Pressor Reflex Research Articles

Intracerebroventricular insulin injection acutely normalizes the augmented exercise pressor reflex in male rats with type 2 diabetes mellitus.

The exercise pressor reflex (EPR) is exaggerated in type 2 diabetes mellitus (T2DM), but the underlying central nervous system aberrations have not been fully delineated. Stimulation of muscle afferents within working skeletal muscle activates the EPR, by sending information to neurons in the brainstem, where it is integrated and results in reflexively increased mean arterial pressure (MAP) and sympathetic nerve activity. Brain insulin is known to regulate neural activity within the brainstem. We hypothesize that brain insulin injection in T2DM rats attenuates the augmented EPR, and that T2DM is associated with decreased brain insulin. Using male Sprague-Dawley rats, T2DM and control rats were generated via an induction protocol with two low doses of streptozotocin (35 and 25mg/kg, i.p.) in combination with a 14-23-week high-fat diet or saline injections and a low-fat diet, respectively. After decerebration, MAP and renal sympathetic nerve activity (RSNA) were evaluated during EPR stimulation, evoked by electrically induced muscle contraction via ventral root stimulation, before and after (1 and 2h post) intracerebroventricular (i.c.v.) insulin microinjections (500mU, 50nl). i.c.v. insulin decreased peak MAP (ΔMAP Pre (36±14mmHg) vs. 1h (21±14mmHg) vs. 2h (11±6mmHg), P<0.05) and RSNA (ΔRSNA Pre (107.5±40%), vs. 1h (75.4±46%) vs. 2h (51±35%), P<0.05) responses in T2DM, but not controls. In T2DM rats, cerebrospinal fluid insulin was decreased (0.41±0.19 vs. 0.11±0.05ng/ml, control (n=14) vs. T2DM (n=4), P<0.01). The results demonstrated that insulin injections into the brain normalized the augmented EPR in brain hypoinsulinaemic T2DM rats, indicating that the EPR can be regulated by brain insulin. KEY POINTS: The reflexive increase in blood pressure and sympathetic nerve activity mediated by the autonomic nervous system during muscle contractions is also known as the exercise pressor reflex. The exercise pressor reflex is dangerously augmented in type 2 diabetes, in both rats and humans. In type 2 diabetic rats both cerebrospinal fluid insulin and phosphoinositide 3-kinase signalling within cardiovascular brainstem neurons decrease in parallel. Brain insulin injections decrease the magnitude of the reflexive pressor and sympathetic responses to hindlimb muscle contraction in type 2 diabetic rats. Partial correction of low insulin within the central nervous system in type 2 diabetes may treat aberrant exercise pressor reflex function.

Autonomic and Enteric Profiling May Help Predict Response to Diverse Obesity Therapies.

Changes in autonomic (ANS) and enteric nervous systems (ENS) may be involved in pathogenesis of obesity. We hypothesized that baseline autonomic and enteric parameters may predict outcomes of diverse obesity therapies. We studied ANS and ENS physiology in 37 patients (8 male, 29 female, age 45years, weight 129.7kg) at 4 centers in patients undergoing medical (9: low-calorie diet) versus invasive (22: 16 sleeve, 6 bypass) and semi-invasive (6: 2 band, 2 high energy stimulation, 2 aspiration) weight loss therapies. Weight loss was reported as percent weight loss from baseline to latest values at 1year and in some up to 5years; classified as < or > /= 20% for each group. ANS testing included sympathetic adrenergic function by measuring reflex vasoconstriction and postural adjustment ratio. ENS was measured non-invasively using cutaneous low-resolution electrogastrogram. Percent weight loss was greater with the invasive (28.5%) than semi-invasive (9.1%) or non-invasive low-calorie diet (4.4%) (p < .001). Percent weight loss at 1year (and up to 5years) corresponded to the adrenergic measure of postural adjustment ratio (r = .42, p = .012), total pulse amplitude at rest (r = .56, p < .001), and electrogastrogram standing-to-rest difference (r = .33, p = .056). Baseline autonomic and enteric function measures correspond to percentage with loss in this pilot study using diverse weight loss methods. Autonomic and enteric profiling has potential clinical use for evaluation and treatment of obesity but needed larger controlled trials.

Effects of voluntary exercise and electrical muscle stimulation on reaction time in the Go/No-Go task.

Acute exercise improves cognitive performance. However, it remains unclear what triggers cognitive improvement. Electrical muscle stimulation (EMS) facilitates the examination of physiological changes derived from peripheral muscle contraction during exercise. Thus, we compared the effects of EMS and voluntary exercise at low- or moderate-intensity on reaction time (RT) in a cognitive task to understand the contribution of central and peripheral physiological factors to RT improvement. Twenty-four young, healthy male participants performed a Go/No-Go task before and after EMS/exercise. In the EMS condition, EMS was applied to the lower limb muscles. In the low-intensity exercise condition, the participants cycled an ergometer while maintaining their heart rate (HR) at the similar level during EMS. In the moderate-intensity exercise condition, exercise intensity corresponded to ratings of perceived exertion of 13/20. The natural log-transformed root mean square of successive differences between adjacent inter-beat (R-R) intervals (LnRMSSD), which predominantly reflects parasympathetic HR modulation, was calculated before and during EMS/exercise. RT improved following moderate-intensity exercise (p = 0.002, Cohen' d = 0.694), but not following EMS (p = 0.107, Cohen' d = 0.342) and low-intensity exercise (p = 0.076, Cohen' d = 0.380). Repeated measures correlation analysis revealed that RT was correlated with LnRMSSD (Rrm(23) = 0.599, p = 0.002) in the moderate-intensity exercise condition. These findings suggest that the amount of central neural activity and exercise pressor reflex may be crucial for RT improvement. RT improvement following moderate-intensity exercise may, at least partly, be associated with enhanced sympathetic nervous system activity.

Influence of endogenous and exogenous hormones on the cardiovascular response to lower extremity exercise and group III/IV activation in young females.

