruitment to peripheral sensory tissues (sciatic nerve and dorsal root ganglia), an increase in inflammatory cytokines in the circulation, and nociceptor sensitization. Peripheral macrophage ablation blocked CIH-induced hyperalgesic priming. The findings suggest that correcting the hypoxia or targeting macrophage signaling might suppress persistent pain in patients with OSA.

Carotid body ablation restores astrocyte/microglia morphology in the NTS and reduces hypertension following long-term intermittent hypoxia

Chronic intermittent hypoxia (CIH) heightened carotid body (CB) chemosensory discharges, which contributes to hypertension development. Previously, we reported that CB ablation significantly reduced blood pressure after 21 days of CIH; however, whether CB-mediated glial cell activation in the caudal Nucleus of the Solitary Tract (cNTS) following long-term CIH contribute to maintain high blood pressure and enhanced ventilatory chemoreflex remains unknown. To test this hypothesis, we exposed male C57BL6 mice to CIH (5% FIO2, 12 times/h, 8 h/day) for 60 days. At 45 days of CIH, CBs were selectively denervated, and animals returned to CIH for 15 more days. At the end of the experimental protocol, we measured arterial blood pressure, hypoxic ventilatory response (HVR) in awake mice and characterized astrocyte and microglia morphological features using Sholl analysis. CIH induces hypertension (MABP: 83.47±1.39 vs. 95.00±2.18 mmHg; Sham vs. CIH), increases the HVR (1.69±0.17 vs. 4.31±0.87 ΔVE/min; Sham vs. CIH), modify cNTS astrocytes phenotype (N° of branches: 13.01±0.66 vs. 11.31±0.52; cable length: 181.00±8.90 vs 148.10±1.48 μm, convex hull: 788.10±37.60 vs. 584.30±23.75 μm3; Sham vs. CIH), and microglia arborization (N° of branches: 196.10±8.35 vs. 376.30±16.80; cable length: 667.4±29.63 vs. 1267±60.47 μm, convex hull: 6177±362 vs. 9721±564 μm3; Sham vs. CIH). Importantly, CB denervation normalized the elevated blood pressure (MABP: 83.47±1.38 mmHg; CIHd), the altered peripheral chemoreflex response (HVR: 1.63±0.43 ΔVE/min; CIHd) and morphological changes in astrocytes (N °of branches: 17.23±0.88, cable length: 231.70±12.87, convex hull: 982.70±55.55 μm3) and microglia located in the cNTS (N° of branches 126.20±13.34; cable length: 126.2±13.3, Convex hull size: 3584±380 μm3; CIHd). Present results suggest that CBs play a crucial role in the maintenance of high arterial pressure and respiratory alterations induced by long-term CIH and may contribute to the formation of a neuroinflammatory niche at the cNTS by modifying glial cell activity. Supported by Fondecyt Grants 1211443 and 1220950. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Ovariectomy Increases Blood Pressure and FosB Staining in the Central Autonomic Control Regions Independent of Chronic Intermittent Hypoxia

Chronic intermittent hypoxia (CIH) experimentally mimics the recurrent hypoxia characteristic of sleep apnea, and it induces sustained hypertension in male and ovariectomized (OVX) female rats but not intact females. While central autonomic control regions are known to mediate CIH-induced hypertension in males, their contribution to CIH hypertension in OVX females remains unclear. We tested the hypothesis that 7 days of CIH increases mean arterial pressure (MAP) and FosB staining in central autonomic regions in OVX but not intact female rats. Adult female Sprague Dawley gonadally intact (INT) or OVX rats were exposed to 7 days of CIH (10% O2 and 21% O2 cycle, every 6 mins, 8h/day) or continuous normoxia (CON). MAP was monitored by radiotelemetry. On day 8, the rats were sacrificed, and their brains were collected and processed for FosB immunohistochemistry. During the light/sleep phase, CIH increased MAP in INT females (n=7; 3.4 ± 0.4 mmHg) as compared to CON (n=6, ΔMAP 1.4 ± 0.3 mmHg; P=0.01 CON vs CIH). This difference was not observed during the dark/active phase (CON ΔMAP -1.7 ± 0.4 mmHg, CIH 0.5 ± 0.3 mmHg, P=0.07). In OVX females, CIH was not associated with significant increases in MAP during the light/sleep phase (CON (n=6) ΔMAP 0.3 ± 0.4 mmHg, CIH (n = 6) 2.1 ± 0.3 mmHg, P=0.10). During the dark phase, MAP was significantly increased in CON OVX and CIH OVX compared to their respective baselines but there were no differences between groups (CON ΔMAP 2.4 ± 0.3 mmHg, CIH 2.2 ± 0.4 mmHg, P=0.0002 vs baseline, P=0.8 CON vs CIH). OVX rats had higher baseline FosB staining in the median preoptic nucleus compared to intact female rats independent of CIH exposure (INT: CON (n = 6) 13 ± 3 cells/section, CIH (n = 6) 14 ± 2; OVX: CON (n = 6) 21 ± 3, CIH (n = 6) 23 ± 2, INT CON vs OVX CON, P < 0.05, INT CIH vs OVX CIH P < 0.05). Compared to CON, CIH significantly increased the number of FosB immunoreactive cells in the caudal nucleus of the solitary tract in INT but not OVX females (INT: CON, 7 ± 1 cells/section, CIH 11 ± 1; OVX CON 6 ± 1, CIH n=6, 9 ± 1; INT CON vs CIH, P=0.02; OVX CON vs CIH, P = 0.09). In the rostral ventrolateral medulla, there were no significant differences among any of the groups (INT: CON n=4, 19 ± 2 cells/section, CIH n=4, 20 ± 3; OVX: CON n=6, 18 ± 2, CIH n=6, 21 ± 2, all P>0.05). In OVX females, CIH tended to increase MAP during both the light and dark phases. CON OVX females showed a trend for increased MAP during the dark phase, independent of CIH. CIH was not associated with increased FosB staining in either the median preoptic nucleus or the rostral ventrolateral medulla of OVX females This suggests that changes in MAP observed in CIH OVX females may not involve the same autonomic control regions as male rats exposed to CIH. Supported by RO1 HL155977. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Chronic Intermittent Hypoxia Alters GABAergic Inhibition in Median Preoptic Nucleus (MnPO) Neurons of Rats

