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Item Acute Exercise Activates Pulmonary eNOS and Lowers Pulmonary Pressure in Rats with Pulmonary Arterial Hypertension(Office of the Vice Chancellor for Research, 2013-04-05) Chingombe, Tsungai J.; Reddy, Jag; Fisher, Amanda; Presson, Robert G.; Lahm, Tim; Petrache, Irina; Brown, Mary BethNO-dependent arterial relaxation is impaired in pulmonary arterial hypertension (PAH). Exercise may be beneficial in PAH, just as it is for systemic vascular disease, via upregulation of endothelial nitric oxide synthase (eNOS) expression and activity. However, exercise-induced cardiac stress in PAH could also promote detrimental RV inflammation. We investigated pulmonary pressure and eNOS, as well inflammatory indicators in the RV, following a single 45 min run bout at moderate intensity in a rat model of PAH. Male Sprague-Dawley rats received either monocrotaline to induce PAH, or saline, for healthy controls. A subset of PAH and healthy controls performed 4 wks of progressive TM familiarization (15-30min, 8-20 m/min) in preparation for their final 45 min run @ 75% of VO2max. Immediately following the run, RV systolic pressure was measured and RV and lung tissues were harvested and cryofixed. eNOS and phosphorylated (at Ser1177) eNOS (p-eNOS) was measured via immunoblotting in lung homogenates and expressed normalized to vinculin. Immunofluorescence for inflammatory markers CD45/68 in cryofixed RV sections evaluated the acute inflammatory response to exercise. MCT reduced VO2max and caused RV hypertrophy (expressed as RV/LV+septum) as consistent with this model. RVSP (normalized by systemic BP) was lower in PAH-Ex vs. unexercised PAH with no difference between exercised and unexercised controls. Greater p-eNOS was measured in PAH-Ex lung compared to unexercised PAH, with no difference between exercised and unexercised controls. PAH-Ex also tended to have greater pulmonary eNOS than their unexercised counterparts. No greater exercise-induced CD45/68 infiltration was observed in RV of PAH compared to that of controls. In rats with moderate MCT-induced PAH, a single exercise bout does not increase acute RV inflammation but lowers pulmonary pressure, possibly mediated in part via pulmonary eNOS activation.Item Beet-ing Muscle Dysfunction and Exercise Intolerance in Pulmonary Hypertension(2019-10) Long, Gary Marshall; Coggan, Andrew R.; Brown, Mary Beth; Lahm, Tim; Avin, Keith; Arnold, BrentBackground: Pulmonary Hypertension (PH) is a devastating disease characterized by pulmonary arterial remodeling, right ventricular dysfunction and ultimately right heart failure. Increased emphasis has been given to skeletal muscle dysfunction in PH, and to its implication in the severe exercise intolerance that is a hallmark of the condition. In this dissertation, skeletal muscle blood flow was measured via the microsphere technique at rest and during exercise (Aim 1), with an acute dose of dietary nitrate via beetroot juice (BRJ) gavage used to determine if supplementation could improve muscle blood flow and alter energetics (Aim 2). VO2max, voluntary running and grip strength tests were used to determine the effect of disease on performance, and to test for an ergogenic effect of BRJ vs. placebo (PL) in healthy and PH rats (Aim 3). Methods: A prospective, randomized, counterbalanced, placebo-controlled trial was used to examine the aforementioned aims across four groups; PH rats (induced with monocrotaline, MCT, 60mg/kg, s.q., 4 weeks) supplemented with BRJ (MCT BRJ, n=9); PH rats supplemented with placebo (MCT PL, n=9); healthy control rats (vehicle, s.q.) supplemented with BRJ (CON BRJ, n=8); healthy control rats supplemented with placebo (CON PL, n=9). Results: Monocrotaline induced a severe PH phenotype evidenced by increased RV wall thickness, RV hypertrophy, RVSP and reduced cardiac output and stroke volume compared to controls (p=<0.001). MCT rats demonstrated lower muscle blood flow at rest, and more prominently during exercise compared to controls (p=0.007-0.047), regardless of supplementation. MCT rats displayed a greater reliance on anaerobic metabolism, demonstrated