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Sieck GC, Hernandez-Vizcarrondo GA, Brown AD, Fogarty MJ. Sarcopenia of the longitudinal tongue muscles in rats. Respir Physiol Neurobiol 2024; 319:104180. [PMID: 37863156 PMCID: PMC10851598 DOI: 10.1016/j.resp.2023.104180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/29/2023] [Accepted: 10/14/2023] [Indexed: 10/22/2023]
Abstract
The tongue is a muscular hydrostat, with lingual movements occurring during breathing, chewing, swallowing, vocalization, vomiting, coughing and grooming/sexual activities. In the elderly, reduced lingual dysfunction and weakness contribute to increased risks of obstructive sleep apnea and aspiration pneumonia. In Fischer 344 (F344) rats, a validated model of aging, hypoglossal motor neuron death is apparent, although there is no information regarding tongue strength. The intrinsic tongue muscles, the superior and inferior longitudinal, transversalis and verticalis exist in an interdigitated state. Recently, we established a method to measure the specific force of individual intrinsic tongue muscle, accounting for the tissue bulk that is not in the direction of uniaxial force. In the longitudinal muscles of 6- (n = 10), 18- (n = 9) and 24-month-old (n = 12) female and male F344 rats, we assessed specific force, fatigability, fiber type dependent cross-sectional area (CSA) and overall CSA. Muscle force and fatigue was assessed ex vivo using platinum plate simulation electrodes. Tongue muscles were frozen in melting isopentane, and transverse sections cut at 10 µm. Muscle fiber type was classified based on immunoreactivity to myosin heavy chain (MyHC) isoform antibodies. In H&E stained muscle, CSA and uniaxial muscle contributions to total tongue bulk was assessed. We observed a robust ∼30% loss of longitudinal specific force, with reductions in overall longitudinal muscle fiber CSA and specific atrophy of type IIx/IIb fibers. It will be important to investigate the mechanistic underpinnings of hypoglossal motor neuron death and tongue muscle weakness to eventually provide therapies for age-associated lingual dysfunctions.
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Affiliation(s)
- Gary C Sieck
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Alyssa D Brown
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Matthew J Fogarty
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA.
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Fogarty MJ, Sieck GC. Tongue muscle contractile, fatigue, and fiber type properties in rats. J Appl Physiol (1985) 2021; 131:1043-1055. [PMID: 34323593 DOI: 10.1152/japplphysiol.00329.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The intrinsic and extrinsic tongue muscles manipulate the position and shape of the tongue and are activated during many oral and respiratory behaviors. In the present study, in 6-mo-old Fischer 344 rats, we examined mechanical and fatigue properties of tongue muscles in relation to their fiber type composition. In an ex vivo preparation, isometric force and fatigue was assessed by direct muscle stimulation. Tongue muscles were frozen in melting isopentane and transverse sections cut at 10 µm. In hematoxylin-eosin (H&E)-stained muscle sections, the relative fractions of muscle versus extracellular matrix were determined. Muscle fibers were classified as type I, IIa and IIx, and/or IIb based on immunoreactivity to specific myosin heavy chain isoform antibodies. Cross-sectional areas (CSAs) and proportions of different fiber types were used to calculate their relative contribution to total muscle CSAs. We found that the superior and inferior longitudinal intrinsic muscles (4.4 N/cm2) and genioglossus muscle (3.0 N/cm2) generated the greatest maximum isometric force compared with the transversalis muscle (0.9 N/cm2). The longitudinal muscles and the transversalis muscle displayed greater fatigue during repetitive stimulation consistent with the greater relative contribution of type IIx and/or IIb fibers. By contrast, the genioglossus, comprising a higher proportion of type I and IIa fibers, was more fatigue resistant. This study advances our understanding of the force, fatigue, and fiber type-specific properties of individual tongue musculature. The assessments and approach provide a readily accessible muscular readout for scenarios where motor control dysfunction or tongue weakness is evident.NEW & NOTEWORTHY For the individual tongue muscles, relatively little quantification of uniaxial force, fatigue, and fiber type-specific properties has been documented. Here, we assessed uniaxial-specific force generation, fatigability, and muscle fiber type-specific properties in the superior and inferior longitudinal muscles, the transversalis, and the genioglossus in Fischer 344 rats. The longitudinal muscles produced the greatest isometric tetanic-specific forces. The genioglossus was more fatigue resistant and comprised higher proportions of I and IIa fibers.
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Affiliation(s)
- Matthew J Fogarty
- Department of Physiology and Biomedical Engineering, grid.66875.3aMayo Clinic, Rochester, Minnesota
| | - Gary C Sieck
- Department of Physiology and Biomedical Engineering, grid.66875.3aMayo Clinic, Rochester, Minnesota
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Abstract
Striated respiratory muscles are necessary for lung ventilation and to maintain the patency of the upper airway. The basic structural and functional properties of respiratory muscles are similar to those of other striated muscles (both skeletal and cardiac). The sarcomere is the fundamental organizational unit of striated muscles and sarcomeric proteins underlie the passive and active mechanical properties of muscle fibers. In this respect, the functional categorization of different fiber types provides a conceptual framework to understand the physiological properties of respiratory muscles. Within the sarcomere, the interaction between the thick and thin filaments at the level of cross-bridges provides the elementary unit of force generation and contraction. Key to an understanding of the unique functional differences across muscle fiber types are differences in cross-bridge recruitment and cycling that relate to the expression of different myosin heavy chain isoforms in the thick filament. The active mechanical properties of muscle fibers are characterized by the relationship between myoplasmic Ca2+ and cross-bridge recruitment, force generation and sarcomere length (also cross-bridge recruitment), external load and shortening velocity (cross-bridge cycling rate), and cross-bridge cycling rate and ATP consumption. Passive mechanical properties are also important reflecting viscoelastic elements within sarcomeres as well as the extracellular matrix. Conditions that affect respiratory muscle performance may have a range of underlying pathophysiological causes, but their manifestations will depend on their impact on these basic elemental structures.
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Affiliation(s)
- Gary C Sieck
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
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O'Connell RA, Carberry J, O'Halloran KD. Sternohyoid and diaphragm muscle form and function during postnatal development in the rat. Exp Physiol 2013; 98:1386-400. [PMID: 23709586 DOI: 10.1113/expphysiol.2013.073346] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Co-ordinated activity of the thoracic pump and pharyngeal dilator muscles is critical for maintaining airway calibre and respiratory homeostasis. Whilst postnatal maturation of the diaphragm has been well characterized, surprisingly little is known about the developmental programme in the airway dilator muscles. What is the main finding and its importance? Developmental increases in force-generating capacity and fatigue in the sternohyoid and diaphragm muscles are attributed to a maturational shift in muscle myosin heavy chain phenotype. This maturation is accelerated in the sternohyoid muscle relative to the diaphragm and may have implications for the control of airway calibre in vivo. The striated muscles of breathing, including the thoracic pump and pharyngeal dilator muscles, play a critical role in maintaining respiratory homeostasis. Whilst postnatal maturation of the diaphragm has been well characterized, surprisingly little is known about the developmental programme in airway dilator muscles given that co-ordinated activity of both sets of muscles is needed for the maintenance of airway calibre and effective pulmonary ventilation. The form and function of sternohyoid and diaphragm muscles from Wistar rat pups [postnatal day (PD) 10, 20 and 30] was determined. Isometric contractile and endurance properties were examined in tissue baths containing Krebs solution at 35°C. Myosin heavy chain (MHC) isoform composition was determined using immunofluorescence. Muscle oxidative and glycolytic capacity was assessed by measuring the activities of succinate dehydrogenase and glycerol-3-phosphate dehydrogenase using semi-quantitative histochemistry. Sternohyoid and diaphragm peak isometric force and fatigue increased significantly with postnatal maturation. Developmental myosin disappeared by PD20, whereas MHC2B areal density increased significantly from PD10 to PD30, emerging earlier and to a much greater extent in the sternohyoid muscle. The numerical density of fibres expressing MHC2X and MHC2B increased significantly during development in the sternohyoid. Diaphragm succinate dehydrogenase activity and sternohyoid glycerol-3-phosphate dehydrogenase activity increased significantly with age. Developmental increases in force-generating capacity and fatigue in the sternohyoid and diaphragm muscles are attributed to a postnatal shift in muscle MHC phenotype. The accelerated maturation of the sternohyoid muscle relative to the diaphragm may have implications for the control of airway calibre in vivo.