Chronic intermittent hypoxia (CIH) is an animal model simulating the hypoxemia associated with obstructive sleep apnea (OSA) in humans. Male rats exposed to CIH exhibit increased sympathetic tone and persistent elevations in blood pressure similar to that observed in patients with. In MnPO neurons, CIH reduces GABAa inhibition and, in some neurons, GABAa activation produces excitation. Here, loose patch and perforated patch recordings were conducted in MnPO neurons in response to optogenetic stimulation of GABAergic SFO (efferent) and MnPO (local) neurons to assess the role of GABAergic signaling in these nuclei on MnPO excitability. Our working hypothesis was that CIH would diminish the inhibitory effects of optogenetic stimulation of GABA neurons. This hypothesis was tested using an AAV vector that selectively expresses channel rhodopsin in GABA neurons Using isoflurane (2-3%) anesthesia, male Sprague-Dawley rats (250-350g) received infusions (0.2 μL) of pAAV-mDlx-ChR2-mCherry-Fishell-3 in the SFO or MnPO. After recovery, rats were subjected to 7 days of CIH (0800-1600 hr) or normoxia (Norm). CIH consisted of 6 min cycles (3 min 21% O2, 3 min 10% O2) repeated 10x/hr for 8 hours (during the normal inactive/sleep phase) on 7 consecutive days. For in vitro recordings, rats were anesthetized with isoflurane (2-3%), and sagittal or coronal slices (300 μm) containing MnPO were cut using standard slice procedures. Voltage-clamp loose patch or perforated patch recordings using gramicidin (100 ug/ml in 140 mM K-gluconate) were collected in MnPO neurons in response to optogenetic stimulation of GABAergic neurons (2 ms pulse, 20 Hz, 1 sec). MnPO neurons from CIH-treated rats showed differing responses to GABAergic stimulation while MnPO neurons from Norm-treated rats predominantly exhibited GABAergic inhibition. MnPO neurons from Norm rats exhibited mIPSCs and outward currents in response to muscimol. MnPO neurons from CIH-treated rats show variable mIPSC frequencies and heterogeneous responses to GABAergic neuronal activation in the SFO and MnPO. The results demonstrate that CIH alters the Cl− homeostasis in some MnPO neurons altering their response to GABAa stimulation. These changes may contribute to the increased sympathetic tone and reactivity, as well as the persistent hypertension associated with CIH. Supported by R01 HL155977. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Chemogenetic inhibition of NTS astrocytes normalizes cardiac autonomic control and ameliorate hypertension during chronic intermittent hypoxia

BackgroundObstructive sleep apnea (OSA) is characterized by recurrent episodes of chronic intermittent hypoxia (CIH), which has been linked to the development of sympathoexcitation and hypertension. Furthermore, it has been shown that CIH induced inflammation and neuronal hyperactivation in the nucleus of the solitary tract (NTS), a key brainstem region involved in sympathetic and cardiovascular regulation. Since several studies have proposed that NTS astrocytes may mediate neuroinflammation, we aimed to determine the potential contribution of NTS-astrocytes on the pathogenesis of CIH-induced hypertension.ResultsTwenty-one days of CIH induced autonomic imbalance and hypertension in rats. Notably, acute chemogenetic inhibition (CNO) of medullary NTS astrocytes using Designer Receptors Exclusively Activated by Designers Drugs (DREADD) restored normal cardiac variability (LF/HF: 1.1 ± 0.2 vs. 2.4 ± 0.2 vs. 1.4 ± 0.3, Sham vs. CIH vs. CIH + CNO, respectively) and markedly reduced arterial blood pressure in rats exposed to CIH (MABP: 82.7 ± 1.2 vs. 104.8 ± 4.4 vs. 89.6 ± 0.9 mmHg, Sham vs. CIH vs. CIH + CNO, respectively). In addition, the potentiated sympathoexcitation elicit by acute hypoxic chemoreflex activation in rats exposed to CIH was also completely abolished by chemogenetic inhibition of NTS astrocytes using DREADDs.ConclusionOur results support a role for NTS astrocytes in the maintenance of heightened sympathetic drive and hypertension during chronic exposure to intermittent hypoxia mimicking OSA.