by increased blood lactate accumulation (p=<0.001), and this was significantly related to reduced blood flow during exercise (r=-0.5879, p=0.001). BRJ supplementation resulted in increased plasma nitrate and nitrite compared to PL (p=<0.001), but at the skeletal muscle level, only nitrate was increased after BRJ. BRJ did not have a significant effect on blood flow, with no improvement during exercise shown vs. PL. Similarly, BRJ did not significantly improve exercise function in MCT or CON rats. Conclusion: MCT rats demonstrated a reduction in muscle blood flow, with BRJ supplementation not resulting in improved flow or exercise performance.Item Cardiac and Skeletal Muscle Lipotoxicity in a Rat Model of Pulmonary Arterial Hypertension(Office of the Vice Chancellor for Research, 2015-04-17) Dave, Priya; Cooney, Sean; Lahm, Tim; Brown, Mary BethPatients with Pulmonary Arterial Hypertension (PAH)experience shift from aerobic to anaerobic respiration in cardiac and skeletal muscle myocytes. This shift can be identified histologically by an increased presence of the glucose transporter Glut 1 in the tissue, indicating increased reliance on cytoplasmic glycolysis. Previous studies have demonstrated that in patients with diabetes, an increase in Glut 1 is accompanied by an increase in fat storage in the cell. Excessive myocyte fat storage may contribute to tissue and systemic inflammation and has therefore been termed ‘lipotoxicity’. This study tested the hypothesis in a PAH rat model that an increase in cardiac and skeletal muscle Glut 1 abundance would be associated with an increase in fat storage in the cell. Oil Red O staining was performed to assay for lipotoxicity in cryosections of right ventricle and soleus muscle tissue, imaged using brightfield microscopy. The experiment was conducted using tissue from a moderately severe PAH phenotype produced by monocrotaline(60 mg/kg) injection, as well as from saline injected control animals. Lipids have been observed in the first few samples tested with Oil Red O staining, and results are still pending as a larger sample size is currently being collected.Item Disinhibiting neurons in the dorsomedial hypothalamus delays the onset of exertional fatigue and exhaustion in rats exercising in a warm environment(Elsevier, 2018-06) Zaretsky, Dmitry V.; Kline, Hannah; Zaretskaia, Maria V.; Brown, Mary Beth; Durant, Pamela J.; Alves, Nathan J.; Rusyniak, Daniel E.; Emergency Medicine, School of MedicineStimulants cause hyperthermia, in part, by increasing heat generation through exercise. Stimulants also delay the onset of fatigue and exhaustion allowing animals to exercise longer. If used in a warm environment, this combination (increased exercise and decreased fatigue) can cause heat stroke. The dorsomedial hypothalamus (DMH) is involved in mediating locomotion from stimulants. Furthermore, inhibiting the DMH decreases locomotion and prevents hyperthermia in rats given stimulants in a warm environment. Whether the DMH is involved in mediating exercise-induced fatigue and exhaustion is not known. We hypothesized that disinhibiting neurons in the dorsomedial hypothalamus (DMH) would delay the onset of fatigue and exhaustion in animals exercising in a warm environment. To test this hypothesis, we used automated video tracking software to measure fatigue and exhaustion. In rats, using wearable mini-pumps, we demonstrated that disinhibiting the DMH, via bicuculline perfusion (5 µM), increased the duration of exercise in a warm environment as compared to control animals (25 ± 3 min vs 15 ± 2 min). Bicuculline-perfused animals also had higher temperatures at exhaustion (41.4 ± 0.2 °C vs 40.0 ± 0.4 °C). Disinhibiting neurons in the DMH also increased the time to fatigue. Our data show that the same region of the hypothalamus that is involved in mediating locomotion to stimulants, is also involved in controlling exhaustion and fatigue. These findings have implications for understanding the cause and treatment of stimulant-induced-hyperthermia.Item Disinhibiting neurons in the dorsomedial hypothalamus delays the onset of exertional fatigue and exhaustion in rats