Fish encounter daily cycles of hypoxia in the wild, but the physiological strategies for coping with repeated cycles of normoxia and hypoxia (intermittent hypoxia) are poorly understood. Contrastingly, the physiological strategies for coping with continuous (constant) exposure to hypoxia have been studied extensively in fish. The main objective of this thesis was to understand how Fundulus killifish cope with a diurnal cycle of intermittent hypoxia, an ecologically relevant pattern of aquatic hypoxia in the natural environment. To do this, I characterized the effects of intermittent hypoxia on hypoxia tolerance, oxygen transport, metabolism, and the oxidative stress defense system of killifish, and compared these effects to fish exposed to normoxia, a single cycle of hypoxia-normoxia, and constant hypoxia. Specifically, I studied the following topics: (i) how acclimation to intermittent hypoxia modifies hypoxia tolerance, and the hypoxia acclimation response of Fundulus heteroclitus (Chapter 2), (ii) metabolic adjustments occurring during a hypoxia-reoxygenation cycle (Chapter 3), (iii) how acclimation to intermittent hypoxia alters O2 transport capacity and maximal aerobic metabolic rate (Chapter 4), (iv) the effects of hypoxia and reoxygenation on reactive oxygen species and oxidative stress (Chapter 5), and (v) variation in hypoxia tolerance and in the hypoxia acclimation responses across Fundulus fishes (Chapter 6). Killifish rely on a unique and effective physiological strategy to cope with intermittent hypoxia, and that this strategy is distinct from both the response to a single bout of acute hypoxia-reoxygenation (12 h hypoxia followed by 6 h reoxygenation) and to chronic exposure to constant hypoxia (24 h hypoxia per day for 28 d). Key features of the acclimation response to intermittent hypoxia include (i) maintenance of resting O2 consumption rate in hypoxia followed by a substantial increase in O2 consumption rate during recovery in normoxia, (ii) reversible increases in blood O2 carrying capacity during hypoxia bouts, (iii) minimal recruitment of anaerobic metabolism during hypoxia bouts, and (iv) protection of tissues from oxidative damage despite alterations in the homeostasis of reactive oxygen species and cellular redox status. Of these features, (i) is unique to intermittent hypoxia, (ii) also occurs in fish exposed to acute hypoxia-reoxygenation, and (iii) and (iv) are observed in both fish acclimated to intermittent hypoxia as well as those acclimated to constant hypoxia. This is the most extensive investigation to date on how fish cope with the energetic and oxidative stress challenges of intermittent hypoxia, and how these responses differ from constant hypoxia. This thesis adds substantial insight into the general mechanisms by which animals can respond to an ecologically important but poorly understood feature of the aquatic environment. / Dissertation / Doctor of Philosophy (PhD) / Oxygen levels in the aquatic environment are dynamic. Many fishes routinely encounter changes in oxygen content in their environment. However, we have very little understanding of how cycles between periods of low oxygen (hypoxia) and periods of high oxygen (normoxia) affect the physiology of fish. This thesis investigated how Fundulus killifish cope with daily cycles between hypoxia and normoxia (intermittent hypoxia) by modifying oxygen transport, metabolism, and oxidative stress defense systems. I found that killifish rely on a unique and effective physiological strategy to cope with intermittent hypoxia, and that this strategy is distinct from how they respond to a single bout of hypoxia (followed by normoxia) and to a constant pattern of only hypoxia. This is the most extensive investigation to date on how fish respond to the challenges of intermittent hypoxia, an understudied but ecologically important type of aquatic hypoxia.