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Affiliation(s)
- R A O'Connell
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
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Ono T. Tongue and upper airway function in subjects with and without obstructive sleep apnea. JAPANESE DENTAL SCIENCE REVIEW 2012. [DOI: 10.1016/j.jdsr.2011.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Dempsey JA, Adams L, Ainsworth DM, Fregosi RF, Gallagher CG, Guz A, Johnson BD, Powers SK. Airway, Lung, and Respiratory Muscle Function During Exercise. Compr Physiol 2011. [DOI: 10.1002/cphy.cp120111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Konow N, Thexton A, Crompton AW, German RZ. Regional differences in length change and electromyographic heterogeneity in sternohyoid muscle during infant mammalian swallowing. J Appl Physiol (1985) 2010; 109:439-48. [PMID: 20538841 DOI: 10.1152/japplphysiol.00353.2010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A complex sling of muscles moves and stabilizes the hyoid bone during many mammalian behaviors. One muscle in this sling, the sternohyoid, is recruited during food acquisition, processing, and swallowing, and also during nonfeeding behaviors. We used synchronous sonomicrometry and electromyography to investigate regional (intramuscular) changes in length and electromyographic (EMG) activity of the sternohyoid during swallowing in the infant pig. The simple straplike architecture of the sternohyoid led us to hypothesize that limited regional variation in length and muscle activity would be present. We found statistically significant regional differences in EMG activity, and, with respect to length dynamics, the sternohyoid did not behave homogeneously during swallowing. The midbelly region typically shortened while the anterior and posterior regions lengthened, although in a minority of swallows (12.5%) the midbelly lengthened simultaneously with the end-regions. Despite its nonpennate architecture and evolutionarily conservative innervation, the mammalian sternohyoid appears to contain previously unrecognized populations of regionally specialized motor units. It also displays differential contraction patterns, very similar to the sternohyoid of nonmammalian vertebrates.
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Affiliation(s)
- Nicolai Konow
- Dept. of Ecology and Evolutionary Biology, Brown Univ., Providence, RI 02912, USA.
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Morello SL, Ducharme NG, Hackett RP, Warnick LD, Mitchell LM, Soderholm LV. Activity of selected rostral and caudal hyoid muscles in clinically normal horses during strenuous exercise. Am J Vet Res 2008; 69:682-9. [DOI: 10.2460/ajvr.69.5.682] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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O'Halloran KD. Effects of nicotine on rat sternohyoid muscle contractile properties. Respir Physiol Neurobiol 2006; 150:200-10. [PMID: 15994135 DOI: 10.1016/j.resp.2005.05.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2004] [Revised: 05/20/2005] [Accepted: 05/23/2005] [Indexed: 11/25/2022]
Abstract
Obstructive sleep apnoea (OSA) is a major clinical disorder characterised by recurring episodes of pharyngeal collapse during sleep. At present, there remains no satisfactory treatment for OSA. Pharmacological therapies as a potential treatment for the disorder are an attractive option and include agents that increase the contractility of the pharyngeal muscles. The aim of the present study was to examine the effects of nicotine on upper airway muscle contractile properties. In vitro isometric contractile properties were determined using strips of rat sternohyoid muscle in physiological salt solution containing nicotine (0-100 microg/ml) at 25 degrees C. Isometric twitch and tetanic tension, contraction time, half-relaxation time and tension-frequency relationship were determined by electrical field stimulation with platinum electrodes. Fatigue was induced by stimulation at 40 Hz with 300 ms trains at a frequency of 0.5 Hz for 5 min. Nicotine at a concentration of 1 microg/ml was associated with a significant increase in sternohyoid muscle specific tension compared to control data. Dose-dependent increases in contractile tension were not observed. Nicotine had effects on tension-frequency relationship and endurance properties of the sternohyoid muscle at some but not all doses. A leftward shift in the tension-frequency relationship was observed at low stimulus frequencies (20-30 Hz) for nicotine at a concentration of 1 and 5 microg/ml and a significant increase in fatigue resistance was observed with nicotine at a concentration of 10 microg/ml. As fatigue of the upper airway muscles has been implicated in obstructive airway conditions, a pharmacological agent that improves muscle endurance may prove useful as a potential treatment for such disorders. Therefore, further studies of the effects of nicotinic agonists on upper airway function are warranted.