Oral contraceptive (OC) use can increase resting blood pressure (BP) in females as well as contribute to greater activation of group III/IV afferents during upper body exercise. It is unknown, however, whether an exaggerated BP response occurs during lower limb exercise in OC users. We sought to elucidate the group III/IV afferent activity-mediated BP and heart rate responses while performing lower extremity tasks during early and late follicular phases in young, healthy females. Females not taking OCs (NOC: n = 8; age: 25 ± 4 yr) and those taking OCs (OC: n = 10; age: 23 ± 2 yr) completed a continuous knee extension/flexion passive stretch (mechanoreflex) and cycling exercise with subsystolic cuff occlusion (exercise pressor reflex), which was followed by a 2-min postexercise circulatory occlusion (PECO) (metaboreflex). Data collection occurred on two occasions: once during the early follicular phase (days 1-4) and once during the late follicular phase (days 10-14) of their menstrual cycle (NOC) or during the placebo and active pill phases (OC). Resting mean arterial BP and heart rate were not different between phases in NOC and OC participants (P > 0.05). Hemodynamic responses to metaboreflex, mechanoreflex, and collective exercise pressor reflex activation were not different between phases in both groups (P > 0.05). In conclusion, although OCs are known to increase BP at rest, our findings indicate that neither endogenous nor exogenous (OC) sex hormones modulate BP during large, lower limb muscle exercise with or without group III/IV afferent activation in young, healthy females.NEW & NOTEWORTHY Sex differences in the cardiovascular response to exercise have been demonstrated and may be dependent on sex hormone levels. Furthermore, oral contraceptives (OCs) have been shown to exaggerate the blood pressure response to upper extremity exercise. The results of this study indicate that neither endogenous nor exogenous (OC) sex hormones modulate BP during lower extremity dynamic exercise or with group III/IV afferent activation in young, healthy females.

The influence of oral contraceptives on the exercise pressor reflex in the upper and lower body.

Previous research has demonstrated that oral contraceptive (OC) users have enhanced cardiorespiratory responses to arm metaboreflex activation (i.e., postexercise circulatory occlusion, PECO) and attenuated pressor responses to leg passive movement (PM) compared to non-OC users (NOC). We investigated the cardiorespiratory responses to arm or leg metaboreflexand mechanoreflex activation in 32 women (OC, n = 16; NOC, n = 16) performing four trials: 40% handgrip or 80% plantarflexion followed by PECO and arm or leg PM. OC and NOC increased mean arterial pressure (MAP) similarly during handgrip, plantarflexion and arm/leg PECO compared to baseline. Despite increased ventilation (VE) during exercise, none of the women exhibited higher VE during arm or leg PECO. OC and NOC similarly increased MAP and VE during arm or leg PM compared to baseline. Therefore, OC and NOC were similar across pressor and ventilatory responses to arm or leg metaboreflexand mechanoreflex activation. However, some differences due to OC may have been masked by disparities in muscle strength. Since women increase VE during exercise, we suggest that while women do not display a ventilatory response to metaboreflex activation (perhaps due to not reaching a theoretical metabolite threshold to stimulate VE), the mechanoreflex may drive VE during exercise in women.

Reflex sympathetic activation to inspiratory muscle loading is attenuated in females relative to males.

Intense inspiratory muscle work can evoke a metabolite-stimulated pressor reflex, commonly referred to as the respiratory muscle metaboreflex. When completing similar relative and absolute levels of inspiratory work, females have an attenuated blood pressure response. We sought to test the hypothesis that the lower blood pressure response to the respiratory muscle metaboreflex in females is associated with a reduced sympathetic response. Healthy young (26 ± 4 yr) males (n = 9) and females (n = 7) completed two experimental days. On day 1, participants completed pulmonary function testing and became familiarized with an inspiratory pressure-threshold loading (PTL) task. On the second day, balloon-tipped catheters were placed in the esophagus and stomach to measure pleural and gastric pressures, and transdiaphragmatic pressure was calculated. A microelectrode was inserted into the fibular nerve to quantify muscle sympathetic nerve activity (MSNA), and participants then completed isocapnic PTL to task failure. There was a significant sex-by-time interaction in the mean arterial pressure (MAP, P = 0.015) and burst frequency (P = 0.039) response to PTL. Males had a greater rise in MAP (Δ21 ± 9 mmHg) than females (Δ13 ± 5 mmHg, P = 0.026). Males also demonstrated a greater rise in MSNA burst frequency (Δ18 ± 7 bursts/min) than females (Δ10 ± 5 bursts/min, P = 0.015). The effect of sex was observed despite females and males completing the same magnitude of diaphragm work throughout the task (P = 0.755). Our findings provide novel evidence that the lower blood pressure response to similar relative and absolute inspiratory muscle work in females is associated with lower sympathetic activation.NEW & NOTEWORTHY The blood pressure response to high levels of inspiratory muscle work is lower in females and occurs alongside a reduced sympathetic response. The reduced blood pressure and sympathetic response occur despite males and females performing similar levels of absolute inspiratory work. Our findings provide evidence that sex differences in the respiratory muscle metaboreflex are, in part, sympathetically mediated.

Inhibition and potentiation of the mechanoreflex following pharmacological modulation of TRPC6 in male rats

We determined the role played by the transient receptor potential canonical 6 (TRPC6) in evoking the mechanical component of the exercise pressor reflex in male decerebrated Sprague-Dawley rats. Quadruple-labelled immunohistochemistry were used in dorsal root ganglion cells to identify the cells that innervate the triceps surae muscles (DiI), the cells that express TRPC6 and the cells that are (Nf200) or are not myelinated (peripherin) (n=4). In addition, static contraction of triceps surae muscles was evoked by electrically stimulating the left tibial nerve before and after injecting into the superficial epigastric artery the TRPC6 antagonists, BI-749327 (n = 11; 12μg.kg−1) or SAR7334 (n = 11; 7μg.kg−1), or the TRPC6 positive modulator, C20 (n = 11; 18μg.kg−1). Similar experiments were conducted while the triceps surae muscles were passively stretched (n = 8 to 12), a maneuver that isolates the mechanical component of the reflex. Blood pressure, tension, renal sympathetic nerve activity (RSNA) and blood flow were recorded throughout the experiments. The neurons innervating the triceps-surae muscles were positive to TRPC6 antigen and co-expressed the neurofilament 200kDa. These cells were not positive for peripherin. While the TRPC6 blockers decreased the pressor response to static contraction (-32 to -42%; P &lt; 0.05) and passive stretch (-35 to 52%; P &lt; 0.05), the positive modulator increased both of these responses (55 to 65%; P &lt; 0.05). In addition, BI-749327 decreased the peak and integrated RSNA responses to both static contraction (-39 to -43%; P &lt; 0.05) and passive stretch (-56 to -62%; P &lt; 0.05) whereas C20 increased these responses to stretch only (55 to 235%; P &lt; 0.05). All of these results were not replicated when the drugs were injected intravenously or when the vehicle of the drug was injected into the superficial epigastric artery. Collectively, our results showed that TRPC6 play a key role in evoking the mechanical component of the exercise pressor reflex in male rats. Supported by NIH grants HL 161160, HL 156594 and HL 156513. 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.

