J Appl Physiol. 2005 Jan;98(1):186-92. Epub 2004 Mar 19.

 


Chronic intermittent hypoxia and incremental cycling exercise independently depress muscle in vitro maximal Na+-K+-ATPase activity in well-trained athletes.

Aughey RJ, Gore CJ, Hahn AG, Garnham AP, Clark SA, Petersen AC, Roberts AD, McKenna MJ.

School of Human Movement, Recreation and Performance (FO22) Victoria University of Technology, P.O. Box 14428, MCMC, Melbourne, Victoria 8001, Australia.

Athletes commonly attempt to enhance performance by training in normoxia but sleeping in hypoxia [live high and train low (LHTL)]. However, chronic hypoxia reduces muscle Na(+)-K(+)-ATPase content, whereas fatiguing contractions reduce Na(+)-K(+)-ATPase activity, which each may impair performance. We examined whether LHTL and intense exercise would decrease muscle Na(+)-K(+)-ATPase activity and whether these effects would be additive and sufficient to impair performance or plasma K(+) regulation. Thirteen subjects were randomly assigned to two fitness-matched groups, LHTL (n = 6) or control (Con, n = 7). LHTL slept at simulated moderate altitude (3,000 m, inspired O(2) fraction = 15.48%) for 23 nights and lived and trained by day under normoxic conditions in Canberra (altitude approximately 600 m). Con lived, trained, and slept in normoxia. A standardized incremental exercise test was conducted before and after LHTL. A vastus lateralis muscle biopsy was taken at rest and after exercise, before and after LHTL or Con, and analyzed for maximal Na(+)-K(+)-ATPase activity [K(+)-stimulated 3-O-methylfluorescein phosphatase (3-O-MFPase)] and Na(+)-K(+)-ATPase content ([(3)H]ouabain binding sites). 3-O-MFPase activity was decreased by -2.9 +/- 2.6% in LHTL (P < 0.05) and was depressed immediately after exercise (P < 0.05) similarly in Con and LHTL (-13.0 +/- 3.2 and -11.8 +/- 1.5%, respectively). Plasma K(+) concentration during exercise was unchanged by LHTL; [(3)H]ouabain binding was unchanged with LHTL or exercise. Peak oxygen consumption was reduced in LHTL (P < 0.05) but not in Con, whereas exercise work was unchanged in either group. Thus LHTL had a minor effect on, and incremental exercise reduced, Na(+)-K(+)-ATPase activity. However, the small LHTL-induced depression of 3-O-MFPase activity was insufficient to adversely affect either K(+) regulation or total work performed.

Publication Types:

·         Clinical Trial

·         Randomized Controlled Trial

Med Sci Sports Exerc. 2005 Jan;37(1):138-46.

 

Click here to read  
Effects of hypoxic interval training on cycling performance.

Roels B, Millet GP, Marcoux CJ, Coste O, Bentley DJ, Candau RB.

UPRES EA 3759 Faculty of Sport Sciences, 700 avenue Pic St Loup, 34090 Montpellier, France. belle.roels@univ-montpl.fr

PURPOSE: The aim of this study was to test the hypothesis that intermittent hypoxic interval training improves sea level cycling performance more than equivalent training in hypoxia or normoxia. METHODS: Thirty-three well-trained cyclists and triathletes (25.9 +/- 2.7 yr, VO(2max) 66.1 +/- 6.1 mL.min(-1).kg(-1)) were divided into three groups: intermittent hypoxic (IHT, N = 11, P(I)O(2) of 100 mm Hg), intermittent hypoxic interval training (IHIT, N = 11) and normoxia (Nor, N = 11, P(I)O(2) of 160 mm Hg) and completed a 7-wk training program, consisting of two high-intensity (100 or 90% relative peak power output) interval training sessions each week. Each interval training session was performed in a laboratory on the subject's own bicycle, in normoxic or hypoxic conditions for the Nor and the IHT group, respectively. The IHIT group performed warm-up and cool-down plus recovery from each interval in hypoxic conditions. In contrast to IHT, interval exercise bouts were performed in normoxic conditions. RESULTS: Mean power output during a 10-min cycle time trial improved after the first 4 wk of training by 5.2 +/- 3.9, 3.7 +/- 5.9, and 5.0 +/- 3.4% for IHIT, IHT, and Nor, respectively, without significant differences between groups. Moreover, mean power output did not show any significant improvement in the following 3 wk in any group. VO(2max) (L.min(-1)) increased only in IHIT during the training period (8.7 +/- 9.1%; P < 0.05). No changes in cycling efficiency or in hematological variables (P > 0.05) were observed. CONCLUSION: Four weeks of interval training induced an improvement in endurance performance. However, short-term exposure to hypoxia (approximately 114 min.wk(-1)) did not elicit a greater increase in performance or any hematological modifications.

J Appl Physiol. 2005 Jan;98(1):186-92. Epub 2004 Mar 19.

 

Click here to read  
Chronic intermittent hypoxia and incremental cycling exercise independently depress muscle in vitro maximal Na+-K+-ATPase activity in well-trained athletes.

Aughey RJ, Gore CJ, Hahn AG, Garnham AP, Clark SA, Petersen AC, Roberts AD, McKenna MJ.

School of Human Movement, Recreation and Performance (FO22) Victoria University of Technology, P.O. Box 14428, MCMC, Melbourne, Victoria 8001, Australia.

Athletes commonly attempt to enhance performance by training in normoxia but sleeping in hypoxia [live high and train low (LHTL)]. However, chronic hypoxia reduces muscle Na(+)-K(+)-ATPase content, whereas fatiguing contractions reduce Na(+)-K(+)-ATPase activity, which each may impair performance. We examined whether LHTL and intense exercise would decrease muscle Na(+)-K(+)-ATPase activity and whether these effects would be additive and sufficient to impair performance or plasma K(+) regulation. Thirteen subjects were randomly assigned to two fitness-matched groups, LHTL (n = 6) or control (Con, n = 7). LHTL slept at simulated moderate altitude (3,000 m, inspired O(2) fraction = 15.48%) for 23 nights and lived and trained by day under normoxic conditions in Canberra (altitude approximately 600 m). Con lived, trained, and slept in normoxia. A standardized incremental exercise test was conducted before and after LHTL. A vastus lateralis muscle biopsy was taken at rest and after exercise, before and after LHTL or Con, and analyzed for maximal Na(+)-K(+)-ATPase activity [K(+)-stimulated 3-O-methylfluorescein phosphatase (3-O-MFPase)] and Na(+)-K(+)-ATPase content ([(3)H]ouabain binding sites). 3-O-MFPase activity was decreased by -2.9 +/- 2.6% in LHTL (P < 0.05) and was depressed immediately after exercise (P < 0.05) similarly in Con and LHTL (-13.0 +/- 3.2 and -11.8 +/- 1.5%, respectively). Plasma K(+) concentration during exercise was unchanged by LHTL; [(3)H]ouabain binding was unchanged with LHTL or exercise. Peak oxygen consumption was reduced in LHTL (P < 0.05) but not in Con, whereas exercise work was unchanged in either group. Thus LHTL had a minor effect on, and incremental exercise reduced, Na(+)-K(+)-ATPase activity. However, the small LHTL-induced depression of 3-O-MFPase activity was insufficient to adversely affect either K(+) regulation or total work performed.

Publication Types:

·         Clinical Trial

·         Randomized Controlled Trial

Eur J Appl Physiol. 2005 Mar;93(5-6):701-7. Epub 2004 Nov 25.

 


Aggravated hypoxia during breath-holds after prolonged exercise.

Lindholm P, Gennser M.