Calcineurin suppresses rat H9c2 cardiomyocyteprotective autophagy under chronic intermittent hypoxia by downregulating the AMPK pathway

Calcineurin plays a key role in cardiovascular pathogenesis by exerting pro-apoptotic effects in cardiomyocytes. However, whether calcineurin can regulate cardiomyocyte autophagy under conditions of chronic intermittent hypoxia (CIH) remains unclear. Here, we showed that CIH induced calcineurin activity in H9c2 cells, which attenuated adenosine monophosphate-activated protein kinase (AMPK) signaling and inhibited autophagy. In H9c2 cells, autophagy levels, LC3 expression, and AMPK phosphorylation were significantly elevated under conditions of CIH within 3 days. However, after 5 days of CIH, these effects were reversed and calcineurin activity and apoptosis were significantly increased. The calcineurin inhibitor 17-Allyl-1,14-dihydroxy-12-[2-(4-hydroxy-3-methoxycyclohexyl) -1-methylvinyl]-23,25-dimethoxy-13,19,21,27-tetramethyl-11,28-dioxa-4-azatricyclo- [22.3.1.04,9]octacos-18- ene-2,3,10,16-tetrone (FK506) restored AMPK activation and LC3 expression and attenuated CIH-induced H9c2 cell apoptosis. In contrast, calcineurin overexpression significantly attenuated the increase in LC3 expression and enhanced H9c2 cell apoptosis under conditions of CIH. Calcineurin inhibition failed to induce autophagy or alleviate apoptosis in H9c2 cells expressing a kinase-dead K45R AMPK mutant. Autophagy inhibition abrogated the protective effects of FK506-mediated calcineurin inhibition. These results indicate that calcineurin suppresses adaptive autophagy during CIH by downregulating AMPK activation. Our findings reveal the underlying mechanism of calcineurin and autophagy regulation during H9c2 cell survival under conditions of CIH and may provide a new strategy for preventing CIH-induced cardiomyocyte damage.

Chronic intermittent hypoxia induced increases in central angiotensin II release in the MnPO

The brain is sensitive to Angiotensin II (ANG II) and we have previously shown that ANG II is released by brain slices containing the median preoptic nucleus (MnPO) and subfornical organ (SFO) in an activity dependent manner. In addition, angiotensin II type 1 receptors and angiotensin converting enzyme 1 are upregulated in the MnPO following chronic intermittent hypoxia (CIH), an animal model of obstructive sleep apnea. Here, we investigate changes in ANG II release in the SFO to MnPO pathway following 7-day CIH treatment.Using isoflurane (2-3%) anesthesia, male Sprague-Dawley rats (250-350g) received microinfusions (0.4 μL) of AAV2-hSyn-ChR2(E123A)-eYFP-WPRE in the SFO. After recovery, rats were subjected to 7 days of CIH (0800-1600 hrs) or Normoxia. The CIH protocol consisted of 6 min cycles (3 min 21% O2, 3 min 10% O2) repeated 10x/hr for 8 hours (during the normal inactive/sleep phase) on 7 consecutive days. For sniffer cell measurements, rats were anesthetized with isoflurane (2-3%) and sagittal slices (300 μm) containing the MnPO and SFO were cut using standard in vitro slice procedures. Sniffer cells consisted of Chinese Hamster Ovary cells transfected with a commercially available plasmid for the angiotensin type 1a (AT1a) receptor (Origene Tech.) and R-GECO (Addgene #32462) as previously described. Sniffer cells were placed on the median preoptic nucleus (MnPO) of sagittal in vitro brain slices. Both spontaneous and evoked (SFO stimulation) changes in fluorescent intensity of sniffer cells on the MnPO were measured.Sniffer cell recordings were made from 5 normoxia and 8 CIH treated rats. The frequency of spontaneous sniffer cell activity in slices from normoxic rats (n = 92) was comparable to rates previously reported in Sprague-Dawley rats. Spontaneous sniffer cell activity in slices from CIH treated rats (n = 156) was increased compared to normoxic treated rats (p < 0.05). Furthermore, bath application of TTX (1 uM) reduced, but did not abolish, spontaneous sniffer cell activity in slices from both normoxic (n = 95, p < 0.001) and CIH (n = 108, p < 0.001) treated rats. Incidence of optogenetic evoked responses in sniffer cells were limited in slices from both the normoxic and CIH treated rats and there were no differences detected in these evoked responses.The current study indicates that spontaneous ANG II release in the MnPO 1) is not entirely action potential dependent, 2) is enhanced following 7-days CIH treatment, and 3) the CIH induced increase is action potential dependent. While optogenetic stimulation of SFO increased sniffer cell activity, CIH had no effect evoked release of ANG II in these preliminary studies. Work supported by: P01 HL088052, R01 HL155977 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Acute Chemogenetic Inhibition of Caudal NTS Astrocytes Reduced Systemic Blood Pressure in Rats Exposed to Chronic Intermittent Hypoxia‐mimicking Sleep Apnea Syndrome

