Health Grant Research Articles

No pain relief by virtual reality during hysterosalpingography (HSG): results from a randomized controlled trial.

Is virtual reality (VR) an effective non-pharmacological tool to reduce procedural pain during hysterosalpingography (HSG)? An HSG with VR does not reduce procedural pain scores compared to an HSG without VR. An HSG is often experienced as painful and uncomfortable. VR has been proven successful to reduce acute procedural pain during a variety of medical procedures and interventions. We performed a two-centre open-label randomized controlled trial between January 2021 and October 2022. Women scheduled for HSG as part of their infertility work-up were screened for participation. After informed consent, women were randomized between HSG with or without VR. Due to the nature of the intervention, the study was not blinded. VR was administered by a head-mounted device displaying nature movies and/or relaxation exercises. The primary endpoint was procedural pain measured using VAS (scale 0.0-10.0 cm). Procedural pain was divided into overall pain score and peak pain score during the procedure. It was measured immediately after HSG. Secondary endpoints included patient satisfaction, VR preferences, and adverse effects of VR. We included a total of 134 women, 69 to the intervention group (HSG with VR) and 65 to the control group (HSG without VR). The mean VAS for peak pain was 6.80 cm (SD 2.25) in the intervention group versus 6.60 cm (SD 2.40) in the control group (mean difference 0.28 (95% CI -0.57, 1.12), P = 0.52). The mean VAS for overall pain was 5.00 cm (SD 2.10) in the intervention group versus 4.90 cm (SD 2.13) in the control group (mean difference 0.06 (95% CI -0.71, 0.84), P = 0.88). The expectation that VR would be a good distraction from pain during HSG was correlated with both overall and peak pain scores. When correcting for this expectation, we found that women in the intervention group reported significantly higher scores, both in peak (adjusted MD 0.58 (95% CI -0.81, 1.97), P = 0.021) and overall (adjusted MD 0.43 (95% CI -0.84, 1.71), P = 0.013) pain, compared to the control group. There were no differences in the prevalence of symptoms that were considered as adverse effects of VR. The study was not blinded. Reasons for declining participation in the study were anxiety or wanting full control during HSG, which might have created selection bias. The distraction score possibly indicates that the level of VR immersiveness was not optimal due to the lack of sound and/or the type of VR applications. Future studies should investigate whether more immersive or interactive VR applications could decrease procedural pain scores during HSG. Since VR does not reduce procedural pain, this additional tool should not be used during HSG. There was no external funding for this study. KR and AvH report receiving a travel grant from Merck outside the scope of this study. BM is supported by a National Health and Medical Research Council (NHMRC) investigator grant (GNT1176437) and BM reports consultancy for Merck, Organon, and Norgine and travel and research funding from Merck. BM holds stock for ObsEva. CL reports receiving research grants from Merck, and Ferring. KD and VM report receiving travel and speaker's fees from Guerbet and research grants from Guerbet. VM also reports research grants from Merck and Ferring. The remaining authors have nothing to declare. The trial is registered prospectively in the Netherlands Trial Register (trialregister.nl registration number NL9203, currently accessible on trialsearch.who.int). 16-01-2021. The first participant was enrolled on 19 January 2021.

Evaluating a grant development public involvement funding scheme: a qualitative document analysis

BackgroundUndertaking Patient and Public Involvement (PPI) when developing health and social care research grant applications is critical. However, researchers may not have any funding to undertake PPI when developing grants. In response, the National Institute for Health and Care Research- Research Design Service for Yorkshire and the Humber in the United Kingdom, provided Public Involvement Fund Awards of up to £600 to fund PPI activity when researchers were developing grant applications. Researchers provided post-activity reports about how they utilised the Public Involvement Fund. These reports were analysed with the aim of evaluating the usefulness of the Public Involvement Fund and to provide learning about supporting researchers to undertake PPI when developing grants.MethodsThe project was a qualitative document analysis of 55 reports. Initially a researcher coded four reports and three Public Contributors provided feedback. Researchers coded the remaining reports and identified key findings. A workshop was held with the three Public Contributors to develop the findings.ResultsResearchers accessing the Public Involvement Fund award were generally early career researchers or clinicians who did not have other sources of funding for pre-grant PPI input. Researchers felt the award was useful in enabling them to conduct PPI, which strengthened their grant applications. Some researchers found that the award limit of £600 and guidance encouraging expenditure within three months, made it difficult to undertake PPI throughout the full grant development process. Instead, the majority of researchers consulted Public Contributors on one or two occasions. Researchers struggled to recruit diverse members or run group sessions due to the time pressures of grant deadlines. Researchers wanted training on undertaking PPI alongside the financial support.ConclusionsResearchers, especially early career researchers found having a Public Involvement Fund award instrumental in enabling them to undertake PPI when developing grant applications. It would be beneficial for similar schemes to be widely available. Schemes need to provide sufficient funding to enable meaningful PPI and allow researchers to hold the award for long enough to facilitate involvement during the whole grant development process. Researchers continue to need training on undertaking PPI.

Chemotherapy-induced peripheral neuropathy research: A National Institute of Health (NIH) grant portfolio analysis.

Chemotherapy-induced peripheral neuropathy research: A National Institute of Health (NIH) grant portfolio analysis.

Primary care for cancer survivors: a review of national institutes of health-funded grants 2017-2022.