Section of Environmental Physiology, Department of Physiology and Pharmacology, Karolinska Institutet, Berzelius vag 13, 17177 Stockholm, Sweden. peter.lindholm@fyfa.ki.se

Hyperventilation prior to breath-hold diving increases the risk of syncope as a result of hypoxia. Recently, a number of cases of near-drownings in which the swimmers did not hyperventilate before breath-hold diving have come to our attention. These individuals had engaged in prolonged exercise prior to breath-hold diving and it is known that such exercise enhances lipid metabolism relative to carbohydrate metabolism, resulting in a lower production of CO(2) per amount of O(2 )consumed. Therefore, our hypothesis was that an exercise-induced increase in lipid metabolism and the associated reduction in the amount of CO(2) produced would cause the urge to breathe to develop at a lower P O(2), thereby increasing the risk of syncope due to hypoxia. Eight experienced breath-hold divers performed 5 or 6 breath-holds at rest in the supine position and then 5 or 6 additional breath-holds during intermittent light ergometer exercise with simultaneous apnoea (dynamic apnoea, DA) on two different days: control (C) and post prolonged sub-maximal exercise (PPE), when the breath-holds were performed 30 min after 2 h of sub-maximal exercise. After C and before the prolonged submaximal exercise subjects were put on a carbohydrate-free diet for 18 h to start the depletion of glycogen. The respiratory exchange ratio ( RER) and end-tidal P CO(2), P O(2), and SaO(2) values were determined and the data were presented as means (SD). The RER prior to breath-holding under control conditions was 0.83 (0.09), whereas the corresponding value after exercise was 0.70 (0.05) ( P <0.01). When the three apnoeas of the longest duration for each subject were analysed, the average duration of the dynamic apnoeas was 96 (14) s under control conditions and 96 (17) s following exercise. Both P O(2) and P CO(2) were higher during the control dynamic apnoeas than after PPE [PO(2) 6.9 (1.0) kPa vs 6.2 (1.2) kPa, P <0.01; P CO(2) 7.8 (0.5) kPa vs 6.7 (0.4) kPa, P <0.001; ANOVA testing]. A similar pattern was observed after breath-holding under resting conditions, i.e., a lower end-tidal P O(2) and P CO(2) after exercise (PPE) compared to control conditions. Our findings demonstrate that under the conditions of a relatively low RER following prolonged exercise, breath-holding is terminated at a lower P O(2) and a lower P CO(2) than under normal conditions. This suggests that elevated lipid metabolism may constitute a risk factor in connection with breath-holding during swimming and diving.

High Alt Med Biol. 2005 Spring;6(1):50-9.

 


Effect of a repeated series of intermittent hypoxic exposures on ventilatory response in humans.

Katayama K, Fujita H, Sato K, Ishida K, Iwasaki K, Miyamura M.

Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan. katayama@htc.nagoya-u.ac.jp

The purpose of this study was to elucidate the magnitude and the time course of ventilatory changes resulting from a repeated series of hypoxic exposures. Eight healthy males participated in the present study. The subjects spent 1 h/day in normobaric hypoxia (12% inspired oxygen). Inspired minute ventilation (V(I)), end-tidal partial pressure of carbon dioxide (P(ET(CO2))), and arterial oxygen saturation (SaO2) were measured in a hypoxic tent. These measurements were taken for 10 consecutive days (series 1), and were taken again after the subjects had been away from hypoxic exposure for 1 month (series 2). P(ET(CO2)) decreased and SaO2 increased progressively in the hypoxic tent during the 10 days of intermittent hypoxia in series 1. At the onset of series 2 (days 1 to 3), P(ET(CO2)) was significantly lower and SaO2 was significantly higher than those on day 1 during series 1. These results suggest that humans who have had previous hypoxic exposure adapt sooner to hypoxic condition due to an increase in the magnitude of hyperventilation in the first few days of a series of reexposures to hypoxia

J Neurosci. 2005 Mar 16;25(11):2925-32.

 


Spinal synaptic enhancement with acute intermittent hypoxia improves respiratory function after chronic cervical spinal cord injury.

Golder FJ, Mitchell GS.

Department of Comparative Biosciences, University of Wisconsin, Madison, Wisconsin 53706, USA. golderf@svm.vetmed.wisc.edu

Respiratory insufficiency is the leading cause of death after high-cervical spinal cord injuries (SCIs). Although respiratory motor recovery can occur with time after injury, the magnitude of spontaneous recovery is limited. We hypothesized that partial respiratory motor recovery after chronic cervical SCI could be strengthened using a known stimulus for spinal synaptic enhancement, intermittent hypoxia. Phrenic motor output was recorded before and after intermittent hypoxia from anesthetized, vagotomized, and pump-ventilated control and C2 spinally hemisected rats at 2, 4, and 8 weeks after injury. Weak spontaneous phrenic motor recovery was present in all C2-injured rats via crossed spinal synaptic pathways that convey bulbospinal inspiratory premotor drive to phrenic motoneurons on the side of injury. Intermittent hypoxia augmented crossed spinal synaptic pathways [phrenic long-term facilitation; pLTF] for up to 60 min after hypoxia at 8 weeks, but not 2 weeks, after injury. Ketanserin, a serotonin 2A receptor antagonist, administered before intermittent hypoxia at 8 weeks after injury prevented pLTF. Serotonergic innervation near phrenic motoneurons was assessed after injury. The limited magnitude of pLTF at 2 weeks was associated with an injury-induced reduction in serotonin-containing nerve terminals in the vicinity of phrenic motoneurons ipsilateral to C2 hemisection. Thereafter, pLTF magnitude progressively increased with the recovery of serotonergic innervation in the phrenic motor nucleus. Intermittent hypoxia (or pLTF) has intriguing possibilities as a therapeutic tool, because its greatest efficacy may be in patients with chronic SCI, a time when most patients have already achieved maximal spontaneous functional recovery.

Hypertension. 2005 Apr;45(4):705-9. Epub 2005 Feb 28.

 


Augmented endothelin vasoconstriction in intermittent hypoxia-induced hypertension.

Allahdadi KJ, Walker BR, Kanagy NL.

Vascular Physiology Group, Department of Cell Biology and Physiology, University of New Mexico, Health Sciences Center, Albuquerque, NM 87131, USA.

We reported previously that simulating sleep apnea in rats by exposing them 7 hours per day to intermittent hypoxia/hypercapnia (IH) elevates plasma endothelin-1 and causes hypertension, which is reversed by an endothelin-1 antagonist. We hypothesized that in this model of sleep apnea-induced hypertension, vascular sensitivity to endothelin-1 is increased in combination with the elevated plasma endothelin-1 to cause the endothelin-1-dependent hypertension. In small mesenteric arteries with endothelial function disabled by passing air through the lumen, diameter and vessel wall [Ca2+] were recorded simultaneously. IH arteries demonstrated increased constrictor sensitivity to endothelin-1 (percentage max constriction 100+/-0% IH versus 80+/-10% Sham; P<0.05). This was accompanied by increased calcium sensitivity of IH arteries. In contrast, constrictor sensitivity and increases in vessel wall [Ca2+] to KCl and phenylephrine were not different between IH and Sham arteries. We have shown previously that endothelin-1 constriction in mesenteric arteries is mediated by endothelin A receptors. In the current study, the selective increase in endothelin-1 constriction in IH resistance arteries was accompanied by increased expression of endothelin A receptor expression (densitometry units 271+/-23 IH versus 158+/-25 Sham; P<0.05). Thus, IH hypertension appears to cause alterations in signaling components unique to endothelin-1 at the receptor level and in postreceptor signaling that increases calcium sensitivity during endothelin A activation. Future studies will determine the specific changes in vascular smooth muscle signaling in IH hypertension causing this augmented contractile phenotype.

Respir Physiol Neurobiol. 2005 Mar;146(1):55-65.

 


Changes in ventilatory responses to hypercapnia and hypoxia after intermittent hypoxia in humans.

Katayama K, Sato K, Matsuo H, Hotta N, Sun Z, Ishida K, Iwasaki K, Miyamura M.

Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya 464-8601, Japan. katayama@htc.nagoya-u.ac.jp

The purpose of this study was to clarify the changes in hypercapnic and hypoxic ventilatory responses (HCVR and HVR) after intermittent hypoxia and following the cessation of hypoxic exposure. Twenty-nine males were assigned to one of four groups, i.e., a hypoxic (EX1-H, n=7) or a control (EX1-C, n=7) group in Experiment 1, and a hypoxic (EX2-H, n=8) or a control (EX2-C, n=7) group in Experiment 2. In each experiment, the hypoxic tent system was utilized for intermittent hypoxia, and the oxygen levels in the tent were maintained at 12.3+/-0.2%. In Experiment 1, the EX1-H group spent 3 h/day in the hypoxic tent for 1 week. HCVR and HVR were determined before and after 1 week of intermittent hypoxia, and again 1 and 2 week after the cessation of hypoxic exposure. In Experiment 2, the subjects in the EX2-H group performed 3 h/day for 2 weeks in intermittent hypoxia. HCVR and HVR tests were carried out before and after intermittent hypoxia, and were repeated again after 2 weeks of the cessation of hypoxic exposure. The slope of the HCVR in the EX1-H group did not show a significant increase after 1 week of intermittent hypoxia, while HCVR in the EX2-H group increased significantly after 2 weeks of intermittent hypoxia. The HCVR intercept was unchanged following 1 or 2 weeks of intermittent hypoxia. There was a significant increase in the slope of the HVR after 1 and 2 weeks of intermittent hypoxia. The increased HCVR and HVR returned to pre-hypoxic levels after 2 weeks of the cessation of hypoxia. These results suggest that 3 h/day for 2 weeks of intermittent hypoxia leads to an increase in central hypercapnic ventilatory chemosensitivity, which is not accompanied by a re-setting of the central chemoreceptors, and that the increased hypercapnic and hypoxic chemosensitivities are restored within 2 weeks after the cessation of hypoxia.

Publication Types:

·         Clinical Trial

J Appl Physiol. 2005 May;98(5):1691-6. Epub 2004 Dec 23.

 

Click here to read  
Chronic intermittent hypoxia increases infarction in the isolated rat heart.

Joyeux-Faure M, Stanke-Labesque F, Lefebvre B, Beguin P, Godin-Ribuot D, Ribuot C, Launois SH, Bessard G, Levy P.

Laboratoire HP2, Hypoxie Physio-Pathologie, Faculte de Pharmacie, Domaine de la Merci, 38706 La Tronche, France. marie.faure@ujf-grenoble.fr

Coronary heart disease is frequently associated with obstructive sleep apnea syndrome and treating obstructive sleep apnea appears to significantly improve the outcome in coronary heart disease. Thus we have developed a rat model of chronic intermittent hypoxia (IH) to study the influence of this condition on myocardial ischemia-reperfusion tolerance and on functional vascular reactivity. Wistar male rats were divided in three experimental groups (n = 12 each) subjected to chronic IH (IH group), normoxia (N group), or control conditions (control group). IH consisted of repetitive cycles of 1 min (40 s with inspired O(2) fraction 5% followed by 20 s normoxia) and was applied for 8 h during daytime, for 35 days. Normoxic cycles were applied in the same conditions, inspired O(2) fraction remaining constant at 21%. On day 36, mean arterial blood pressure (MABP) was measured before isolated hearts were submitted to an ischemia-reperfusion protocol. The thoracic aorta and left carotid artery were also excised for functional reactivity studies. MABP was not significantly different between the three experimental groups. Infarct sizes (in percent of ventricles) were significantly higher in IH group (46.9 +/- 3.6%) compared with N (26.1 +/- 2.8%) and control (21.7 +/- 2.1%) groups. Vascular smooth muscle function was similar in aorta and carotid arteries from all groups. The endothelium-dependent relaxation in response to acetylcholine was also similar in aorta and carotid arteries from all groups. Chronic IH increased heart sensitivity to infarction, independently of a significant increase in MABP, and did not affect vascular reactivity of aorta and carotid arteries.

Exp Physiol. 2005 May;90(3):411-6. Epub 2005 Feb 22.

 


Chronic intermittent asphyxia increases platelet reactivity in rats.

Dunleavy M, Dooley M, Cox D, Bradford A.

Department of Physiology Royal College of Surgeons in Ireland St. Stephen's Green, Dublin 2, Ireland.

Sleep-disordered breathing is associated with chronic intermittent asphyxia and with a variety of cardiovascular abnormalities. Cardiovascular morbidity and mortality are linked to altered platelet function, and platelet function is affected in sleep-disordered breathing. As there is evidence that chronic continuous hypoxia may alter platelet number and function, the aim of the present study was to test the hypothesis that chronic intermittent asphyxia affects platelet count, activation and aggregation. Rats were treated with a hypercapnic hypoxic gas mixture (minimum of 6-8% O2, maximum of 10-14% CO2) for 15 s, twice per minute for 8 h per day for 3 weeks. Blood was analysed for platelet count, platelet activation (CD62p expression using flow cytometry), response to low dose ADP, haematocrit, red cell count and haemoglobin concentration. A platelet function analyser measured the closure time of an aperture, dependent on platelet aggregation. Compared to controls (n = 16), chronic intermittent asphyxia (n = 13) reduced body weight and increased right ventricular weight but had no significant effect on platelet count (control, 880.4 +/- 20.1; treated: 914.1 +/- 35.2 x 10(3) microl(-1); mean +/- S.E.M.), on the reduction in platelet count in response to ADP (control, reduced to 206.7 +/- 49.0; treated, reduced to 193.8 +/- 35.9 x 10(3) microl(-1)), or on the percentage of platelets positive for CD62p (control, 5.2 +/- 0.7; treated, 6.0 +/- 0.8%). Chronic intermittent asphyxia significantly (P = 0.037) reduced the closure time (control, 90.9 +/- 7.7; treated, 77.7 +/- 3.8 s), indicating greater adhesion and aggregation. There was no significant difference in haematocrit, red cell count and haemoglobin concentration. In conclusion, chronic intermittent asphyxia has no effect on platelet count but does increase platelet aggegation in rats. These data support the idea that chronic intermittent asphyxia alters platelet function in sleep-disordered breathing.

Acta Pharmacol Sin. 2005 Mar;26(3):315-22.

 


Inducible nitric oxide synthase contributes to intermittent hypoxia against ischemia/reperfusion injury.

Ding HL, Zhu HF, Dong JW, Zhu WZ, Yang WW, Yang HT, Zhou ZN.

Physiological Laboratory of Hypoxia, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China.

AIM: To investigate the role of inducible nitric oxide synthase (iNOS)-derived nitric oxide (NO) in the cardioprotection of intermittent hypoxia (IH) against ischemia/reperfusion (I/R) injury. METHODS: Langendorff-perfused isolated rat hearts were used to measure variables of left ventricular function during baseline perfusion, ischemia, and reperfusion period. Nitrate plus nitrite (NOx) content in myocardium was measured using a biochemical method. iNOS mRNA and protein expression in rat left ventricles were detected using reverse transcription polymerase chain reaction (RT-PCR) and Western blot, respectively. RESULTS: Myocardial function recovered better in IH rat hearts than in normoxic control hearts. The iNOS-selective inhibitor aminoguanidine (AG) (100 micromol/L) significantly inhibited the protective effects of IH, but had no influence on normoxic rat hearts. The baseline content of NOx in IH hearts was higher than that in normoxic hearts. After 30 min ischemia, the NOx level in normoxic hearts increased compared to the corresponding baseline level, whereas there was no significant change in IH hearts. However, the NOx level in IH hearts was still higher than that of normoxic hearts during ischemia and reperfusion period. AG 100 micromol/L significantly diminished the NOx content in IH and normoxic hearts during ischemia and reperfusion period. The baseline levels of iNOS mRNA and protein in IH hearts were higher than those of normoxic hearts. Compared to the corresponding baseline level, iNOS mRNA and protein levels in normoxic rat hearts increased and those in IH rat hearts decreased after reperfusion. The addition of AG 100 micromol/L significantly decreased iNOS mRNA and protein expression in IH rat hearts after I/R. CONCLUSION: IH upregulated the baseline level of iNOS mRNA and protein expression leading to an increase in NO production, which may play an important role in the cardiac protection of IH against I/R injury.

Am J Respir Crit Care Med. 2005 Oct 1;172(7):915-20. Epub 2005 Jun 23.

 

Oxidative stress and left ventricular function with chronic intermittent hypoxia in rats.

Chen L, Einbinder E, Zhang Q, Hasday J, Balke CW, Scharf SM.

Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, University of Maryland, 685 West Baltimore Street, MSTF 800, Baltimore, MD. sscharf@medicine.umaryland.edu.

Rationale and Objectives: Obstructive sleep apnea (OSA) is associated with oxidative stress and myocardial dysfunction. We hypothesized that the chronic intermittent hypoxia (CIH) component of OSA is sufficient to lead to these adverse effects.Methods and Results: Rats were exposed to CIH (nadir O(2), 4-5%) for 8 hours/day, 5 days/week, for 5 weeks. Results were compared with similarly handled controls (HC). Outcomes included blood pressure (tail cuff plethysmograph), echocardiographic and invasive measures of left-ventricular (LV) function, and indices of oxidative stress that included levels of myocardial lipid peroxides and Cu/Zn superoxide dismutase. Blood pressure was greater in CIH (n = 22) than in HC (n = 22) after 2 weeks of exposure (136 +/- 12 vs. 128 +/- 8 mm Hg; p < 0.05). However, the difference disappeared by 5 weeks (127 +/- 13 vs. 127 +/- 13 mm Hg). LV weight/heart weight was greater with CIH (CIH, 0.52 +/- 0.05; HC, 0.47 +/- 0.06; p < 0.005). Echocardiograms revealed LV dilation, as well as decreased LV fractional shortening (CIH, 29.7 +/- 9.8%; HC, 37.4 +/- 7.1%; p < 0.001). LV end-diastolic pressure was increased with CIH (CIH, 13.7 +/- 5.5; HC, 8.0 +/- 2.9 mm Hg; p < 0.001), decreased LV dp/dt(max) (CIH, 5072 +/- 2191; HC, 6596 +/- 720 mm Hg/second; p < 0.039), and decreased cardiac output (CIH, 48.2 +/- 10.5; HC, 64.1 +/- 10.9 ml/minute; p < 0.001). LV myocardial lipid peroxides were greater (CIH, 1,258 +/- 703; HC 715 +/- 240 mum/mg protein; p < 0.05) and LV myocardial superoxide dismutase levels were lower (CIH, 10.3 +/- 4.9; HC, 18.6 +/- 8.2 U/mg protein; p < 0.05) with CIH.Conclusions: CIH leads to oxidative stress and LV myocardial dysfunction.

High Alt Med Biol. 2005 Fall;6(3):215-25.

 


Effects of Intermittent Hypoxia on Heart Rate Variability during Rest and Exercise.

Povea C, Schmitt L, Brugniaux J, Nicolet G, Richalet JP, Fouillot JP.

Universite Paris 13, Faculte de Medecine, Bobigny, France.

Povea, Camilo; Laurent Schmitt; Julien Brugniaux; Gerard Nicolet; Jean-Paul Richalet; and Jean-Pierre Fouillot. Effects of intermittent hypoxia on heart rate variability during rest and exercise. High Alt. Med. Biol. 6:215-225, 2005.-Changes in heart rate variability induced by an intermittent exposure to hypoxia were evaluated in athletes unacclimatized to altitude. Twenty national elite athletes trained for 13 days at 1200 m and either lived and slept at 1200 m (live low, train low, LLTL) or between 2500 and 3000 m (live high, train low, LHTL). Subjects were investigated at 1200 m prior to and at the end of the 13-day training camp. Exposure to acute hypoxia (11.5% O(2)) during exercise resulted in a significant decrease in spectral components of heart rate variability in comparison with exercise in normoxia: total power (p < 0.001), low-frequency component. LF (p < 0.001), high-frequency component, HF (p < 0.05). Following acclimatization, the LHTL group increased its LF component (p < 0.01) and LF/HF ratio during exercise in hypoxia after the training period. In parallel, exposure to intermittent hypoxia caused an increased ventilatory response to hypoxia. Acclimatization modified the correlation between the ventilatory response to hypoxia at rest and the difference in total power between normoxia and hypoxia (r (2) = 0.65, p < 0.001). The increase in total power, LF component, and LF/HF ratio suggests that intermittent hypoxic training increased the response of the autonomic nervous system mainly through increased sympathetic activity.

Hypertension. 2005 Sep 12; [Epub ahead of print]

 


Sex Differences in Blood Pressure Response to Intermittent Hypoxia in Rats.

Hinojosa-Laborde C, Mifflin SW.

Department of Anesthesiology, University of Texas Health Science Center at San Antonio, San Antonio, Tex; Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, Tex.

Intermittent hypoxia is used to mimic the arterial hypoxemia that occurs during sleep apnea. The present study examined the blood pressure and heart rate responses to exposure to intermittent hypoxia in male rats and in female rats before and after ovariectomy. Rats were instrumented with telemetry transmitters and blood pressure, heart rate, and activity measured during 7 days of exposure to intermittent hypoxia (3 minutes of normoxia [21% oxygen] alternating with 3 minutes 10% oxygen between 8 AM and 4 PM, remainder of day at normoxia). Blood pressure increased in males, females, and ovariectomized females in response to 7 days of intermittent hypoxia during the hours of exposure to hypoxia. Blood pressure increased less in intact females (average change in blood pressure 1.6+/-0.6 mm Hg, n=11) than in females studied after ovariectomy (5.1+/-1.1 mm Hg, n=6) or males (5.4+/-1.0 mm Hg, n=10). This elevated blood pressure persisted throughout the remainder of the day when the animals were not exposed to intermittent hypoxia and remained significantly attenuated in female rats. Ovariectomy abolished the protection against the elevated blood pressure response to intermittent hypoxia in females. Heart rate increased only in males, and only during the period of the day associated with intermittent hypoxia. Female rats were protected against this tachycardia independent of the ovarian hormones. These results indicate that females are protected from the hypertensive and tachycardia effects of intermittent hypoxia.

Am J Physiol Heart Circ Physiol. 2005 Sep 9; [Epub ahead of print]

 


Postnatal intermittent hypoxia alters baroreflex function in adult rats.

Soukhova-O'hare GK, Cheng Z, Roberts AA, Gozal D.

Pediatrics, University of Louisville, Louisville, KY, USA.

Chronic perinatal intermittent hypoxia (IH) could have long-term cardiovascular effects by altering baroreflex function. To examine this hypothesis, we exposed rats (n=6/group) for postnatal days P1-P30, or prenatal embryonic days E5- E21, to IH (8% ambient O2 for 90 s following 90 s of 21% of O2, 12 hr/day), or to normoxia (control). Baroreflex sensitivity (BRS) and cardiac chronotropic responses were examined in anesthetized animals 3.5 to 5 months later by infusing phenylephrine (PE) or sodium nitroprusside (NP) (6-12 microg/min, 1-2 min, i.v.) during normoxia and after 18 min of acute IH (IHA). In controls after IHA, baroreflex gain was 42% (P<0.05) less than during normoxia. BRS in the postnatal IH group during normoxia was approximately 50% less than in control rats and similar to controls after IHA. The heart rate (HR) response to PE in the IH group was also less than in controls (P<0.05) and was not changed by IHA. BRS and HR responses in the prenatal IH group were similar to the normoxic control group. Vagal efferent projections to atrial ganglia neurons in rats after postnatal IH (n=4) were examined by injecting tracer into the left nucleus ambiguous. After 35 days of postnatal IH, basket ending density was reduced by 17% (P<0.001) and vagal axon varicose contacts by 56% (P<0.001) compared to controls. We conclude that reduction of vagal efferent projections in cardiac ganglia could be a cause of long-term modifications in baroreflex function.

Pediatr Res. 2005 Sep;58(3):594-9.

 


Intermittent Hypoxia during Development Induces Long-Term Alterations in Spatial Working Memory, Monoamines, and Dendritic Branching in Rat Frontal Cortex.

Kheirandish L, Gozal D, Pequignot JM, Pequignot J, Row BW.

Exposure to intermittent hypoxia (IH), such as occurs in sleep-disordered breathing, is associated with increased apoptosis in vulnerable brain regions as well as with spatial reference memory deficits in adult and developing rats. The latter are more susceptible to IH, suggesting that early exposure to IH may have long-term consequences. Rats were exposed to 14 d of room air (RA) or IH starting at postnatal d 10. Working memory was then assessed in the water maze at 4 mo of age using a delayed matching to place task in which the rats were required to locate a submerged platform hidden in a novel location on the first trial (T1 or acquisition trial), and then remember that position after a delay (T2 or test trial). Mean escape latencies and swim distances were derived and the savings (T1-T2) were used as a measure of working memory. Male but not female rats exposed to IH showed working memory deficits at both a 10- and 120-min delay (for both latency and pathlength). Additionally, Sholl analysis of Golgi-stained neurons revealed decreased dendritic branching in the frontal cortex, but not the hippocampus, of male rats exposed to IH. Norepinephrine concentrations, dopamine turnover, and tyrosine hydroxylase activity were increased similarly in males and females. However, increased dopamine concentrations were present only in the frontal cortex of female rats. In conclusion, exposure to IH during a critical developmental period is associated with long-term alterations in frontal cortical dopaminergic pathways that may underlie gender differences in neurobehavioral deficits.

Circ Res. 2005 Aug 25; [Epub ahead of print]


Intermittent Hypoxia Induces Hyperlipidemia in Lean Mice.

Li J, Thorne LN, Punjabi NM, Sun CK, Schwartz AR, Smith PL, Marino RL, Rodriguez A, Hubbard WC, O'donnell CP, Polotsky VY.

Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, Endocrinology and Metabolism, and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Md; and the Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pennsylvania.

Obstructive sleep apnea, a syndrome leading to recurrent intermittent hypoxia (IH), has been associated previously with hypercholesterolemia, independent of underlying obesity. We examined the effects of experimentally induced IH on serum lipid levels and pathways of lipid metabolism in the absence and presence of obesity. Lean C57BL/6J mice and leptin-deficient obese C57BL/6J-Lep(ob) mice were exposed to IH for five days to determine changes in serum lipid profile, liver lipid content, and expression of key hepatic genes of lipid metabolism. In lean mice, exposure to IH increased fasting serum levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, phospholipids (PLs), and triglycerides (TGs), as well as liver TG content. These changes were not observed in obese mice, which had hyperlipidemia and fatty liver at baseline. In lean mice, IH increased sterol regulatory element binding protein 1 (SREBP-1) levels in the liver, increased mRNA and protein levels of stearoyl-coenzyme A desaturase 1 (SCD-1), an important gene of TG and PL biosynthesis controlled by SREBP-1, and increased monounsaturated fatty acid content in serum, which indicated augmented SCD-1 activity. In addition, in lean mice, IH decreased protein levels of scavenger receptor B1, regulating uptake of cholesterol esters and HDL by the liver. We conclude that exposure to IH for five days increases serum cholesterol and PL levels, upregulates pathways of TG and PL biosynthesis, and inhibits pathways of cholesterol uptake in the liver in the lean state but does not exacerbate the pre-existing hyperlipidemia and metabolic disturbances in leptin-deficient obesity.

Biol Neonate. 2005 Aug 18;88(4):313-320 [Epub ahead of print]

 


Mild Intermittent Hypoxia Does Not Induce Stress Responses in the Neonatal Rat Brain.

Boss V, Sola A, Wen TC, Decker MJ.

Department of Pharmacology, Emory University School of Medicine, Atlanta, Ga., USA.

We previously demonstrated that intermittent hypoxia evokes persistent changes in extracellular striatal dopamine, locomotor activity and executive function, using a rodent model emulating apnea of prematurity in which rat pups are exposed to 20-second bursts of hypoxic gas mix containing 10% oxygen (60 events/h; 6 h/day) from postnatal days 7 to 11. To determine whether subtle repetitive hypoxic insults also induce expression of stress-related genes, we employed real-time RT-PCR to assay gene transcription in neonatal rats subjected to the same paradigm. In addition, we also measured expression of stress-induced transcripts in an age-matched cohort following a more severe oxidative stressor: permanent focal ischemia. Four transcripts were elevated following the ischemic insult: heat shock protein 70 (Hsp70), CL100, nurr77, and heme oxygenase-1. In contrast, these transcripts were not regulated in the majority of neonatal rats exposed to an intermittent hypoxia protocol. Hsp70 was strongly induced, and CL100 and nurr77 were slightly induced in only 2 of 11 post-hypoxic rats compared to controls. These data demonstrate that a single ischemic event elicits expression of specific stress-related genes, whereas 5 days of brief intermittent hypoxic insults typically do not. Thus, it is unlikely that the neurochemical and behavioral morbidity observed in juvenile and adult rodents exposed to intermittent hypoxia during a critical period of brain development are related to stress-induced changes in gene expression. Copyright (c) 2005 S. Karger AG, Basel.

Sleep in athletes undertaking protocols of exposure to nocturnal simulated altitude at 2650 m.

Kinsman TA, Gore CJ, Hahn AG, Hopkins WG, Hawley JA, McKenna MJ, Clark SA, Aughey RJ, Townsend NE, Chow CM.

Department of Physiology, Australian Institute of Sport Canberra, Australia.

A popular method to attempt to enhance performance is for athletes to sleep at natural or simulated moderate altitude (SMA) when training daily near sea level. Based on our previous observation of periodic breathing in athletes sleeping at SMA, we hypothesised that athletes' sleep quality would also suffer with hypoxia. Using two typical protocols of nocturnal SMA (2650 m), we examined the effect on the sleep physiology of 14 male endurance-trained athletes. The selected protocols were Consecutive (15 successive exposure nights) and Intermittent (3x 5 successive exposure nights, interspersed with 2 normoxic nights) and athletes were randomly assigned to follow either one. We monitored sleep for two successive nights under baseline conditions (B; normoxia, 600 m) and then at weekly intervals (nights 1, 8 and 15 (N1, N8 and N15, respectively)) of the protocols. Since there was no significant difference in response between the protocols being followed (based on n=7, for each group) we are unable to support a preference for either one, although the likelihood of a Type II error must be acknowledged. For all athletes (n=14), respiratory disturbance and arousal responses between B and N1, although large in magnitude, were highly individual and not statistically significant. However, SpO2 decreased at N1 versus B (p<0.001) and remained lower on N8 (p<0.001) and N15 (p<0.001), not returning to baseline level. Compared to B, arousals were more frequent on N8 (p=0.02) and N15 (p=0.01). The percent of rapid eye movement sleep (REM) increased from N1 to N8 (p=0.03) and N15 (p=0.01). Overall, sleeping at 2650 m causes sleep disturbance in susceptible athletes, yet there was some improvement in REM sleep over the study duration.

Atherosclerosis. 2005 Jul 29; [Epub ahead of print]

 


Intimal thickening after arterial balloon injury is increased by intermittent repetitive hypoxia, but intermittent repetitive hyperoxia is not protective.

Lau AK, Chaufour X, McLachlan C, Leichtweis SB, Celermajer DS, Sullivan C, Stocker R.

The Heart Research Institute, University of Sydney, Sydney, Australia.

Hypoxia increases and hyperoxia decreases experimental atherosclerosis, but it is unclear if repetitive hypoxic and hyperoxic insults affect intimal thickening after arterial injury. Rabbits on 2% cholesterol diet for 6 weeks underwent balloon injury to the abdominal aorta (AA) after week 3, and were then exposed to normoxia (n=6), or 12h daily of intermittent repetitive hypoxia (n=6) or hyperoxia (n=6). After week 6, damaged AA and undamaged thoracic aorta (TA) were assessed for intimal thickening and lipid content. Compared with normoxia, hypoxia and hyperoxia did not alter the rise in serum cholesterol related to cholesterol feeding. However, compared to normoxia, hypoxia markedly increased the intima-to-media ratio in AA (1.18+/-0.09 versus 1.96+/-0.14, P<0.01) and TA (0.15+/-0.02 versus 0.41+/-0.01, P<0.01) whereas hyperoxia had no effect on AA disease and increased intimal thickening in TA (0.26+/-0.03, P<0.01). Hyperoxia promoted positive arterial remodeling in both TA and AA, resulting in larger luminal size. The cholesterol content in AA was increased by hypoxia and decreased by hyperoxia, but decreased by both treatments in TA. Lipophilic antioxidants and the proportion of arterial lipids that was oxidized were not altered by hypoxia or hyperoxia. These results suggest that intermittent repetitive hyperoxia is not protective and intermittent repetitive hypoxia promotes arterial disease in normal and injured arteries independent of lipid peroxidation

Prague Med Rep. 2005;106(1):61-9.

 


Functional and morphological changes of the brain in rats exposed to intermittent hypobaric hypoxia after the repetitive magnesium administration.

Maresova D, Jandova K, Bortelova J, Trojan S, Trnkova B.

Department of Physiology of the First Faculty of Medicine, Charles University in Prague, Czech Republic. dana.maresova@lf1.cuni.cz

Intermittent hypobaric hypoxia induces functional and morphological changes of the brain in 25-day-old rats. Administration of magnesium has partial pro-convulsion effect in hypoxia not exposed rats and it practically does not influence the excitability of cortical neurones in rats exposed to intermittent hypoxia. Magnesium administration decreases the number of NADPH-diaphorase neurones in rats exposed to hypoxia in all studied areas of the hippocampus and dentate gyrus. In control rats this effect was only in CA1, CA3 and in the ventral blade of the dentate gyrus. Increased concentration of magnesium in cells of the hypoxia exposed rats after the repeated magnesium administration was found.

J Appl Physiol. 2005 Jul 7; [Epub ahead of print]

 


THE ACUTE AND CHRONIC CARDIOVASCULAR EFFECTS OF INTERMITTENT HYPOXIA IN C57BL/6J MICE.

Campen MJ, Shimoda LA, O'donnell CP.

Division of Toxicology, Lovelace Respiratory Research Institute, Albuquerque, NM, USA.

We investigated the effects of (1) acute hypoxia and (2) five weeks of chronic intermittent hypoxia (IH) on the systemic and pulmonary circulations of C57BL/6J mice. Mice were chronically instrumented with either femoral artery or right ventricular catheters. In response to acute hypoxia (four minutes of 10% O2; n=6) systemic arterial blood pressure fell (P<0.005) from 107.7 +/- 2.5 to 84.7 +/- 6.5 mmHg while right ventricular pressure increased (P<0.005) from 11.7 +/- 0.8 to 14.9 +/- 1.3 mmHg. Another cohort of mice was then exposed to IH for 5 weeks (O2 nadir = 5%, 60 second cycles, 12 h/day), then implanted with catheters. In response to five weeks of chronic IH, mice (n=8) increased systemic blood pressure by 7.5 mmHg, left ventricle (LV)+septum weight by 32.2 +/- 7.5 x10 mg/100g b.w. (P<0.015), and right ventricle (RV) weight by 19.3 +/- 3.2 x10 mg/100g b.w. (P<0.001), resulting in a 14% increase in the RV/LV+septum weight (P<0.005). We conclude that in C57BL/6J mice, (1) acute hypoxia causes opposite effects on the pulmonary and systemic circulations leading to preferential loading of the right heart, and (2) chronic IH in mice results in mild to moderate systemic and pulmonary hypertension, with resultant left and right-sided ventricular hypertrophy.

Auton Neurosci. 2005 Aug 31;121(1-2):87-93.

 


Effects of intermittent hypoxia on sympathetic activity and blood pressure in humans.

Leuenberger UA, Brubaker D, Quraishi S, Hogeman CS, Imadojemu VA, Gray KS.

Division of Cardiology, MC H047, The Pennsylvania State University College of Medicine, The Milton S. Hershey Medical Center, P.O. Box 850, Hershey, PA 17033, United States.

Sympathetic nerve activity and arterial pressure are frequently elevated in patients with obstructive sleep apnea (OSA). The mechanisms responsible for chronic sympathetic activation and hypertension in OSA are unknown. To determine whether repetitive apneas raise sympathetic nerve activity and/or arterial pressure, awake and healthy young subjects performed voluntary end-expiratory apneas for 20 s per min for 30 min (room air apneas). To accentuate intermittent hypoxia, in a separate group of subjects, hypoxic gas (inspired O(2) 10%) was added to the inspiratory port for 20 s before each apnea (hypoxic apneas). Mean arterial pressure (MAP) and muscle sympathetic nerve activity (MSNA, peroneal microneurography) were determined before and up to 30 min following the repetitive apneas. Following 30 hypoxic apneas (O(2) saturation nadir 83.1+/-1.2%), MSNA increased from 17.4+/-2.7 to 23.4+/-2.5 bursts/min and from 164+/-28 to 240+/-35 arbitrary units respectively (P<0.01 for both; n=10) and remained elevated while MAP increased transiently from 80.5+/-3.7 to 83.1+/-3.9 mm Hg (P<0.05; n=11). In contrast, in the subjects who performed repetitive apneas during room air exposure (O(2) saturation nadir 95.1+/-0.8%), MAP and MSNA did not change (n=8). End-tidal CO(2) post-apnea, an index of apnea-induced hypercapnia, was similar in the 2 groups. In a separate control group, no effect of time on MAP or MSNA was noted (n=7). Thus, repetitive hypoxic apneas result in sustained sympathetic activation and a transient elevation of blood pressure. These effects appear to be due to intermittent hypoxia and may play a role in the sympathetic activation and hypertension in OSA.

Respir Physiol Neurobiol. 2005 Jun 23; [Epub ahead of print]

 


Functional assessment of vascular reactivity after chronic intermittent hypoxia in the rat.

Lefebvre B, Godin-Ribuot D, Joyeux-Faure M, Caron F, Bessard G, Levy P, Stanke-Labesque F.

Laboratoire HP2, Hypoxie Physio-Pathologie Respiratoire et Cardiovasculaire, Faculte de Medecine-Pharmacie, Universite Grenoble I, Inserm Espri EA 3745, France.

We recently developed a model of chronic intermittent hypoxia (CIH) (FiO(2) 5%, 8h/day, 35 days) in the rat that was associated with an increased infarction in isolated heart. The aim of the present study was to characterize its functional consequences on vasoreactivity. Aorta and carotid artery were studied using organ bath technique while mesenteric vascular bed was perfused. In the three vascular beds, relaxation to acetylcholine was similar in CIH and control normoxic (NX) rats. Contractions to noradrenaline and angiotensin II were similar between CIH and NX rats. In contrast, contraction to endothelin-1 was increased by 17% (P<0.05) in carotid artery from CIH rats. Indomethacin pre-treatment reduced by 24% (P<0.001) contraction to endothelin-1 in carotid artery from CIH rats only. These data suggested that 35-day CIH-exposure induced no change in endothelial function of aorta, carotid artery and mesenteric bed. In contrast, CIH-exposure induced an increased contractile response to endothelin-1 in carotid artery, presumably owing to the release of constrictor cyclooxygenase-derived products.

J Physiol. 2005 Sep 1;567(Pt 2):689-99. Epub 2005 Jun 23.

 


Effects of two protocols of intermittent hypoxia on human ventilatory, cardiovascular and cerebral responses to hypoxia.

Foster GE, McKenzie DC, Milsom WK, Sheel AW.

School of Human Kinetics, University of British Columbia, Vancouver, BC, Canada.

We determined the ventilatory, cardiovascular and cerebral tissue oxygen response to two protocols of normobaric, isocapnic, intermittent hypoxia. Subjects (n = 18, male) were randomly assigned to short-duration intermittent hypoxia (SDIH, 12% O2 separated by 5 min of normoxia for 1 h) or long-duration intermittent hypoxia (LDIH, 30 min of 12% O2). Both groups had 10 exposures over a 12 day period. The hypoxic ventilatory response (HVR) was measured before each daily intermittent hypoxia exposure on days 1, 3, 5, 8, 10 and 12. The HVR was measured again 3 and 5 days after the end of intermittent hypoxia. During all procedures, ventilation, blood pressure, heart rate, arterial oxyhaemoglobin saturation and cerebral tissue oxygen saturation were measured. The HVR increased throughout intermittent hypoxia exposure regardless of protocol, and returned to baseline by day 17 (day 1, 0.84 +/- 0.50; day 12, 1.20 +/- 1.01; day 17, 0.95 +/- 0.58 l min(-1) %S(aO2)(-1); P < 0.01). The change in systolic blood pressure sensitivity (r = +0.68; P < 0.05) and the change in diastolic blood pressure sensitivity (r = +0.73; P < 0.05) were related to the change in HVR, while the change in heart rate sensitivity was not (r = +0.32; NS). The change in cerebral tissue oxygen saturation sensitivity to hypoxia was less on day 12, and returned to baseline by day 17 (day 1, -0.51 +/- 0.13; day 12, -0.64 +/- 0.18; day 17, -0.51 +/- 0.13; P < 0.001). Acute exposure to SDIH increased mean arterial pressure (+5 mmHg; P < 0.01), but LDIH did not (P > 0.05). SDIH and LDIH had similar effects on the ventilatory and cardiovascular response to acute progressive hypoxia and hindered cerebral oxygenation. Our findings indicate that the vascular processes required to control blood flow and oxygen supply to cerebral tissue in a healthy human are hindered following exposure to 12 days of isocapnic intermittent hypoxia.

