Parasympathetic Research Articles

Parasympathetic tone activity, heart rate, and grimace scale in conscious horses of 3 breeds before, during, and after nociceptive mechanical stimulation.

Parasympathetic tone activity (PTA) in response to nociceptive stimulus in conscious non-sedated horses is unknown. Study PTA, heart rate (HR), and horse grimace scale (HGS) at rest and during mechanical nociceptive stimulation. Ninety healthy young adult horses (females, males): 30 each of Friesians, Quarter Horses, and Warmbloods. Prospective control study. The study consisted of habituation to equipment (Day 1), baseline recordings (Days 2 and 3), and nociceptive testing applying mild pressure to the metacarpus (Day 4). Parasympathetic tone, HR, and HGS were recorded simultaneously on Days 2 to 4. Each study lasted 30 minutes and was done in triplicate at 3 different time points per day. Baseline PTA was not different among breeds. It decreased in Warmbloods and Quarter Horses during placement of the stimulus device without stimulation (P < .01). A significant decrease in PTA (P < .001) occurred during nociceptive stimulus (marked in Quarter Horses, intermediate in Warmbloods, and mild in Friesians). Heart rate and HGS increased significantly (P < .001) during the stimulus in all breeds but returned to baseline poststimulation. Friesians required higher pressure (P < .05) to elicit an aversive response to the stimulus. Horses' PTA, HR, and HGS change in response to a mild mechanical nociceptive stimulus with Friesians showing less variation. Stress induced a decrease in PTA in Quarter Horses and Warmbloods but not in Friesians. Friesians appeared to be more tolerant to pain based on PTA, HR, and HGS findings compared with other breeds.

Water-Salt Homeostasis of the Human Body and Electrolytic Composition of the Internal Liquid Environment

Maintaining water and salt balance in the body is important for the basic functioning of cells. It reduces the water level by increasing the urine production of the kidneys. During excessive salt intake, the blood absorbs water from the tissues and edema occurs. To prevent this, the kidneys increase the amount of urine. Excess salt is excreted in the urine. Blood pressure regulation is one of the most complex aspects of homeostasis. The adrenal glands, spine, and sympathetic and parasympathetic nervous systems work together to balance blood pressure and keep it at a healthy level. Changes in blood pressure are detected by receptors and the information is sent to the brain for processing. Blood pressure either rises or falls with the help of nerve impulses and hormones to the heart.

The Detection and Calculation of Design-Weighting on Indoor Environmental Elements—Illustrated by Real Interior Design Projects

In interior design projects, homeowners’ expectations and thoughts in mind are sometimes ambiguous and hard to pinpoint. This lack of clarity can lead to disagreements between owners and designers, making it difficult for designers to receive due remuneration. At the same time, the design project always has a restricted budget. Suppose the funds could be prioritized based on owners’ preferred weight of the indoor elements, with a larger portion of the budget allocated to the most crucial elements. In that case, it can significantly enhance the owner’s satisfaction. To address these challenges, this research introduces a novel analytical and computational approach that leverages the Positive And Negative Affects Schedule (PANAS) and Heart Rate Variability (HRV) to assess homeowners’ sentiments toward various indoor elements. This method aims to determine indoor elements’ design-weighting, design sequence, and distribution of project budgets, enabling designers to understand better and meet homeowners’ genuine needs and expectations in interior design projects. The efficacy of this approach was evaluated through the analysis of three real-life residential interior design projects. Data from the PANAS emotion scale and heart rate variability (HRV) measurements of the homeowners were collected before and after project completion. The findings revealed high satisfaction among homeowners following project execution. By adjusting indoor elements, owners’ negative emotions decreased significantly, positive emotions surged, and there was an improvement in the activity of sympathetic and parasympathetic nerves, leading to enhanced physical and mental well-being. Furthermore, in-depth interviews with homeowners corroborated the effectiveness of the analytical calculation method in identifying latent negative indoor elements of concern to homeowners, thereby validating the practical utility of this approach in real-world design scenarios.

