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Carr JMJR, Ainslie PN, Day T. Confined spaces in space: Cerebral implications of chronic elevations of inspired carbon dioxide and implications for long-duration space travel. Exp Physiol 2025. [PMID: 39776002 DOI: 10.1113/ep091659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Accepted: 12/05/2024] [Indexed: 01/11/2025]
Abstract
Cerebrovascular regulation is critically dependent upon the arterial partial pressure of carbon dioxide (P aC O 2 ${P_{{\mathrm{aC}}{{\mathrm{O}}_{\mathrm{2}}}}}$ ), owing to its effect on cerebral blood flow, tissueP C O 2 ${P_{{\mathrm{C}}{{\mathrm{O}}_{\mathrm{2}}}}}$ , tissue proton concentration, cerebral metabolism and cognitive and neuronal function. In normal environments and in the absence of pathology, at least over acute time frames, hypercapnia is usually managed readily via the respiratory chemoreflex arcs and/or acid-base buffering capacity, such that there is minimal impact on cerebrovascular and neurological function. However, in non-normal environments, such as enclosed spaces, or with pathology, extended exposures to elevations inP aC O 2 ${P_{{\mathrm{aC}}{{\mathrm{O}}_{\mathrm{2}}}}}$ can be detrimental to cerebral health. Given the direct effect of protons on cellular function, even if pH is normalized, it is feasible that higher proton concentrations could still produce detrimental effects. Although it seems that humans can work safely in mildly hypercapnic environments for extended periods, chronic respiratory acidosis can cause bone demineralization, renal calcification, perinatal developmental abnormalities, systemic inflammation and impairments in cognitive function and visuomotor skills and can produce cerebral acidosis, potentially inducing sustained alterations in cerebral function. With the advancement of new initiatives in spaceflight, including proposed long-duration missions to Mars, the study of the effects of chronic inspired CO2 on human health is relevant. In this review, we draw on evidence from preclinical, physiological and clinical research in humans to summarize the cerebral ramifications of prolonged and chronic exposures to elevated partial pressures of inspired CO2 and respiratory acidosis.
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Affiliation(s)
- Jay M J R Carr
- Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Trevor Day
- Department of Biology, Mount Royal University, Calgary, AB, Canada
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Imenez Silva PH, Unwin R, Hoorn EJ, Ortiz A, Trepiccione F, Nielsen R, Pesic V, Hafez G, Fouque D, Massy ZA, De Zeeuw CI, Capasso G, Wagner CA. Acidosis, cognitive dysfunction and motor impairments in patients with kidney disease. Nephrol Dial Transplant 2021; 37:ii4-ii12. [PMID: 34718761 PMCID: PMC8713149 DOI: 10.1093/ndt/gfab216] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Indexed: 12/20/2022] Open
Abstract
Metabolic acidosis, defined as a plasma or serum bicarbonate concentration <22 mmol/L, is a frequent consequence of chronic kidney disease (CKD) and occurs in ~10–30% of patients with advanced stages of CKD. Likewise, in patients with a kidney transplant, prevalence rates of metabolic acidosis range from 20% to 50%. CKD has recently been associated with cognitive dysfunction, including mild cognitive impairment with memory and attention deficits, reduced executive functions and morphological damage detectable with imaging. Also, impaired motor functions and loss of muscle strength are often found in patients with advanced CKD, which in part may be attributed to altered central nervous system (CNS) functions. While the exact mechanisms of how CKD may cause cognitive dysfunction and reduced motor functions are still debated, recent data point towards the possibility that acidosis is one modifiable contributor to cognitive dysfunction. This review summarizes recent evidence for an association between acidosis and cognitive dysfunction in patients with CKD and discusses potential mechanisms by which acidosis may impact CNS functions. The review also identifies important open questions to be answered to improve prevention and therapy of cognitive dysfunction in the setting of metabolic acidosis in patients with CKD.
