博士(スポーツ健康科学) / Doctor of Philosophy in Health and Sports Science / 同志社大学 / Doshisha University

No description available.

Background: Even though specific agents for the treatment of patients with pulmonary hypertension (PH) are available, in PH patients, physical capacity and quality of life (QoL) are often restricted and survival is reduced. Objectives: This study prospectively investigated the long-term effects of respiratory and exercise training in patients with severe chronic PH regarding safety, time to clinical worsening and survival. Methods: Fifty-eight consecutive patients with severe PH on stable disease-targeted medication received exercise and respiratory training in hospital for 3 weeks and continued at home. They were prospectively followed for 24 ± 12 months. Primary endpoints were time to clinical worsening and survival. Adverse events and changes in the 6-min walking test, QoL, WHO functional class and gas exchange were secondary endpoints and were evaluated at baseline and at weeks 3 and 15. Results: All patients tolerated the exercise training well without severe adverse events. In week 15, 6-min walking test results were significantly improved compared to baseline (by 84 ± 49 m, p < 0.001), as well as QoL scores, WHO functional class (from 2.9 ± 0.5 to 2.6 ± 0.6, p < 0.01), peak oxygen consumption (from 12.5 ± 3.0 to 14.6 ± 3.9 ml/min/kg, p < 0.001), heart rate at rest (from 75 ± 12 to 61 ± 18 beats/min, p < 0.001) and maximal workload (from 65 ± 21 to 80 ± 25 W, p < 0.001). Survival at 1 and 2 years was 100 and 95%, respectively. Fifteen events occurred during the follow-up. Conclusion: This study indicates that exercise and respiratory training as add-on to medical treatment may improve exercise capacity and QoL, and that they have a good long-term safety in the described setting. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Globally, cancer is one of the leading causes of mortality, with an estimated 18.1 million cancer cases, 10 million deaths, and 1.9 million new cases diagnosed in 2020 (Sung et al., 2021). However, during the past several decades, cancer survival has improved such that 82% of children and >2/3 of adults diagnosed with cancer will survive beyond five years (World Health Organization (WHO) - Childhood Cancer, 2021). Skeletal muscle atrophy and fibrosis are long-term adverse effects experienced by 80% of cancer survivors for which there is no available therapy (Paulino, 2004). These long-term consequences are related to the toxicity from the cancer treatment, leading to alterations in skeletal muscle function which can lead to comorbidities and increased mortality among cancer survivors (Paulino, 2004; Williams et al., 2016). Thus, novel approaches to address the long-term effects of cancer therapy on skeletal muscle are critically needed. Exercise training is a potential non-pharmacological strategy that improves common cancer- and treatment-related side effects (Mustian et al., 2012). Specifically, exercise programs that combine resistance and endurance training (RET) have been shown to improve muscle strength and cardiovascular fitness in cancer survivors (Tong et al., 2020). The mechanisms responsible for these effects remain unknown. The remarkable plasticity of skeletal muscle relies primarily on muscle stem (satellite) cells (MuSCs) (Lepper et al., 2011) that are regulated, in part, by muscle-resident stromal cells (Bentzinger et al., 2013). These different stromal cell types, including: vascular endothelial cells (ECs), immune cells, and mesenchymal progenitors, also known as fibro-adipogenic progenitors (FAPs), create the muscle stem cell niche (Yin et al., 2013). FAPs possess a dual role as they are involved in skeletal muscle maintenance and regeneration by secreting pro-myogenic trophic factors (Biferali et al., 2019; Joe et al., 2010; Uezumi et al., 2010; Wosczyna et al., 2019), but also contribute to fibrotic and fatty tissue accumulation in chronic degenerative conditions (Uezumi et al., 2010). The divergent features of FAPs highly depend on signals they receive from their microenvironment (Giuliani et al., 2021); however, FAP's contribution to cancer treatment-induced muscle pathology in cancer survivors remains unknown. The overall objective of this thesis is to begin to develop an understanding of the role of FAPs in cancer treatment-induced muscle pathology and to determine if RET represents an effective therapy to prevent the long-term muscle defects of juvenile cancer plus therapy.

No description available.