Supplemental Material for The Infant Parasympathetic Nervous System Is Socially Embedded and Dynamic at Multiple Timescales, Within and Between People

Supplemental Material for The Infant Parasympathetic Nervous System Is Socially Embedded and Dynamic at Multiple Timescales, Within and Between People

A bioecological longitudinal study of depressive symptoms from pregnancy to 36 months postpartum

PurposeDepressive symptoms during the perinatal period have broad and enduring health implications for birthing parents and their offspring. Rising prevalence rates of perinatal depression highlight the need for research examining factors influencing depressive symptoms during pregnancy, and trajectories during the early postnatal period. Grounded in bioecological systems theory, this longitudinal multimethod study examined whether prenatal bioecological factors predict depressive symptoms from pregnancy to 36 months postpartum. MethodsParticipants were 162 pregnant individuals, oversampled for high emotion dysregulation, who completed a life stress interview and physiological assessment during the 3rd trimester and a self-report measure of depression at five time-points (3rd trimester, within 48 h of birth, 7, 18, and 36 months postpartum). Multilevel models were used to test study aims. ResultsParticipants exhibited the highest levels of depressive symptoms at 3rd trimester, and substantial variability in depressive symptom trajectories over time. Lower resting respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system functioning, in the 3rd trimester was associated with higher concurrent depressive symptoms. Higher levels of stress related to partner relationships, finances, and health were concurrently associated with more depressive symptoms during pregnancy and decreases in depressive symptoms over time. Specifically, depressive symptoms decreased only for individuals who reported high levels of stress during pregnancy. LimitationsAlthough grounded in bioecological systems theory, this study did not assess the macrosystem. ConclusionsResults of this study underscore the importance of multilevel predictors of perinatal health and highlights potential targets for preventing depression and promoting well-being during the perinatal transition.

EFEKTIVITAS SLOW STROKE BACK MASSAGE TERHADAP TEKANAN DARAH DAN KUALITAS TIDUR PENDERITA HIPERTENSI

Known as hypertension, or high blood pressure, is a non-communicable disease (NCD). Preliminary study data from Dr. Kariadi Semarang Central Public Hospital indicated 561 patients with hypertension over the last three years (2021–2023). Hypertension symptoms often resemble those of other diseases and can vary among individuals, including fatigue, palpitations, increased blood pressure, nosebleeds, headaches, and nocturia, which can disrupt sleep quality. One of the non-pharmacological effort to prevent hypertension is slow-stroke back massage, This study aimed to determine the effect of slow-stroke back massage on blood pressure and sleep quality in hypertension sufferers. The research design employed a quasi-experimental method with a one-group pretest-posttest approach, involving 42 respondents selected through purposive sampling. The results demonstrated that slow-stroke back massage effectively reduced systolic blood pressure (p-value = 0.00) and improved sleep quality scores (p-value = 0.00). Slow-stroke back massage can enhance relaxation and increase parasympathetic nerve activity, thereby reducing the heart's workload. This study recommends that nurses apply slow-stroke back massage therapy in hospitals to help control blood pressure and improve the sleep quality of hypertension sufferers.

Ação Imunomoduladora da Estimulação Parassimpática promovida pelo Exercício Físico

Introduction: Physical exercise promotes the stimulation of the vagal nerve and different neural networks, contributing to a more effective anti-inflammatory response in order to contribute to cardiovascular, metabolic and immunological benefits. Objective: To associate the role of physical exercise with parasympathetic stimulation and its possible implications in immunomodulation Methods: This is a qualitative, explanatory and descriptive study on the immunomodulatory action of parasympathetic activation through physical exercise through a bibliographic review. The databases used were: PubMed, Scopus, Scielo and Web of Science involving all original articles from January 2015 and June 2024. Results: The main findings are related to differences in physical exercise intensity, which can contribute to the modulation of the innate immune system and the expression of neutrophil and lymphocyte cell populations, which can contribute to a more specific immune response. Aerobic training and strength training had similar responses in reducing BMI and glycated hemoglobin, reducing sympathetic tone, increasing parasympathetic tone, and improving the sympatho/vagal balance for controlling heart rate variability. There was a negative association between vagal neuroimmunomodulation (NIM) and mortality, since the lower the NIM index, the shorter the survival time in the population sample. Conclusion: Aerobic physical exercise and strength training can contribute to the activation of the parasympathetic system and immune system and provide better adjustments in the innate and adaptive immune response dependent on the intensity and volume of training.

