Respiratory Muscle Training Improves Diaphragm Citrate Synthase Activity and Hemodynamic Function in Rats with Heart Failure.

INTRODUCTION:: Enhanced respiratory muscle strength in patients with heart failure positively alters the clinical trajectory of heart failure. In an experimental model, respiratory muscle training in rats with heart failure has been shown to improve cardiopulmonary function through mechanisms yet to be entirely elucidated. OBJECTIVE:: The present report aimed to evaluate the respiratory muscle training effects in diaphragm citrate synthase activity and hemodynamic function in rats with heart failure. METHODS:: Wistar rats were divided into four experimental groups: sedentary sham (Sed-Sham, n=8), trained sham (RMT-Sham, n=8), sedentary heart failure (Sed-HF, n=7) and trained heart failure (RMT-HF, n=7). The animals were submitted to a RMT protocol performed 30 minutes a day, 5 days/week, for 6 weeks. RESULTS:: In rats with heart failure, respiratory muscle training decreased pulmonary congestion and right ventricular hypertrophy. Deleterious alterations in left ventricular pressures, as well as left ventricular contractility and relaxation, were assuaged by respiratory muscle training in heart failure rats. Citrate synthase activity, which was significantly reduced in heart failure rats, was preserved by respiratory muscle training. Additionally, a negative correlation was found between citrate synthase and left ventricular end diastolic pressure and positive correlation was found between citrate synthase and left ventricular systolic pressure. CONCLUSION:: Respiratory muscle training produces beneficial adaptations in the diaphragmatic musculature, which is linked to improvements in left ventricular hemodynamics and blood pressure in heart failure rats. The RMT-induced improvements in cardiac architecture and the oxidative capacity of the diaphragm may improve the clinical trajectory of patients with heart failure.

Respiratory muscle training improves diaphragm citrate synthase activity and hemodynamic function in rats with heart failure

Abstract INTRODUCTION: Enhanced respiratory muscle strength in patients with heart failure positively alters the clinical trajectory of heart failure. In an experimental model, respiratory muscle training in rats with heart failure has been shown to improve cardiopulmonary function through mechanisms yet to be entirely elucidated. OBJECTIVE: The present report aimed to evaluate the respiratory muscle training effects in diaphragm citrate synthase activity and hemodynamic function in rats with heart failure. METHODS: Wistar rats were divided into four experimental groups: sedentary sham (Sed-Sham, n=8), trained sham (RMT-Sham, n=8), sedentary heart failure (Sed-HF, n=7) and trained heart failure (RMT-HF, n=7). The animals were submitted to a RMT protocol performed 30 minutes a day, 5 days/week, for 6 weeks. RESULTS: In rats with heart failure, respiratory muscle training decreased pulmonary congestion and right ventricular hypertrophy. Deleterious alterations in left ventricular pressures, as well as left ventricular contractility and relaxation, were assuaged by respiratory muscle training in heart failure rats. Citrate synthase activity, which was significantly reduced in heart failure rats, was preserved by respiratory muscle training. Additionally, a negative correlation was found between citrate synthase and left ventricular end diastolic pressure and positive correlation was found between citrate synthase and left ventricular systolic pressure. CONCLUSION: Respiratory muscle training produces beneficial adaptations in the diaphragmatic musculature, which is linked to improvements in left ventricular hemodynamics and blood pressure in heart failure rats. The RMT-induced improvements in cardiac architecture and the oxidative capacity of the diaphragm may improve the clinical trajectory of patients with heart failure.

Protection by pyridostigmine bromide of marmoset hemi-diaphragm acetylcholinesterase activity after soman exposure.