Beneficial Effect of Heat Treatment on the Exercise Pressor Reflex in Hindlimb Ischemia-Reperfusion: Potential Role of P2X3

PURPOSE: In peripheral artery disease (PAD), a greater blood pressure (BP) response during exercise causes cardiovascular and cerebrovascular risks. The exercise pressor reflex (EPR) is a key factor for why BP is exaggerated in PAD patients. Thus, we examined the effect of heat treatment (HT) with two temperature increments in skeletal muscle: 1.5 and 3oC on the EPR response following limb ischemia-reperfusion (IR) injury, one of the most common pathological conditions seen in PAD. In addition, the P2X3 (an ATP-sensitive receptor) in the muscle afferent dorsal root ganglion (DRG) was also evaluated. We hypothesized that IR upregulates the BP response to static muscle contraction and the protein expression of P2X3 in muscle afferent nerves. HT attenuates those exaggerated responses. METHODS: An experimental IR model was induced by 6 hours of ischemia followed by 18 hours of reperfusion in rats (IR rats). For HT groups, three HT sessions (muscle temperature increased by 1.5 or 3oC) for 30 mins/each time were applied. EPR response was evoked by static muscle contraction (30s). Protein expression of the P2X3 receptor in DRGs was examined. Data are presented as mean ± standard deviation. Results: The mean arterial pressure (MAP) response to the static muscle contraction was significantly exaggerated in rats of IR 18h (vs. Sham, P=0.018). With increasing Tm by 1.5°C, there was a promising trend that thus exaggerated BP response was attenuated (IR 18h + HT 1.5°C, n=5 vs. IR 18h rats, n=5, P=0.08). Meanwhile, the exaggerated BP response was significantly attenuated with the Tm increasing by 3°C (IR 18h + HT 3°C, n=5, vs. IR 18h rats, n=5, P=0.032). The expression of the P2X3 receptor was significantly enhanced in the DRGs of IR 18h rats (n=4, p&lt;0.01 vs. sham, n=6). The upregulated P2X3 was suppressed in the DRGs of IR 18h rats +HT of 1.5°C (n=3, p&lt;0.01 vs. IR 18h, n=4) and there was a promising trend that upregulated P2X3 was suppressed in the DRGs of IR 18h rats +HT of 3°C (n=3, P=0.079 vs. IR 18h, n=4). CONCLUSION: IR injury leads to upregulation of EPR response and this effect was attenuated by HT. The P2X3 signaling pathways are likely involved in the beneficial regulatory effect of HT on EPR in IR. Further data collection will be performed to test this conclusion. Supported by NIH R01 HL141198 &amp; HL164571; AHA GRANT # 940567/Lu Qin/2022; and College of Medicine DOM Innovation and Inspiration Award. The authors sincerely thank Chunying Yang for the excellent technical assistance. 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.

Effects of acute whole-body and lower limb heating on hemodynamic responses to walking in patients with peripheral artery disease

Background: The exercise pressor reflex is exaggerated in patients with peripheral artery disease (PAD). There has been speculation regarding cardiovascular benefits of heating therapy for patients with PAD. The impact of acute leg heating and whole-body heating on hemodynamic responses during walking remains incompletely understood. The purpose of this study was to evaluate the effects of acute whole-body and lower leg heating on hemodynamic responses to walking in both patients with PAD and healthy control subjects. Hypothesis: We hypothesized that both acute whole-body and lower leg heating would attenuate the pressor response to walking in patients with PAD. Methods: 10 PAD patients (68 ± 7 yrs; Male/Female, N = 7/3) and 8 age-matched healthy control subjects (64 ± 5 yrs, Male/Female, N = 5/3) participated in this study. The treadmill walking test followed the Gardner protocol, involving a constant speed of 2 mph with a 2%-grade increment every 2 minutes. The study encompassed 3 trials/visits: 1) non-heating (control), 2) post leg heating, and 3) post whole-body heating. The order of these visits was randomized. During the leg heating visit, the subjects' lower limbs (below the knees) were immersed in warm water (40-42℃) for 30 minutes. Whole-body heating was administered by outfitting the subjects in a tube-lined heating suit until their internal temperature increased by 0.3℃ (~ 45 min). Hemodynamic responses were assessed by comparing the average systolic blood pressure (SBP) and heart rate (HR) during the last 3 stages of treadmill walking with baseline values. Results: Resting SBP and HR did not exhibit significant differences between groups (all P &gt; 0.05). During the control visit, the increase in SBP due to treadmill walking was significantly (P = 0.04) higher in patients with PAD than in healthy subjects. No group differences were observed in the increase in HR by treadmill walking. The responses in SBP and HR to treadmill walking, following leg heating, were comparable to those observed in the control visit for both groups (all P &gt; 0.05). Compared to the control visit, whole-body heating significantly attenuated the SBP (ΔSBP%, 32.9 ± 13.5 vs. 21.3 ± 9.5 %, P = 0.02) and HR responses (ΔHR%, 61.6 ± 24.3 vs. 42.7 ± 15.6 %, P = 0.03) to treadmill walking in PAD. However, in healthy subjects after whole-body heating, these responses were not different from the control visit (both P &gt; 0.05). Neither whole-body nor leg heating had any impact on the walking distance in patients with PAD. Discussion and Conclusion: Acute whole-body heating significantly attenuated the pressor response to walking in patients with PAD, while lower leg heating exhibited no such impact. These findings suggest potential benefits of acute whole-body heating for patients with PAD. We speculate that the comprehensive systemic adjustments by whole-body heat exposure play a pivotal role in improving the exaggerated pressor response to exercise in PAD. Conversely, local lower leg heating, as observed in our study, seems insuffcient to change the hemodynamic response to exercise in patients with PAD. This study was supported by NIH R01 HL141198 and R01 HL144781. 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.