Mechanism underlying the influence of humidity on thermal comfort and stress under mimicked working conditions

Thermal comfort in an office impacts physical health, stress, and productivity. Humidity affects thermal comfort; however, the underlying mechanism remains unclear. This study assessed the influence of humidity on body temperature, thermal comfort, stress, and their relationship in working individuals. Thirteen participants performed three sets of 20-min calculation tasks followed by a 10-min rest in 26 °C or 33 °C with relative humidity (RH) of 30 % or 60 %. Core body temperature (Tcore), mean skin surface temperature (Tskin), and electrocardiogram were continuously recorded. Subjective thermal sensations and comfort were assessed with visual analog scales. Stress level was estimated based on α-amylase activity and immunoglobulin A level in saliva and heart rate variability. Mean Tskin and Tcore elevated at 33 °C with 60 % RH, where warm sensation and thermal discomfort also increased. Heart rate variability reflecting parasympathetic nerve activity decreased. There was a negative linear relationship between weighted body temperature and thermal comfort. However, thermal discomfort was augmented at a given weighted body temperature at 60 % RH. Thus, under indoor working conditions, high humidity may augment thermal discomfort and become a stress factor. Increases in Tskin and Tcore are involved in the mechanism, alongside other factors.

Parasympathetic regulation and support from family and friends predict prosocial development in U.S. Mexican-origin adolescents.

Both parasympathetic nervous system regulation and receipt of social support from close relationships contribute to prosocial development, although few studies have examined their combined influences in adolescence and particularly within racially and ethnically minoritized populations. In this longitudinal study of 229 U.S. Mexican-origin adolescents (48% female-identifying), youths reported on receipt of social support from family and friends from 10 to 16 years, had their baseline respiratory sinus arrhythmia (RSA) measured at 17 years, reported their prosocial behavior and completed the Mind in the Eyes test to assess cognitive empathy at 17 and 19 years, and reported their prosocial civic behavior (i.e., community activity) at 19 years. Family social support predicted prosocial behavior at 17 years, and friend social support predicted prosocial civic behavior at 19 years. Compared to youths with lower or higher baseline RSA, youths with moderate RSA reported more prosocial civic behavior, had greater cognitive empathy, and tended to report more general prosocial behavior at 19 years. The quadratic association between baseline RSA and cognitive empathy was stronger for youths with greater family social support. These findings are the first to extend the evidence that moderate baseline parasympathetic nervous system activity supports prosocial development into late adolescence and with the U.S. Mexican-origin community, and these findings address calls for more integrative biopsychosocial studies of prosociality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pengaruh Senam Lansia Terhadap Lansia Dengan Hipertensi di UPTD Puskesmas Sei Lekop Kabupaten Bintan

In the elderly, the cardiovascular system will experience changes, such as arteries losing their elasticity, which can cause an increase in pulse and systolic blood pressure. Elderly exercise utilizes movement by activating the sympathetic and parasympathetic nervous systems and increasing the release of various hormones which cause the individual's condition to relax. Elderly exercise is a physical activity that is useful for eliminating fat and cholesterol in blood vessels. This exercise is rarely carried out routinely at research sites. The aim of this study was to determine the effect of elderly exercise on hypertension in the elderly at the Sei Lekop Community Health Center. This study used a pre-experimental research design with a one group pre-post test design with probability sampling, involving 31 elderly people with hypertension. Blood pressure was measured with a spygmomanometer and elderly exercise was carried out according to procedures. Data analysis was carried out using paired t-test. The results showed that the average blood pressure before the intervention was 150.00/94.48 mmHg, whereas after the intervention the average blood pressure was 140.48/90.48 mmHg, with a p value = 0.001 for systolic pressure and 0.003 for diastolic pressure, so it was proven that there was a significant influence on blood pressure before and after the elderly exercise intervention was given to the elderly at the Sei Lekop Community Health Center. It is hoped that elderly exercise can be used and become a work program at the Community Health Center which is carried out routinely for both elderly people with hypertension and those who are healthy.