exercising in a warm environment(Elsevier, 2018-06-15) Zaretsky, Dmitry V.; Kline, Hannah; Zaretskaia, Maria V.; Brown, Mary Beth; Durant, Pamela J.; Alves, Nathan J.; Rusyniak, Daniel E.; Emergency Medicine, School of MedicineStimulants cause hyperthermia, in part, by increasing heat generation through exercise. Stimulants also delay the onset of fatigue and exhaustion allowing animals to exercise longer. If used in a warm environment, this combination (increased exercise and decreased fatigue) can cause heat stroke. The dorsomedial hypothalamus (DMH) is involved in mediating locomotion from stimulants. Furthermore, inhibiting the DMH decreases locomotion and prevents hyperthermia in rats given stimulants in a warm environment. Whether the DMH is involved in mediating exercise-induced fatigue and exhaustion is not known. We hypothesized that disinhibiting neurons in the dorsomedial hypothalamus (DMH) would delay the onset of fatigue and exhaustion in animals exercising in a warm environment. To test this hypothesis, we used automated video tracking software to measure fatigue and exhaustion. In rats, using wearable mini-pumps, we demonstrated that disinhibiting the DMH, via bicuculline perfusion (5 µM), increased the duration of exercise in a warm environment as compared to control animals (25 ± 3 min vs 15 ± 2 min). Bicuculline-perfused animals also had higher temperatures at exhaustion (41.4 ± 0.2 °C vs 40.0 ± 0.4 °C). Disinhibiting neurons in the DMH also increased the time to fatigue. Our data show that the same region of the hypothalamus that is involved in mediating locomotion to stimulants, is also involved in controlling exhaustion and fatigue. These findings have implications for understanding the cause and treatment of stimulant-induced-hyperthermia.Item The Effect of 17beta Estradiol on Glut1 Expression In The Right Ventricle Of Rats With Severe Pulmonary Hypertension(Office of the Vice Chancellor for Research, 2013-04-05) Taylor, Vanessa N.; Lahm, Tim; Cucci, Anthony; Petrache, Irina; Albrecht, Marjorie E.; Brown, Mary Beth; Chingombe, Tsungai J.; Gaidoo, Richard G.Pulmonary hypertension (PH) is a devastating disease that is characterized by a rise of blood pressure in the blood vessels of the lung. This puts significant strain on the right ventricle (RV) of the heart. If untreated, PH can lead to right heart failure and death. One of the hallmarks of right heart failure in PH is the development of cytoplasmic glycolysis in the cardiac muscle cells (myocytes) of the RV. This describes a compensatory process where glucose uptake into the mitochondria is inhibited, thereby leading to its conversion to lactate in the cytoplasm. Importantly, cytoplasmic glycolysis is associated with an increase in a protein called glucose transporter 1 (Glut 1). 17beta estradiol (E2) can ameliorate experimental PH, but its effects on RV glut 1 expression are not yet known. The aim of this project is to determine the RV expression of Glut 1 in a rat model of severe PH, and to investigate whether this is decreased by E2 treatment. We assessed Glut 1 via immunofluorescence staining in cryosections of RV tissue from control rats, untreated PH rats, and E2-treated PH rats. Cell nuclei were stained with DAPI (Diamidinophenyl-indole), cell membranes were stained with WGA (wheat germ agglutinin), and Glut1 was stained with a Glut1 antibody conjugated to a red immunofluorescent dye. Nuclei are stained blue; cell membranes are stained green. Glut 1 quantification occurs via visual inspection and determination of red staining via specific software (Metamorph). We were able to successfully establish the protocol for Glut1 staining. In pilot experiments, there was little Glut1 staining present in normal RVs, but we detected up-regulation of Glut 1 in the RV of animals with PH. Whether this is affected by E2 is currently under investigation.Item Effect of Exercise on Right Ventricle Inflammation in a Rat Model of Severe Monocrotaline-Induced Pulmonary Arterial Hypertension(Office of the Vice Chancellor for Research, 2015-04-17) Chingombe, Tsungai J.; Lahm, Tim; Brown, Mary BethPulmonary arterial hypertension (PAH) is a