To describe the characteristics of National Institutes of Health (NIH) grants on primary care cancer research in cancer survivorship funded over the past 5years. Research project grants (RPG) funded during Fiscal Year (FY) 2017 to 2022 focused on cancer survivorship were identified using a text mining algorithm of words from the NIH Research, Condition, and Disease Categorization (RCDC) thesaurus with survivorship-relevant terms. Grants were then reviewed and double-coded to identify those that were carried out in a primary care setting, targeted primary care providers, or had primary care providers in the study team. A total of 24 grants were identified; 23 were funded by the National Cancer Institute and one was funded by the National Institute on Minority Health and Health Disparities. The majority were funded under the R01 mechanism (70.8%) and led by established investigators. Most were interventional design (91.7%), including both survivors and providers (79.2%), and focused care coordination or healthcare utilization (91.7%). Grants focused on primary care cancer survivorship are uncommon in the NIH portfolio. For the over 18 million cancer survivors in the USA, being cared for in a primary care setting is common. Yet, NIH-funded research on primary care cancer survivorship is sparse.

Metabolic imaging of human cumulus cells reveals associations with pregnancy and live birth.

Can fluorescence lifetime imaging microscopy (FLIM) detect associations between the metabolic state of cumulus cell (CC) samples and the clinical outcome of the corresponding embryos? FLIM can detect significant variations in the metabolism of CC associated with the corresponding embryos that resulted in a clinical pregnancy versus those that did not. CC and oocyte metabolic cooperativity are known to be necessary for the acquisition of developmental competence. However, reliable CC biomarkers that reflect oocyte viability and embryo developmental competency have yet to be established. Quantitative measures of CC metabolism could be used to aid in the evaluation of oocyte and embryo quality in ART. A prospective observational study was carried out. In total, 223 patients undergoing IVF with either conventional insemination or ICSI at a tertiary care center from February 2018 to May 2020 were included, with no exclusion criteria applied. This cohort had a mean maternal age of 36.5 ± 4.4 years and an average oocyte yield of 16.9 (range 1-50). One to four CC clusters from each patient were collected after oocyte retrieval and vitrified. CC metabolic state was assessed using FLIM to measure the autofluorescence of the molecules NAD(P)H and FAD+, which are essential for multiple metabolic pathways. CC clusters were tracked with their corresponding oocytes and associated embryos. Patient age, Day 3 and Day 5/6 embryo morphological grades, and clinical outcomes of embryos with traceable fate were recorded. Nine FLIM quantitative parameters were obtained for each CC cluster. We investigated associations between the FLIM parameters and patient maternal age, embryo morphological rank, ploidy, and clinical outcome, where false discovery rate P-values of <0.05 were considered statistically significant. A total of 851 CC clusters from 851 cumulus-oocyte complexes from 223 patients were collected. Of these CC clusters, 623 were imaged using FLIM. None of the measured CC FLIM parameters were correlated with Day 3 morphological rank or ploidy of the corresponding embryos, but FAD+ FLIM parameters were significantly associated with morphological rank of blastocysts. There were significant differences for FAD+ FLIM parameters (FAD+ fraction engaged and short lifetime) from CC clusters linked with embryos resulting in a clinical pregnancy compared with those that did not, as well as for CC clusters associated with embryos that resulted in a live birth compared those that did not. Our data are based on a relatively low number of traceable embryos from an older patient population. Additionally, we only assessed CCs from 1 to 4 oocytes from each patient. Future work in a younger patient population with a larger number of traceable embryos, as well as measuring the metabolic state of CCs from all oocytes from each patient, would provide a better understanding of the potential utility of this technology for oocyte/embryo selection. Metabolic imaging via FLIM is able to detect CC metabolic associations with maternal age and detects variations in the metabolism of CCs associated with oocytes leading to embryos that result in a clinical pregnancy and a live birth versus those that do not. Our findings suggest that FLIM of CCs may be used as a new approach to aid in the assessment of oocyte and embryo developmental competence in clinical ART. National Institutes of Health grant NIH R01HD092550-03 (to C.R., and D.J.N.). Becker and Hickl GmbH and Boston Electronics sponsored research with the loaning of equipment for FLIM. D.J.N. and C.R. are inventors on patent US20170039415A1. N/A.

EGFR inhibition with erlotinib induces membrane accumulation of aquaporin-2 via PDK1 and RSK activation

In the canonical aquaporin-2 (AQP2) signaling pathway, vasopressin (VP) binds to its V2 receptor, which in turn activates adenylate cyclase and protein kinase A (PKA), resulting in AQP2 S256 phosphorylation and accumulation of AQP2 in the membrane. The epidermal growth factor receptor (EGFR) inhibitor erlotinib also increases AQP2 S256 phosphorylation and membrane accumulation, yet it does not increase cAMP or PKA activity. We hypothesize that the ribosomal s6 kinase (RSK), a downstream effector in the EGFR-MAPK/ERK pathway, is the terminal kinase phosphorylating AQP2 in this novel PKA-independent pathway activated by erlotinib, and that the phosphoinositide dependent kinase-1 (PDK1), a well-established activator of RSK, is indispensable for erlotinib-induced AQP2 activation. Using our LLC-AQP2 cell model, we show that erlotinib-induced AQP2 membrane accumulation and S256 phosphorylation are abolished by the specific RSK inhibitor BI-D1870. RSK knockdown with siRNA also blocked AQP2 S256 phosphorylation and membrane accumulation, as did RSK knockout with CRISPR/cas9 editing. Next, rat kidney slices were incubated in Hank’s buffer with or without BI-D1870 and treated with erlotinib. BI-D1870 inhibited AQP2 membrane accumulation in collecting duct principal cells, supporting the relevance of this pathway in kidney cells in situ. An in-vitro kinase assay using purified proteins demonstrated that RSK directly phosphorylates AQP2 at the S256 residue. Additionally, erlotinib consistently increased phosphorylation of RSK T359, a residue associated with RSK’s active state. In canonical RSK activation, a phosphorylation cascade results in PDK1 binding to and activating RSK. We found that PDK1 inhibition with an experimental compound PS-222 also blocked erlotinib-induced AQP2 membrane accumulation and S256 phosphorylation. This implicates PDK1 along with RSK in the novel erlotinib-induced pathway of AQP2 traffcking. Our data show that RSK and PDK1 are terminal effectors in the novel, PKA-independent pathway of AQP2 activation induced by erlotinib. Further elaboration of this new non-canonical pathway promises to uncover potential pharmacological targets for the treatment of water balance disorders. This work was supported by the National Institutes of Health (NIH) grant DK096586 (D. Brown). P. W. Cheung was supported was supported by NIH K-award DK115901. Richard Babicz is the recipient of the Ben J Lipps Research Fellowship (American Society of Nephrology). Additional support for the Program in Membrane Biology Microscopy Core came from the Boston Area Diabetes and Endocrinology Research Center (DK057521) and the Massachusetts General Hospital (MGH) Center for the Study of Inflammatory Bowel Disease (DK043351). 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.

