A hipóxia mantida de curta duração (HM) está associada a alterações cardiorrespiratórias e ao desencadeamento de processo inflamatório em humanos e modelos experimentais. Ademais, há evidências de que a HM pode alterar a transmissão sináptica na região do Núcleo do Trato Solitários (NTS). No presente estudo, utilizamos a minociclina, um inibidor da ativação microglial e antiinflamatório, para avaliar a influência da inflamação desencadeada pela HM sobre a neurotransmissão glutamatérgica nos neurônios do NTS que enviam projeções para a região ventrolateral da medula (NTS-VLM). A hipótese geral do nosso estudo foi a seguinte: a HM induz processo inflamatório no tronco encefálico, o qual contribui para o aumento da neurotransmissão glutamatérgica em neurônios NTS-VLM, colaborando para a elevação da pressão arterial média (PAM) observada nestes ratos. Embora tenhamos observado aumento da pressão arterial média em ambos os grupos de ratos tratados com veículo (solução salina + água destilada, ip) ou minociclina [(30mg/Kg ip por 3 dias) submetidos a 24h de HM (FiO2 0.1) em relação aos seus respectivos grupos controle (FiO2 0,28), o aumento da MAP foi menor nos ratos previamente tratados com minociclina. Os registros eletrofisiológicos utilizando a técnica de whole cell patch-clamp mostraram que a HM não produziu alterações nas propriedades ativas e passivas dos neurônios NTS-VLM. No entanto, os neurônios de ratos submetidos a HM apresentaram aumento nas correntes glutamatérgicas espontâneas e evocadas pelo estímulo do trato solitário. Esse grupo de animais também apresentou aumento no número de microgliais na região do NTS. As alterações mencionadas foram atenuadas pelo tratamento prévio com minociclina. Concluímos que a inflamação induzida pela HM contribui para o aumento da neurotransmissão glutamatérgica nos neurônios NTS-VLM o qual poderia estar relacionado com a hipertensão arterial observada nestes ratos. / Short-term Sustained hypoxia (SH) is associated with cardiorespiratory changes and inflammatory process in humans and experimental models. There is also evidence that SH can change the synaptic transmission in the nucleus tractus solitarius (NTS) region. Here we use the minocycline, an anti-inflammatory and microglial inhibitor, to evaluate the role of inflammation triggered by SH on the excitatory neurotransmission in the NTS neurons sending projections to the ventrolateral medulla (NTS-VLM). We hypothesized that SH induces brainstem inflammatory process, which may contribute to increase in excitatory neurotransmission and excitability of the NTS-VLM neurons, collaborating to the high blood pressure observed on these rats. Although we have observed increased MAP in both groups of rats treated with vehicle (saline + distilled water, i.p) or minociclina [(30mg/Kg i.p for 3 days) submitted to 24h of SH (FiO2 0.1) in relation to their respective control groups (FiO2 0.28), the MAP increase was lower in rats treated with minociclina. The whole cell patch-clamp recordings showed that SH produced no changes in active properties of NTS neurons. However, neurons of rats submitted SH presented an increase in the glutamatergic neurotransmission and the number of microglial at the NTS region. These increases were prevented in the groups previously treated with minociclina. We conclude that inflammation induced by SH contributes to the increased excitatory neurotransmission in NTS-VLM neurons that could be associated to high blood pressure observed in these rats.