Aims In heart failure with preserved ejection fraction (HFpEF), the reduction of nitric oxide (NO)-bioavailability and consequently endothelial dysfunction leads to LV stiffness and diastolic dysfunction of the heart. Besides shear stress, high-density lipoprotein (HDL) stimulates endothelial cells to increased production of NO via phosphorylation of endothelial nitric oxide synthase (eNOS). For patients with heart failure with reduced ejection fraction, earlier studies demonstrated a positive impact of exercise training (ET) on HDL-mediated eNOS activation. The study aims to investigate the influence of ET on HDL-mediated phosphorylation of eNOS in HFpEF patients. Methods and results The present study is a substudy of the OptimEx-Clin trial. The patients were randomized to three groups: (i) HIIT (high-intensity interval training; (ii) MCT (moderate-intensity continuous training); and (iii) CG (control group). Supervised training at study centres was offered for the first 3 months. From months 4–12, training sessions were continued at home with the same exercise protocol as performed during the in-hospital phase. Blood was collected at baseline, after 3, and 12 months, and HDL was isolated by ultracentrifugation. Human aortic endothelial cells were incubated with isolated HDL, and HDL-induced eNOS phosphorylation at Ser1177 and Thr495 was assessed. Subsequently, the antioxidative function of HDL was evaluated by measuring the activity of HDL-associated paraoxonase-1 (Pon1) and the concentration of thiobarbituric acid-reactive substances (TBARS). After 3 months of supervised ET, HIIT resulted in increased HDL-mediated eNOS-Ser1177 phosphorylation. This effect diminished after 12 months of ET. No effect of HIIT was observed on HDL-mediated eNOS-Thr495 phosphorylation. MCT had no effect on HDL-mediated eNOS phosphorylation at Ser1177 and Thr495. HIIT also increased Pon1 activity after 12 months of ET and reduced the concentration of TBARS in the serum after 3 and 12 months of ET. A negative correlation was observed between TBARS concentration and HDL-associated Pon1 activity in the HIIT group (r = −0.61, P < 0.05), and a trend was evident for the correlation between the change in HDL-mediated eNOS-Ser1177 phosphorylation and the change in peak V̇O2 after 3 months in the HIIT group (r = 0.635, P = 0.07). Conclusions The present study documented that HIIT but not MCT exerts beneficial effects on HDL-mediated eNOS phosphorylation and HDL-associated Pon1 activity in HFpEF patients. These beneficial effects of HIIT were reduced as soon as the patients switched to home-based ET.

Preeclampsia is among the leading causes of perinatal mortality and morbidity, affecting 2-7% of pregnancies. Its incidence increases to 10-25% in already hypertensive women. To date, no treatment, aside from delivery, is known. Interestingly, several studies have reported that exercise training (ExT) can reduce preeclampsia prevalence although the available studies are considered insufficient. Therefore, the aim of this study is to determine the impact of ExT when practiced before and during gestation on pregnancy outcome in a mouse model of preeclampsia superimposed on chronic hypertension (SPE). To do so, mice overexpressing both human angiotensinogen and renin (R+A+) were used because they are hypertensive at baseline and they develop many hallmark features of SPE. Mice were trained by placing them in a cage with access to a running wheel 4 weeks before and during gestation. ExT in this study prevented the rise in blood pressure at term observed in the sedentary transgenic mothers. This may be realized through an increased activity of the angiotensin-(1-7) axis in the aorta. In addition, ExT prevented the increase in albumin/creatinine ratio. Moreover, placental alterations were prevented with training in transgenic mice, leading to improvements in placental and fetal development. Placental mRNA and circulating levels of sFlt-1 were normalized with training. Additionally, the increase in angiotensin II type I receptor and the decrease in Mas receptor protein were reversed with training. ExT appears to prevent many SPE-like features that develop in this animal model and may be of use in the prevention of preeclampsia in women. / La prééclampsie est l’une des causes primaires de mortalité et morbidité périnatales, touchant 2-7% des grossesses. Sa prévalence augmente à 10-25% chez les femmes hypertendues. Jusqu’à maintenant, aucun traitement, mis à part l’accouchement précoce, n’est connu. Néanmoins, plusieurs études épidémiologiques suggèrent une diminution de l’incidence de la prééclampsie chez les femmes entraînées quoique, ces études sont considérées insuffisantes. Ainsi, le but de cette étude est de déterminer si l’entraînement avant et pendant la grossesse prévient la maladie dans un modèle animal de prééclampsie superposée à de l’hypertension chronique (SPE). Nous avons utilisé des souris double transgéniques, surexpirmant la rénine et l’angiotensinogène humaines (R+A+), puisqu'elles sont hypertensives à la base, et développent plusieurs symptômes de la prééclampsie. Pour l'entraînement, les souris ont été mises dans des cages d’exercice 4 semaines avant leur grossesse et y sont restées jusqu’au sacrifice. L'entraînement physique a prévenu la hausse de pression artérielle en fin de gestation présente chez les souris R+A+ sédentaires, possiblement via l’axe de l’angiotensine-(1-7). Le rapport entre l’albumine: créatinine a également été réduit avec l’entraînement. Les altérations placentaires ont été prévenues chez les souris entraînées, améliorant le développement placentaire et fœtal. Ceci était accompagné d'une normalisation de sFlt-1 circulant et placentaire. De plus, l’augmentation du récepteur à l’angiotensine II de type 1 et la diminution du récepteur Mas dans le placenta étaient renversées. L’entraînement semble prévenir plusieurs symptômes de la SPE dans un modèle animal suggérant qu'il pourrait être d'une grande utilité dans la prévention de la maladie chez la femme.