Hibernating Golden-Mantled Ground Squirrels (Spermophilus [Callospermophilus] lateralis) have High Inter-individual Variability in Oxygen Consumption Rates with Warmer Ambient Temperatures

Ambient temperature (Ta) is a prominent part of mammalian hibernation. An excellent example of this can be found in the ground squirrels, which hibernate relatively well in cold Tas of &lt;4°C, where extremely low body temperatures (Tb) of -2.9°C and profound metabolic depression (1% of active oxygen consumption rates [VȮ2]) have been reported. These characteristics highlight the importance of initiating and maintaining a decreased Tb to effectively shut down key homeostatic processes. Resumption of such processes occurs during interbout arousals (IBAs), where VȮ2 and Tb return to active (‘euthermic’) values. An important question then is whether these torpor characteristics would continue at warmer Tas, and if so, up to which Ta? Previous research demonstrated an acute uncoupling of translational initiation from elongation precisely at Tb = 18°C in squirrels entering torpor. Given that protein synthesis often accounts for ~30% of VȮ2, one might expect a large change in VȮ2 at ~18-20°C. Further, we hypothesized that squirrels hibernating at warmer temperatures would be more variable as their ability to depress energetically expensive processes was compromised. We hibernated golden-mantled ground squirrels ( Spermophilus [Callospermophilus] lateralis) at Tas of 4, 8, 12, 16, 20, 24, 28, and 30°C and measured VȮ2, carbon dioxide production (V̇CO2), and core Tb. We found hibernation at Ta&gt;20°C caused VȮ2 to become less predictable and more variable. Further, animals had a larger difference between Tb and Ta at higher Tas. We interpret the results to suggest an inability to effectively depress homeostatic processes. These data have profound implications for the engineering of torpor use in humans as it relates to spaceflight. The data suggests that humans will either 1) have to be very cold wherein homeostatic processes are depressed and the person is arrested in a quasi-homeostatic state or 2) be at a higher temperature that provides for adequate homeostasis. NASA-Translational Research Institute for Space Health (TRISH) grant. 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.

A novel target for attenuating T1DM-induced myocardial ferroptosis

Background: The DMCM-AHEAD trial showed that lipotoxicity is a distinct feature of diabetic heart failure, which initiates and exacerbates cardiac pathogenesis in diabetic patients. Circulating iron levels are increased in diabetic patients. The combined presence of lipids and iron suggests a predominant role of ferroptosis in diabetes-induced heart failure. However, molecular targets for diabetes-induced myocardial ferroptosis remain unclear. In the T1DM heart, matrix metalloproteinase-9 (MMP9), a protease, is upregulated, and targeted deletion of MMP9 is cardioprotective. Hypothesis: Targeted deletion of MMP9 mitigates T1DM-induced myocardial ferroptosis. Methods and results: We performed in vitro studies on the loss and gain-of-function of MMP9 using human cardiomyocytes (AC16 cells). Overexpression of MMP9 downregulates (-1.55-fold p&lt;0.001) GPX4, a key marker of ferroptosis, while inhibition of MMP9 upregulates (+2.03-fold p&lt;0.001) GPX4 (n=6), suggesting a key role of MMP9 in GPX4 regulation and ferroptosis signaling. To determine the specific role of MMP9 in T1DM-induced ferroptosis, we evaluated ferroptosis markers in the heart (LV) tissue of male Insulin2 mutant (Ins2+/-) Akita (T1DM), littermate euglycemic Ins2+/+ WT, Akita/MMP9 knockout (MMP9KO), and MMP9KO mice (n=3-6). The cardiac levels of Acyl-CoA synthetase long-chain family member-4 (ASCL4), which initiates the formation of lipid peroxides, and divalent metal transporter-1 (DMT1), which increases redox-active iron, were upregulated in the Akita while downregulated in the Akita/MMP9KO hearts (Akita vs WT: ASCL4: +1.42-fold p&lt;0.05, DMT1: +1.34-fold p&lt;0.05; Akita/MMP9 vs Akita: ACSL4: -1.46-fold p&lt;0.05, DMT1: -1.03-fold p&lt;0.05). Furthermore, cardiac levels of Ferritin-Light Chain (FLC), which stores iron to suppress ferroptosis, was downregulated in the Akita but upregulated in the Akita/MMP9KO hearts (Akita vs WT: -2.01-fold p&lt;0.01, Akita/MMP9 vs Akita: +1.36-fold p&lt;0.05). These results suggest that upregulation of MMP9 promotes while inhibition of MMP9 mitigates ferroptosis in the T1DM heart. Conclusion: This is the first report to reveal MMP9 as a promising therapeutic target for T1DM-induced myocardial ferroptosis. This work was supported in part by the National Institutes of Health (NIH) Grant R56HL156806 to PKM, and University of Nebraska Medical Center (UNMC) Presidential Graduate Fellowship to FIG. 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.

