Notre étude avait pour objectifs d'évaluer l'exposition chronique du fœtus aux pesticides et d'en étudier l'impact sur ses fonctions neurophysiologiques du nouveau-né prématuré. L'évaluation de l'exposition aux pesticides des enfants a été réalisée par questionnaire d'exposition maternelle et par le dosage de certains pesticides dans le méconium des nouveau-nés. Les paramètres hypniques et cardiovasculaires ont été obtenus lors d’une polysomnographie nocturne. La sensibilité des chémorécepteurs périphériques a été évaluée par un test hypoxique (15% O2) réalisé dans chacun des stades de sommeil. 100% des nouveau-nés présentaient au moins un des pesticides recherchés dans leur méconium, et pour 58,3% d’entre eux, plus de 3 substances ont été retrouvées. Nos résultats ont montré un impact des pesticides sur la structure du sommeil avec un temps de sommeil plus court (DMP), et une proportion de sommeil agité plus importante et de sommeil calme plus faible (DEP). Les enfants avaient également un sommeil plus fractionné lorsque les mamans étaient exposées aux pesticides par l'alimentation. La ventilation de base était plus élevée en présence de DEP (+18%) mais plus faible en présence de DMDTP (-14%). La sensibilité des chémorécepteurs périphériques était également plus faible chez les enfants exposés au DMDTP. Enfin, la balance sympatho-vagale était perturbée par l'exposition aux pesticides. Nos résultats suggèrent que l'exposition chronique in utero aux pesticides pourrait entrainer des dysfonctionnements des fonctions neurovégétatives du nouveau-né prématuré les rendant plus vulnérables face à divers stress cardio-ventilatoires / First we aimed to assess chronic pesticides exposure of the fetus. Then, we investigated the impact of pesticide exposure on vital neurophysiological functions of preterm neonates such as sleep, ventilation and its control, as well as cardiovascular control. We assessed pesticides exposure of neonates using a maternal exposure questionnaire, completed by a multi-residue analysis of pesticides in meconium in order to identify and quantify some pesticides and their metabolites. Cardiovascular and sleep parameters were obtained by polysomnography. Peripheral chemoreceptors sensitivity was measured using a hypoxic test (15% O2) during each sleep state. All newborns had at least one pesticide in their meconium and 58.3% of them, had more than 3 substances detected. Our results showed an impact of pesticides exposure on sleep structure as sleep duration was shortened (DMP), active sleep proportion was higher, and quiet sleep proportion was lower. Neonates also had a more fractionated sleep when their mothers were exposed to pesticides through dietary habits. With regards to ventilation, our results showed heterogeneous effects. Indeed, ventilation was higher when DEP was detected (+18%) but lower when DMDTP was identified (-14%). Peripheral chemoreceptors sensitivity was also weaker for neonates exposed to DMDTP. Finally, the sympatho-vagal balance were altered by pesticides exposure. Our results suggest that chronic pesticide exposure in utero could lead to a disruption of neurophysiological functions in preterm neonates (sleep, ventilation, cardiovascular system) making them even more vulnerable to various cardiorespiratory challenges

L'érythropoïétine (EPO) est une cytokine ayant un rôle important dans l'homéostasie de l'oxygène (O2). Lors d'une hypoxie chronique, l'EPO stimule la maturation des progéniteurs érythroïdes en globules rouges augmentant ainsi le transport de l'O2 aux tissus. Outre cet effet érythropoïétique, l'EPO module la réponse ventilatoire à l'hypoxie (RVH) par une action directe sur la commande centrale respiratoire (CCR) et les chémorécepteurs périphériques. Cet effet a été principalement caractérisé chez des souris mutantes surexprimant l'EPO. Cependant, plusieurs aspects de l'effet de l'EPO sur l'activité du réseau respiratoire demeurent inconnus. Nos résultats montrent qu'une application aigüe d'EPO diminue la dépression centrale hypoxique mesurée in vitro chez le nouveau-né. En revanche, elle n'affecte pas la RVH mesurée in vivo au cours du développement postnatal mais diminue la fréquence des apnées survenant en hypoxie sévère à 6% d'O2. Aussi, chez la souris adulte, l'administration chronique d'EPO et de C-EPO augmente la sensibilité des chémorécepteurs périphériques à l'O2 et maintient la ventilation durant la phase tardive de la RVH. Enfin, l'EPO diminue la sensibilité ventilatoire à l'hypercapnie grâce à des effets périphériques et centraux. L'ensemble de nos résultats montrent que l'EPO module la respiration et contribue à l'homéostasie de l'O2 et du CO2 grâce à ses effets plasmatiques et centraux. Elle représente un candidat à fort potentiel thérapeutique pour les pathologies respiratoires où la sensibilité chimique à l'O2 et au CO2 sont altérés telles que l'apnée du nouveau-né ou le mal chronique des montagnes. / Erythropoietin (EPO) is a cytokine that plays a major role in O2 homeostasis. Upon chronic hypoxia, EPO stimulates the maturation of erythroid progenitors into red blood cells, contributing to increased O2 carrying to tissues. Besides this well-known erythropoietic effect, EPO also modulates the respiratory response to hypoxia by interacting with the central respiratory network in the brainstem and the peripheral chemoreceptors. This effect was mainly characterized in adult mutant mice that overexpress EPO. Several aspects regarding EPO's effect on breathing regulation remain unknown. Our results show that acute EPO treatment increases the O2 sensitivity of the central respiratory network in newborn mice in vitro. However, EPO does not impact the hypoxic ventilatory response to hypoxia in vivo, but decreases the apneic events during severe hypoxia in mice at postnatal day 7. In WT adults, chronic but not acute EPO and C-EPO treatment increases the O2 sensitivity by stimulating both peripheral chemoreceptor and central respiratory network. Finally, both cerebral and plasmatic EPO blunt the ventilatory response to increased CO2 levels in adult mice. Taken together, these results imply that EPO, by acting on the ventilatory system, plays a key role in the modulation of the chemical sensitivity to O2 and CO2.