Evidências disponíveis na literatura sugerem uma conexão entre ingestão de frutose, síndrome metabólica e declínio cognitivo. Na sociedade ocidental, o aumento de casos de síndrome metabólica ocorreu em paralelo ao aumento do consumo de excesso de frutose na dieta. Além disso, animais que consomem excesso de frutose em sua dieta apresentam alterações típicas de resistência à insulina em seus cérebros, além de desenvolverem declínio cognitivo. Sabe-se que exercício físico é capaz de prevenir atrofia do hipocampo e atenuar declínio cognitivo. O objetivo desse estudo foi avaliar se exercício aeróbico é capaz de prevenir o declínio cognitivo associado a um excesso de frutose na dieta e investigar os mecanismos pelos quais isso poderia ocorrer. Ratos Wistar machos foram divididos em quatro grupos: controle sedentário, exercício, frutose sedentário e frutose+exercício. A memória operacional foi testada através do labirinto de Barnes. A sinalização de insulina e de moléculas relacionadas ao exercício foram avaliados no hipocampo e no músculo quadríceps através de Western Blot e PCR em tempo real. A ingestão de excesso de frutose induziu declínio cognitivo que não foi atenuado pelo exercício. O hipocampo dos animais que ingeriram frutose não apresentou deficiência na sinalização de insulina, mas apresentou leve diminuição em BDNF e sinaptofisina, o que foi acompanhado de diminuição significativa da expressão de PGC1alfa tanto no músculo quanto no hipocampo. O musculo quadríceps dos animais alimentados com frutose também mostrou uma diminuição significativa na expressão da miocina irisina (FNDC5) e de genes ligados à autofagia, ao transporte de glicose (GLUT4) e à oxidação de ácidos graxos (NR4A3, PPAR?, Erralfa). Treino aeróbico foi incapaz de reverter todas essas alterações. Em contraste, tratamento metformina foi capaz de prevenir o declínio cognitivo de animais que ingeriram excesso de frutose. Podemos concluir que ingestão de frutose prejudicou a expressão de genes críticos à adaptação do músculo ao exercício e, como resultado, atenuou efeitos benéficos do exercício no cérebro. Tratamento com metformina preveniu a queda na expressão de FNDC5 e BDNF e, consequentemente, o declínio cognitivo em ratos alimentados com frutose através de uma ação direta no cérebro, apesar de não prevenir os efeitos deletérios da frutose no músculo esquelético / Available evidence in the literature suggests a link between fructose ingestion, Metabolic Syndrome and cognitive impairment. In Western society, the rise in the frequency of Metabolic Syndrome was paralleled by a rise in consumption of a high fructose diet. Moreover, molecular alterations typically related to insulin resistance have been found in brains of fructose-induced insulin-resistant rats, and these rodents also develop cognitive deterioration. Physical exercise is well known to prevent hippocampal atrophy and to attenuate cognitive decline. The objective of this study was to evaluate if aerobic training can ameliorate cognitive decline associated with excessive fructose ingestion and to investigate the pathways through which this might occur. Male Wistar rats were divided into four groups: sedentary control, exercise, sedentary fructose, fructose+exercise. Working memory was assessed on the Barnes Maze. Intracellular insulin and exercise-related signaling molecules of the hippocampus and quadriceps femori were assayed using Western blot and Real time PCR. Fructose ingestion induced cognitive decline which was not attenuated by exercise. Insulin signaling was not impaired in the hippocampus in the fructose-fed animals, but there was a slight decrease in BDNF and synaptophysin in the hippocampus, accompanied by a significant decrease in exercise-induced expression of PGC1alpha both in the hippocampus and the muscle of exercised animals that ingested fructose. The quadriceps femori of fructose-fed animals also showed a significant decrease in expression of the myokine irisin (FNDC5) and of genes related to autophagy, glucose transport (GLUT4) and fatty acid oxidation (NR4A3, PPAR?, Err alpha). Exercise training was unable to reverse all of these alterations. Contrarily, metformin administration ameliorated cognitive decline in fructose-fed rats. We conclude that fructose feeding impaired expression of genes that are critical to skeletal muscle adaptation to exercise, which in turn attenuated the beneficial effects of exercise in the brain. Treatment with metformin was able to prevent the decline in expression of FNDC5 and BDNF ameliorating cognitive decline in fructose fed rats by direct action in the brain, despite being unable to reverse the effects of fructose feeding in the muscle