Role of ASIC3 in Evoking the Exercise Pressor Reflex in Type 1 Diabetes Mellitus Rats

Previous studies have suggested that the exercise pressor reflex is exaggerated in individuals with type 1 diabetes mellitus (T1DM); however, the mechanisms responsible for this altered reflex are poorly understood. Acid-sensing ion channel 3 (ASIC3) likely contributes to this exaggeration as previous studies found that peripheral blockade, as well as functional knockout (KO) of the ASIC3 gene, prevented the exaggeration of exercise pressor reflex in rats with cardiovascular-related diseases. However, whether ASIC3 plays a similar role in the exaggerated exercise pressor reflex in T1DM is currently unknown. Therefore, the purpose of this study was to determine whether ASIC3 contributes to the exaggerated exercise pressor reflex in T1DM rats. We hypothesized that the exaggerated exercise pressor reflex would be attenuated in ASIC3 KO T1DM rats compared to their wild-type (WT) counterparts. To test this, we used adult, male and female Wistar-Kyoto ASIC3 KO (n=3; body weight: 348 ± 84 g) and WT counterparts (n=5; body weight: 318 ± 112 g) rats. Streptozotocin (50 mg/kg) was injected intraperitoneally in fasted anesthetized rats to induce T1DM, and a random blood glucose over 300 mg/dl was used to diagnose diabetes. One week later, the exercise pressor reflex was evoked in unanesthetized, decerebrated rats by statically contracting the hindlimb muscles for 30 s. Peak mean arterial pressure (MAP) and heart rate (HR) were calculated as the highest change (Δ) during 30 s contraction baseline. We found that the peak pressor and cardioaccelerator responses to static contraction, although is not statistically significant, appear to be lower in ASIC3 KO (ΔMAP: 17 ± 14 mmHg; ΔHR: 13 ± 12 bpm), compared to WT rats (ΔMAP: 23 ± 11 mmHg; P=0.26 ΔHR:23 ± 9 bpm; P=0.11). Furthermore, we found that within female rats, the peak pressor and heart rate responses were lower in ASIC3 KO (n=1) rat (ΔMAP: 7 mmHg; ΔHR: 15 bpm) compared to WT rats (n=3) (ΔMAP: 27 ± 12 mmHg; ΔHR: 27 ± 11 bpm). Our preliminary findings suggest that ASIC3 may play a role in the exaggerated exercise pressor reflex in T1DM rats and that sex differences may also be present. Further studies involving larger sample sizes will reveal if trends from the current results become significant. This project was supported by NIH R01HL 166323-01A1. 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.

Sleep Duration Irregularity is Associated with Elevated Blood Pressure During Submaximal Exercise in Young Adults.

Irregularity in nightly sleep duration is reported to associate with elevated blood pressure (BP), but it is unclear whether this association can be observed with BP measured during exercise after controlling for factors known to influence the exercise pressor reflex. Twenty-nine young adults (22±4y; 19 men, 10 women) performed cycling exercise until volitional fatigue to assess peak oxygen uptake (VO2). Actigraphy was used to monitor sleep duration and daily physical activity for seven consecutive days after which participants completed two bouts of moderate-intensity cycling while BP and VO2 were measured using a Tango+ device and indirect calorimetry, respectively. Systolic BP was averaged from the two bouts of exercise and expressed as a change from seated rest (∆SBP). Sleep duration regularity was calculated as standard deviation (SD) and coefficient of variation (CV). Systolic BP at seated rest, during exercise, and ∆SBP was 113±13, 152±21, and 38±13 mmHg, respectively. Sleep duration SD (range 10-146 min) and sleep duration CV (range 2-54%) when excluding weekend nights were significantly correlated with ∆SBP (r = 0.58 and r = 0.62, respectively; both p<0.01) after adjusting for age, sex, body mass index, peak VO2, physical activity, resting systolic BP, chronotype, and the VO2 response to exercise. Sleep duration regularity analyzed with weekend nights included (across all seven days) was also significantly correlated with ∆SBP (p≤0.01), but had weaker correlation coefficients. These results indicate that sleep regularity, especially when excluding weekend nights, is associated with the rise in systolic BP during moderate-intensity exercise in young adults. Sleep duration regularity may be a useful tool to capture the impact of intermittent nights of insufficient sleep on BP dysregulation.

Endomorphin-2 and oxycodone paradoxically potentiate the exercise pressor reflex via acid-sensing ion channel 3 (ASIC3) in decerebrated rat

The exercise pressor reflex is evoked by the stimulation of group III and IV muscle afferents in response to muscle contractions. When the contracting muscles are freely perfused, acid-sensing ion channel 3 (ASIC3) on the endings of group IV afferents appear to play a minor role in evoking the exercise pressor reflex. We recently showed in isolated dorsal root ganglion (DRG) neurons innervating the gastrocnemius muscles that two μ opioid receptor agonists, namely endomorphin-2, and oxycodone, potentiated the sustained inward ASIC3 current evoked by acidic saline (pH 6.0). This in vitro finding prompted us to investigate whether endomorphin-2 and oxycodone, when infused into the arterial supply of freely perfused contracting hindlimb muscles, could potentiate the exercise pressor reflex. We found that infusing endomorphin-2 and naloxone (a μ opioid receptor antagonist) into the superficial epigastric artery of decerebrated unanesthetized rats potentiated the peak and integrated pressor responses to static contraction of the triceps surae muscles. The opioid-induced potentiation of the pressor responses to contraction were prevented by infusion of APETx2, an ASIC3 antagonist. Specifically, the peak pressor response to contraction averaged 19.3 ± 5.6 mmHg for control (n=10), 27.2 ± 8.1 mmHg after naloxone and endomorphin-2 infusion (n=10), and 20 ± 8 mmHg after APETx2 and endomorphin-2 infusion (n=10). Infusion of endomorphin-2 and naloxone did not potentiate the pressor responses to contraction in ASIC3 knockout rats (n=6), averaging 21.5 ± 7.7 mmHg for control (n=6), 20 ± 6.2 mmHg after naloxone and endomorphin-2 infusion (n=6), and 19.8 ± 6.9 mmHg after APETx2 and endomorphin-2 infusion (n=4). Similar findings were observed when oxycodone was substituted for endomorphin-2. Specifically, the peak pressor response to contraction averaged 24.3 ± 8.9 mmHg for control (n=10), 33.9 ± 10.6 mmHg after naloxone and oxycodone were infused (n=10), and 26.8 ± 8.1 mmHg after APETx2 and oxycodone were infused (n=10). Altogether, our data strongly suggest that ASIC3 stimulation by mu opioid agonists can potentiate the exercise pressor reflex, provided that mu opioid receptors on group III and IV afferents are not operative. (Supported by HL156594 and HL 156513). HL156594 and HL 156513. 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.