Chronic intermittent hypoxia (CIH), the main feature of obstructive sleep apnea, enhances carotid body (CB) discharges, leading to heightened sympathetic outflow and systemic hypertension. Previously, we found that CBs play a pivotal role in the hyperactivation of central nervous system (CNS) autonomic nuclei following CIH, particularly at the level of the caudal portion of the nucleus of the tractus solitary (NTS). Indeed, increased CB afferent activity during CIH increases the expression of pro‐inflammatory cytokines in the NTS, suggesting that CBs may drive neuroinflammation at key cardiorespiratory regulatory areas. Astrocytes has been implicated in inflammatory processes at the CNS. However, the contribution of NTS astrocytes on the cardiorespiratory abnormalities following CIH has not been studied. Accordingly, we assessed the role of astrocytes residing within the NTS on the maintenance of hypertension following CIH. Male Sprague‐Dawley rats (200 g) were exposed to CIH (5–6% inspired O2 for 20s, followed by room air for 280s, 12 times/h, 8 h/day, for 28 days). Arterial blood pressure (BP) was measured by indwelling telemetry. At 7 days of CIH exposure, rats were anesthetized and an adeno‐associated virus (AAV; 450 nL, 1*10‐12 vg) containing an inhibitory (Gi) Designer Receptor Exclusively Activated by Designer Drugs (DREADD) expressed under the control of the GFAP promoter was bilaterally injected into the caudal portion of the NTS using stereotaxic coordinates (–14.3 mm to bregma). At day 28 of CIH, hemodynamic and respiratory parameters were recorded before and after inhibition of NTS astrocytes with clozapine N‐oxide (CNO, 1mg/kg, ip.). At the end of the experiments rats were transcardially perfused with 4% buffered paraformaldehyde, brains extracted and sectioned to assess astrocyte activation within the NTS. Twenty‐eight days of CIH resulted in a significant 2‐fold increase in NTS astrocyte activation as evidenced by enhanced reactivity of GFAP. Additionally, resting BP was markedly elevated compared to Sham conditions (MABP, 98±2 vs. 84±2 mmHg, CIH vs. Sham; p<0.05). Acute chemogenetic inhibition of NTS astrocytes following 28 days of CIH results in a significant reduction in BP (⁓10 mmHg; p<0.05). In addition, the exacerbated hemodynamic response triggered by acute hypoxic stimulation (FiO2 10%) in rats exposed to CIH for 28 days was also reduced by NTS astrocyte inhibition ΔMABP, 30±2 vs. 15±2 mmHg, pre vs. post CNO; p<0.05). No cardiovascular effects of CNO alone were found in control rats that did not underwent AAV‐DREADD‐Gi injection into the NTS. Taken together, our results support a role for NTS astrocyte activation on the maintenance of hypertension following chronic CIH and suggest that activation of NTS astrocytes may participate in the CB‐mediated cardiovascular reflex response during hypoxic stimulation.

Chronic Intermittent Hypoxia Alters Chloride Gradients in Median Preoptic Nucleus (MnPO) Neurons of Rats: Comparing ClopHensorN and Perforated Patch Recording

Chronic intermittent hypoxia (CIH) is an animal model that simulates the hypoxemia associated with sleep apnea. Male rats exposed to CIH exhibit increased sympathetic tone and reactivity and persistent elevations in blood pressure. In MnPO neurons, CIH induces reductions in GABAa inhibition that are, in some neurons, exacerbated to the point of GABAa mediated excitation. The genetically encoded ratiometric Cl‐ sensor, ClopHensorN, was used to monitor the Cl‐ flux of PVN projecting MnPO neurons in normoxic (Norm) and CIH treated rats in response to GABAa receptor activation. In some experiments, ClopHensorN imaging was combined with perforated patch recordings.Using isoflurane (2‐3%) anesthesia, male Sprague‐Dawley rats (250‐350g) received bilateral infusions (0.4 µL) of a retrograde AAV9‐Cre in the PVN and a DIO‐ClopHensorN in the MnPO. After recovery, rats were subjected to 7 days of CIH (0800‐1600 hr) or normoxia. CIH consisted of 6 min cycles (3 min 21% O2, 3 min 10% O2) repeated 10x/hr for 8 hours (during the normal inactive/sleep phase) on 7 consecutive days. For recordings, rats were anesthetized with isoflurane (2‐3%) and coronal slices (300 µm) containing the MnPO were cut using standard in vitro slice procedures. All cells were tested in standard artificial cerebrospinal fluid for their responses to 10 s focal application of muscimol (100 uM). ClopHensorN images were captured every 3 sec. Cl‐ flux was determined from the ratio of GFP (ex 488 nm, em 500‐550 nm) to tdTomato (ex 594 nm, em 650‐700 nm) fluorescence. For some cells, voltage‐clamp recordings using gramicidin (100 ug/ml in 140 mM K‐gluconate) perforated patch were also collected (in labeled and unlabeled MnPO neurons).MnPO neurons from CIH treated rats (n = 632), 20.1% showed a decrease in the ratio of GFP to tdTomato fluorescence (n = 127) while 0.3% showed increases in this ratio (n = 2) indicative of Cl‐ efflux. In MnPO neurons from Norm rats (n = 482), 41.9% showed a muscimol dependent decrease in the ratiometric Cl‐ signal (n = 202) with 0 cells showing increases. Muscimol dependent decreases in the Cl‐ signal were reduced in the CIH treated rats suggesting reduced GABAa inhibition. During perforated patch recordings, MnPO neurons from Norm rats exhibited mIPSCs and outward currents in response to muscimol. MnPO neurons from CIH treated rats show variable mIPSC frequencies and heterogeneous responses to muscimol.The results demonstrate that CIH alters the Cl‐ flux of PVN projecting MnPO neurons in response to GABAa stimulation. These changes may contribute to the increased sympathetic tone and reactivity, as well as the persistent hypertension associated with CIH.

Crucial Role of Stromal Interaction Molecule-Activated TRPC-ORAI Channels in Vascular Remodeling and Pulmonary Hypertension Induced by Intermittent Hypoxia.