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Affiliation(s)
- Ken D O'Halloran
- Department of Human Anatomy and Physiology, University College Dublin, Earlsfort Terrace, Dublin 2, Ireland.
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Saboisky JP, Butler JE, Fogel RB, Taylor JL, Trinder JA, White DP, Gandevia SC. Tonic and phasic respiratory drives to human genioglossus motoneurons during breathing. J Neurophysiol 2005; 95:2213-21. [PMID: 16306175 DOI: 10.1152/jn.00940.2005] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A tongue muscle, the genioglossus (GG), is important in maintaining pharyngeal airway patency. Previous recordings of multiunit electromyogram (EMG) suggest it is activated during inspiration in humans with some tonic activity in expiration. We recorded from populations of single motor units in GG in seven subjects during quiet breathing when awake. Ultrasonography assisted electrode placement. The activity of single units was separated into six classes based on a step-wise analysis of the discharge pattern. Phasic and tonic activities were analyzed statistically with the coefficient of determination (r2) between discharge frequency and lung volume. Of the 110 motor units, 29% discharged tonically without phasic respiratory modulation (firing rate approximately 19 Hz). Further, 16% of units increased their discharge during expiration (expiratory phasic and expiratory tonic units). Only half the units increased their discharge during inspiration (inspiratory phasic and inspiratory tonic units). Units firing tonically with an inspiratory increase had significantly higher discharge rates than those units that only fired phasically (peak rates 25 vs. 16 Hz, respectively). Simultaneous recordings of two or three motor units showed neighboring units with differing respiratory and tonic drives. Our results provide a classification and the first quantitative measures of human GG motor-unit behavior and suggest this activity results from a complex interaction of inspiratory, expiratory, and tonic drives at the hypoglossal motor nucleus. The presence of different drives to GG implies that complex premotor networks can differentially engage human hypoglossal motoneurons during respiration. This is unlike the ordered recruitment of motor units in limb and axial muscles.
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Smith JC, Goldberg SJ, Shall MS. Phenotype and contractile properties of mammalian tongue muscles innervated by the hypoglossal nerve. Respir Physiol Neurobiol 2005; 147:253-62. [PMID: 16087149 DOI: 10.1016/j.resp.2005.02.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2004] [Revised: 02/22/2005] [Accepted: 02/23/2005] [Indexed: 10/25/2022]
Abstract
The XIIth cranial nerve plays a role in chewing, respiration, suckling, swallowing, and speech [Lowe, A.A., 1981. The neural regulation of tongue movements. Prog. Neurobiol. 15, 295-344.]. The muscles innervated by this nerve are functionally subdivided into three categories: those causing protrusion, retrusion, and changing the shape of the tongue. Myosin heavy chain (MHC) II isoform makes up the majority of the MHC phenotype with some variability among mammalian species and some evidence suggests between genders. In addition, there are regional differences in fiber type within some of these muscles that suggest functional compartmentalization. The transition from developmental MHC isoforms to their adult phenotype appears to vary not only from muscle to muscle but also from species to species. Motor units within this hypoglossal motor system can be categorized as predominantly fast fatigue resistant. Based on twitch contraction time and fatigue index, it appears that hypoglossal innervated muscles are more similar to fast-twitch muscles innervated by spinal nerves than, for example, extraocular muscles.