devastating disease of progressive remodeling of small and mid-size pulmonary arteries that leads to elevated pulmonary pressure. The work of the right heart is increased due to the elevated pulmonary pressures and can lead to maladaptive cardiac wall hypertrophy, right heart failure and then eventually death. Whether exercise-induced cardiac stress also promotes detrimental right ventricle (RV) inflammation in PAH has not been thoroughly examined. The purpose of this study is to determine if treadmill exercise at low relative intensity in a rat model of severe PAH without promoting greater RV inflammation. Adult male Sprague- Dawley rats were injected with monocrotaline (60mg/kg, subcutaneously, n=14) or saline (healthy controls, n=4). RV tissue was obtained from these rats following a 6 week, 5 times/week treadmill training program at a low intensity of 50% of measured aerobic capacity (VO2max) and compared to tissue obtained from sedentary counterparts. RV immunofluorescent staining for CD45, a lymphocyte marker, was performed to evaluate the inflammatory response due to chronic exercise training. The experiment is still underway and the expected result is that there is no greater exercised induced RV inflammation in PAH rats compared to healthy rats.Item EFFECT OF TREADMILL RUNNING ON CARDIAC AND SKELETAL MUSCLE METABOLISM AND RIGHT VENTRICLE INFLAMMATION IN RATS WITH PULMONARY ARTERIAL HYPERTENSION(Office of the Vice Chancellor for Research, 2012-04-13) Chingombe, Tsungai J.; Lahm, Tim; Reddy, Jag; Fisher, Amanda; Petrache, Irina; Brown, Mary BethIt has been suggested that a shift from oxidative to non-oxidative (glycolytic) metabolism promotes a right ventricle (RV) and skeletal muscle dysfunction in patients with pulmonary arterial hypertension (PAH), contributing to their reduced exercise tolerance. Exercise training may ameliorate this glycolytic switch in PAH as it does for other cardiopulmonary diseases. However, whether exercise-induced cardiac stress also promotes detrimental RV inflammation in PAH has not yet been thoroughly examined. We hypothesized that exercise training will promote a shift back towards the more efficient oxidative metabolism in cardiac and skeletal muscle of PAH rats and that 45 minutes of exercise at a prescribed moderate intensity will not promote greater RV inflammation in PAH rats. Tissues were obtained from monocrotaline-induced PAH and healthy control rats immediately following a 45 min treadmill run (75% VO2max) that concluded a 4 week treadmill familiarization/running program (15-45 min, 4x/wk). A group of unexercised PAH and healthy rats served as sedentary controls. Immunofluorescent staining (IF) for inflammatory markers CD45 (lymphocytes) and CD68 (macrophages) in cryofixed RV sections were used to assess the acute inflammatory response to exercise. In fixed soleus and RV sections, IF for the glucose transporter Glut1, and for capillary marker CD31, were used as indicators of glycolytic metabolism and tissue capillarization, respectively. Data thus far indicates no greater acute exercise-induced RV inflammation in PAH rats compared to healthy rats. We observed higher expression of Glut1 and lower capillarization in the RV and soleus of PAH rats, indicative of a shift toward greater dependency on non-oxidative metabolism. However, since Glut1 levels for exercised rats were measured in tissue harvested immediately following a run bout, evaluation of a chronic training effect on Glut1 expression is potentially confounded by the acute exercise effect and therefore remains to be investigated in a follow-up study.Item Exercise Training Improves Cardiac and Skeletal Muscle Metabolism in Rats with Pulmonary Arterial Hypertension(Office of the Vice Chancellor for Research, 2013-04-05) Gaidoo, Richard G.; Crist, Jacob; Little, Nathaniel; Chingombe, Tsungai J.; Fisher, Amanda; Presson, Robert G.; Lahm, Tim; Petrache, Irina; Brown, Mary BethIn patients with pulmonary arterial hypertension (PAH), a shift from oxidative to glycolytic metabolism promotes right ventricular (RV) and skeletal muscle dysfunction that contributes to reduced exercise tolerance. As seen for