Obstructive sleep apnea (OSA), a sleep breathing disorder featured by chronic intermittent hypoxia (CIH), is associate with pulmonary hypertension. Rats exposed to CIH develop lung vascular remodeling and pulmonary hypertension, which paralleled the upregulation of stromal interaction molecule (STIM)-activated TRPC-ORAI Ca2+ channels (STOC) in the lung, suggesting that STOC participate in the pulmonary vascular alterations. Accordingly, to evaluate the role played by STOC in pulmonary hypertension we studied whether the STOC blocker 2-aminoethoxydiphenyl borate (2-APB) may prevent the vascular remodeling and the pulmonary hypertension induced by CIH in a rat model of OSA. We assessed the effects of 2-APB on right ventricular systolic pressure (RVSP), pulmonary vascular remodeling, α-actin and proliferation marker Ki-67 levels in pulmonary arterial smooth muscle cells (PASMC), mRNA levels of STOC subunits, and systemic and pulmonary oxidative stress (TBARS) in male Sprague-Dawley (200 g) rats exposed to CIH (5% O2, 12 times/h for 8h) for 28 days. At 14 days of CIH, osmotic pumps containing 2-APB (10 mg/kg/day) or its vehicle were implanted and rats were kept for 2 more weeks in CIH. Exposure to CIH for 28 days raised RVSP > 35 mm Hg, increased the medial layer thickness and the levels of α-actin and Ki-67 in PASMC, and increased the gene expression of TRPC1, TRPC4, TRPC6 and ORAI1 subunits. Treatment with 2-APB prevented the raise in RVSP and the increment of the medial layer thickness, as well as the increased levels of α-actin and Ki-67 in PASMC, and the increased gene expression of STOC subunits. In addition, 2-APB did not reduced the lung and systemic oxidative stress, suggesting that the effects of 2-APB on vascular remodeling and pulmonary hypertension are independent on the reduction of the oxidative stress. Thus, our results supported that STIM-activated TRPC-ORAI Ca2+ channels contributes to the lung vascular remodeling and pulmonary hypertension induced by CIH.

Leptin: A Potential Link Between Obstructive Sleep Apnea and Obesity.

Chronic intermittent hypoxia (CIH), a pathophysiological manifestation of obstructive sleep apnea (OSA), is strongly correlated with obesity, as patients with the disease experience weight gain while exhibiting elevated plasma levels of leptin. This study was done to determine whether a relationship may exist between CIH and obesity, and body energy balance and leptin signaling during CIH. Sprague-Dawley rats were exposed to 96 days of CIH or normoxic control conditions, and were assessed for measures of body weight, food and water intake, and food conversion efficiency. At the completion of the study leptin sensitivity, locomotor activity, fat pad mass and plasma leptin levels were determined within each group. Additionally, the hypothalamic arcuate nucleus (ARC) was isolated and assessed for changes in the expression of proteins associated with leptin receptor signaling. CIH animals were found to have reduced locomotor activity and food conversion efficiency. Additionally, the CIH group had increased food and water intake over the study period and had a higher body weight compared to normoxic controls at the end of the study. Basal plasma concentrations of leptin were significantly elevated in CIH exposed animals. To test whether a resistance to leptin may have occurred in the CIH animals due to the elevated plasma levels of leptin, an acute exogenous (ip) leptin (0.04 mg/kg carrier-free recombinant rat leptin) injection was administered to the normoxic and CIH exposed animals. Leptin injections into the normoxic controls reduced their food intake, whereas CIH animals did not alter their food intake compared to vehicle injected CIH animals. Within ARC, CIH animals had reduced protein expression of the short form of the obese (leptin) receptor (isoform OBR100) and showed a trend toward an elevated protein expression of the long form of obese (leptin) receptor (OBRb). In addition, pro-opiomelanocortin (POMC) protein expression was reduced, but increased expression of the phosphorylated extracellular-signal-regulated kinase 1/2 (pERK1/2) and of the suppressor of cytokine signaling 3 (SOCS3) proteins was observed in the CIH group, with little change in phosphorylated signal transducer and activator of transcription 3 (pSTAT3). Taken together, these data suggest that long-term exposure to CIH, as seen in obstructive sleep apnea, may contribute to a state of leptin resistance promoting an increase in body weight.

AT1a-dependent GABAA inhibition in the MnPO following chronic intermittent hypoxia.

Chronic intermittent hypoxia (CIH) is associated with diurnal hypertension, increased sympathetic nerve activity (SNA), and increases in circulating angiotensin II (ANG II). In rats, CIH increases angiotensin type 1 (AT1a) receptor expression in the median preoptic nucleus (MnPO), and pharmacological blockade or viral knockdown of this receptor prevents CIH-dependent increases in diurnal blood pressure. The current study investigates the role of AT1a receptor in modulating the activity of MnPO neurons following 7 days of CIH. Male Sprague-Dawley rats received MnPO injections of an adeno-associated virus with an shRNA against the AT1a receptor or a scrambled control. Rats were then exposed to CIH for 8 h a day for 7 days. In vitro, loose patch recordings of spontaneous action potential activity were made from labeled MnPO neurons in response to brief focal application of ANG II or the GABAA receptor agonist muscimol. In addition, MnPO K-Cl cotransporter isoform 2 (KCC2) protein expression was assessed using Western blot. CIH impaired the duration but not the magnitude of ANG II-mediated excitation in the MnPO. Both CIH and AT1a knockdown also impaired GABAA-mediated inhibition, and CIH with AT1a knockdown produced GABAA-mediated excitation. Recordings using the ratiometric Cl- indicator ClopHensorN showed CIH was associated with Cl- efflux in MnPO neurons that was associated with decreased KCC2 phosphorylation. The combination of CIH and AT1a knockdown attenuated reduced KCC2 phosphorylation seen with CIH alone. The current study shows that CIH, through the activity of AT1a receptors, can impair GABAA-mediated inhibition in the MnPO and contribute to sustained hypertension.