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Affiliation(s)
- J Chadwick Smith
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, P.O. Box 980709, Richmond, VA 23298-0709, USA
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Kirkness JP, Christenson HK, Garlick SR, Parikh R, Kairaitis K, Wheatley JR, Amis TC. Decreased surface tension of upper airway mucosal lining liquid increases upper airway patency in anaesthetised rabbits. J Physiol 2003; 547:603-11. [PMID: 12562967 PMCID: PMC2342661 DOI: 10.1113/jphysiol.2002.031013] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The obstructive sleep apnoea syndrome (OSA) is a disorder characterised by repetitive closure and re-opening of the upper airway during sleep. Upper airway luminal patency is influenced by a number of factors including: intraluminal air pressure, upper airway dilator muscle activity, surrounding extraluminal tissue pressure, and also surface forces which can potentially act within the liquid layer lining the upper airway. The aim of the present study was to examine the role of upper airway mucosal lining liquid (UAL) surface tension (gamma) in the control of upper airway patency. Upper airway opening (PO) and closing pressures (PC) were measured in 25 adult male, supine, tracheostomised, mechanically ventilated, anaesthetised (sodium pentabarbitone), New Zealand White rabbits before (control) and after instillation of 0.5 ml of either 0.9 % saline (n = 9) or an exogenous surfactant (n = 16; Exosurf Neonatal) into the pharyngeal airway. The gamma of UAL (0.2 microl) was quantified using the 'pull-off' force technique in which gamma is measured as the force required to separate two curved silica discs bridged by the liquid sample. The gamma of UAL decreased after instillation of surfactant from 54.1 +/- 1.7 mN m-1 (control; mean +/- S.E.M.) to 49.2 +/- 2.1 mN m-1 (surfactant; P < 0.04). Compared with control, PO increased significantly (P < 0.04; paired t test, n = 9) from 6.2 +/- 0.9 to 9.6 +/- 1.2 cmH2O with saline, and decreased significantly (P < 0.05, n = 16) from 6.6 +/- 0.4 to 5.5 +/- 0.6 cmH2O with surfactant instillation. Findings tended to be similar for PC. Change in both PO and PC showed a strong positive correlation with the change in gamma of UAL (both r > 0.70, P < 0.001). In conclusion, the patency of the upper airway in rabbits is partially influenced by the gamma of UAL. These findings suggest a role for UAL surface properties in the pathophysiology of OSA.
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Affiliation(s)
- Jason P Kirkness
- Ludwig Engel Centre for Respiratory Research, Westmead Hospital and University of Sydney, New South Wales, Australia, 2145.
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McGuire M, MacDermott M, Bradford A. The effects of chronic episodic hypercapnic hypoxia on rat upper airway muscle contractile properties and fiber-type distribution. Chest 2002; 122:1400-6. [PMID: 12377871 DOI: 10.1378/chest.122.4.1400] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is caused by episodes of upper airway (UA) obstruction due to an inability of UA muscles such as the geniohyoids and sternohyoids to maintain airway patency. This results in chronic episodic hypercapnic hypoxia. Chronic continuous hypoxia and episodic hypocapnic hypoxia affect skeletal muscle structure and function, but the effects of chronic episodic hypercapnic hypoxia on UA muscle structure and function are unknown. DESIGN Rats breathed air and hypercapnic hypoxic gas twice per minute for 8 h/d for 5 weeks in order to mimic the intermittent hypercapnic hypoxia of OSA in humans. Isometric contractile properties were determined using strips of isolated geniohyoid and sternohyoid muscles in physiologic saline solution at 30 degrees C. Fiber-type distribution was determined by adenosine triphosphatase staining. RESULTS For both muscles, chronic episodic hypercapnic hypoxia had no significant effect on twitch or tetanic tension, twitch/tetanic tension ratio, and tension-frequency relationship. There was a significant (p < 0.05) increase in geniohyoid fatigue (50.5 +/- 6.6% vs 43.6 +/- 5.8% of initial tension), but sternohyoid fatigue was reduced (31.5 +/- 5.2% vs 37.8 +/- 6.0% of initial tension). Geniohyoid type 1 fibers were reduced and type 2B fibers increased, whereas sternohyoid muscle had an increase in type 1 and 2A fibers and a decrease in type 2B fibers. CONCLUSIONS Chronic episodic hypercapnic hypoxia alters UA muscle structure and function, changes that may affect the regulation of UA patency.