A hipóxia mantida de curta duração (HM) está associada a alterações cardiorrespiratórias e ao desencadeamento de processo inflamatório em humanos e modelos experimentais. Ademais, há evidências de que a HM pode alterar a transmissão sináptica na região do Núcleo do Trato Solitários (NTS). No presente estudo, utilizamos a minociclina, um inibidor da ativação microglial e antiinflamatório, para avaliar a influência da inflamação desencadeada pela HM sobre a neurotransmissão glutamatérgica nos neurônios do NTS que enviam projeções para a região ventrolateral da medula (NTS-VLM). A hipótese geral do nosso estudo foi a seguinte: a HM induz processo inflamatório no tronco encefálico, o qual contribui para o aumento da neurotransmissão glutamatérgica em neurônios NTS-VLM, colaborando para a elevação da pressão arterial média (PAM) observada nestes ratos. Embora tenhamos observado aumento da pressão arterial média em ambos os grupos de ratos tratados com veículo (solução salina + água destilada, ip) ou minociclina [(30mg/Kg ip por 3 dias) submetidos a 24h de HM (FiO2 0.1) em relação aos seus respectivos grupos controle (FiO2 0,28), o aumento da MAP foi menor nos ratos previamente tratados com minociclina. Os registros eletrofisiológicos utilizando a técnica de whole cell patch-clamp mostraram que a HM não produziu alterações nas propriedades ativas e passivas dos neurônios NTS-VLM. No entanto, os neurônios de ratos submetidos a HM apresentaram aumento nas correntes glutamatérgicas espontâneas e evocadas pelo estímulo do trato solitário. Esse grupo de animais também apresentou aumento no número de microgliais na região do NTS. As alterações mencionadas foram atenuadas pelo tratamento prévio com minociclina. Concluímos que a inflamação induzida pela HM contribui para o aumento da neurotransmissão glutamatérgica nos neurônios NTS-VLM o qual poderia estar relacionado com a hipertensão arterial observada nestes ratos. / Short-term Sustained hypoxia (SH) is associated with cardiorespiratory changes and inflammatory process in humans and experimental models. There is also evidence that SH can change the synaptic transmission in the nucleus tractus solitarius (NTS) region. Here we use the minocycline, an anti-inflammatory and microglial inhibitor, to evaluate the role of inflammation triggered by SH on the excitatory neurotransmission in the NTS neurons sending projections to the ventrolateral medulla (NTS-VLM). We hypothesized that SH induces brainstem inflammatory process, which may contribute to increase in excitatory neurotransmission and excitability of the NTS-VLM neurons, collaborating to the high blood pressure observed on these rats. Although we have observed increased MAP in both groups of rats treated with vehicle (saline + distilled water, i.p) or minociclina [(30mg/Kg i.p for 3 days) submitted to 24h of SH (FiO2 0.1) in relation to their respective control groups (FiO2 0.28), the MAP increase was lower in rats treated with minociclina. The whole cell patch-clamp recordings showed that SH produced no changes in active properties of NTS neurons. However, neurons of rats submitted SH presented an increase in the glutamatergic neurotransmission and the number of microglial at the NTS region. These increases were prevented in the groups previously treated with minociclina. We conclude that inflammation induced by SH contributes to the increased excitatory neurotransmission in NTS-VLM neurons that could be associated to high blood pressure observed in these rats.

L’hypoxie désigne une baisse de la biodisponibilité en oxygène au niveau tissulaire. La combinaison de l’hypoxie intermittente et de l’hypercapnie est identifiée dans le cadre de plusieurs maladies respiratoires comme un élément physiopathologique déterminant. Cependant, des travaux de recherche suggèrent qu’une exposition à l’hypoxie hypo- ou normocapnique à l’éveil peut améliorer la santé cardiovasculaire. La combinaison d’une exposition hypoxique et de l’entraînement à l’effort est utilisée par les athlètes pour améliorer la performance sportive aérobie. Des études pilotes récentes y compris chez le malade chronique indiquent que l’exposition à l’hypoxie modérée au repos ou à l’effort chez le patient est susceptible d’induire des gains significatifs en termes de santé cardiovasculaire, de composition corporelle et de statut métabolique.Nous nous sommes intéressés aux effets cardiorespiratoires et tissulaires de l’exposition hypoxique normobarique chez le sujet sain et chez la personne en surpoids ou obèse présentant un risque ou des anomalies cardio-métaboliques. Nous avons étudié l’efficacité de 2 types de conditionnement au repos consistant en une hypoxie continue ou une hypoxie intermittente et un entraînement à l’effort hypoxique par comparaison à la situation normoxique. Nous avons tout d’abord étudié les effets d’une exposition hypoxique à court terme au repos chez 14 sujets sains. Nous avons ensuite étudié les effets cardiorespiratoires, tissulaires, vasculaires et métaboliques d’un programme de conditionnement hypoxique normobarique à moyen terme au repos chez 35 patients en surpoids ou obèse. Nous avons de plus réalisé chez 24 sujets sains une étude préliminaire afin de vérifier la faisabilité et de caractériser les réponses cardio-respiratoires et l’oxygénation tissulaire au cours d’un exercice aigu à charge constante d’intensité