CIH Enhances Glutamatergic Transmission in Median Preoptic Nucleus

Studies have shown that the median preoptic nucleus (MnPO) contributes to hypertension associated with chronic intermittent hypoxia (CIH), a model of the hypoxemia associated with sleep apnea. Virally mediated lesions of MnPO neurons prevent the development of a sustained hypertension associated with CIH. To gain more insight into the properties of excitatory transmission to MnPO neurons develops in CIH, whole cell patch clamp recordings were from MnPO neurons brain slices from rats exposed to 7 days of CIH (6 minute cycles; 3 minutes of 21% oxygen room air pumped in, 90 seconds of nitrogen pumped in to lower the chamber O2 to 10% oxygen, and then 90 seconds of maintenance at 10% oxygen) for 8 h during the light phase or were normoxic controls. Slices were perfused with oxygenates artificial cerebrospinal fluid and the MnPO was visually identified. Miniature excitatory postsynaptic currents (mEPSCs) were recorded in the presences of 25 µm SR95531 (GABAA antagonist) and 1 µm TTX (block Na+ channel-mediated action potentials) using a conventional whole cell patch clamp configuration. The mEPSCs were collected over a 4 min period and amplitude and frequency were compared between cells obtained from slice prepared from normoxic control rats (NORM) or rats exposed to CIH. CIH was associated with a significant increase in mean amplitude (CIH 17.15 ± 0.65 pA, n=19 cells; NORM (15.6 ± 0.6 pA; n=18 cells, P <0.05). Similarly, mean frequency was significantly elevated after CIH (CIH 4.05 ± 0.5 Hz, n=19 vs NORM 2.56 ± 0.37 Hz, n=18; p<0.05) and associated with a significant leftward shift in the cumulative probability of inter event intervals. The results suggest that CIH simultaneously increases enhances spontaneous presynaptic neurotransmitter release while also increasing postsynaptic responsiveness in MnPO. These presynaptic and postsynaptic changes in MnPO that are associated with CIH may represent mechanism contributing to CIH hypertension.

Carbamylated form of human erythropoietin normalizes cardiorespiratory disorders triggered by intermittent hypoxia mimicking sleep apnea syndrome.

Chronic intermittent hypoxia (CIH), one of the main features of obstructive sleep apnea (OSA), enhances carotid body-mediated chemoreflex and induces hypertension and breathing disorders. The carbamylated form of erythropoietin (cEpo) may have beneficial effects as it retains its antioxidant/anti-inflammatory and neuroprotective profile without increasing red blood cells number. However, no studies have evaluated the potential therapeutic effect of cEpo on CIH-related cardiorespiratory disorders. We aimed to determine whether cEpo normalized the CIH-enhanced carotid body ventilatory chemoreflex, the hypertension and ventilatory disorders in rats. Male Sprague-Dawley rats (250 g) were exposed to CIH (5% O2, 12/h, 8 h/day) for 28 days. cEPO (20 μg/kg, i.p) was administrated from day 21 every other day for one more week. Cardiovascular and respiratory function were assessed in freely moving animals. Twenty-one days of CIH increased carotid body-mediated chemoreflex responses as evidenced by a significant increase in the hypoxic ventilatory response (FiO2 10%) and triggered irregular eupneic breathing, active expiration, and produced hypertension. cEpo treatment significantly reduced the carotid body--chemoreflex responses, normalizes breathing patterns and the hypertension in CIH. In addition, cEpo treatment effectively normalized carotid body chemosensory responses evoked by acute hypoxic stimulation in CIH rats. Present results strongly support beneficial cardiorespiratory therapeutic effects of cEpo during CIH exposure.

Peripheral Dopamine 2-Receptor Antagonist Reverses Hypertension in a Chronic Intermittent Hypoxia Rat Model.

The sleep apnea-hypopnea syndrome (SAHS) involves periods of intermittent hypoxia, experimentally reproduced by exposing animal models to oscillatory PO2 patterns. In both situations, chronic intermittent hypoxia (CIH) exposure produces carotid body (CB) hyperactivation generating an increased input to the brainstem which originates sympathetic hyperactivity, followed by hypertension that is abolished by CB denervation. CB has dopamine (DA) receptors in chemoreceptor cells acting as DA-2 autoreceptors. The aim was to check if blocking DA-2 receptors could decrease the CB hypersensitivity produced by CIH, minimizing CIH-related effects. Domperidone (DOM), a selective peripheral DA-2 receptor antagonist that does not cross the blood-brain barrier, was used to examine its effect on CIH (30 days) exposed rats. Arterial pressure, CB secretory activity and whole-body plethysmography were measured. DOM, acute or chronically administered during the last 15 days of CIH, reversed the hypertension produced by CIH, an analogous effect to that obtained with CB denervation. DOM marginally decreased blood pressure in control animals and did not affect hypoxic ventilatory response in control or CIH animals. No adverse effects were observed. DOM, used as gastrokinetic and antiemetic drug, could be a therapeutic opportunity for hypertension in SAHS patients’ resistant to standard treatments.

Stim-activated TRPC-ORAI channels in pulmonary hypertension induced by chronic intermittent hypoxia.

Obstructive sleep apnea (OSA), a breathing disorder featured by chronic intermittent hypoxia (CIH) is associated with pulmonary hypertension (PH). Rodents exposed to CIH develop pulmonary vascular remodeling and PH, but the pathogenic mechanisms are not well known. Overexpression of Stim-activated Transient Receptor Potential Channels (TRPC) and Calcium Release-Activated Calcium Channel Protein (ORAI) TRPC-ORAI Ca2+ channels (STOC) has been involved in pulmonary vascular remodeling and PH in sustained hypoxia. However, it is not known if CIH may change STOC levels. Accordingly, we studied the effects of CIH on the expression of STOC subunits in the lung and if these changes paralleled the progression of the vascular pulmonary remodeling and PH in a preclinical model of OSA. Male Sprague-Dawley rats (∼200 g) were exposed to CIH (5%O2, 12 times/h for 8 h) for 14, 21, and 28 days. We measured right ventricular systolic pressure (RVSP), cardiac morphometry with MRI, pulmonary vascular remodeling, and wire-myographic arterial responses to KCl and endothelin-1 (ET-1). Pulmonary RNA and protein STOC levels of TRPC1, TRPC4, TRPC6, ORAI 1, ORAI 2, and STIM1 subunits were measured by qPCR and western blot, and results were compared with age-matched controls. CIH elicited a progressive increase of RVSP and vascular contractile responses to KCl and ET-1, leading to vascular remodeling and augmented right ventricular ejection fraction, which was significant at 28 days of CIH. The levels of TRPC1, TRPC4, TRPC 6, ORAI 1, and STIM 1 channels increased following CIH, and some of them paralleled morphologic and functional changes. Our findings show that CIH increased pulmonary STOC expression, paralleling vascular remodeling and PH.