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Affiliation(s)
- Michelle McGuire
- Department of Physiology, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2, Ireland
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McGuire M, MacDermott M, Bradford A. Effects of chronic episodic hypoxia on rat upper airway muscle contractile properties and fiber-type distribution. Chest 2002; 122:1012-7. [PMID: 12226048 DOI: 10.1378/chest.122.3.1012] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Contraction of upper airway (UA) muscles such as the geniohyoids and sternohyoids dilates and/or stabilizes the UA, thereby maintaining its patency. Obstructive sleep apnea (OSA) is caused by episodes of UA collapse, and this results in chronic episodic hypoxia. Chronic continuous hypoxia affects skeletal muscle structure and function, but the effects of chronic episodic hypoxia on UA muscle structure and function are unknown. DESIGN Rats were exposed to alternating periods of hypoxia and normoxia twice per minute for 8 h/d for 5 weeks in order to mimic the intermittent hypoxia of OSA in humans. Isometric contractile properties were determined using strips of isolated geniohyoid and sternohyoid muscles in physiologic saline solution at 30 degrees C. Fiber-type distribution was determined using adenosine triphosphatase staining. RESULTS Chronic episodic hypoxia had no significant effect on twitch or tetanic tension, twitch/tetanic tension ratio, contractile kinetics, tension-frequency relationship, or fiber-type distribution for either the sternohyoid or geniohyoid muscle. However, chronic episodic hypoxia did significantly increase sternohyoid and geniohyoid fatigue and reduced recovery from fatigue. CONCLUSIONS Chronic episodic hypoxia increases UA muscle fatigue, an effect that may compromise the maintenance of UA patency.
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Affiliation(s)
- Michelle McGuire
- Department of Physiology, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin, Ireland
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DelloRusso C, Khurana N, Rankin L, Sullivan J, Fregosi RF. Mechanisms of force failure during repetitive maximal efforts in a human upper airway muscle. Muscle Nerve 2002; 26:94-100. [PMID: 12115954 DOI: 10.1002/mus.10167] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The upper airway respiratory muscles play an important role in the regulation of airway resistance, but surprisingly little is known about their contractile properties and endurance performance. We developed a technique that allows measurement of force and the electromyogram (EMG) of human nasal dilator muscles (NDMs). Endurance performance was quantified by measuring NDM "flaring" force and EMG activity as healthy human subjects performed 10 s maximal voluntary contractions (MVCs), separated by 10 s rest, until the area under the force curve fell to 50% MVC (the time limit of the fatigue task, Tlim), which was reached in 34.2 +/- 3.1 contractions (685.0 +/- 62.3 s). EMG activity was unchanged except at Tlim, where it averaged 78.7 +/- 3.6% of pretest activity (P < 0.01). M-wave amplitude did not change, suggesting that neuromuscular propagation was not impaired. MVC force increased to 80% of the pretest level within 10 min of recovery but twitch force failed to recover, suggesting low-frequency fatigue. The data suggest that a failure of the nervous system to excite muscle could explain at most only a small fraction of the NDM force loss during an intermittent fatigue task, and then only at Tlim. Thus, the majority of the force failure during this task is due to impairment of mechanisms that reside within the muscle fibers.
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Affiliation(s)
- Christiana DelloRusso
- Department of Physiology, The University of Arizona, Gittings Building, Tucson, Arizona 85721-0093, USA
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Van Lunteren E, Kaminski HJ. Disorders of Sleep and Breathing during Sleep in Neuromuscular Disease. Sleep Breath 2002; 3:23-30. [PMID: 11898100 DOI: 10.1007/s11325-999-0023-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Erik Van Lunteren
- Departments of Medicine and Neurology, Cleveland VA Medical Center and Case Western Reserve University, Cleveland, Ohio
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Fuller DD, Fregosi RF. Fatiguing contractions of tongue protrudor and retractor muscles: influence of systemic hypoxia. J Appl Physiol (1985) 2000; 88:2123-30. [PMID: 10846026 DOI: 10.1152/jappl.2000.88.6.2123] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The influence of systemic hypoxia on the endurance performance of tongue protrudor and retractor muscles was examined in anesthetized, ventilated rats. Tongue protrudor (genioglossus) or retractor (hyoglossus and styloglossus) muscles were activated via medial or lateral XII nerve branch stimulation (0.1-ms pulse; 40 Hz; 330-ms trains; 1 train/s). Maximal evoked potentials (M waves) of genioglossus and hyoglossus were monitored with electromyography. Fatigue tests were performed under normoxic and hypoxic (arterial PO(2) = 50 +/- 1 Torr) conditions in separate animals. The fatigue index (FI; %initial force) after 5 min of normoxic stimulation was 85 +/- 6 and 79 +/- 7% for tongue protrudor and retractor muscles, respectively; these values were significantly lower during hypoxia (protrudor FI = 52 +/- 10, retractor FI = 18 +/- 6%; P < 0.05). Protrudor and retractor muscle M-wave amplitude declined over the course of the hypoxic fatigue test but did not change during normoxia (P < 0.05). We conclude that hypoxia attenuates tongue protrudor and retractor muscle endurance performance; potential mechanisms include neuromuscular transmission failure and/or diminished sarcolemmal excitability.