Clock and Bmal1 inhibit expression of Sglt1 in mouse Kidneys and glucose reabsorption

Aberrantly elevated sodium/glucose cotransporter 1 (Sglt1) expression and increased glucose reabsorption contribute to obesity or lean-associated metabolic complications, however, the precise mechanisms underlying the high expression of Sglt1 and increased glucose absorption are unclear. Clock (circadian locomotor output cycles kaput protein) is known as the master clock gene; Bmal1 (basic helix-loop-helix arnt like 1) is a known heterodimer of Clock that is a critical regulator of circadian metabolism and has the potential for regulating obesity-related diseases. We examined whether circadian clock genes involving Clock/Bmal1 and the orphan nuclear receptor Shp (the small heterodimer partner) regulate the expression of Sglt1 to maintain glucose reabsorption and glucose homeostasis. Renal Sglt1 levels were increased in Clock-mutant or Bmal1-knockout (KO) mice and were decreased by activation of Bmal1 in an SHP-dependent manner. Mechanistically, the transactivation of Sglt1 by HNF1α (hepatic nuclear factor 1 alpha) was inhibited by SHP. In wild-type mice fed a western diet, activation of Shp by Nobiletin reduced Sglt1 levels and improved glucose reabsorption and glucose handling, but these beneficial effects were not seen in Clock−mutant and Bmal1 KO mice. These results demonstrate that normal inhibition of Sglt1 by Clock/Bmal1-SHP is defective in obesity, resulting in increased Sglt1 levels, glucose reabsorption, and renal steatosis. This Clock/Bmal1-SHP-Sglt1 pathway may present novel targets for treating obesity. This work was supported in part by National Institutes of Health (NIH) grant R56 HL137912 and American Heart Association Scientist Development Grant 2300158 and Grant-in-Aid 16GRNT30960027 to XP; by U.S. NIH grants DK121490, HL137202, HL158054 and HD094778, and VA Merit Award BX004113 to MMH; and NIH grants R01DK112042, R01HL142814, RF1AG061296, the UAB/UCSD O’Brien Center of Acute Kidney Injury NIH-P30DK079337, and the Department of Veterans Affairs to V Vallon. 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.

Regeneration of Neuromuscular Synapses by Inhibition of the Prostaglandin Degrading Enzyme 15-PGDH

Background: Skeletal muscles require voluntary activation to move, which is supplied via motor neurons. The terminal axons of motor neurons innervate muscle fibers at the neuromuscular junction (NMJ). NMJ degeneration increases with age and injury, decreasing muscle contractility and strength and severely reducing individuals’ quality of life. Treatments able to restore NMJ integrity and muscle innervation after injury and in aging are currently lacking. Aim: Our lab has recently shown that boosting prostaglandin E2 (PGE2) levels in aged mice by inhibiting its degrading enzyme 15-prostaglandin dehydrogenase (15-PGDH) stimulates muscle growth and restores muscle strength and endurance. The present study aimed at investigating whether 15-PGDH inhibition promotes muscle reinnervation and NMJ restoration, thus improving muscle function. Methods and results: We treated young (3-month) and old (27-month) mice with a small molecule compound with high specificity for 15-PGDH inhibition for 30 days. Old treated mice displayed increased muscle mass and strength (p&lt;0.05) compared to aged control mice. While aged control displayed, as expected, a high percentage of denervated NMJ (21.6%), denervation was partially rescued by 15-PGDH inhibition (12.1%, p&lt;0.05). Similarly, NMJ fragmentation was lower in treated versus control mice (18.1% vs 29.3%, p&lt;0.05). To translate our findings to a more acute scenario, we induced nerve-crush injury in young mice (3-month) and treated animals with 15-PGDH inhibition during injury recovery. Treated mice were able to exert a 37.2% higher tetanic force 14 days after injury compared to control mice. This was accompanied by increased muscle mass and specific force (+32.2%, p&lt;0.05) and an increased percentage of innervated NMJs (97.4% versus 84.5%) in treated versus control mice, suggesting that 15-PGDH inhibition was promoting NMJ restoration and muscle reinnervation after injury. Conclusion: In this study we identify 15-PGDH inhibition as a new potential therapeutic strategy to promote reinnervation of NMJs and strength recovery after acute or chronic denervation due to injury or aging. Funding: E.M. is supported by a “Wu Tsai Human Performance Alliance” fellowship. This study was supported by the Donald E. and Delia B. Baxter Foundation, the Li Ka Shing Foundation, Milky Way Research Foundation MWRF-216064, California Institute for Regenerative Medicine grant DISC2-10604, and U.S. National Institutes of Health (NIH) grants R01-AG020961, R01-AG069858, and R01-RHG009674 to H.M.B. 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.

Obesity induces an increase in fatty acid uptake in endothelium of visceral adipose arteries without altering CD36 expression

Obesity is a prevalent metabolic condition and major contributor to the development of cardiovascular disease. Arteries of visceral adipose present with significant endothelial dysfunction whereas subcutaneous adipose arteries remain functional in obese humans and diet-induced obese mice. Obesity is also associated with elevated plasma long chain fatty acids (LCFAs), well-established contributors to endothelial dysfunction, which require a receptor to facilitate their uptake. CD36, a scavenger receptor, facilitates LCFA uptake, which when in excess would contribute to endothelial dysfunction. Therefore, we aimed to determine the role of CD36 in arteries ex vivo in both mouse and human subcutaneous and visceral adipose arteries as well as examine the difference in uptake of LCFAs in arteries from both depots. First, to determine if CD36 contributes to obesity-induced endothelial dysfunction in visceral adipose arteries, mesenteric (visceral) and subcutaneous adipose arteries isolated from lean and diet-induced obese WT and CD36 knockout were mounted for pressure myography. As expected, visceral adipose arteries of obese mice exhibited a blunted response to endothelium-dependent stimuli, whereas subcutaneous adipose arteries remained functional. CD36 ablation restored endothelium-dependent vasodilation in visceral arteries of obese mice, suggesting a critical role for CD36 in obesity-induced endothelial dysfunction. We next aimed to determine if obesity alters endothelial CD36 expression using two distinct approaches: flow cytometry and immunofluorescence staining of en face preparations in isolated mouse and/or human arteries. For flow cytometry, arteries were digested and sorted to identify the endothelial cell population (i.e., CD45-CD31+ cells). En face preparations were stained for VE-cadherin to locate the endothelial cell layer via confocal microscopy. In both experiments, an antibody that detects an extracellular epitope to CD36 was used to detect membrane expression. Obesity did not alter the expression of CD36 expression in visceral adipose arteries relative to lean counterpart controls or subcutaneous arteries from obese mice or humans. We next aimed to determine if LCFA uptake was altered by obesity. Arteries were exposed to a fluorescent fatty acid, and internalized endothelial LCFA uptake was assessed at different time points via confocal microscopy. Visceral arteries from obese mice and humans had elevated LCFA uptake relative to respective controls which may be an underlying mediator for the dichotomy in endothelial dysfunction observed in obesity. Ongoing work in our lab is focused on determining if this is indeed the case and, if so, if this process is mediated by endothelial CD36. National Institutes of Health (NIH) Grant P20GM113125-6564 (IF). 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.