The sympathetic nervous system plays a key role in the regulation of cardiovascular and ventilatory responses during exercise. The regulation of the heart and peripheral circulation by the autonomic nervous system is accomplished by control centers that receive input from mechanical and chemical receptors through the body. Therefore, the changes in sympathetic and parasympathetic activity allow for rapid responses. <p><p>Exercise is associated with increases of ventilation, heart rate and blood pressure. Ventilation increases adaptedly to increased oxygen uptake (VO2) and carbon dioxide output (VCO2) and eventually to limit metabolic acidosis occurring above the ventilatory threshold. Cardiac output increases to meet the contracting muscles’ requirement for flow. The increase in cardiac output occurs through increases in both heart rate and stroke volume and is regulated by feed-forward mechanisms: central command and exercise pressor reflex. <p><p>Skeletal muscle contraction elicits a reflex increase in sympathetic outflow which causes vasoconstriction contributing to the exercise induced rise in blood pressure. This reflex is triggered by stimulation of metabo- and chemoreceptors. Although the precise stimulus is not known, adrenergic receptor signaling is involved in the cardiovascular and respiratory alterations in response to exercise. <p><p>This thesis has been devoted to a better understanding of the functional aspects of sympathetic nervous system activation during dynamic and resistive exercise, with use of β blocker and β2 stimulant interventions The hypotheses were: 1) that β blocker interventions would decrease aerobic exercise capacity by a limitation of maximal cardiac output, but more so the ventilatory responses to exercise because of a decreased chemosensitivity, thereby decreasing dyspnea, and 2) β2 stimulant interventions would slightly increase aerobic exercise capacity by an increase in maximal cardiac output, but also the ventilatory responses because of an increased chemosensitivity, with possible decrease of the ventilatory reserve at exercise and increased dyspnea. Both interventions could affect maximal muscle strength through central effects.<p><p>Ventilatory responses to hyperoxic hypercapnia (central chemoreflex) and to isocapnic hypoxia (peripheral chemoreflex) were confronted to measurements of ventilatory equivalents for oxygen (O2) and carbon dioxide (CO2) during standard cardiopulmonary exercise test (CPET). Resting 5 measurements of muscle sympathetic nervous activity (MSNA) were obtained in different conditions with and without pharmacological interventions. Muscle metaboreflex and muscle stength measurements were also considered. Drugs with β blocker or β2 stimulant properties were administered in range of doses used in clinical practice for the teatment of cardiovascular or rerspiratory conditions. The results show that β blockade with bisoprolol slightly reduced maximal exercise capacity as assessed by a maximal oxygen uptake (VO2max) or maximal workload (Wmax), with a decreased maximal heart rate, without significant effect on ventilation (VE) or MSNA responses to hypercapnia, hyperoxia or to isometric muscle contraction or ischemia. Both VE/VO2 and VE/VCO2 slopes were decreased during CPET, which was attributable to β blockade-related hemodynamic changes. On the other hand, stimulation of β2 receptors with salbutamol did not affect exercise capacity as assessed by VO2max or Wmax in spite of increased peripheral chemosensitivity with increased VE/VCO2 slopes and early lactic acidosis. MSNA burst frequency, muscle metaboreflex and maximal isokinetic muscle strength were not affected by salbutamol. <p><p>Thus, aerobic exercise capacity in healthy subjects is sensitive to sympathetic nervous system modulation by β blocker or β2 stimulant interventions with drugs at doses prescribed in clinical practice. B blocker intervention has a slight limitation of aerobic exercise capacity and a hemodynamic decrease in ventilation, while β2 stimulant intervention has no change in exercise capacity with associated increased ventilatory responses because of increased chemosensitivity, partly related to early lactic acidosis. None of the studied phamacologic interventions affected MSNA or muscle strength measurements. <p><p>We hope that these results might be useful for the understanding of the effects of revalidation to exercise of patients treated with β blocker or β2 stimulant drugs, document the limited ergogenic properties and also side effects of the intake of these substances in healthy exercising subjects.<p> / Doctorat en Sciences de la motricité / info:eu-repo/semantics/nonPublished