Head Neck. 2005 Jul;27(7):622-38.

 


Hypoxia in head and neck cancer: how much, how important?

Janssen HL, Haustermans KM, Balm AJ, Begg AC.

Division of Experimental Therapy, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.

BACKGROUND: Hypoxia develops in tumors because of a less ordered, often chaotic, and leaky vascular supply compared with that in normal tissues. In preclinical models, hypoxia has been shown to be associated with treatment resistance and increased malignant potential. In the clinic, several reports show the presence and extent of tumor hypoxia as a negative prognostic indicator. This article reviews the biology and importance of hypoxia in head and neck cancer. METHODS: A review of literature was carried out and combined with our own experience on hypoxia measurements using exogenous and endogenous markers. RESULTS: Hypoxia can increase resistance to radiation and cytotoxic drugs and lead to malignant progression, affecting all treatment modalities, including surgery. Hypoxia measurements using electrodes, exogenous bioreductive markers, or endogenous markers show the presence of hypoxia in most head and neck cancers, and correlations with outcome, although limited, consistently indicate hypoxia as an important negative factor. Each hypoxia measurement method has disadvantages, and no "gold standard" yet exists. Distinctions among chronic, acute, and intermediate hypoxia need to be made, because their biology and relevance to treatment resistance differ. Reliable methods for measuring these different forms in the clinic are still lacking. Several methods to overcome hypoxia have been tested clinically, with radiosensitizers (nimorazole), hypoxic cytotoxins (tirapazamine), and carbogen showing some success. New treatments such as hypoxia-mediated gene therapy await proper clinical testing. CONCLUSIONS: The hypoxia problem in head and neck cancer needs to be addressed if improvements in current treatments are to be made. Increased knowledge of the molecular biology of intermediate, severe, and intermittent hypoxia is needed to assess their relevance and indicate strategies for overcoming their negative influence.

Fiziol Zh. 2005;51(2):90-5.

 


[Mechanisms of adaptation to intermittent hypoxic training course in sportsmen of high qualification]

[Article in Ukrainian]

Radziievs'kyi PO.

Boris Grinchenko Kyiv Municipal Pedagogical University.

Normobaric intermittent hypoxic training (IHT) is an effective method for improvement of the FRS state, increase of the aerobic productivity, as well as general and special capacity for work in sportsmen of high qualification. High efficacy of IHT in improving all aspects of sportsmen FRS is a result of alternating the hypoxic influences and normoxic intervals between them during which the level of plastic processes remains increased, oxygen tension in arterial blood and tissues increases to nonnoxic values. After IHT course, the state of organ respiration improves, the respiration volume, a part of alveolar ventilation in the minute volume of respiration, oxygen saturation of arterial blood, hemoglobin content in blood--increase as well as economy and efficacy of oxygen regimes of organism, general and special (especially important) physical capacity for work.

Scand J Med Sci Sports. 2005 Jun;15(3):182-7.

 


The influence of intermittent altitude exposure to 4100 m on exercise capacity and blood variables.

Lundby C, Nielsen TK, Dela F, Damsgaard R.

The Copenhagen Muscle Research Centre, Rigshospitalet, Blegdamsvej, Copenhagen O, Denmark. Carsten@CMRC.dk

This study was performed to investigate the effects of intermittent hypoxic exposure on blood and exercise parameters. Eight sea level residents were exposed to 2 h daily stimulus to 4100 m altitude in a hypobaric chamber for a total of 14 days. Exercise performance was evaluated at sea level before and after the hypoxic stimulation. Blood samples were obtained before, during, and at time points up to 14 days after the hypoxic exposure. No changes were observed in haemoglobin, haematocrit, reticulocytes, serum transferrin receptors, or EPO levels in the blood. Submaximal cycle (150 W) ergometer exercise corresponded to a oxygen uptake of 1.9+/-0.1 and 1.9+/-0.1 L min(-1) before and after the intermittent altitude exposure, respectively. At maximal exercise the workloads attained were 343+/-17 and 354+/-27 W before and after the exposure, with corresponding oxygen uptakes of 4.0+/-0.2 and 4.2+/-0.2 L min(-1). It is concluded that intermittent hypoxic exposure to 4100 m altitude for 2 h daily and a total of 14 days does not affect exercise capacity.

Appl Physiol. 2005 Sep;99(3):1064-9. Epub 2005 May 5.

 


Acute intermittent hypoxia improves rat myocardium tolerance to ischemia.

Beguin PC, Joyeux-Faure M, Godin-Ribuot D, Levy P, Ribuot C.

Laboratoire HP2, Hypoxie Physiopathologie Respiratoire et Cardiovasculaire, EA3745, ESPRI INSERM, Faculte de Medecine-Pharmacie, Universite Grenoble I, Domaine de la Merci, 38706 La Tronche Cedex, France.

In this study, we investigated the influence of depth and duration of intermittent hypoxia (IH) on the infarct size development in isolated rat heart. The role of nitric oxide synthase (NOS) and ATP-sensitive K+ (K(ATP)) channel was also studied. Wistar male rats were exposed to IH [repetitive cycles of 1 min, 40 s with inspired oxygen fraction (FI(O2)), 5 or 10%, followed by 20-s normoxia], during 30 min or 4 h. Another group was exposed to 4 h of continuous hypoxia with 10% FI(O2). Twenty-four hours later, their hearts were isolated and subjected to a 30-min no-flow global ischemia-120-min reperfusion sequence. For some hearts, N(omega)-nitro-L-arginine methyl ester (L-NAME) (a nonselective inhibitor of NOS) or 5-hydroxydecanoic acid (5-HD) (a selective mitochondrial K(ATP) blocker) was infused before ischemia. Infarct size (in percentage of ventricles) was significantly reduced by prior IH for 4 h (10% FI(O2)) (21.8 +/- 3.1 vs. 33.5 +/- 2.5% in sham group). This effect was abolished by L-NAME or 5-HD. Infarct size was not different in groups subjected to either 30 min of IH or to continuous hypoxia compared with sham group. In contrast, IH for 4 h (5% FI(O2)) significantly increased infarct size (45.1 +/- 3.6 vs. 33.5 +/- 2.5% in sham group). Acute IH for 4 h with a minimal FI(O2) of 10% induced a delayed preconditioning against myocardial infarction in the rat, which was abolished by NOS inhibition and mitochondrial K(ATP) channel blockade. Depth, duration, and intermittence of hypoxia appeared to be critical for cardioprotection to occur.

Can J Appl Physiol. 2005 Feb;30(1):61-73.

 


Does intermittent hypoxia increase erythropoiesis in professional cyclists during a 3-week race?

Villa JG, Lucia A, Marroyo JA, Avila C, Jimenez F, Garcia-Lopez J, Earnest CP, Cordova A.

Dept. of Physical Education, Univ. of Leon, Leon, Spain.

In this study we examined the effects of intermittent hypoxia exposure (IHE) in a group of professional cyclists (n = 6; age 26 +/- 1 yr) competing in the 2001 Vuelta a Espana. After each daily stage, treated subjects received four 5-min bouts of normobaric IHE (mean O2 concentration of 12.6%, simulating a mean altitude of 4,000 m) interspersed with 5-min bouts of breathing hotel room air (normoxia) until completing a total IHE of 20-min duration. The primary outcome, compared to a control group of similar characteristics not receiving IHE (n = 5; age 25 +/- 1 yr), was the % increase in erythropoietin (Epo) from the beginning to the end of the Vuelta. Statistical analysis showed that Epo increase tended to be higher (p = 0.052) in the IHE group than in controls (37.4 +/- 5.8% vs. -4.4 +/- 19.5%, respectively). However IHE had no effect on reticulocytes or erythrocyte count (p > 0.05).