Ce travail a été consacré à l’étude non invasive de la circulation pulmonaire normale par mise en œuvre de l’échocardiographie Doppler. <p>En intégrant les mesures obtenues dans une approche physiopathologique, et en exploitant les nouvelles possibilités d’échocardiographes portables, techniquement performants, nous avons analysé les effets d’un inhibiteur de la phosphodiestérase-5 et d’une prostacycline, pour tenter d’en identifier d’éventuels effets introtropes intrinsèques, nous avons exploré le concept de réserve vasculaire pulmonaire comme facteur limitant de l’aptitude aérobie et indice potentiel d’une atteinte vasculaire pulmonaire précoce, et obtenu des résultats préliminaires permettant d’identifier une hypertension artérielle pulmonaire (HTAP) latente. Nos principaux résultats peuvent être résumés comme suit :<p>1. Chez le sujet sain, en normoxie ou dans un modèle expérimental d’HTAP induite par l’inhalation d’un mélange gazeux hypoxique, le sildenafil per os ou l’epoprostenol par voie intraveineuse, à des doses utilisées en clinique pour le traitement de l’HTAP, améliorent les indices de la fonction ventriculaire droite en proportion de leurs effets vasodilatatoires pulmonaires, sans effets inotropes intrinsèques détectables.<p>2. La consommation d’oxygène maximale du sujet sain augmente en raison directe de son volume capillaire pulmonaire (calculé à partir de sa capacité de diffusion pour l’oxyde nitrique et le monoxyde de carbone) et en raison inverse de sa résistance vasculaire pulmonaire, non seulement en altitude, mais aussi au niveau de la mer. Ce résultat suggère qu’une plus grande réserve vasculaire pulmonaire est propice aux efforts aérobiques intenses, probablement par moindre postcharge ventriculaire droite.<p>3. Des mesures réalisées chez un petit nombre de sujets suggèrent que la distensibilité vasculaire pulmonaire, calculée à partir d’une relation débit-pression vasculaire pulmonaire, est typiquement réduite chez des porteurs asymptomatiques de la mutation BMPR2, qui est actuellement le facteur de risque le plus élevé connu de l’HTAP. La mutation BMPR2 pourrait aussi être associée à une réactivité vasculaire pulmonaire accrue à l’hypoxie. <p>Nos résultats suggèrent indirectement que l’échocardiographie Doppler, de repos ou de stress, pourrait être davantage développée dans la mise au point de patients à risque d’HTAP./<p><p>Novel advances in echocardiography offer the opportunity to reliably characterize pulmonary circulation in terms of pressure-flow relationship, and to better understand the coupling of right ventricular (RV) function with normal and abnormal pulmonary hemodynamics. Moreover, when combined with the measurement of pulmonary capillary blood volume, this renewed methodological approach may help to understand the concept of pulmonary vascular reserve as a limiting factor of exercise capacity and potential sensitive marker of early vascular disease.<p><p>In the present work we used a model of hypoxic pulmonary vasoconstriction to analyse the effects of two targeted therapies of pulmonary arterial hypertension (PAH) on the RV function. We showed that the beneficial effects of these drugs are mainly driven by a decrease in RV afterload and not an enhanced myocardial inotropic state. Whether this is transposable to abnormal RV-arterial coupling in PAH patients remains to be investigated.<p><p>Echocardiography may be useful to explore the pulmonary vascular reserve as an important limiting factor of exercise capacity. We showed that a higher pulmonary vascular reserve, defined by a decreased PVR and increased lung diffusing capacity, allows for an improved aerobic exercise capacity (as assessed by a higher peak oxygen consumption), at a lower ventilatory cost, at sea level and at high altitude. <p><p>Stress echocardiography may detect an abnormal pulmonary vasoreactivity. We showed that asymptomatic relatives of patients suffering from idiopathic pulmonary arterial hypertension, and who carry a bone morphogenetic protein receptor type 2 mutation (BMPR2) present with a decreased pulmonary vascular distensibility and an enhanced pulmonary vasoreactivity to hypoxia, which are identifiable by echocardiography examination. However, the predictive value of these findings is not known. <p><p>Thus echocardiography may represent, in experienced and dedicated hands, a noninvasive, safe, widely available, applicable at the bed-side as well as in extreme environment (e.g. high altitudes), less expensive alternative for the evaluation of the pulmonary circulation, either by the interrogation of pressure-flow relationship (stress echocardiography), by the investigation of the right ventricle global and regional function in relation to its afterload (standard and Tissue Doppler Imaging), or by a combined approach with the measurement of lung diffusing capacity (DLNO / DLCO) to assess the pulmonary vascular reserve.<p><p>The present data are encouraging for further development and implementation of echocardiography for the detection, but also the diagnosis and follow-up of patients with pulmonary hypertension.<p><p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished