Effects of a physical exercise program on HIF-1α in people with Chronic Obstructive Pulmonary Disease living at high altitude: study protocol for a clinical trial.

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a chronic, noncommunicable disease characterized by hypoxemia, with altered lung function, dyspnea on mild exertion, limited tolerance to physical exertion, and functional impairment. Physical exercise has been recommended worldwide as an efficient strategy to improve the autonomy and quality of life of patients affected by COPD. However, the adaptive molecular mechanisms occurring in these patients after the exposure to the hypoxic stimulus triggered by physical exercise have currently not been described in populations living at high altitude. METHODS: The clinical trial we are presenting here consists of a quasi-experimental design with longitudinal analysis of repeated measures, with intra- and inter-group comparisons, measuring primary and secondary variables in 4 temporal points. Participants will be people with a diagnosis of COPD residing at high altitudes (> 2600 m), without oncological, renal, cardiac, or musculoskeletal comorbidities with a low level of physical activity. The intervention will be an 8-week program of physical exercise of resistance and muscular strength (8-WVP) which will be carried out at home. Primary outcome variables will be the expression of HIF-1α, VEGF, and EPO. As secondary outcome variables, we will consider lung function (measured by spirometry), physical performance (measured by ergospirometry and dynamometry), and hematological parameters. DISCUSSION: The results obtained after the clinical trial proposed here will promote knowledge on the expression of signaling proteins as an adaptive response to hypoxia in people with COPD living at high altitude, which will be relevant because there are not data on this population group. The knowledge generated from the application of this protocol will increase the pathophysiological understanding of the disease and future medical and therapeutic decision-making based on physical exercise prescription. TRIAL REGISTRATION {2A}: NCT04955977 [ClinicalTrials.gov]-NCT04955977 [WHO ICRTP]. First Posted: July 9, 2021.

Gestational Exercise Increases Male Offspring's Maximal Workload Capacity Early in Life.

Mothers' antenatal strategies to improve the intrauterine environment can positively decrease pregnancy-derived intercurrences. By challenging the mother-fetus unit, gestational exercise (GE) favorably modulates deleterious stimuli, such as high-fat, high-sucrose (HFHS) diet-induced adverse consequences for offspring. We aimed to analyze whether GE alters maternal HFHS-consumption effects on male offspring's maximal workload performance (MWP) and in some skeletal muscle (the soleus-SOL and the tibialis anterior-TA) biomarkers associated with mitochondrial biogenesis and oxidative fitness. Infant male Sprague-Dawley rats were divided into experimental groups according to mothers' dietary and/or exercise conditions: offspring of sedentary control diet-fed or HFHS-fed mothers (C-S or HFHS-S, respectively) and of exercised HFHS-fed mothers (HFHS-E). Although maternal HFHS did not significantly alter MWP, offspring from GE dams exhibited increased MWP. Lower SOL AMPk levels in HFHS-S were reverted by GE. SOL PGC-1α, OXPHOS C-I and C-IV subunits remained unaltered by maternal diet, although increased in HFHS-E offspring. Additionally, GE prevented maternal diet-related SOL miR-378a overexpression, while upregulated miR-34a expression. Decreased TA C-IV subunit expression in HFHS-S was reverted in HFHS-E, concomitantly with the downregulation of miR-338. In conclusion, GE in HFHS-fed dams increases the offspring's MWP, which seems to be associated with the intrauterine modulation of SM mitochondrial density and functional markers.

Enzyme activity and myoglobin concentration in rat myocardium and skeletal muscles after passive intermittent simulated altitude exposure.

We studied the effect of intermittent hypobaric hypoxia exposure on lactate dehydrogenase and citrate synthase activities, together with myoglobin content, of rat myocardium, tibialis anterior, and diaphragm muscles. The intermittent hypoxia exposure programme consisted of daily 4-h sessions in a hypobaric chamber (5000 m) over a period of 22 days. Samples were taken at the end of the programme, and 20 and 40 days later, and compared with those of control animals. In myocardium, lactate dehydrogenase activity was significantly depressed in animals 20 days post-exposure (314.6 +/- 15.3 IU . g(-1)) compared with control animals (400 +/- 14.3 IU . g(-1)), while citrate synthase activity and myoglobin concentration showed a significant stepwise increase from control animals (88.2 +/- 3.6 IU . g(-1) and 4.38 +/- 0.13 microm . mg(-1)) to animals 20 days (104.7 +/- 3.7 IU . g(-1) and 5.01 +/- 0.17 microm . mg(-1)) and 40 days post-exposure (108.8 +/- 6.5 IU . g(-1) and 5.11 +/- 0.22 microm . mg(-1)). In contrast, no differences were found in diaphragm and tibialis anterior muscles. Our results show that intermittent hypobaric hypoxia exposure increased the oxidative character of myocardium even 20 days after the hypoxic stimulus has ceased, and that this effect lasts for more than 40 days for citrate synthase activity and myoglobin concentration. These findings support our previous results on skeletal and cardiac muscle capillarization after passive intermittent simulated altitude exposure, thus providing morphofunctional and biochemical evidence for increased cardiac aerobic efficiency.