Exercise Pressor Reflex Function Is Exacerbated in Decerebrate Adenine-Induced Chronic Kidney Disease Rats

Cardiovascular disease is the leading cause of death in chronic kidney disease (CKD). While the underlying mechanisms are not completely understood, elevated sympathetic nerve activity (SNA) and exercise intolerance are thought to play an important role. In normal physiological conditions, sympathetic modulation of the cardiovascular system during physical activity is largely governed by a peripheral neural reflex originating in contracting skeletal muscle, known as the exercise pressor reflex (EPR). Pioneering work by Park et al. demonstrated that CKD patients exhibited abnormal SNA and blood pressure (BP) elevations during both static and rhythmic handgrip exercise, suggesting an overactive EPR. However, due to experimental design constraints inherent to humans, the contribution of the EPR to the augmented SNA and BP responses to exercise could not be fully addressed. Therefore, the purpose of this study was to specifically test EPR function in CKD using a reduced animal model. Sprague-Dawley rats were randomly assigned to receive either a powdered chow diet containing adenine (0.25%w/w in feed) to induce CKD or a powdered chow diet alone (control group) for 12 weeks. Subsequently, in decerbrate animals, we measured mean arterial pressure (MAP) and renal SNA (RSNA) in response to isolated EPR activation during hindlimb muscle contraction (i.e., simulated exercise). We further assessed cardiovascular and sympathetic responses to passive muscle stretch to stimulate the mechanoreflex (i.e., activation of the mechanically-sesnsitive component of the EPR), and intra-arterial capsaicin administratration to activate the metaboflex (i.e., stimulation of the metabolically-sensitive component of the EPR). After completion of the diet, levels of plasma creatinine were significantly increased in adenine-fed rats compared to control rats (2.57±1.05 vs. 0.34±0.05 mg/dL, P&lt;0.01), suggesting impaired renal function (i.e., adenine-induced CKD). We found that CKD animals exhibited augmentations in RSNA (Δ=153±75 vs. 61±50 %, P&lt;0.05) and MAP (Δ=35±18 vs. 17±8 mmHg, P&lt;0.05) in response to muscle contraction when compared to control animals. Importantly, the muscle tension developed during contraction was similar between the two groups (Δ=0.9±0.2 vs. 1.0±0.3 kg, P&gt;0.1, CKD vs. control). During stimulation of the mechanoreflex, CKD rats also exhibited significantly greater RSNA (Δ=100±54 vs. 32±26 %, P&lt;0.05) and MAP responses (Δ=25±14 vs. 10±7 mmHg, P&lt;0.05) than control rats. The developed muscle tension during passive stretch was similar between the two groups (Δ=0.9±0.2 vs. 1.0±0.4 kg, P&gt;0.1, CKD vs. control). There was a tendency for the responses to metaboreflex activation to be heightened in the CKD group compared with the control group, but the difference did not reach statistical significance (ΔRSNA=212±68 vs. 107±105 %, P=0.06, ΔMAP=67±12 vs. 48±21 mmHg, P=0.06, CKD vs. control, respectively). Our findings suggest that EPR function, particularly muscle mechanoreflex function, is exaggerated in CKD, leading to sympathetic activation and hypertensive responses during exercise. P30 DK079307 Subaward to H.K. and R01HL-133179 to W.V. 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.

Blunted Exercise Pressor Reflex in Individuals with Down Syndrome

INTRODUCTION: Individuals with Down syndrome (DS) exhibit autonomic dysfunction, which contributes to reduced work capacity. The chemically sensitive component of the exercise pressor reflex, the metaboreflex, is responsible for exercise-induced sympathoexcitation and can be assessed via post-exercise muscle ischemia (PEMI). Blunted sympathoexcitation is common in individuals with DS and contributes to the physiological basis for reduced work capacity observed this population, but the influence of the metaboreflex is unknown. Using unilateral isometric knee extension exercise with PEMI, we hypothesized that individuals with DS would demonstrate a reduced metaboreflex compared to individuals without DS. METHODS: Twenty-four individuals with DS (M/F: 13/11; 24±5yrs; 30.3±6.2kg/m2) and without DS (M/F: 13/11; 25±4yrs; 26.5±4.5kg/m2) performed a unilateral isometric knee extension at 30% of their maximal voluntary contraction using their dominant leg on a leg dynamometer. Following 2-min of contraction, a thigh-cuff was rapidly inflated to 220 mmHg on the exercised leg for 3-min to isolate the activation of the muscle metaboreflex via PEMI. Beat-to-beat systolic blood pressure (SBP), stroke volume (SV), mean arterial pressure (MAP), and cardiac output (CO) were assessed using finger photoplethysmography coupled with Modelflow. Heart rate (HR) was collected via three-lead electrocardiogram. RESULTS: Despite similar baseline values of all variables in both groups, individuals with DS demonstrated a blunted pressor response to the isometric knee extension compared to individuals without DS (SBP; DS: 133±17 vs. Non-DS: 167±28 mmHg), and the blunted SBP response was maintained with PEMI (SBP; DS: 124±19 vs. Non-DS: 150±21 mmHg; time × group interaction, p&lt;0.001). Individuals with DS also exhibited a reduced HR 2-min into the contraction compared to those without DS (HR; DS: 90±16 vs. Non-DS: 114±22 bpm; timexgroup interaction, p&lt;0.001). Controlling for MVC, BMI, peak torque/body weight, and quadricep fat &amp; lean mass did not impact our results. Further, individuals with DS had a lower SV during the PEMI compared to individuals without DS (SV; DS: 93±24 vs. Non-DS: 113±23 mL/min; timexgroup interaction, p=0.003). CONCLUSION: Individuals with DS demonstrated a diminished metaboreflex response compared to their peers without DS, during a task known to induce sympathoexcitation, even when controlling for MVC. Our novel findings suggest that reduced influence of the metaboreflex contributes to the reduced exercise pressor response in persons with DS. Such exercise-specific peripheral autonomic perturbations contribute beyond our previous cardiac autonomic findings demonstrating blunted sympathoexcitatory perturbations in persons with DS, which likely contribute to reduced work capacity for this population. This research was funded in part by the American College of Sports Medicine Doctoral Research Award (#21-01558). 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.