Pyridostigmine bromide (PB) was approved by the U.S. Food and Drug Administration (FDA) in 2003 as a pretreatment in humans against the lethal effects of the irreversible nerve agent soman (GD). Organophosphate (OP) chemical warfare agents such as GD exert their toxic effects by inhibiting acetylcholinesterase (AChE) from terminating the action of acetylcholine at postsynaptic sites in cholinergic nerve terminals (including crucial peripheral muscle such as diaphragm). As part of the post-marketing approval of PB, the FDA required (under 21CFR314, the "two animal rule") the study of a non-human primate model (the common marmoset Callithrix jacchus jacchus) to demonstrate increased survival against lethal GD poisoning, and protection of physiological hemi-diaphragm function after PB pretreatment and subsequent GD exposure. Marmosets (male and female) were placed in the following experimental groups: (i) control (saline pretreatment only), (ii) low dose PB (12.5 microg/kg), or (iii) high dose (39.5 microg/kg) PB. Thirty minutes after the PB dose, animals were challenged with either saline (control) or soman (GD, 45 microg/kg), followed 1 min later by atropine (2mg/kg) and 2-PAM (25mg/kg). After a further 16 min, animals were euthanized and the complete diaphragm removed; the right hemi-diaphragm was frozen immediately at -80 degrees C, and the left hemi-diaphragm was placed in a tissue bath for 4h (to allow for decarbamylation to occur), then frozen. AChE activities were determined using the automated WRAIR cholinesterase assay. Blood samples were collected for AChE activities prior to PB, before GD challenge, and after sacrifice. RBC-AChE was inhibited by approximately 18% and 50% at the low and high doses of PB, respectively, compared to control (baseline) activity. In the absence of PB pretreatment, the inhibition of RBC-AChE by GD was 98%. The recovery of hemi-diaphragm AChE activity after the 4h wash period (decarbamylation) was approximately 8% and 17%, at the low and high PB doses, respectively, compared with the baseline (control) AChE activity prior to PB pretreatment or soman exposure. The results suggest that PB pretreatment protects a critical fraction of AChE activity in the marmoset diaphragm, which is sufficient to allow the animal to breathe despite exposure to a dose of soman that is lethal in unprotected animals.

Understanding abnormal retinoid signaling as a causative mechanism in congenital diaphragmatic hernia.

Congenital diaphragmatic hernia (CDH) is a frequently occurring source of severe neonatal respiratory distress. It has been hypothesized that abnormal retinoid signaling contributes to the etiology of this developmental anomaly. Here, we use rodent models toward specifically understanding the role of retinoid signaling in the developing diaphragm and how its perturbation is a common mechanism in drug-induced CDH. This includes monitoring of retinoic acid (RA) response element (RARE) activation with RARE-lacZ mice, RA supplementation studies, systematic analyses of the expression profile of key elements in the RA signaling pathway within the developing diaphragm, and the in utero delivery of a RA receptor (RAR) antagonist. These data demonstrate the timing of RARE perturbation by CDH-inducing teratogens and the efficacy of RA supplementation. Furthermore, a detailed profile of retinoid binding proteins, synthetic enzymes, and retinoid receptors within primordial diaphragm cells was obtained. The expression profile of RAR-alpha was particularly striking in regard to its overlap with the regions of primordial diaphragm affected in multiple CDH models. Blocking of RAR signaling with the pan-RAR antagonist BMS493 induced a very high degree of CDH, with a marked left-right sidedness that depended on the timing of drug delivery. Collectively, these data demonstrate that retinoid signaling is essential for normal diaphragm development, providing further support to the hypothesis that abnormalities related to the retinoid signaling pathway cause diaphragmatic defects. This study also yielded a novel experimental model that should prove particularly useful for further studies of CDH.

Effects of pyridostigmine on acetylcholinesterase in different muscles of the mouse.

