Browsing by Subject "sleep apnea"
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Item Androgen Modulation of CNS During Chronic Intermittent Hypoxia(2018-05) Snyder, Brina D.; Cunningham, Rebecca L.; Barber, Robert C.; Cunningham, J. Thomas; Schreihofer, Derek A.; Planz, John V.The underlying causes of age-related neurodegenerative diseases, such as Alzheimer's disease or Parkinson's disease, are unknown. It is likely conditions which contribute to an abundance of oxidative stress throughout life renders an individual more susceptible to late-life neurodegenerative processes. Sex differences are observed in the onset and prevalence of these diseases, suggesting estrogens and androgens influence these processes. This study investigates the early role of androgens under a known oxidative stressor, sleep apnea, which frequently goes untreated in the clinical population but is but is associated with an increased risk of late-life neurodegeneration. The hypoxic events of sleep apnea can be modeled in rats by the use of chronic intermittent hypoxia (CIH). Male rats are more susceptible to hypertensive effects of CIH, a key characteristic of sleep apnea. After one week of CIH treatment, they also exhibit oxidative stress and inflammation in circulation and in brain nuclei associated with early stages of Parkinson's disease or Alzheimer's disease. This led to the hypothesis that oxidative stress and inflammation would be associated with behavior deficits and these effects are mediated by androgens. Results show that oxidative stress and inflammatory dysregulation can be prevented by testosterone, but are highly exacerbated by testosterone's non-aromatizable metabolite, dihydrotestosterone (DHT). Administration of DHT also resulted in significant memory impairments under CIH. In the central nervous system, DHT significantly altered oxidative stress and pro-inflammatory signals, which may underlie its detrimental actions in an oxidative stress environment. There was also evidence of hypothalamic-pituitary-adrenal axis dysregulation, which can influence testosterone and circadian rhythms. These findings have broad implications for clinical populations with conditions which chronically increase oxidative stress and inflammation, while at the same time alter endocrine function. Conditions, such as untreated sleep apnea, may pose a latent risk for neurodegeneration and should be addressed early to prevent later detrimental effects.Item Mechanisms of Post-Apneic Symathoinhibition in Humans(2002-08-01) Swift, Nicolette Muenter; Michael Smith; David Barker; John R BurkMuenter Swift, Nicolette, Mechanisms of Post-Apneic Sympathoinhibition in Humans. Doctor of Philosophy (Biomedical Sciences), August, 2002, 110 pp., 14 figures, references. Apnea is accompanied by a concomitant rise in arterial pressure and muscle sympathetic nerve activity (MSNA), the latter primarily due to chemoreflex stimulation and possibly the lack of sympathoinhibitory input from pulmonary stretch receptors. The progressive sympathoexcitation during apnea suggests a possible overriding of arterial baroreflex sympathoinhibitory input to sympathoregulatory centers by apnea-induced sympathoexcitatory mechanisms. Nevertheless, it is unknown whether apnea attenuates baroreflex control of MSNA. Apnea termination is accompanied by a profound and immediate sympathoinhibition, the mechanisms of which are unclear; however, potential mediators include normalization of blood gases (i.e. chemoreflex unloading), the lung inflation reflex, and arterial baroreflex stimulation. Therefore, the purpose of the current studies was to: i) determine the contribution of chemoreflex unloading to post-apneic sympathoinhibition, ii) determine the contribution of the lung inflation reflex to post-apneic sympathoinhibition, and iii) determine whether carotid baroreflex control of MSNA is altered by apnea and its termination. The first study compared MSNA during post-apneic administration of room air versus a gas mixture designed to maintain the subjects’ end-apneic alveolar gas levels. Regardless of post-apneic gas administration, post-apneic MSNA was at or below baseline pre-apneic levels; thus; chemoreflex unloading does not contribute to post-apneic sympathoinhibition. Furthermore, quantification of post-apneic MSNA associated only with the low lung volume phase of respiration, when sympathoinhibitory input from the lung inflation reflex is minimal, demonstrated that post-apneic sympathoinhibition persists even during the low lung volume phase of respiration, when sympathoinhibitory input from the lung inflation reflex is minimal, demonstrated that post-apneic sympathoinhibition persists even during the low lung volume phase of respiration. Therefore, the lung inflation reflex does not appear to be the primary mediator of post-apneic sympathoinhibition. The second study utilized neck suction (NS) and neck pressure (NP) to assess carotid baroreflex function during and following sleep apnea. The sympathoinhibitory response to -60 Torr NS was maintained throughout apnea; conversely, the sympathoexcitatory response to +30 Torr NP was attenuated for nearly one minute post-apnea. Thus, carotid baroreflex control of MSNA is not altered by apnea but is transiently attenuated by apnea termination. We