Studies on Membrane Potential and Ca2+ Oscillations in Rat Carotid Body Type I Cells

Carotid body (CB) glomus cells sense changes in arterial O2 pressure (PO2) and pH, and adjust the secretory and carotid sinus nerve activity and ventilation to help maintain normal levels of blood PO2 and pH. Our recent studies showed that isolated CB cell clusters perfused with physiological buffer solution generate spontaneous Ca2+ oscillations at low frequency in normoxia. Mild and moderate levels of hypoxia (2-5%O2) and acidosis (pHo7.2-7.3) increased the frequency and amplitude of Ca2+ oscillations. Inhibitors of voltage-dependent Ca2+ channels and removal of external Ca2+ abolished Ca2+ oscillations, indicating that Ca2+ influx was critical for generating Ca2+ oscillations. To better understand the phenomenon of Ca2+oscillations in glomus cells, we examined the potential role of oscillations in cell membrane potential (Em) in CB cells in triggering Ca2+ influx and Ca2+ oscillations. Using the cell-attached patch configuration, we assessed cell Em by recording TASK single channels, because a linear relationship exists between TASK amplitude and cell Em. Recording of TASK in CB cells in normoxia showed that many CB cells exhibit oscillations in TASK amplitude, indicating the presence of spontaneous oscillations in cell Em. The oscillation frequency of cell Em was similar to that of Ca2+ oscillations. Oscillations in TASK single channel amplitude were blocked by nifedipine (Ca2+ channel antagonist), by removal of extracellular Ca2+, and by 2-APB (an inhibitor of ER Ca2+ channel and store-operated Ca2+ entry). Mild hypoxia increased the frequency of oscillations of TASK amplitude, indicating that mild hypoxia increased the frequency of cell Em oscillations. These findings suggest that cell Em oscillations (that open voltage-dependent Ca2+ channels and increase Ca2+ influx) are an integral component of the cellular signaling mechanism by which Ca2+ oscillations are produced in CB cells. This work was funded by National Institutes of Health (NIH) grants to D.K. (HL111497) and C.W. (HL142906), and an award from Rosalind Franklin University of Medicine and Science. 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.

Deletion of the Aryl Hydrocarbon Receptor in Endothelial Cells Improves Ischemic Angiogenesis in Chronic Kidney Disease

Background: Chronic kidney disease (CKD) is a strong yet underappreciated risk factor for peripheral arterial disease (PAD) that exacerbates disease progression and increases risk for limb amputation and cardiovascular mortality. An estimated 25-35% of CKD patients develop PAD, but mechanistic data linking these two pathologies is limited. Several tryptophan-derived uremic metabolites are retained in the blood and tissues as a consequence of CKD and are endogenous ligands of the aryl hydrocarbon receptor (AHR), a ligand-activated transcription factor that has been shown to regulate angiogenesis. Hypothesis: We tested the hypothesis that endothelial cell-specific conditional deletion of the AHR would enhance ischemic limb outcomes in mice with CKD and femoral artery ligation (FAL). Methods: Twelve-week-old male and female endothelium-specific AHR knockout mice (AHRecKO) and AHR floxed mice (AHRfl/fl, Cre-negative control) were fed 0.2% adenine to induce CKD or casein control diet (n=10/group/sex) prior to undergoing FAL to induce limb ischemia. Laser Doppler flowmetry was used to measure limb perfusion. Isometric contraction of the tibialis anterior in-situ via nerve stimulus was performed to measure muscle function. Skeletal muscle mitochondrial respiratory function and H2O2 production were evaluated. Primary endothelial cells were isolated from male and female wildtype mice and treated with known AHR ligand indoxyl sulfate (IS) under hypoxic conditions to uncover sex-dependent differences in AHR activating potential. Results: In male mice with CKD, endothelium-specific ablation of the AHR resulted in significant increases in percentage of perfused capillaries within the ischemic limb (AHRecKO 73.41% ± 4.80% vs AHRfl/fl 64.75% ± 8.325%; p= 0.0074), improved laser Doppler perfusion recovery in the paw and gastrocnemius muscle, and larger myofiber cross-sectional area ( p=0.0258) compared to AHRfl/fl mice. However, these improvements did not translate to improved muscle contractile function. In contrast, deletion of the AHR in female mice with CKD had no significant impact on major outcome measures. Primary cells from male mice treated with IS had significantly higher expression of the AHR controlled gene Cyp1a1 ( p=0.026) compared to cells from female mice. Conclusion: Endothelium-specific deletion of the AHR improved ischemic angiogenesis in male, but not female, mice with CKD. These data reveal sex-dependent differences in AHR activating potential within endothelial cells that exist in the absence of sex hormones. This study was supported by National Institutes of Health (NIH) grant R01-HL149704 (T.E.R.). 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.