L’ADOA-1 (Autosomal dominant optic atrophy) est une maladie neurologique pouvant être causée par la mutation de la protéine mitochondriale OPA1 (Optic atrophy type 1) et pouvant conduire à une cécité. Certains patients peuvent présenter un dysfonctionnement mitochondrial plus généralisé, et développer d'autres complications neuromusculaires (ADOA-1+). La protéine OPA1 est une dynamine GTPasique impliquée dans la dynamique mitochondriale en modulant la fusion des membranes internes, et plus largement dans le maintien des fonctions mitochondriales. Le rôle de cette protéine a été étudié dans beaucoup de types cellulaires, mais peu d’études se sont intéressées à la cellule cardiaque qui pourtant possède de nombreuses mitochondries.La 1ère question soulevée par cette thèse était de déterminer l’implication de la protéine OPA1 dans l’organisation du réseau mitochondrial et dans le fonctionnement de la cellule cardiaque en condition physiologique ou pathologique. Pour répondre à cela, nous avons utilisé un modèle murin hétérozygote pour Opa1 (Opa1+/-). Nous avons montré que dans le cardiomyocyte adulte, la diminution d’expression d’OPA1 induisait un déséquilibre de la balance fusion/fission, qui se traduisait par une désorganisation du réseau mitochondrial, ainsi qu’une altération de la morphologie des mitochondries. Cependant, ces modifications n’engendraient pas d’altération des capacités oxydatives des mitochondries, mais conduisaient à une perturbation des propriétés d’ouverture du PTP. En outre, la déficience en OPA1 n’influençait pas la fonction cardiaque en condition physiologique, mais était associée à son altération plus sévère en condition pathologique. La 2nde question de cette thèse était de savoir l’implication d’OPA1 dans la réponse à un stress physiologique des cellules musculaires squelettiques, et ainsi étudier le lien éventuel entre OPA1 et la mise en place de la biogénèse mitochondriale. Nous avons donc soumis nos souris Opa1+/- à un exercice d’endurance. Nos résultats ont révélé que nos deux groupes d’animaux disposaient des mêmes capacités physiques à l’entraînement. L’adaptation des souris Opa1+/- à l’entrainement s’effectuait par un remodelage métabolique, vraisemblablement pour contrer un défaut d’adaptation de la biogénèse mitochondriale. En conclusion, nos résultats ont permis de mieux définir le rôle de la protéine OPA1 dans les muscles striés et son implication dans l’adaptation à un stress. Ce travail nous ouvre des perspectives sur le rôle de la dynamique mitochondriale dans l’adaptation à un stress. / ADOA-1 (Autosomal dominant optic atrophy) is a neurological disease that can be caused by mutations in mitochondrial protein OPA1 (Optic atrophy type 1) and can lead to blindness. Some patients with OPA1 mutations may have a generalized mitochondrial dysfunction, and may develop additional neuromuscular complications (ADOA-1+). OPA1 protein is a GTPase dynamin involved in mitochondrial dynamics by controlling the fusion of inner membranes, and also in the maintenance of mitochondrial functions. The role of this protein has been studied in many cell types, but only few studies have been done on cardiac cell, which nevertheless has many mitochondria.The first question raised by this thesis was to determine the involvement of OPA1 protein in mitochondrial network organization and the functioning of the cardiac cell in physiological or pathological condition. To answer this, we used a mouse model heterozygous for Opa1 (Opa1+/-). We have shown that in adult cardiomyocytes, a decrease expression of OPA1 induces an imbalance fusion/fission, which results in a disruption of mitochondrial network, as well as alteration of the morphology of mitochondria. However, these changes did not alter oxidative capacities, but leads to a disturbance of PTP opening. Additionally, OPA1 deficiency did not affect cardiac function under physiological conditions, but it is associated with a stronger impairment of cardiac function in pathological condition.The 2nd part of this thesis was to determine the involvement of OPA1 in response to physiological stress in cells of skeletal muscle, and thus to study the possible link between OPA1 and mitochondrial biogenesis activation. For this, we submitted our Opa1+/- mice to an exercise training. Our results showed that both groups of animals were able to perform the same physical activity. The adaptation of Opa1+/- mice to training did not involve mitochondrial biogenesis and led to a specific response involving a metabolic remodelling towards higher fatty acids utilization.In conclusion, our results allowed us a better understanding of OPA1 role in striated muscle and its involvement for adaptation to a stress. This work opens new perspectives on the role of mitochondrial dynamics in cardiac and muscle cells and during adaptation to a stress