propose that the carotid baroreflex-MSNA function curve resets rightward and upward during apnea. Return of the function curve to baseline upon apnea termination may partly explain the reduced MSNA response to NP post-apnea.Item The Effects of Short-Term Intermittent Hypoxic Apneas on Sympathetic Nerve Activity and the Chemoreflex Control of Sympathetic Nerve Activity in Humans(2004-05-01) Cutler, Michael J.; Smith, Michael L.; Raven, Peter B.; Downey, H. FredCutler, Michael J., The Effects of Short-Term Intermittent Hypoxic Apneas on Sympathetic Nerve Activity and the Chemorelex Control of Sympathetic Nerve Activity in Humans. Doctor of Philosophy (Integrative Physiology), May 2004. Obstructive sleep apnea is associated with sustained elevation of muscle sympathetic nerve activity (MSNA) and altered chemoreflex control of MSNA both of which likely play an important role in the development of hypertension in these patients. Hypoxia is postulated to be primary stimulus for elevated daytime MSNA and altered chemoreflex control of MSNA both of which likely play an important role in the development of hypertension in these patients. Hypoxia is postulated to be the primary stimulus for elevated daytime MSNA and altered chemoreflex control of MSNA in OSA patients. Recently, short-term exposure to hypoxia was shown to produce sustained elevation of MSNA. Therefore, we studied the effects of 20 min of intermittent voluntary hypoxic apneas (to mimic OSA) on MSNA and the chemoreflex control of MSNA during 180 min post exposure. Also, we compared MSNA and chemoreflex control of MSNA for 180 min following either 20 min of intermittent voluntary hypoxic apneas, hypercapnic hypoxia, or isocapnic hypoxia. Consistent with our hypotheses, both total MSNA and MSNA burst frequency were elevated following 20 min of intermittent hypoxic apnea compared to baseline (p [less than] 0.05). Both total MSNA and MSNA burst frequency remained elevated throughout the 180 min recovery period and were statistically different from time control subjects throughout this period (p [less than] 0.05). Additionally, a significant main effect for chemoreflex control of SNA was observed following 20 min of intermittent hypoxic apneas (p [less than] 0.001). Specifically, the MSNA response to a single hypoxic apnea was attenuated 1 min post exposure compared to baseline (p [less than] 0.001), became augmented within 30 min of recovery, and remained augmented through 165 min of recovery (p [less than] 0.05). Finally, comparison of treatment groups (hypoxic apnea, hypercapnic hypoxia, and isocapnic hypoxia) revealed no differences in resting MSNA (p=0.50) and the chemoreflex control of MSNA (p=0.69) during recovery. Therefore, these data support the hypothesis that short-term exposure to intermittent hypoxic apneas resulted in sustained elevation of MSNA and altered chemoreflex control of MSNA. Furthermore, these responses appear to be mediated by hypoxia.Item The Role of Angiotensin Converting Enzyme 1 within the Median Preoptic Nucleus Following Chronic Intermittent Hypoxia(2016-08) Faulk, Katelynn E.; Cunningham, J. Thomas; Mifflin, Steve W.; Schreihofer, Ann M.; Ma, Rong; Jung, Marianna E.These experiments focused on the importance of the brain renin-angiotensin system (RAS) in hypertension caused by a chronic intermittent hypoxia (CIH) model of the hypoxemia associated with sleep apnea. In the CIH model, the sustained diurnal blood pressure increase has been shown to be dependent on the transcription factor FosB and its downstream target genes such as angiotensin converting enzyme 1 (ACE1) in the median preoptic nucleus (MnPO) in the anterior hypothalamus. These studies focused on the transcriptional regulation of MnPO ACE1 and the development of the sustained CIH hypertension. The first project focused on ACE1 within the MnPO and its regulation by FosB during CIH. Using immunohistochemistry, ACE1 staining within the MnPO did not overlap with glial fibrillary acidic protein (GFAP), a glial cell marker. ACE1 and FosB colocalization increased within the MnPO following 7 days of CIH. A retrograde tract tracer, fluorogold, was used to determine if ACE1 positive MnPO neurons project to the paraventricular nucleus of the hypothalamus (PVN). MnPO cells containing ACE1 and FosB immunoreactivity after CIH did project to the PVN, an area known to regulate sympathetic nerve activity. Chromatin Immunoprecipitation Assay was used to authenticate an association of FosB with ACE1 within the MnPO following CIH. In the MnPO, the association of FosB with the ACE1 gene was significantly increased by CIH. The second aim tested the functional role of MnPO ACE1 in sustained diurnal CIH hypertension. We used virally mediated expression of short hairpin RNA (shRNA) against ACE1 to significantly knockdown MnPO ACE1. Rats injected in the MnPO with shRNA against ACE1 demonstrated normal blood pressure responses to hypoxic events but the sustained blood pressure increase to CIH was significantly attenuated. ACE1 knockdown within the MnPO also decreased FosB/ΔFosB staining within the MnPO, the PVN and the rostral ventrolateral medulla (RVLM) but not in the nucleus of the solitary tract. Together, these studies suggest that MnPO ACE1 contributes to the development of sustained CIH hypertension.