Chronic Intermittent Hypoxia Enhances GABAergic and Glycinergic Signaling in NTS Neurons

In our past studies, spontaneous miniature IPSPs (mIPSCs) recorded from caudal NTS neurons surrounding the tractus solitarius appeared to be mainly mediated by GABA in normal rats. However, the averaged rise time and decay time are significant shorter in NTS neurons from rats after 7 days Chronic Intermittent Hypoxia (CIH) exposure as compared to normoxic, control rats (p&lt;0.001). This study test whether CIH alters evoked inhibition in the NTS by recruiting a glycine mediated mechanism. The inhibitory postsynaptic currents(eIPSCs) evoked by electrical stimulation of the tractus solitarius were examined with whole cell patch‐clamp recordings on NTS second‐order neurons identified by DiA labeling of carotid bodies in a horizontal brainstem slice preparation from CIH exposed and control rats. All experiments were performed in the lateral NTS at the level of the area postrema. The results indicate that NTS neurons from the CIH rats had variable peak amplitudes from 67.6 to 617.28 pA compared with neurons from controls (47.15 to 284.07 pA). CIH significantly increased eIPSC amplitudes (33 neurons in CIH: −189.84 ± 22.76 pA vs 34 neurons in control: −124.3 ± 11.63 pA, p&lt;0.05). This was accompanied by faster eIPSC kinetics (max rise slope of CIH: −150.54 ± 13.47 pA/ms vs control: −106.04 ± 8.82 pA/ms, p&lt;0.01: and max decay slope of CIH: 53.24 ± 1.67 pA/ms vs control: 47.58 ± 1.41 pA/ms, p=0.01) that were significantly increased in neurons from CIH rats as compared to controls. To discriminate among glycine, GABA, or dual eIPSCs, we applied 3 μm strychnine (glyR antagonist) or 25 μm gabazine (GABAAR antagonist) in the presence of 10 μm CNQX (a competitive AMPA/kainate receptor antagonist). Baseline eIPSCs were recorded and either gabazine or strychnine was added to the perfusion solution to differentiate GABA‐mediated current and glycine‐mediated current. Of the 12 neurons from control rats, 7 neurons were gabazine‐sensitive, 1 neuron was strychnine‐sensitive, and 4 neurons had both GABA‐mediated and glycine‐mediated currents. In the 13 neurons from CIH rats, there were 4 gabazine‐sensitive neurons, 3 strychnine sensitive neurons and 6 neurons sensitive to both gabazine and strychnine. The glyR‐mediated eIPSCs expressed faster rise and decay kinetics. In NTS neurons from normoxic control rats, most eIPSCs appear to be GABA mediated while neurons from CIH rats demonstrated glycine and mixed eIPSCs. Our findings suggest that evoked glycinergic signaling in the NTS may be enhanced by seven days of CIH exposure.Support or Funding InformationThis work was supported by P01 HL088052

Chronic Intermittent Hypoxia Alters the Chloride Gradient in Median Preoptic Nucleus (MnPO) Neurons of Rats

Chronic intermittent hypoxia (CIH) is an animal model that simulates the hypoxemia associated with obstructive sleep apnea (OSA). Rats exposed to CIH exhibit increased sympathetic tone and reactivity and a persistent elevation in blood pressure during periods of normoxia, similar to patients with OSA. In MnPO neurons, angiotensin II type 1 receptor knock down (AT1aR KD) mediated reductions in GABAa inhibition are exacerbated to the point where GABAa activation is excitatory following CIH. Here, we use the genetically encoded ratiometric Cl‐sensor, ClopHensorN, to monitor the chloride flux of PVN projecting MnPO neurons in normoxic (Norm) and CIH treated rats in response to GABAa receptor activation.Using isoflurane (2–3%) anesthesia, male Sprague‐Dawley rats (250–350g) received microinfusions (0.4 μL) of a retrograde AAV9‐Cre in the PVN and a DIO‐ClopHensorN in the MnPO. After recovery, rats were subjected to 7 days of CIH (0800–1600 hrs) or Normoxia. The CIH protocol consisted of 6 min cycles (3 min 21% O2, 3 min 10% O2) repeated 10x/hr for 8 hours (during the normal inactive/sleep phase) on 7 consecutive days. For ClopHensorN measurements, rats were anesthetized with isoflurane (2–3%) and coronal slices (300 μm) containing the MnPO were cut using standard in vitro slice procedures. Image sets were captured every 3 sec. Cl‐flux was determined from the ratio of GFP (ex 488 nm, em 500–550 nm) to tdTomato (ex 594 nm, em 650–700 nm) fluorescence in response to 10 s focal application of muscimol (100 uM).Twelve rats (6 Norm, 6 CIH) were used for ClopHensorN studies. In MnPO neurons from CIH treated rats (n = 632), 20.1% showed a decrease in the ratio of GFP to tdTomato fluorescence (n = 127) while 0.3% showed an increase in this ratio (n = 2) indicative of Cl‐efflux. In MnPO neurons from Norm rats (n = 482), 41.9% showed a muscimol dependent decrease in the ratiometric Cl‐signal (n = 202) with 0 cells showing an increase. Furthermore, the magnitude if muscimol dependent decreases in the Cl‐signal were reduced in the CIH treated rats suggestive of reduced GABAa mediated inhibition. In a separate groups of rats, Western blot analysis showed that CIH increased the expression of pKCC2 (n = 6) in punches containing the MnPO compared to MnPO punches from Norm controls (n = 5) injected with Scr. CIH/AT1a KD rats showed decreased pKCC2 (n = 6) compared to CIH/Scr but increased pKCC2 in Norm/AT1a KD rats (n = 6) compared to Norm/Scr rats.The results demonstrate that CIH alters the Cl‐flux of PVN projecting MnPO neurons and these changes are likely due to altered function of KCC2. These changes may contribute to the increased sympathetic tone and reactivity, as well as the persistent hypertension associated with CIH.Support or Funding InformationSupported by P01 HL088052