Effect of Lavender Essential Oil Topical Treatment on the Autonomic Nervous System in Human Subjects Without Olfactory Influence: A Pilot Study

Objective/background As part of a scientific study into the effects of aromatherapy, we investigated the effects of lavender essential oil (LEO) treatment on the autonomic nervous system in subjects for whom the sense of smell had been eliminated. Methods This study used a single-blinded cross-over design for verification. Heart rate variability was measured and effects on the autonomic nervous system were investigated. Results and discussion Although no significant differences were found, aromatherapy treatment with 1% LEO tended to increase parasympathetic nervous system activity. Further, when differences between values before and during aromatherapy treatment were compared, LEO treatment significantly increased parasympathetic nervous system activity. Given these findings, LEO appears to increase parasympathetic nervous system activity, even in the absence of a psychological effect due to an absence of olfactory stimulation. Conclusion The present results provide a scientific method for verifying the effects of aromatherapy and will aid in further elucidation of aromatherapy.

Cardioneural ablation-the first case series without the use of fluoroscopy.

Cardioneural ablation (CNA) and fluoroless ablation (FA) are emerging procedures and movements in contemporary in electrophysiology. Ablation of ganglionated plexus (GP) inputs in the atrium has been successfully targeted as a treatment for symptomatic bradyarrhythmias due to increased parasympathetic tone. As most of these patients are young, avoidance of ionizing radiation is of critical importance to limit potential long term deleterious effects. With widespread use of 3D electroanatomic mapping systems and advanced intracardiac echo (ICE) imaging, fluoroless ablation has become more widely adopted. However, fluoroless CNA has not been widely performed. The objective of this study is to demonstrate that CNA can be done safely and effectively without fluoroscopy. At a single-center, consecutive patients undergoing CNA with a fluoroless approach are described. GP mapping and ablation were performed in both atria. From the right atrium (RA), the right atrium-superior vena cava (RA-SVC GP), the posteromedial ganglionated plexus (PMLGP), which can be accessed from the right atrium-coronary sinus ostium, and the Vein of Marshall GP (VOM-GP) were evaluated. From the left atrium (LA), the superior left atrial ganglionated plexus (LSGP), the left inferior ganglionated plexus (LIGP), the right anterior ganglionated plexus (RAGP), and the right inferior ganglionated plexus (RIGP) were targeted. Over the study period, beginning on January 31, 2021, 30 consecutive subjects (15 females/15 males) aged 42.9 ± 13.6years underwent GP ablation. The average subject had 9.5 (± 9.2) episodes of syncope prior to ablation. The average CHADS2-VA2SC score was zero. The average LVEF was 64.8% (± 4.9). Two of the subjects had concomitant ablations, six failed prior medical therapy, and one had a prior pacemaker placed. All of the procedures were done without fluoroscopy. The average follow-up was 604 (± 366) days. There were 8 patients that did not improve symptomatically postfirst ablation. Four of the eight underwent repeat ablation and have subsequently improved. 26/30 patients symptomatically improved after the 1st or 2nd ablation. There were no complications noted. In comparison to the traditional CNA with fluoroscopy, this proof of concept study reveals fluoroless GP ablation can be performed safely. In addition, the durability and success rate are comparable to other studies of CNA. Given the young age of the cohort and the longitudinal risks of ionizing radiation, fluoroless CNA is a feasible procedure for this patient population.

Effect of remimazolam and propofol anesthesia on autonomic nerve activities during Le Fort I osteotomy under general anesthesia: blinded randomized clinical trial.