Evidências disponíveis na literatura sugerem uma conexão entre ingestão de frutose, síndrome metabólica e declínio cognitivo. Na sociedade ocidental, o aumento de casos de síndrome metabólica ocorreu em paralelo ao aumento do consumo de excesso de frutose na dieta. Além disso, animais que consomem excesso de frutose em sua dieta apresentam alterações típicas de resistência à insulina em seus cérebros, além de desenvolverem declínio cognitivo. Sabe-se que exercício físico é capaz de prevenir atrofia do hipocampo e atenuar declínio cognitivo. O objetivo desse estudo foi avaliar se exercício aeróbico é capaz de prevenir o declínio cognitivo associado a um excesso de frutose na dieta e investigar os mecanismos pelos quais isso poderia ocorrer. Ratos Wistar machos foram divididos em quatro grupos: controle sedentário, exercício, frutose sedentário e frutose+exercício. A memória operacional foi testada através do labirinto de Barnes. A sinalização de insulina e de moléculas relacionadas ao exercício foram avaliados no hipocampo e no músculo quadríceps através de Western Blot e PCR em tempo real. A ingestão de excesso de frutose induziu declínio cognitivo que não foi atenuado pelo exercício. O hipocampo dos animais que ingeriram frutose não apresentou deficiência na sinalização de insulina, mas apresentou leve diminuição em BDNF e sinaptofisina, o que foi acompanhado de diminuição significativa da expressão de PGC1alfa tanto no músculo quanto no hipocampo. O musculo quadríceps dos animais alimentados com frutose também mostrou uma diminuição significativa na expressão da miocina irisina (FNDC5) e de genes ligados à autofagia, ao transporte de glicose (GLUT4) e à oxidação de ácidos graxos (NR4A3, PPAR?, Erralfa). Treino aeróbico foi incapaz de reverter todas essas alterações. Em contraste, tratamento metformina foi capaz de prevenir o declínio cognitivo de animais que ingeriram excesso de frutose. Podemos concluir que ingestão de frutose prejudicou a expressão de genes críticos à adaptação do músculo ao exercício e, como resultado, atenuou efeitos benéficos do exercício no cérebro. Tratamento com metformina preveniu a queda na expressão de FNDC5 e BDNF e, consequentemente, o declínio cognitivo em ratos alimentados com frutose através de uma ação direta no cérebro, apesar de não prevenir os efeitos deletérios da frutose no músculo esquelético / Available evidence in the literature suggests a link between fructose ingestion, Metabolic Syndrome and cognitive impairment. In Western society, the rise in the frequency of Metabolic Syndrome was paralleled by a rise in consumption of a high fructose diet. Moreover, molecular alterations typically related to insulin resistance have been found in brains of fructose-induced insulin-resistant rats, and these rodents also develop cognitive deterioration. Physical exercise is well known to prevent hippocampal atrophy and to attenuate cognitive decline. The objective of this study was to evaluate if aerobic training can ameliorate cognitive decline associated with excessive fructose ingestion and to investigate the pathways through which this might occur. Male Wistar rats were divided into four groups: sedentary control, exercise, sedentary fructose, fructose+exercise. Working memory was assessed on the Barnes Maze. Intracellular insulin and exercise-related signaling molecules of the hippocampus and quadriceps femori were assayed using Western blot and Real time PCR. Fructose ingestion induced cognitive decline which was not attenuated by exercise. Insulin signaling was not impaired in the hippocampus in the fructose-fed animals, but there was a slight decrease in BDNF and synaptophysin in the hippocampus, accompanied by a significant decrease in exercise-induced expression of PGC1alpha both in the hippocampus and the muscle of exercised animals that ingested fructose. The quadriceps femori of fructose-fed animals also showed a significant decrease in expression of the myokine irisin (FNDC5) and of genes related to autophagy, glucose transport (GLUT4) and fatty acid oxidation (NR4A3, PPAR?, Err alpha). Exercise training was unable to reverse all of these alterations. Contrarily, metformin administration ameliorated cognitive decline in fructose-fed rats. We conclude that fructose feeding impaired expression of genes that are critical to skeletal muscle adaptation to exercise, which in turn attenuated the beneficial effects of exercise in the brain. Treatment with metformin was able to prevent the decline in expression of FNDC5 and BDNF ameliorating cognitive decline in fructose fed rats by direct action in the brain, despite being unable to reverse the effects of fructose feeding in the muscle