Peripheral artery disease patients with chronic kidney disease have lower muscle strength and mitochondrial function compared to those with normal kidney function

Introduction: Chronic kidney disease is a significant risk factor for both the development of peripheral artery disease (PAD) and major adverse limb events. However, little is known about how the coalescence of these two conditions impacts limb muscle pathophysiology. The objective of the current study was to determine the impact of CKD on skeletal muscle strength and mitochondrial health in patients with and without PAD. Methods: A cross-sectional prospective study design was employed to assess plantar flexor muscle strength, muscle fiber cross-sectional area (CSA), and mitochondrial health in four groups of patients (61 males and 29 females): PAD only (Toe brachial index, TBI&lt;0.5 and eGFR&gt;60 mL/min), CKD only (TBI&gt;0.75 and eGFR:15-45 mL/min), PAD with CKD (TBI&lt;0.5 and eGFR:15-45 mL/min), and adult controls without PAD and CKD (TBI&gt;0.75 and eGFR&gt;60 mL/min). Results: Plantar flexor muscle strength was lowest in PAD patients with CKD compared to adult controls ( P&lt;0.0001), PAD only ( P=0.001), and CKD only ( P=0.003). No differences in the mean muscle fiber CSA were detected. The percentage of COX+ fibers was significantly lower in PAD patients with CKD compared to adult controls ( P=0.03). High resolution respirometry analysis of mitochondrial oxidative phosphorylation (OXPHOS) function demonstrated that CKD has a significant negative impact on muscle bioenergetics. PAD patients with CKD had lower OXPHOS function than adult controls ( P=0.0016) and PAD patients without CKD ( P=0.0015). Notably, CKD patients without PAD also had lower OXPHOS function than adult controls ( P=0.0054) and PAD patients without CKD ( P=0.005). Conclusion: The current results demonstrate a profound negative impact of CKD on the associated myopathy of PAD patients. This study was supported by National Institutes of Health (NIH) grant R01-HL149704 (T.E.R.). 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.

Single-Nuclei RNA-Sequencing Uncovers Alterations in the Transcriptional Profile of Skeletal Muscle in Peripheral Artery Disease

BACKGROUND: Lower extremity peripheral artery disease (PAD) is caused by atherosclerotic occlusion of lower limb blood vessels, impacting &gt;200 million people worldwide. PAD causes life-altering symptomatology such as claudication, ischemic rest pain, and gangrene, with limited effective treatment options. Herein, we performed single-nuclei RNA-sequencing (snRNAseq) to facilitate a better understanding of the complex pathobiological environment within the PAD limb and intercellular communication. METHODS: Gastrocnemius muscle specimens were collected from 20 patients with PAD and 12 non-PAD controls. Patients with PAD were classified as Rutherford category 3 (severe claudication). Non-PAD participants were of similar age, body mass index and medication usage as patients with PAD. Nuclei were isolated and snRNAseq was performed. Bioinformatic analysis was conducted to determine differences in gene expression between PAD and non-PAD nuclei, as well as analysis of intercellular signaling networks. Histological analysis of muscle specimens assessed the following: myosin heavy chain fiber distributions, myofiber cross-sectional area and myofiber denervation. RESULTS: 57,364 high-quality nuclei were captured (21,417 PAD; 35,947 non-PAD) and unsupervised clustering revealed 12 distinct nuclei populations based on their transcriptional profile. Quantification of the relative abundance of nuclei populations identified several differences, including PAD muscles having a lower percentage of type I myonuclei, muscle stem cells, and endothelial cells but a higher proportion of type II and regenerating myonuclei. Differentially expressed gene analysis of myonuclei populations uncovered upregulation of genes involved in stress response, autophagy, and atrophy in patients with PAD. Ligand-receptor interactions were used to determine how PAD alters the communication between identified nuclei populations. The inferred strength of interactions was greater in non-PAD compared to PAD patients. Further, intercellular communication network analysis revealed fibro-adipogenic progenitors as a primary signaling hub in PAD muscle. CONCLUSION: snRNAseq uncovered novel transcriptional differences and intercellular communication pathways unique to PAD muscle. This study was supported by National Institutes of Health (NIH) grant R01-HL149704 (T. Ryan). K. Kim supported by the American Heart Association grant POST903198. T. Thome supported by NIH grant F31-DK128920. 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.

Loss of FAM210A in Satellite Cell Drives Mitochondrial Dysfunction and Muscle Weakness in Experimental Peripheral Artery Disease