Clin Exp Pharmacol Physiol. 2005 May-Jun;32(5-6):447-9.

 


Cardiovascular alterations by chronic intermittent hypoxia: importance of carotid body chemoreflexes.

Prabhakar NR, Peng YJ, Jacono FJ, Kumar GK, Dick TE.

Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA. nrp@po.cwru.edu

1.
Humans experiencing intermittent hypoxia (IH) owing to recurrent apnoea syndromes exhibit serious cardiovascular morbidity, including high blood pressure, increased sympathetic nerve activity, cardiac arrhythmia and myocardial infarction. Although apnoeas are accompanied by a simultaneous decrease in arterial O(2) (hypoxia) and an increase in CO(2) (hypercapnia), studies on experimental animals suggest that hypoxia, rather than hypercapnia, is the primary stimulus for developing hypertension and enhanced sympathetic nerve activity. Enhanced hypoxic-sensing ability of the carotid bodies and the ensuing reflex activation of the sympathetic nervous system have been suggested to play a critical role in cardiorespiratory alterations resulting from recurrent apnoeas. 2. The purpose of the present review is to highlight recent studies demonstrating the effects of IH on carotid body sensory activity and its consequences on sympathetic activation in a rodent model of chronic IH. Adult rats exposed to chronic IH (15 s of 5% O(2) followed by 5 min of 21% O(2), nine episodes per h, 8 h/day for 10 days) exhibited selective enhancement of carotid body sensory response to hypoxia. In addition, chronic IH induced a novel form of sensory plasticity in the carotid body, manifested as sensory long-term facilitation (LTF). Functional changes in the carotid body occurred in the absence of morphological changes in the chemoreceptor tissue. 3. Acute hypoxia increased expiratory modulated splanchnic nerve activity (SNA) and acute IH-induced LTF in SNA. Hypoxia-induced SNA activation was prevented by bilateral sectioning of the sinus nerves. Rats exposed to chronic IH exhibited enhanced hypoxia-induced sympathetic activation and augmented LTF of the SNA. Bilateral sectioning of the sinus nerves abolished these responses, suggesting chronic IH-induced alterations in carotid body sensitivity contribute to LTF in SNA and the subsequent cardiovascular alterations.

Eur J Appl Physiol. 2005 Jun;94(3):254-61. Epub 2005 Apr 7.

 


Intermittent short-term graded running performance in middle-distance runners in hypobaric hypoxia.

Ogawa T, Ohba K, Nabekura Y, Nagai J, Hayashi K, Wada H, Nishiyasu T.

Institute of Health and Sports Science, University of Tsukuba, Tsukuba City, Ibaraki 305-8574, Japan.

This study investigated whether in trained middle-distance runners, intermittent short-term graded running performance is affected by a hypobaric hypoxic environment (simulated 2,500 m) (H). Seven male middle-distance runners performed an aerobic performance test and an intermittent short-term graded anaerobic running-performance test (MART) both in H and in a normobaric normoxic environment (N). VO(2max) and OBLA were markedly lower (by 18.1% and 8.7%, respectively) in H than in N. In MART, neither maximal running velocity (V(max)) nor exhaustion-time was different between N and H (454 (7) m min(-1) vs. 451 (6) m min(-1), respectively, and 208.7 (5.2) s vs. 205.7 (4.2) s, respectively). The blood lactate concentration at sub-maximal running speed (425 m min(-1)) was significantly greater in H than in N (paired t-test: P<0.05). These results suggest that, in trained middle-distance runners, intermittent short-term graded running performance is not affected by H, despite a considerable decrease in aerobic power in H during the aerobic performance test.

Comp Biochem Physiol C Toxicol Pharmacol. 2005 Jan;140(1):59-67.

 


Adaptations of the antioxidant system in erythrocytes of trained adult rats: impact of intermittent hypobaric-hypoxia at two altitudes.

Asha Devi S, Subramanyam MV, Vani R, Jeevaratnam K.

Laboratory of Gerontology, Department of Zoology, Bangalore University, Bangalore, India. asuba@blr.vsnl.net.in

We have investigated the effects of daily exposure to intermittent hypobaric-hypoxia to two simulated altitudes (5700 m and 6300 m) in adult male rats that had been regularly swim trained in normoxia at sea level prior to exposures. Superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) along with the oxidative stress (OS) indices, malondialdehyde (MDA) and protein carbonyl content were measured in erythrocytes and their membranes. Hemoglobin increased in the trained animals exposed to 5700 m and in untrained rats exposed to 6300 m. Osmotic fragility in terms of hemolysis increased in altitude exposed animals. SOD increased in those exposed to 6300 m, while CAT increased in trained rats exposed to 5700 m and to 6300 m unlike in untrained rats where CAT increased only at 6300 m. GSH-Px showed varying degrees of elevation in all animals exposed to both altitudes. Erythrocyte membranes showed significant elevations in malondialdehyde (MDA) at 6300 m, while elevated protein carbonyls were noticeable at both altitudes in whole cells and membranes. These results suggest a positively associated elevation in protein oxidation with altitude in trained rats. At 5700 m, animals were less stressed, unlike at 6300 m, as seen from the magnitude of elevations in the OS indices and from the responses of the antioxidant enzymes.

Foot Ankle Int. 2005 Jan;26(1):15-8.

 

Click here to read  
Hyperbaric oxygen as an intervention for managing wound hypoxia: its role and usefulness in diabetic foot wounds.

Strauss MB.

Department of Hyperbaric Medicine, Long Beach Memorial Medical Center, 2801 Atlantic Avenue, PO Box 1428, Long Beach, CA 90801-1428, USA. mstrauss@memorialcare.org

Few topics in diabetic wound management generate as much "heated" discussion as hyperbaric oxygen (HBO). Hyperbaric oxygen is an intermittent inhalation therapy in which the patient breathes oxygen at greater than 1 atm of pressure. This requires placement of the patient into a sealed vessel (chamber) which is capable of withstanding pressurization. This article discusses the role of HBO as an adjunct to the management of diabetic problem foot wounds from evidenced-based, approved (by Medicare) indications and cost-effectiveness perspectives.

Am J Physiol Regul Integr Comp Physiol. 2005 Jun;288(6):R1571-80. Epub 2005 Jan 27.

 

Click here to read  
Time-dependent modulation of carotid body afferent activity during and after intermittent hypoxia.

Cummings KJ, Wilson RJ.

Department of Physiology and Biophysics, University of Calgary, 3330 Hospital Dr. N.W., Calgary, Alberta T2N 4N1, Canada.

The ventilatory response to several minutes of hypoxia consists of various time-dependent phenomena, some of which occur during hypoxia (e.g., short-term depression), whereas others appear on return to normoxia (e.g., posthypoxic frequency decline). Additional phenomena can be elicited by acute, intermittent hypoxia (e.g., progressive augmentation, long-term facilitation). Current data suggest that these phenomena originate centrally. We tested the hypothesis that carotid body afferent activity undergoes time-dependent modulation, consistent with a direct role in these ventilatory phenomena. Using an in vitro rat carotid body preparation, we found that 1) afferent activity declined during the first 5 min of severe (40 Torr Po(2)), moderate (60 Torr Po(2)), or mild (80 Torr Po(2)) hypoxia; 2) after return to normoxia (100 Torr Po(2)) and after several minutes of moderate or severe hypoxia, afferent activity was transiently reduced compared with prehypoxic levels; and 3) with successive 5-min bouts of mild, moderate, or severe hypoxia, afferent activity during bouts increased progressively. We call these phenomena sensory hypoxic decline, sensory posthypoxic decline, and sensory progressive augmentation, respectively. These phenomena were stimulus specific: similar phenomena were not seen with 5-min bouts of normoxic hypercapnia (100 Torr Po(2) and 50-60 Torr Pco(2)) or hypoxic hypocapnia (60 Torr Po(2) and 30 Torr Pco(2)). However, bouts of either normoxic hypercapnia or hypocapnic hypoxia resulted in sensory long-term facilitation. We suggest time-dependent carotid body activity acts in parallel with central mechanisms to shape the dynamics of ventilatory responses to respiratory chemostimuli

Respir Physiol Neurobiol. 2005 Jan 15;145(1):33-9.