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Affiliation(s)
- Pedro H Imenez Silva
- Institute of Physiology, University of Zurich, Zürich, Switzerland.,National Center of Competence in Research NCCR Kidney.CH, Zürich, Switzerland
| | - Robert Unwin
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
| | - Ewout J Hoorn
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alberto Ortiz
- Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
| | - Francesco Trepiccione
- Biogem Institute of Molecular Biology and Genetics, Ariano Irpino, Italy.,Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Rikke Nielsen
- Department of Biomedicine-Anatomy, University of Aarhus, Aarhus, Denmark
| | - Vesna Pesic
- Department of Physiology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Gaye Hafez
- Department of Pharmacology, Faculty of Pharmacy, Altinbas University, Istanbul, Turkey
| | - Denis Fouque
- CarMeN, INSERM 1060, Université Claude Bernard Lyon 1, Lyon, France.,Service de Néphrologie, Lyon-Sud Hospital, Pierre-Bénite, France
| | - Ziad A Massy
- Department of Nephrology, Ambroise Paré University Hospital, Assistance Publique Hôpitaux de Paris, Boulogne-Billancourt, France.,Centre de Recherche en Epidémiologie et Santé des Populations, Institut National de la Santé et de la Recherche Médicale U1018-Team 5, Université de Versailles Saint-Quentin-en-Yvelines, University Paris Saclay, Villejuif, France
| | - Chris I De Zeeuw
- Department of Neuroscience, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Netherlands Institute for Neuroscience, Royal Dutch Academy of Art and Science, Amsterdam, The Netherlands
| | - Giovambattista Capasso
- Biogem Institute of Molecular Biology and Genetics, Ariano Irpino, Italy.,Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Carsten A Wagner
- Institute of Physiology, University of Zurich, Zürich, Switzerland.,National Center of Competence in Research NCCR Kidney.CH, Zürich, Switzerland
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He Y, Liu Z, Huang Y, Li B. Role of the p38MAPK signaling pathway in hippocampal neuron autophagy in rats with chronic intermittent hypoxia. J Neurophysiol 2021; 126:1112-1121. [PMID: 34469698 DOI: 10.1152/jn.00240.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This study explored the role of the p38 mitogen-activated protein kinase (MAPK) signaling pathway in hippocampal neuron autophagy in rats with chronic intermittent hypoxia (CIH). Male Sprague-Dawley rats were randomly divided to normoxic control (CON), CIH (optimal modeling time was determined prior by measuring the expression of several proteins after 2-, 4-, and 6-wk intermittent hypoxia), solvent (CIH+Veh), or p38MAPK inhibitor (CIH+SB203580) groups. DMSO and SB203580 were injected intraperitoneally 30 min before hypoxia in CIH+Veh and CIH+SB203580 group rats, respectively. Rat learning and memory were evaluated via the Morris water maze test. Ultrastructural changes in the hippocampal CA1 region autophagic vesicles and neurons were observed under transmission electron and light microscopy. Hippocampal microtubule-associated proteins were detected by western blot. Morris water maze test showed that CIH+SB203580 group rats spent significantly more time on the platform quadrant and crossed the platform more times than CIH+Veh group rats (P < 0.01). Hematoxylin-eosin (HE) staining showed greater rat cell damage in the CIH+SB group than in the CIH and CIH+Veh groups. Western blot analysis showed that CIH+SB group rats had significantly lower p-p38MAPK/p38MAPK, LC3I, and p62 expression and higher beclin-1 expression than CIH+Veh group rats (P < 0.01). Electron microscopy showed that CIH+SB203580 group rats had several small hippocampal neuron autophagic vesicles. On immunofluorescence analyses, it showed a higher LC3II expression in CIH+SB203580 group rats than in CIH+Veh group rats (P < 0.01). These results indicate that inhibition of the CIH p38MAPK signaling pathway can activate autophagy and protect hippocampal neurons in rats.NEW & NOTEWORTHY The pathophysiological processes related to autophagy obstructive sleep apnea-hypopnea syndrome (OSAHS) are unclear. This study clarified that the inhibition of the p38MAPK signaling pathway could further activate autophagy in hippocampal nerve cells, thus reducing nerve cell injury.
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Affiliation(s)
- Yuxin He
- Department of ENT, First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhili Liu
- Department of ENT, First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yinpei Huang
- Department of ENT, First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Bing Li
- Department of ENT, First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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