This study evaluated the effect of remimazolam and propofol on changes in autonomic nerve activity caused by surgical stimulation during orthognathic surgery, using power spectrum analysis of blood pressure variability (BPV) and heart rate variability (HRV), and their respective associations with cardiovascular fluctuations. A total of 34 patients undergoing Le Fort I osteotomy were randomized to the remimazolam (Group R, 17 cases) or propofol (Group P, 17 cases) groups. Observables included the low-frequency component of BPV (BPV LF; index of vasomotor sympathetic nerve activity), high-frequency component of HRV (HRV HF; index of parasympathetic nerve activity), balance index of the low- and high-frequency components of HRV (HRV LF/HF; index of sympathetic nerve activity), heart rate (HR), and systolic blood pressure (SBP). Four observations were made: (1) baseline, (2) immediately before down-fracture, (3) down-fracture, and (4) 5 min after down-fracture. Data from each observation period were compared using a two-way analysis of variance with a mixed model. A Bonferroni multiple comparison test was performed in the absence of any interaction. One-way analysis of variance followed by Tukey's multiple comparisons test was performed when a significant interaction was observed between time and group, with P < 0.05 indicating statistical significance. Evaluation of autonomic nerve activity in comparison with baseline during down-fracture showed a significant increase in BPV LF (P < 0.001), an increasing trend in HRV LF/HF in Group P, and an increasing trend in HRV HF in Group R. There were no significant differences in HR or SBP between the two groups. During down-fracture of Le Fort I osteotomy, sympathetic nerve activity was predominant with propofol anesthesia, and parasympathetic nerve activity was predominant with remimazolam anesthesia.

The new face of diabetes mellitus — rhythm and conduction disorders

This review article is devoted to changes in heart rhythm against the background of type 2 diabetes mellitus, which is one of the most common endocrine diseases. In recent years, there has been an increasing association between type 2 diabetes mellitus and heart rhythm disorders. Arrhythmias such as tachycardia, bradycardia and atrial fibrillation are common in patients with type 2 diabetes and can have serious consequences on health and quality of life. Type 2 DM is increasingly common worldwide due to the rise in sedentary lifestyles, overweight, abdominal forms of obesity, and diets containing too much fat and carbohydrates. Insulin-independent diabetes is a metabolic disease responsible for autonomic neuropathy of the heart that affects both sympathetic and parasympathetic fibers, which can be explained by the adverse effect of blood glucose levels on heart rate variability (HRV). Although the gold standard is cardiovascular reflex tests to assess cardiovascular autonomic neuropathy, one of the most important is the measurement of heart rate variability (HRV). HRV is the variation between two consecutive contractions: the higher the variation, the higher the activity of the parasympathetic nervous system. A high HRV reflects the fact that a person can constantly adapt to changes in the microenvironment. Thus, low HRV is a marker of cardiovascular risk.

Angiotensin Receptor-Neprilysin Inhibitor Is Associated With Improved Cardiac Autonomic Function in Heart Failure.

Heart failure with reduced ejection fraction is associated with potentially deleterious imbalance of the cardiac autonomic nervous system. Sacubitril/valsartan (angiotensin receptor-neprilysin inhibitor [ARNI]) reduces cardiovascular mortality and hospitalization for heart failure with reduced ejection fraction. Whether ARNI affects the cardiac autonomic nervous system has not been studied. This investigator-initiated, prospective, single-center cohort study compared heart rate (HR) variability, HR, deceleration capacity, and periodic repolarization dynamics as noninvasive measures of the cardiac autonomic nervous system before and after initiation of ARNI therapy. Patients underwent standardized 12-lead Holter-ECG, echocardiography and laboratory testing before and 3 months after start of therapy. End points were changes in HR variability (SD of normal-to-normal intervals, mean square of differences between consecutive R-R intervals), HR, deceleration capacity, and periodic repolarization dynamics as well as ventricular function and NT-proBNP (N-terminal pro-B-type natriuretic peptide). Of 63 patients with heart failure with reduced ejection fraction enrolled, 48 (76.2%) patients were still on ARNI at follow-up. SD of normal-to-normal intervals increased from 25 to 36 milliseconds (P<0.001), mean square of differences between consecutive R-R intervals increased from 12 to 19 milliseconds (P<0.001), HR decreased from 73±9 bpm to 67±4 bpm, (P<0.001), and deceleration capacity increased from 2.1 to 4.4 milliseconds (P<0.001). A trend for periodic repolarization dynamics reduction was observed (5.6 deg2 versus 4.7 deg2, P=0.09). Autonomic changes were accompanied by increased left ventricular ejection fraction (29±6% versus 40±8%, P<0.001) and reduced NT-proBNP (3548 versus 685 ng/L, P<0.001). Correlation analysis showed a significant relationship between volume-unloading (as evidenced by NT-proBNP reduction) and autonomic improvement. Three months of ARNI therapy resulted in a significant increase in cardiac parasympathetic tone. The improvement in autonomic properties may be mediated by "volume unloading" and likely contributes to the beneficial effects of ARNI in heart failure with reduced ejection fraction. URL: https://www.clinicaltrials.gov; Unique Identifier: NCT04587947.