What Is the Role of the Carotid Baroreflex in Exaggerating the Exercise Pressor Reflex in Male UCD-Type 2 Diabetes Mellitus Rats?

Previous studies have shown that exercise evokes an excessive increase in blood pressure in individuals with type 2 diabetes mellitus (T2DM), which is mediated, in part, by an altered exercise pressor reflex. Importantly, in healthy individuals the arterial baroreflex modulates the pressor response to exercise; however, the effects of T2DM on this modulatory effect of the baroreflex remain unclear. Therefore, the purpose of this study was to characterize the arterial baroreflex function in T2DM rats and to determine whether the carotid baroreflex plays a role in exaggerating the exercise pressor reflex. We hypothesized that T2DM rats would present a baroreflex dysfunction that likely contributes to the exaggerated pressor response during muscle contraction. Experiments were performed on adult (8 ± 2 months old), male University of California Davis (UCD)-T2DM ( n=7; body weight: 640 ± 43 g) and healthy Sprague-Dawley rats ( n=3; body weight: 485 ± 29 g). Female rats were not included in this study because they become diabetic when they are much older (&gt;10 months old). Cardiac baroreflex function was characterized in anesthetized T2DM and healthy rats using the modified Oxford technique, which involved sequential bolus infusions of sodium nitroprusside (10 μg/kg) and phenylephrine (10 μg/kg) to induce blood pressure decreases and increases, respectively. Overall cardiac baroreflex gain (i.e., slope of the relationship between systolic blood pressure and R-R interval) was calculated using logistic regression, while gains to blood pressure falling and rising were calculated separately using piecewise and linear regression. The role of the carotid baroreflex in exaggerating the exercise pressor reflex was tested by statically contracting the hindlimb muscles for 30 s after surgical sinoaortic denervation (SAD) in decerebrated T2DM ( n=1; body weight: 555 g) and healthy ( n=1; body weight: 519 g) rats. Carotid barointact T2DM ( n=8; body weight: 521 ± 38 g) and healthy rats ( n=8; body weight: 482 ± 56 g) were included as controls. The pressor responses were calculated as a change (Δ) in peak mean arterial pressure during 30 s contraction relative to baseline. Data are presented as mean ± SD. T2DM rats presented with lower overall baroreflex sensitivity (T2DM: 0.07 ± 0.02 ms/mmHg, healthy: 0.61 ± 0.81 ms/mmHg, p=0.044), as well as sensitivity to increases in blood pressure (T2DM: 0.14 ± 0.10 ms/mmHg , healthy: 0.28 ± 0.15 ms/mmHg, p=0.049) compared to healthy controls. In contrast, cardiac baroreflex gain during decreases in blood pressure were not different between groups (T2DM: 0.16 ± 0.07 ms/mmHg, healthy: 0.10 ± 0.06 ms/mmHg, p=0.109). Notably, SAD did not alter blood pressure response to muscle contraction in the T2DM rat (SAD: Δ32 mmHg vs barointact: Δ32 ± 12 mmHg), but evoked an exaggerated blood pressure response in healthy rat (SAD: Δ34 mmHg vs barointact: Δ12 ± 3 mmHg). Our preliminary findings suggest that despite an attenuated cardiac baroreflex function in T2DM rats, specifically during acute increases in blood pressure, carotid baroreflex dysfunction may not contribute significantly to the exaggerated exercise pressor reflex in diabetes. This project was supported by NIH R01 HL144723. 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.

Neuro-inflammatory interactions as a mediator of the Exaggerated Exercise Pressor Reflex (EPR) in a mouse model of Peripheral Artery Disease