1. Pyridostigmine bromide was administered subcutaneously in mice, in a dose of 4.0 or 2.0 mu moles/kg, and the activity of the predominant (G1, G4 and A12) molecular forms of acetylcholinesterase were examined in diaphragm, extensor digitorum longus (EDL), and soleus muscles at 3 h, 6 h, 24 h and 5 days. 2. In diaphragm, no effect was apparent after the low dose, but after the high dose there was a reduction in activity of the functional A12 form at 24 h, followed by an increase which had overshot the control level at 5 days. 3. In the fast EDL, after the low dose, all three molecular forms were decreased at 3 h but had returned to normal by 6 h. This effect was not apparent after the high dose. 4. In the slow soleus the low dose caused a significant increase in total enzyme activity at 5 days, but the high dose caused significant increases in all molecular forms at 3 hours. 5. Thus pyridostigmine had delayed effects on the levels of acetylcholinesterase. The three muscles displayed different sensitivities to the drug, but the changes were consistent with initial inhibition of the activity leading to down-regulation of the enzyme followed by up-regulation, which could overshoot the normal levels.

Hyperbaric oxygenation treatments and metabolic enzymes in the heart and diaphragm.

We previously found that intermittent hyperbaric oxygen exposure increases metabolic enzyme activity in soleus muscle. Since the metabolic enzyme activities of the heart and diaphragm of healthy animals are difficult to alter, we questioned whether intermittent hyperbaric oxygenation would provide a stimulus sufficient to increase metabolic enzyme activity. Therefore, we exposed 36 rabbits (4 groups of 9) twice daily for 90 min 5 days/wk to either 100% O2 at 243 kPa, 8.5% O2, and 91.5% N2 at 243 kPa, 100% O2 at 101 kPa, or 21% O2 at 101 kPa. After 4 wk of treatment, the activities of citrate synthase, succinate dehydrogenase, alpha-glycerophosphate dehydrogenase, phosphofructokinase, and glyceraldehyde-3-phosphate dehydrogenase were measured. In both the heart and the diaphragm, none of the treatments significantly altered the mean enzyme activities for any of the enzymes measured. Therefore, it seems that the hyperbaric oxygenation treatment protocols used do not induce an increase in metabolic enzyme activity in the heart and diaphragm in healthy animals.

Soman and sarin inhibition of molecular forms of acetylcholinesterase in mice. Time course of recovery and reactivation by the oxime HI-6.

The in vivo sensitivity of the molecular forms of the enzyme acetylcholinesterase to inhibition by either soman or sarin, reactivation by HI-6 and the time course of recovery following inhibition by soman were investigated in mice. Administration of HI-6 (50 mg/kg, i.p.) immediately after soman (100 micrograms/kg, s.c.) or sarin (150 micrograms/kg, s.c.) resulted in an apparent selective reactivation of the 10S and 16S molecular forms of acetylcholinesterase and no reactivation of the 4S form of diaphragm acetylcholinesterase. The apparent selectivity of the reactivation of the molecular forms of the acetylcholinesterase was probably due to the fact that the 10S and 16S forms of acetylcholinesterase are located primarily extracellularly and the 4S form intracellularly. The HI-6 was restricted primarily to the extracellular compartment due to its quaternary, hydrophilic nature. If the administration of HI-6 was delayed until 60 min following soman (100 micrograms/kg, s.c.) injection, no reactivation of any of the molecular forms of acetylcholinesterase could be found in the diaphragm. The soman-inhibited acetylcholinesterase had probably aged and, thus, was not susceptible to reactivation by HI-6. The time course of recovery of the molecular forms in the diaphragm occurred rather quickly with the smaller 4S and 10S forms recovering to control levels faster than the larger 16S form. It took between 8 and 16 days for the 16S form to recover to normal. In the brain, hypothalamic acetylcholinesterase molecular forms such as the 4S recovered faster than the 10S form which had not recovered to control 16 days after soman administration; the 16S form of acetylcholinesterase was not detected in the brain.

Effects of pancuronium and vecuronium on creatine phosphokinase in rat isolated heart, liver, kidney and diaphragm.