Effects of 2‐APB, a Stim‐Activated TRPC‐ORAI Channels Blocker, on the Vascular Remodeling and Pulmonary Hypertension Induced by Chronic Intermittent Hypoxia

Obstructive sleep apnea (OSA), a breathing disorder characterized by episodes of chronic intermittent hypoxia (CIH), is an independent risk for systemic hypertension. Furthermore, 20–60% of OSA patients develop moderate pulmonary hypertension (PH). Rats exposed to CIH developed pulmonary vascular remodeling and PH, but the mechanisms underlaying these responses are not well known. Stim‐activated TRPC‐ORAI channel (STOC), cationic calciumpermeable channels, are overexpressed in the lung and plays a key role in the development of pulmonary vascular remodeling and PH in animals exposed to sustained hypoxia. We previously demonstrated that STOC are overexpressed in lung of rats exposed to CIH. However, whether these channels are involved in the pulmonary vascular remodeling and PH induced by CIH have not been addressed. Thus, we studied the effects of treatment of 2‐aminoethyldiphenylborinate (2‐APB), a STOC blocker, in rats exposed to CIH. Male Sprague‐Dawley rats (~200g) were exposed for 28 days to CIH (5% O2, 12 times/h, for 8h). At 14 days of CIH, rats under anesthesia were implanted with osmotic pumps containing 2‐APB (10 mg/kg/day) or its vehicle, and then rats were exposed to CIH for 14 more days. At the end of CIH exposure, the right ventricular systolic pressure (RVSP) was measure under anesthesia with urethane/α‐cloralose (800 mg/kg, i.p). Animals were then euthanized and lungs dissected to determine vascular remodeling in arteries of 200–300 μm, and the mRNA levels of the STOC forming subunits TRPC1, TRPC4, TRPC6, ORAI 1 and ORAI 2 by qPCR. 2‐APB infusion prevented the increase of the RVSP (36.5 ± 1.1 mmHg vs. 24.7 ± 1.6 mmHg, 28d‐CIH vs. 2‐APB respectively), and the pulmonary vascular remodeling (66.3 ± 9.4 % vs 48.2 ± 3.5 %, CIH, 28d‐CIH vs. 2‐APB, respectively). In addition, 2‐APB treatment reverted the increase in the mRNA levels of TRPC1, TRPC4 and TRPC6, but induced an overexpression of ORAI 1, while ORAI 2 remained unchanged. Present results suggest that STOC plays a key role in the developing of the vascular remodeling and pulmonary hypertension induced by CIH.Support or Funding InformationSUPPORTED BY FONDECYT 1150040 and 1180341

Intermittent Hypoxia Induces Pulmonary Vascular Remodeling and Increases the Expression of STIM‐activated TRPC‐ORAI Channels in the Lung

Obstructive sleep apnea (OSA), a breathing disorder characterized by episodes of chronic intermittent hypoxia (CIH) and re‐oxygenation during sleep, is an independent risk for systemic hypertension. Furtheremore, 20–60% of OSA patients develop moderate pulmonary hypertension. Rats exposed to CIH developed pulmonary vascular remodeling, but the mechanisms underlaying the vascular remodeling are not well known. Stim‐activated TRP‐CORAI channel (STOC), cationic calcium‐permeable channels, are overexpressed in the lung and plays a key role in the development of pulmonary vascular remodeling in animals exposed to sustained hypoxia. However, whether these channels are involved in the pulmonary vascular remodeling induced by CIH have not been addressed. We studied the time‐course of the vascular pulmonary remodeling and the changes in STOC expression, in a rodent model of OSA. Male Sprague‐Dawley rats (~200g) were exposed for 14 to 28 days to CIH (5% O2, 12 times/h, for 8h). At 14, 21 and 28 days of CIH animals were euthanized and lungs dissected to determine the vascular remodeling index by histology analysis, and the pulmonary mRNA and protein levels of the STOC forming subunits TRPC1, TRPC4, TRPC6, ORAI 1, ORAI 2 and STIM1 by qPCR and western blot, respectively. Results were compared with age‐matched controls. CIH increased the pulmonary expression of TRPC 6, ORAI 1, ORAI 2 and STIM1 at 21 and 28 days compared with controls. In addition, CIH was associated to an increased in pulmonary arteries medial thickness at 21 and 28 days (66.6% ± 2.4, 66.3% ± 4.2 vs 45.4 ± 1.6, 21 and 28 days of CIH vs control respectively, p &lt; 0.05). Present results shown that CIH increased the pulmonary STOC expression, and these changes paralleled the vascular remodeling.Support or Funding InformationFondecyt grants 1150040 and 1180341This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.