The Practical Management of Rhinitis in Athletes.

Exercise-induced rhinitis (EIR) is a poorly understood condition that can have a massive impact within elite sport. This was epitomized in 2019 when British cyclist and Tour de France winner Chris Froome lost control of his bike at 37 mph while wiping his nose, resulting in an admission to intensive care. We aim to produce a comprehensive resource to guide the assessment and management of rhinitis in athletes. Rhinitis is a common condition which can be broadly divided into allergic rhinitis (AR) and non-AR (NAR), a subset of which is known as vasomotor rhinitis. Exercise-induced rhinitis is an important but understudied subcategory of NAR. The pathophysiology of the disease is broadly believed to be an imbalance of the sympathetic and parasympathetic nervous systems, leading to symptoms of watery rhinorrhea, nasal congestion, and paroxysmal sneezing. Up to 50% of people suffer from some degree of EIR, which impedes their nasal breathing and affects performance. The assessment of the athlete with rhinitis requires consideration of both allergic and vasomotor contributions to ensure optimal management is introduced. There is no clear guidance for the management of EIR, with uncertainty regarding the most effective pharmaceuticals and optimizing the timing of treatment to enable peak performance. N/A. N/A. N/A. N/A. Based on expert clinical experience in a busy ear, nose, and throat center and a systematic review of current literature, this article proposes a step-wise, incremental approach to the management of EIR symptoms. In an industry where marginal gains give athletes a competitive edge, optimal management of EIR is crucial.

Anxiety is related to slower RSA oscillation during stress response and regulation.

Respiratory sinus arrhythmia (RSA), an index of the parasympathetic nervous system activity, has been considered indicative of stress response and emotion regulation. However, the relationship between RSA and anxiety remains inconclusive, partly because previous research has primarily focused on static RSA levels. In this nonclinical sample (N = 75, Mage = 20.89 ± 1.72 SD, 48 males), we used a damped oscillator model to characterize RSA dynamics across 30-s epochs while participants completed the Trier social stress test. Results showed that RSA constantly oscillated during the three periods of TSST (namely Rest, Stress, and Recovery). Importantly, slower RSA oscillation in the Stress period was related to elevated state anxiety, whereas in the Recovery period, it was related to higher trait anxiety. These findings demonstrated the dynamic nature of RSA during the whole course of stress response. Slower RSA oscillation may indicate inflexible and tardy physiological regulation which may give rise to anxiety issues.

Analysis of the correlations between ECG components in adolescents both before and after exposure to different types of physical stress in the Subarctic winter conditions

BACKGROUND: Adaptive responses to harsh environmental conditions of the Arctic may vary not only among adults, but also among children and adolescents. These compensatory reactions are influenced by the predominant type of regulation of the autonomic nervous system. The myocardium and its electrical properties play a significant role in determining how individuals adapt to to environmental conditions. AIM: To study correlations between PP and TR intervals in adolescents in adolescents undergoing the clinostatic test and the Martinet test during the winter season. MATERIAL AND METHODS: Twenty cardiac cycles were recorded in 22 adolescents aged 15–16 years in the II standard lead, both at baseline and after conducting the clinostatic and Martinet tests. Durations of the RR and TR intervals were measured and used for the analysis. Statistical processing of the data was performed using the MS Excel tables. RESULTS: Based on both individual and group data analysis, it has been observed that the duration of RR and TR increases during the clinostatic test, while it decreases during the Martinet test. The extent of these changes in RR and TR varies between the two tests. Specifically, the RR:TR ratios are 1:3.5 during the clinostatic test and 1:2.5 during the Martinet test. These findings suggest a higher likelihood of parasympathetic influences on the electrical properties of the myocardium during the clinostatic test, and sympathetic influences during the Martinet test. CONCLUSION: Duration of RR and TR intervals increased by 25% and 85%, respectively, in response to the clinostatic test. Conversely, after the Martinet test, the duration of both intervals decreased by 15% and 38%, respectively. These findings suggest that the changes in the duration of RR and TR intervals are influenced by the parasympathetic and sympathetic divisions of the autonomic nervous system, under different types of physical stress. Further research should be conducted in other seasons, particularly during transitional periods such as spring and autumn, to better understand the electrical properties of the myocardium under physical stress.