1. The effects of two muscle relaxants, namely, pancuronium and vecuronium, on creatine phosphokinase (CPK) release from four different types of tissues, namely, heart, liver, kidney and diaphragm, were studied in the rat in vitro. 2. The total, neat and CPK levels (units/ml), released by muscle relaxants were measured using spectrophotometric determination at 340 nm. 3. The results showed that both muscle relaxants, in low concentrations, i.e. 0.34 or 0.32 microM, close to a clinical dose of 0.1 mg/kg, had no significant effect on CPK leakage in all four types of tissues studied. However, in concentrations 12-122 times clinical dose, the two muscle relaxants produced differential adverse effects in the tissues studied. 4. In most concentrations, pancuronium and vecuronium produced significant increases in the CPK release in the kidney and diaphragm. In contrast, pancuronium had no significant effect on CPK release in the liver and the lowest effect in the heart. Similar results were obtained with vecuronium. 5. The clinical relevance and/or implications of the present results are discussed and the results are compared to those previously reported by other workers in other preparations.

Comparative effects of vecuronium and pancuronium on release of lactate dehydrogenase in rat isolated diaphragm, liver, kidney and heart.

The comparative effects of two muscle relaxants, namely pancuronium and vecuronium, on the release of intracellular lactate dehydrogenase (LDH), released from four different types of tissues, namely, the heart, liver, kidney and diaphragm, were studied in the rat in vitro. The LDH and its leakage into extracellular space, was used as an indicator for cellular membrane damage, and the aim was to see if the two muscle relaxants enhanced the release of LDH, and hence, by implication, caused adverse effects, i.e., damage to cell membrane. The total amount of LDH, the neat (LDH), and the increase in LDH release caused by different concentrations of the two muscle relaxants were measured using spectrophotometric determination at 340 nm. The results showed that both muscle relaxants, in low concentrations (0.32 or 0.34 microM, a concentration which is close to a clinical dose of 0.1 mg/ml), did not significantly enhance the LDH release from any of the 4 different types of tissues studied. However, in concentrations of 10-130 times the clinical dose, both drugs significantly enhanced the LDH release in all the 4 tissues, with pancuronium being more effective than vecuronium. In addition, the diaphragm and kidney were most affected, whereas the heart and liver being the least affected. The clinical relevance and/or implications of these comparative effects are discussed, and the results are compared to those previously reported by other workers. Pancuronium and vecuronium are among the non-depolarising neuromuscular blocking drugs currently-used in clinical anaesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

[Nervous regulation of glycogen concentration and the lactate dehydrogenase isoenzyme spectrum in the diaphragm of rats]. / Nervnaia reguliatsiia soderzhaniia glikogena i izofermentnogo spektra laktatdegidrogenazy v diafragme krysy.

Content of glycogen, activity of lactate dehydrogenase (LDH) and its isoenzyme spectrum were studied in two cases of partial diaphragm denervation as well as in electro-stimulation of separate phrenic nerve branches. Dissimilar postdenervational alterations were observed in the content of glycogen and in the isozyme spectrum of LDH, which depended on the type of partial denervation. Stimulation of individual branches of the phrenic nerve showed that they separately affected the synthesis and consumption of glycogen. The data obtained suggest the nervous regulation of glycogensynthetic processes in muscle tissue.

[Histochemical behavior of acetylcholinesterase in the diaphragm and that of unspecific esterase in the hypothalamus, testes and liver of rats in relation to organophosphates]. / Ein Beitrag zum histochemischen Verhalten der Acetylcholinesterase im Zwerchfell und der unspezifischen Esterasen in Hypothalamus, Hoden und Leber der Ratte gegenüber Organophosphaten.

The enzyme behaviour of acetylcholinesterase in diaphragm and that of unspecific esterase in liver, testes and hypothalamus were investigated in view of various organophosphates on total-preparation and cryostat section of 10 male wistar rats. It had pointed out that the blockade was dependent upon the concentration as well as the acid possessing P = O-binding proved to be appropriate for in vitro experiment. The most intense blockade of unspecific esterase was reached in tanycytependym of the third ventricle. The acetylcholinesterase in the motor endplate of diaphragm was less influenced. From these findings follows that a direct conclusion for in vivo toxicity can not be drawn from in vitro results. The significance of the chemical structure of the substance utilized was discussed concerning its inhibitory effect.