Introduction: Peripheral artery disease (PAD) affects approximately 200 million people globally. Chronic limb-threatening ischemia (CLTI) represents the most advanced clinical phenotype of PAD. Mitochondrial metabolism defects are apparent in the satellite cells of CLTI patients, and the muscle regeneration process demands increased energy, with satellite cell mitochondrial metabolism and dynamics playing a crucial role. However, our current understanding of the role of satellite cells and muscle regeneration in PAD pathology is notably inadequate. Recent studies have shown that the absence of FAM210A, a newly identified mitochondrial protein, can trigger morphological and energetic abnormalities in mitochondria, resulting in muscle function deterioration and promoting muscle wasting. Given the impaired mitochondrial function in satellite cells in CLTI patients and the heightened energy demand regulated by mitochondrial dynamics during muscle regeneration in satellite cell, it is therefore essential to exploring the role of FAM210A in satellite cells in CLTI limb pathology. The objective of this study was to investigate the impact of the loss of FAM210A in satellite cells in mice with experimental PAD. Methods: Male and female conditional FAM210A satellite cell knock out (FAM210ASCKO) and FAM210A floxed (FAM210Afl/fl) mice (N=3-5) were used for this project. Femoral artery ligation surgery was performed to induce PAD. Tamoxifen was administered for 5 days intraperitoneally one week prior to the surgery. Mice were euthanized twenty-eight days after surgery. Outcome measures included limb perfusion assessment, muscle weight, muscle force production, and mitochondrial respiration. Results: FAM210ASCKO mice had significantly decreased muscle mass of the tibialis anterior and extensor digitorum longus ( p&lt;0.0001 and p=0.0004 respectively). More importantly, maximal muscle force with in-situ contraction in tibialis anterior was significantly lower in FAM210ASCKO mice compared to FAM210Afl/fl mice (FAM210Afl/fl mice: 1085.16 ± 331.08 mN; FAM210ASCKO mice: 430.77 ± 467.91 mN; p=0.0139). Furthermore, analysis of mitochondrial oxidative phosphorylation (OXPHOS) revealed that FAM210ASCKO mice had a significant reduction compared to FAM210Afl/fl mice (48%) in skeletal muscle mitochondrial bioenergetic function at various levels of energy demand mimicking from resting to maximal exercise when carbohydrate was used to energize mitochondria ( p=0.034). Importantly, the analysis of mitochondrial membrane potential consistently reveals a substantial reduction in FAM210ASCKO mice compared to FAM210Afl/fl mice, which can partially explain the diminished mitochondrial bioenergetic function observed in ischemic FAM210ASCKO mice. Conclusion: The results of this study indicate that the loss of FAM210A in satellite cells exacerbates ischemic muscle pathology evidenced by muscle weakness and mitochondrial failure in FAM210ASCKO mice with PAD. Future work is needed to elucidate the mechanisms by which FAM210A regulate ischemic satellite cell function and the therapeutic potential of preventing ischemia-induced loss of FAM210A in PAD. This study was supported by National Institutes of Health (NIH) grant R01-HL149704 (to Dr Ryan). Mr Thome was supported by NIH grant F31-DK128920. 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.

Ischemic Conditioning Reduces Neuromuscular Fatigability During Dynamic Exercise Post Stroke

INTRODUCTION: In addition to baseline muscle weakness, stroke survivors often demonstrate increased neuromuscular fatigability (an acute exercise-induced reduction in power, hereafter referred to as fatigability), which limits endurance during functional tasks. Ischemic conditioning (IC) is a non-invasive and easy-to-administer intervention that can reduce fatigability in stroke survivors during a sustained isometric contraction of their paretic knee extensors. However, IC’s effects on fatigability during dynamic contractions are unknown, despite the greater relevance to everyday activities. Additionally, fatigability is known to be task specific. Thus, the purpose of this study was to quantify the effects of IC on fatigability (percent reduction in power) during dynamic contractions of the paretic knee extensors in stroke survivors. We hypothesized that fatigability would be less after a single session of IC versus IC-sham treatment in stroke survivors. Methods: Eight stroke survivors (66 ± 6 years of age, 6 male) performed 60 maximal voluntary concentric contractions (1 every 4 seconds) with their paretic knee extensors against a resistance of 30% of their maximal voluntary isometric contraction torque through a 60-degree range of motion after receiving a single session of IC and IC-sham treatment on two separate days. IC consisted of 5 sets of 5-minute upper thigh blood flow occlusion at 225 mmHg (25 mmHg for IC-sham) with 5 minutes of no occlusion between each set. The order of the 2 sessions was randomized. All participants visited the laboratory on a different day for functional measurements (Fugl-Meyer Assessment, 10-meter walk test, and 6-minute walk test). Reduction in power was calculated as the difference between the highest average power output from 5 consecutive contractions within the first 15 contractions and the average power output from the last 5 contractions. A paired t-test was used to compare if fatigability during dynamic exercise would differ between the 2 sessions after IC and IC-sham treatment. Pearson correlation was performed to determine the relationship between the difference in fatigability (after IC versus IC-sham treatment) and functional measurements. Results: After a single session of IC treatment, stroke survivors were less fatigable compared to IC-sham treatment (21.9 ± 19.2% power reduction vs. 29.4 ± 19.0%, p = 0.016). Improvement in fatigability after IC versus IC-sham treatment was positively correlated with Fugl-Meyer Assessment lower extremity motor score ( r = 0.82, p = 0.013). CONCLUSION: These preliminary results indicate that IC could serve as a potential intervention to reduce fatigability during dynamic exercise in stroke survivors, especially those who are mildly affected by stroke. Funding Source: American Heart Association Predoctoral Fellowship (903373, ZZ) and Eunice Kennedy Shriver National Institute of Child Health and Human Development R01 Grant (HD099340, AH &amp; MD). 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.