modérée ou intermittent intense en hypoxie comparé à une condition placébo normoxique. La dernière étude a consisté à étudier les conséquences cardiorespiratoires, tissulaires, vasculaires et métaboliques d’un programme d’entraînement à l’effort en hypoxie par rapport au même programme en normoxie chez 23 patients en surpoids ou obèses.L’étude réalisée chez le sujet sain met en évidence l’intérêt à court terme d’un conditionnement hypoxique intermittent au repos sur des variables associées aux risques cardiovasculaires (diminution de la pression artérielle systolique en normoxie et augmentation de la variabilité sinusale) et une modulation de l’hypoxie tissulaire. Nous avons montré chez le sujet sain que l’hypoxie combiné à l’exercice aigu provoque une diminution de l’oxygénation musculaire similaire mais une diminution de l’oxygénation du cortex préfrontal plus importante par comparaison à un effort normoxique à même intensité relative. Ensuite, chez le sujet en surpoids ou obèse, nous avons montré que le conditionnement hypoxique passif chronique induit une diminution de la pression artérielle diastolique de repos en normoxie, une augmentation de la réponse ventilatoire hypoxique et une diminution de la variabilité cardiaque (après conditionnement par hypoxie intermittente seulement) et que le conditionnement hypoxique actif chronique améliore l’aptitude maximale aérobie par rapport à une situation placébo normoxique.Les résultats obtenus montrent la faisabilité de plusieurs conditionnements hypoxiques prometteurs au plan vasculaire y compris chez le sujet en surpoids ou obèse limité à l’exercice musculaire. Le conditionnement hypoxique actif montre également des bénéfices accrus sur l’aptitude aérobie. Ces protocoles de conditionnement doivent être affinés en vue d’optimiser leur efficacité en termes de perte de poids et d’amélioration du risque cardio-vasculaire et métabolique dans des populations présentant une obésité associée à une morbidité cardio-métabolique. Ils représentent également une piste thérapeutique innovante dans d’autres pathologies chroniques / Hypoxia refers to a decrease in the oxygen bioavailability at the tissue level. The combination of intermittent hypoxia and hypercapnia is identified in several respiratory diseases as a critical pathophysiological element. However, research suggests that exposure to hypo- or normocapnic hypoxia can improve cardiovascular health. The combination of hypoxic exposure and exercise training has been used by athletes to improve aerobic exercise performance. Recent pilot studies in patients with chronic diseases indicate that exposure to moderate hypoxia at rest or during exercise is likely to induce significant gains in cardiovascular health, body composition and metabolic status.We investigated the effects of normobaric hypoxic exposure on cardiorespiratory and tissue function in healthy subjects, overweight or obese subjects at risk or with cardio-metabolic abnormalities. We assessed the efficacy of 2 types of passive hypoxic conditioning consisting in sustained hypoxia or intermittent hypoxia and hypoxic exercise training in comparison with normoxic condition. First, we assessed the effects of short-term hypoxic exposure at rest in 14 healthy subjects. Then, we evaluated the cardiovascular and metabolic effects of a 8-week normobaric hypoxic conditioning program at rest (intermittent or sustained hypoxia) in 35 overweight or obese patients, compared to placebo normoxic exposure. Next, we conducted a preliminary study in 24 healthy subjects to assess the acute responses to submaximal constant-load and high intensity interval cycling exercise performed in normoxia and in hypoxia. The last study aimed to compare the effect of an 8-week exercise training program performed either in normoxia or hypoxia on maximal aerobic capacity in overweight or obese subjects.In the healthy subject, we emphasized the rapid benefits of intermittent hypoxic conditioning on cardiovascular function (lower baseline systolic blood pressure and increased heart rate variability) and the modulation of tissue deoxygenation in response to hypoxia. We have also shown in healthy subjects that acute exercise (combined with hypoxia causes a similar decrease in muscle oxygenation but a greater prefrontal cortex deoxygenation compared to normoxic condition. Then, in the overweight or obese subject, we have shown that chronic passive hypoxic conditioning induces a decrease in diastolic blood pressure at rest in normoxia, an increase in the hypoxic ventilatory response and a decrease in heart rate variability after intermittent hypoxic conditioning only. In addition, chronic active (exercise training) hypoxic conditioning improves the maximal aerobic capacity compared to placebo normoxic training.Our results show the feasibility of several hypoxic conditioning strategies and their interesting effects on the vascular function in overweight/obese subjects presenting exercise limitations impeding exercise reconditioning. In addition, active hypoxic conditioning showed a greater effect on physical fitness than normoxic exercise training. These hypoxic conditioning strategies must be further optimized to improve their efficacy regarding weight loss and cardiometabolic morbidity in obese. They also represent promising therapeutic opportunities for other chronic diseases