Introduction and rationale: The Exercise pressor reflex (EPR) is a physiological mechanism in which the contraction of skeletal muscle results in a rise in heart rate (HR) and mean arterial pressure (MAP). In patients with Peripheral Artery Disease (PAD), this reflex is exaggerated, leading to abnormally high elevations in blood pressure during exercise. These cardiovascular responses in patients with PAD have been linked to increased morbidity and mortality, thus limiting the prescription of exercise for these patients. Using a novel murine model of the EPR, our laboratory has demonstrated that mice with femoral artery ligation (a well-established model of PAD), exhibit augmented increases in MAP which is mediated by PIEZO2 positive, mechanosensitive afferent neurons. We have demonstrated that inhibition of PIEZO2 expressing channels normalizes the MAP response to exercise. Patients with PAD also display increased macrophage infiltration in their ischemia-injured limbs, indicating a pro-inflammatory environment. Sensory neurons have been reported to detect various signals produced by immune cells including IL-1β and TNFα. The immune-derived signals can sensitize the peripheral terminals of the sensory neurons, thereby reducing their firing threshold and increasing their responsiveness. Previous studies have also reported the enhancement of Piezo2-mediated mechanosensitive currents in the presence of inflammatory signals. Hypothesis: We, therefore, hypothesize that in mice with femoral artery ligation, muscle inflammation increases the expression and activation of resident ion channels (e.g., Piezo2) in mechanosensitive afferent neurons to mediate the exaggerated EPR in PAD.Study objective: To mechanistically investigate the interaction between muscle inflammation and Piezo2 in mechanosensitive afferent neurons.Methods: We performed sham surgery or ligation of the femoral artery ipsilaterally in C57BL/6 mice. After 72 hours, we harvested the gastrocnemius muscle for histological and molecular analyses.Data and summary and results: Our preliminary findings reveal that there is significantly increased expression of pro-inflammatory genes and infiltrating immune cells in the ischemic muscle when compared to non-ischemic muscle.Specifically, H&amp;E staining revealed the presence and accumulation of inflammatory cells, including macrophages, in the ischemic muscle compared to control, along with observed necrosis. Transcript analysis of the ischemic gastrocnemius muscle showed significantly increased IL-1β and TNFα, two pan-proinflammatory genes that encode cytokines released by macrophages. TNFα is known to induce the synthesis of adhesion molecules (E-selectin and ICAM-1) on endothelial cells, allowing leukocytes to adhere and cross the endothelial wall into the injured tissue. Indeed, we observed significantly increased ICAM-1 and E-selectin transcripts in the ischemic muscle compared to controls. MCP1, a well-established chemokine, was also significantly increased, further emphasizing the recruitment of leukocytes to the ischemic muscle. In addition, inducible NOS ( iNOS), which is known to be expressed in IL-1β- and TNFα-rich proinflammatory environment was also significantly increased in our FAL model compared to Sham. These data establish that the ischemic muscle of a femoral-artery ligated mouse has a high proinflammatory phenotype. We are currently exploring the impact of proinflammatory mediators on Piezo2 channel expression and activity, as well as the effect of macrophage depletion on Piezo2 in afferent neurons. The data from these studies will provide novel insights regarding the influence of neuroimmune interactions on cardiovascular responses to exercise in PAD. These data hold the potential to reveal innovative therapies enabling safe prescription of exercise, thus alleviating the burden of PAD, and improving the quality of life for those affected by this condition. Internal sources. 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.

Disrupted Phosphorylated Phosphoinositide 3-kinase in the NTS of Type 2 Diabetic Rats

The hallmark of type 2 diabetes mellitus (T2DM) is systemic insulin resistance, where insulin signaling is impaired, blood glucose is chronically elevated, and various pathophysiological processes ensue. Much is known about the cardiovascular and metabolic consequences of T2DM. However, the impact of T2DM on autonomic nervous system function remains to be fully elucidated. Increasing evidence suggests that in both human and animal models of T2DM, the exercise pressor reflex (EPR) is abnormally augmented, characterized by heightened cardiovascular and sympathetic responses to physical activity. The underlying mechanisms are still not completely understood. Our recent studies suggest that T2DM induces alterations in peripheral somatosensory nerve activity that could explain the augmented EPR function. However, it is possible that neurons within the cardiovascular control areas of the brainstem, such as the nucleus tractus solitarius (NTS), could also be impaired by this disease. In the central nervous system, insulin has been shown to hyperpolarize neurons through activation of the phosphoinositide 3-kinase (PI3K) pathway, resulting in reduced neuronal excitability. Therefore, we hypothesized that decreased insulin transport into the brain in T2DM rats, results in increased cellular excitability as evidenced by decreased activity of the PI3K pathway in the NTS. Purpose: The aim of this study was to examine alterations in brain insulin levels and the PI3K pathway in T2DM rats as compared to control rats. Methods: Control rats were fed a low fat control diet (13% fat, 67.8% carbohydrate, and 19.2% protein) for 12-16 wks, while T2DM were generated by two low dose bolus injections of i.p. streptozotocin (35mg/kg, week 1; 25mg/kg week 2) and then fed a high fat diet (42% fat, 42.8% carbohydrate, and 15.2% protein) for 12-16wks. Cerebrospinal fluid (CSF) were collected from control and T2DM rats after an overnight fast. NTS micro-punches were performed, and then total and phosphorylated PI3K protein expressions were examined by the western blot technique. Results: CSF insulin was significantly decreased in T2DM rats as compared to control rats (0.41 ± 0.19 vs 0.11 ± 0.05 (ng/mL), Control (n=14) vs T2DM (n=4), p&lt;0.01). Total PI3K expression in the NTS did not differ between control and T2DM (1.0 ± 0.2 vs 1.1 ± 0.2 (au), Control (n=9) vs T2DM (n=9), P=0.172). However, phosphorylated PI3K expression in the NTS of T2DM was significantly decreased as compared with control animals (1.0 ± 0.2 vs 0.8 ± 0.1 (au), Control (n=9) vs T2DM (n=9), p&lt;0.05). Conclusion: These results suggest that 1) in consistent with earlier studies, insulin transport into the brain is impaired in high fat diet/streptozotocin-induced T2DM animals, and 2) decreased phospho-PI3K signaling in the NTS of diabetic animals is associated with lower brain insulin. Taken together, these alterations may increase neuronal excitability in the NTS, thereby contributing, at least in part, to the exaggerated EPR response to exercise in this disease. Supported by NIH HL-151632 and NIH HL-151632-01S1. 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.

Lactate and hydrogen ions play a predominant role in evoking the exercise pressor reflex during ischaemic contractions but not during freely perfused contractions.