Effect of Inactivation of Prefrontal Cortex on Sleep-Wake States in Rat

There is a large body of literature to support subcortical regulation of sleep-wake states, but there have been limited studies to investigate the role of cortex in sleep-wake regulation. Previously, we have demonstrated that cholinergic stimulation of prefrontal cortex can reverse general anesthesia and promote wakefulness in unanesthetized rats, and there is emerging evidence to suggest that the prefrontal cortex might be a critical node in arousal state control. To better understand the direct role of prefrontal cortex in the regulation of sleep-wake states, we quantified the effect of prefrontal cortex inactivation, via local tetrodotoxin (156 μM) infusion, on sleep architecture. Under surgical isoflurane anesthesia, adult Sprague Dawley rats (n=7 male) were instrumented with electrodes to record electroencephalogram (EEG) from frontal and parietal cortices, and electromyogram (EMG) from dorsal nuchal muscles. In addition, a bilateral guide cannula was implanted aimed at the medial prefrontal cortex for tetrodotoxin infusion. After at least a week of post-surgical recovery and conditioning to the recording chambers, rats received bilateral microinjection (500 nL) of either 156 μM tetrodotoxin or 0.9% saline (vehicle control). The tetrodotoxin and 0.9% saline infusions were performed 30-minutes before the start of lights-OFF period (8:00 pm) after which EEG and EMG data were recorded for 24h across dark and light cycles. The EEG and EMG data were manually scored (SleepSign, Kissei Comtec Inc.) in 4-second intervals into wakefulness, slow-wave sleep, and rapid eye movement sleep, and then averaged in 3h bins across 24h recording period. A linear mixed model was used to compare the changes in percent time spent in each state, mean duration per episode for each state, and mean number of episodes for each state, between the vehicle control and tetrodotoxin-infusion sessions. Inactivation of prefrontal cortex via tetrodotoxin infusion produced long-lasting statistically significant increase in slow-wave sleep (p&lt;0.05 for 0-3h, 4-6h, 7-9h, 10-12h, 13-15, 16-18, 22-24) and decrease in wakefulness (p&lt;0.05 for 0-3h, 4-6h, 10-12h) and rapid eye movement sleep (p&lt;0.05 for 7-9h, 10-12h, 13-15h). These data further support a causal contribution of prefrontal cortex in regulating arousal states. This work was supported by the National Institutes of Health (Bethesda, MD, USA) grant (R01 GM111293) to GAM and DP, and funding from the Department of Anesthesiology, University of Michigan Medical School, Ann Arbor. 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.

Programming of neutrophil transcriptome by endothelial ERG maintains anti-inflammatory vascular niche in the lungs

Neutrophils, the predominant blood leukocyte and first responders to the infection, reside as the marginated pool in the lungs. Vascular hyperpermeability and activation of infiltrating neutrophils is the hallmark of lethal acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). However, signaling nodes that govern crosstalk among these ontologically distinct cell types to maintain tissue homeostasis remain unclear. Here, we identify the ERG transcription factor, which maintains endothelial cell (EC) lineage, as the instructor of anti-inflammatory neutrophils. We show that ERG is highly expressed in lung EC, but the expression was reduced markedly during neutrophilic injury by bacterial pneumonia. Intravital imaging and FACS analysis of mice lungs conditionally lacking ERG in the endothelium (iEC-ERG−/−mice) showed increased neutrophil retention and activation due to rewiring of their transcriptome (hereafter referred to as EC-ERG null neutrophils). RNA sequencing of EC-ERG null neutrophils showed genes enriched with inflammation (IL-1β, TNF-α, MIP-2α), survival (RelB, CD47), and retention (CXCR4) markers. Neutrophils isolated from the blood of ARDS patients similarly showed increased expression of IL-8, TNF-α, and CXCR4 expression. EC-ERG null neutrophils induced lung injury when adoptively transferred into a naïve mouse. EC-ERG loss elicited an immune migratory and chemotactic program by activating the NF-κB-IL8 cascade, exacerbating ALI in a mouse model. We show that ERG in endothelium preserves neutrophil activation and infiltration by upregulating the multipurpose deubiquitinase A20 expression in mouse and human lung endothelial cells (EC). Rescuing A20 deubiquitinase or suppressing IL8-CXCR2 axis through small molecule inhibitor, Reparixin, reversed hyperpermeability, and neutrophilic injury. In summary, our study identifies specialized ERG-instructed anti-inflammatory ‘immune niche’ to prevent neutrophilic inflammation and lung injury. National Institutes of Health (NIH) Grants HL060678, HL084153. 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.

Comparison of acute glucose responses following combined arm and leg cycling in non and pre-diabetic males

Prolonged and chronic sedentary behavior contributes to negative metabolic health conditions. Recent research has shown that a single bout of combined arm and leg cycling (CALC) can improve acute glucose metabolism in non-diabetic college aged adults. If a short bout of CALC can improve glucose metabolism in individuals that are non-diabetic then one could hypothesize that a short bout of CALC may improve glucose metabolism in individuals that are pre-diabetic. We hypothesized that short bouts of CALC would result in a greater decrease in the 60-min total (tAUC) area under the curve in pre-diabetic compared to non-diabetic males. PURPOSE: To compare acute glucose responses following a short bout of CALC in non and pre-diabetic males. METHODS: College age males were recruited for this trial. Diabetes status was based upon a fasting blood glucose measurement taken after an overnight 12 hour fast. Participants completed three randomized experimental trials. Two of the experimental trials consisted of a 1-min (1M) or 5-min (5M) bout of CALC at a self-selected pace. The third trial was a non-exercise control (CON) trial. Immediately following both exercise trials and during the CON trial, participants completed a 60-min oral glucose tolerance test. A 2-way (diabetes status vs trial) repeated measures ANOVA was done to determine if there were any significant differences between the two groups and the three trials for the tAUC during the 60-min OGTT. RESULTS: A total of 18 college age males completed this study. Fasting blood glucose was 94.0 ± 3.7 and 108.1 ± 4.6 mg/dl for the non (n=8, 21.4 ± 2.4 yrs) and pre-diabetics (n = 10, 22.6 ± 3.9 yrs) participants respectively. There was a significant interaction between trials and diabetes status (p = 0.04) for tAUC. Follow-up analysis showed that within the pre-diabetic group, tAUC was significantly lower in the 5-min trial compared to the CON trial (113.7 ± 22.5 mg/dl, p &gt; 0.001). Within the pre-diabetic group, the tAUC for the 1M trial was not significantly different from the CON or 5M trials. Within the non-diabetic group, there were no significant differences in tAUC between the three trials. CONCLUSIONS: The results of this study indicate that a 5M bout of CALC done at a self-selected pace may have the ability to acutely improve glucose metabolism in college age pre-diabetic males when compared to non-diabetic males. Supported by a SIUE Graduate School Research Grant for Graduate Students, the School of Education, Health, and Human Behavior Dean's Grant, and the Undergraduate Research and Creative Activities Program. 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.