Parasympathetic nervous system: A key role in control and mood disorders in patients with asthma

BackgroundPatients with severe asthma often have uncontrolled disease and experience mood disorders, particularly anxiety and depression. The autonomic nervous system (ANS) plays an important role in asthma, mainly through the parasympathetic ANS system (PANS), which favors bronchoconstriction and mental health status. ObjectiveTo evaluate the role of the activation of the PANS in uncontrolled asthma and related mood disorders. MethodsThis was a proof-of-concept cross-sectional study that analyzed demographic and clinical variables reflecting asthma severity and control, lung function, inflammation (from induced sputum), evaluation of quality of life, and the risk for anxiety and depression according to validated questionnaires. The PANS analysis was conducted based on heart rate variability: SD of the difference between consecutive normal-to-normal (NN) intervals (SDNN), root mean square of the successive differences (RMSSD), percentage of consecutive NN intervals (pNN50), total power (TP), and respiratory-related power (Pr). ResultsA total of 30 patients with asthma were grouped according to asthma control and the risk for anxiety and depression; 10 patients with uncontrolled asthma compared with the patients with controlled asthma showed significant differences (P < .05) in SDNN (26.5 [8.2] vs 42.7 [29.7]), RMSSD (14.1 [6.5] vs 24 [20]), pNN50 (0.6 [1.5] vs 6.2 [11.8]), TP (0.0005 [0.00046] vs 0.0014 [0.00085]), and Pr (0.0003 [0.00025] vs 0.0007 [0.00060]) respectively. A total of 13 patients at risk for anxiety and depression compared with the patients without showed reduced values (P < .05) for SDNN (26.5 [7.9] vs 45.6 [31.3]), pNN50 (0.75 [1.4] to 7.12 [12.6]), TP (0.0005 [0.00048] to 0.0012 [0.0008]), and Pr (0.0003 [0.00027] to 0.0008 [0.00062]). ConclusionOur results suggest that PANS activity is depressed in patients with uncontrolled asthma and common mood disorders such as depression and anxiety, and the evaluation of heart rate variability may be a useful means for follow-up of asthma control and related mood disorders.

Deepening insights into cholinergic agents for intraocular pressure reduction: systems genetics, molecular modeling, and in vivo perspectives.

Parasympathetic activation in the anterior eye segment regulates various physiological functions. This process, mediated by muscarinic acetylcholine receptors, also impacts intraocular pressure (IOP) through the trabecular meshwork. While FDA-approved M3 muscarinic receptor (M3R) agonists exist for IOP reduction, their systemic cholinergic adverse effects pose limitations in clinical use. Therefore, advancing our understanding of the cholinergic system in the anterior segment of the eye is crucial for developing additional IOP-reducing agents with improved safety profiles. Systems genetics analyses were utilized to explore correlations between IOP and the five major muscarinic receptor subtypes. Molecular docking and dynamics simulations were applied to human M3R homology model using a comprehensive set of human M3R ligands and 1,667 FDA-approved or investigational drugs. Lead compounds from the modeling studies were then tested for their IOP-lowering abilities in mice. Systems genetics analyses unveiled positive correlations in mRNA expressions among the five major muscarinic receptor subtypes, with a negative correlation observed only in M3R with IOP. Through modeling studies, rivastigmine and edrophonium emerged as the most optimally suited cholinergic drugs for reducing IOP via a potentially distinct mechanism from pilocarpine or physostigmine. Subsequent animal studies confirmed comparable IOP reductions among rivastigmine, edrophonium, and pilocarpine, with longer durations of action for rivastigmine and edrophonium. Mild cholinergic adverse effects were observed with pilocarpine and rivastigmine but absent with edrophonium. These findings advance ocular therapeutics, suggesting a more nuanced role of the parasympathetic system in the anterior eye segment for reducing IOP than previously thought.