other cardiopulmonary diseases, exercise training (ExT) may ameliorate this glycolytic switch in PAH and improve exercise capacity. The purpose of this research is to investigate ExT in a rat model of PAH on markers of glycolytic and oxidative metabolism in RV and skeletal muscle. Male Sprague-Dawley rats received monocrotaline (MCT, 40 mg/kg, s.q.) to induce PAH (n= 13), or saline, for healthy controls (n=5). After 2 wks, with MCT-induced PAH established, 6 wks of treadmill (TM) ExT was initiated for a subset of PAH animals (PAH-ExT, n= 6) and healthy controls (CON-ExT, n=3). ExT runs progressed up to 60 min at mild relative intensity, 50% of maximal aerobic capacity (VO2max). VO2max was assessed at baseline, in pre-training and post-training TM testing via analysis of expired gases. Abundance of Glut-1, a marker of glycolytic metabolism, was evaluated in cryosections of RV and soleus with immunofluorescent (IF) staining and quantification. Data are presented as mean±SE. MCT-ExT rats maintained aerobic capacity over 6 wks better than sedentary counterparts (MCT-SED)(VO2max= -134±109 vs. -521±129 ml/kg/hr, p=0.04) and was not different than CON-ExT (-201±31 ml/kg/hr, p=0.82). A lower abundance of Glut-1 was observed in both RV and soleus myocytes of PAH-ExT rats (MPI= 10.9 ±0.9 for RV; 13.7±0.8 for soleus) compared to PAH-SED rats (15.7±2.4, p=0.05, for RV; 17.4±1.4, p=0.04, for soleus) and was similar to CON-ExT rats (13.0±2.2, p=0.33, for RV; 9.0±2.3, p=0.26, for soleus), indicative of a shift toward greater dependency on oxidative metabolism. Exercise training attenuates functional decline following MCT administration in rats. Preservation of aerobic capacity may be explained by promotion of more efficient RV and skeletal muscle mitochondrial substrate utilization.Item High Intensity Interval Training Benefits Right Heart Function in a Rat Model of Pulmonary Arterial Hypertension(Office of the Vice Chancellor for Research, 2016-04-08) Troutman, Ashley; Brown, Mary Beth; Johnson, Breann; Neves, Evandro; Fisher, Amanda; Graber, Jeremy; Gladish, Brett; Presson, Robert; Petrache, Irina; Kline, Jeffrey A.; Lahm, TimPulmonary Arterial Hypertension (PAH) is a disease of progressive remodeling in pulmonary arteries that elevates pulmonary pressures and eventually leads to right ventricular (RV) failure and death. The purpose of this study was to examine the benefit and detriment of high intensity interval training (HIIT) to the RV in a monocrotaline (MCT) PAH rat model. It is hypothesized that HIIT will improve indicators of RV function without increasing myocardial inflammation or apoptosis. Male Sprague Dawley rats were injected with either MCT (40 mg/kg, n=14)) to induce mild PAH or saline for healthy controls (CON, n=9). A subgroup of MCT (n= 8) and CON rats (n=6) performed a 6 week treadmill HIIT program 5x/week using short bouts of alternating high intensity (2 min, 85-90%VO2max) and low intensity (3 min, ~30%VO2max) running for 30 min/session. Histochemistry/immunohistochemistry was performed on cryofixed or formalin-fixed/paraffin-embedded RV sections to assess indicators of inflammation (CD45+ cells), apoptosis (TUNEL), fibrosis (trichrome) and was imaged using epifluorescence or brightfield microscopy. Image quantification was performed using ImageJ. For the HIIT rats, a reduction in MCTinduced RV hypertrophy was observed, as measured echocardiographically, and by the calculated ratio of RV mass relative to LV+Septum mass. RV function was better preserved for HIIT vs. sedentary MCT, as indicated by stroke volume and cardiac index (cardiac output normalized by body weight) in echocardiography. MCT-induced RV fibrosis as measured by trichrome staining was lower for HIIT, also indicating a healthier myocardium. HIIT did not prompt greater counts per field of CD45+ cells and TUNEL+ cells in HIIT vs. sedentary MCT RV myocardium. In conclusion, in the monocrotaline rat model of PAH, HIIT appears to be a beneficial exercise approach that improves RV function without exacerbating RV inflammation or apoptosis. Future work will examine effects in other PAH models and ultimately in patients with disease.