We investigated the role played by lactate and hydrogen in evoking the exercise pressor reflex (EPR) in decerebrated rats whose hindlimb muscles were either freely perfused or ischaemic. Production of lactate and hydrogen by the contracting hindlimb muscles was manipulated by knocking out the myophosphorylase gene (pygm). In knockout rats (pygm-/-; n=13) or wild-type rats (pygm+/+; n=13), the EPR was evoked by isometrically contracting the triceps surae muscles. Blood pressure, tension, blood flow, renal sympathetic nerve activity and blood lactate concentrations were measured. Intramuscular metabolites and pH changes induced by the contractions were quantified by 31P-magnetic resonance spectroscopy (n=5). In a subset of pygm-/- rats (n=5), contractions were evoked with prior infusion of lactate (pH 6.0) in an attempt to restore the effect of lactate and hydrogen ions. Contraction of freely perfused muscles increased blood lactate and decreased muscle pH in pygm+/+ rats only. Despite these differences, the reflex pressor and sympathetic responses to freely perfused contraction did not differ between groups (P=0.992). During ischaemia, contraction increased muscle lactate and hydrogen ion production in pygm+/+ rats (P<0.0134), whereas it had no effect in pygm-/- rats (P>0.783). Likewise, ischaemia exaggerated the reflex pressor, and sympathetic responses to contraction in pygm+/+ but not in pygm-/- rats. This exaggeration was restored when a solution of lactate (pH 6.0) was infused prior to the contraction in pygm-/- rats. We conclude that lactate and hydrogen accumulation in contracting myocytes play a key role in evoking the metabolic component of the EPR during ischaemic but not during freely perfused contractions. KEY POINTS: Conflicting results exist about the role played by lactate and hydrogen ions in evoking the exercise pressor reflex. Using CRISP-Cas9, we rendered the myophosphorylase gene non-functional to block the production of lactate and hydrogen ions. The exercise pressor reflex was evoked in decerebrated rats by statically contracting the triceps surae muscles with or without muscle ischaemia. Static contraction elevated the concentration of lactate and hydrogen ions in pygm+/+ but not in pygm-/- rats. Despite these differences, the exercise pressor reflex was not different between groups. Acute muscle ischaemia exaggerated the concentration of lactate and hydrogen ions in pygm+/+ but not in pygm-/- rats. Likewise, acute muscle ischaemia exaggerated the exercise pressor reflex in pygm+/+ but not in pygm-/- rats. We conclude that lactate and hydrogen play a key role in evoking the exercise pressor reflex during ischaemic but not during freely perfused contractions.

Cyclooxygenase products contribute to the exaggerated exercise pressor reflex evoked by static muscle contraction in male UCD-type 2 diabetes mellitus rats.

Cyclooxygenase (COX) products of arachidonic acid metabolism, specifically prostaglandins, play a role in evoking and transmitting the exercise pressor reflex in health and disease. Individuals with type 2 diabetes mellitus (T2DM) have an exaggerated exercise pressor reflex; however, the mechanisms for this exaggerated reflex are not fully understood. We aimed to determine the role played by COX products in the exaggerated exercise pressor reflex in T2DM rats. The exercise pressor reflex was evoked by static muscle contraction in unanesthetized, decerebrate, male, adult University of California Davis (UCD)-T2DM (n = 8) and healthy Sprague-Dawley (n = 8) rats. Changes (Δ) in peak mean arterial pressure (MAP) and heart rate (HR) during muscle contraction were compared before and after intra-arterial injection of indomethacin (1 mg/kg) into the contracting hindlimb. Data are presented as means ± SD. Inhibition of COX activity attenuated the exaggerated peak MAP (Before: Δ32 ± 13 mmHg and After: Δ18 ± 8 mmHg; P = 0.004) and blood pressor index (BPi) (Before: Δ683 ± 324 mmHg·s and After: Δ361 ± 222 mmHg·s; P = 0.006), but not HR (Before: Δ23 ± 8 beats/min and After Δ19 ± 10 beats/min; P = 0.452) responses to muscle contraction in T2DM rats. In healthy rats, COX activity inhibition did not affect MAP, HR, or BPi responses to muscle contraction. Inhibition of COX activity significantly reduced local production of prostaglandin E2 in T2DM and healthy rats. We conclude that peripheral inhibition of COX activity attenuates the pressor response to muscle contraction in T2DM rats, suggesting that COX products partially contribute to the exaggerated exercise pressor reflex in those with T2DM.NEW & NOTEWORTHY We compared the pressor and cardioaccelerator responses to static muscle contraction before and after inhibition of cyclooxygenase (COX) activity within the contracting hindlimb in decerebrate, unanesthetized type 2 diabetic mellitus (T2DM) and healthy rats. The pressor responses to muscle contraction were attenuated after peripheral inhibition of COX activity in T2DM but not in healthy rats. We concluded that COX products partially contribute to the exaggerated pressor reflex in those with T2DM.

Paradoxical potentiation of the exercise pressor reflex by endomorphin 2 in the presence of naloxone.

When contracting muscles are freely perfused, the acid-sensing ion channel 3 (ASIC3) on group IV afferents plays a minor role in evoking the exercise pressor reflex. We recently showed in isolated dorsal root ganglion neurons innervating the gastrocnemius muscles that two mu opioid receptor agonists, namely endomorphin 2 and oxycodone, potentiated the sustained inward ASIC3 current evoked by acidic solutions. This in vitro finding prompted us to determine whether endomorphin 2 and oxycodone, when infused into the arterial supply of freely perfused contracting hindlimb muscles, potentiated the exercise pressor reflex. We found that infusion of endomorphin 2 and naloxone in decerebrated rats potentiated the pressor responses to contraction of the triceps surae muscles. The endomorphin 2-induced potentiation of the pressor responses to contraction was prevented by infusion of APETx2, an ASIC3 antagonist. Specifically, the peak pressor response to contraction averaged 19.3 ± 5.6 mmHg for control (n = 10), 27.2 ± 8.1 mmHg after naloxone and endomorphin 2 infusion (n = 10), and 20 ± 8 mmHg after APETx2 and endomorphin 2 infusion (n = 10). Infusion of endomorphin 2 and naloxone did not potentiate the pressor responses to contraction in ASIC3 knockout rats (n = 6). Partly similar findings were observed when oxycodone was substituted for endomorphin 2. Oxycodone infusion significantly increased the exercise pressor reflex over its control level, but subsequent APETx2 infusion failed to restore the increase to its control level (n = 9). The peak pressor response averaged 23.1 ± 8.6 mmHg for control (n = 9), 33.2 ± 11 mmHg after naloxone and oxycodone were infused (n = 9), and 27 ± 8.6 mmHg after APETx2 and oxycodone were infused (n = 9). Our data suggest that after opioid receptor blockade, ASIC3 stimulation by the endogenous mu opioid, endomorphin 2, potentiated the exercise pressor reflex.NEW & NOTEWORTHY This paper provides the first in vivo evidence that endomorphin 2, an endogenous opioid peptide, can paradoxically increase the magnitude of the exercise pressor reflex by an ASIC3-dependent mechanism even when the contracting muscles are freely perfused.