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Affiliation(s)
- D D Fuller
- Respiratory Physiology Laboratory, Department of Physiology, University of Arizona, Tucson 85719, USA.
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Sutlive TG, McClung JR, Goldberg SJ. Whole-muscle and motor-unit contractile properties of the styloglossus muscle in rat. J Neurophysiol 1999; 82:584-92. [PMID: 10444658 DOI: 10.1152/jn.1999.82.2.584] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Investigations of whole muscle and motor-unit contractile properties have provided valuable information for our understanding of the spinal cord and extraocular motor systems. However, no previous investigation has examined these properties in an isolated tongue muscle. The purpose of this study was to determine the contractile properties and muscle fiber types of the rat styloglossus muscle. The styloglossus is one of three extrinsic tongue muscles and serves to retract the tongue within the oral cavity. Adult male Sprague-Dawley rats (n = 19) were used in these experiments. The contractile characteristics of the whole styloglossus muscle (n = 9) were measured in response to stimulation of the hypoglossal nerve branch to the muscle. The average twitch tension produced was 3.30 g with a mean twitch contraction time of 13.81 ms. The mean maximum tetanic tension was 19.66 g and occurred at or near the fusion frequency, which averaged 109 Hz. The styloglossus muscle was resistant to fatigue [fatigue index (F. I.) = 0.76]. In separate experiments (n = 7), the contractile characteristics of 37 single motor units were measured in response to extracellular stimulation of hypoglossal motoneurons. The twitch tension generated by styloglossus motor units averaged 35.7 mg, and the mean twitch contraction time was 12.46 ms. The mean fusion frequency was 92 Hz. Maximum tetanic tension averaged 177.8 mg. Styloglossus single motor units were resistant to fatigue (F. I. = 0.74). The sites of stimulation that yielded a contractile response in the styloglossus muscle were consistent with the location of the styloglossus motoneuron pool reported in earlier anatomy studies. Muscle fiber typing was determined in three animals based on the myofibrillar ATPase reaction at pH 9.8, 4.6, and 4.3. The styloglossus muscle was composed of approximately 99% type IIA fibers with a few scattered type I fibers present in the study sample. On the basis of the combined findings of the physiology and histochemistry experiments, the styloglossus muscle appeared to be a homogeneous muscle composed almost exclusively of fast, fatigue-resistant motor units. These properties of the styloglossus muscle and its motor units were compared with findings in other rat skeletal muscles.
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Affiliation(s)
- T G Sutlive
- Department of Anatomy, Virginia Commonwealth University, Richmond, Virginia 23298-0709, USA
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Carrera M, Barbé F, Sauleda J, Tomás M, Gómez C, Agustí AG. Patients with obstructive sleep apnea exhibit genioglossus dysfunction that is normalized after treatment with continuous positive airway pressure. Am J Respir Crit Care Med 1999; 159:1960-6. [PMID: 10351945 DOI: 10.1164/ajrccm.159.6.9809052] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of pharyngeal closure during sleep. The pathogenesis of OSAS is unclear. We hypothesized that the genioglossus (GG), the most important pharyngeal dilator muscle, would be abnormal in patients with OSAS. Further, because treatment with continuous positive airway pressure (CPAP) is very effective clinically in these patients, we investigated the effects of CPAP upon the structure and function of the GG. We studied 16 patients with OSAS (nine of them at diagnosis and seven after having been under treatment with CPAP for at least 1 yr) and 11 control subjects in whom OSAS was excluded clinically. A biopsy of the GG was obtained in each subject, mounted in a tissue bath, and stimulated through platinum electrodes. The following measurements were obtained: maximal twitch tension, contraction time, half-relaxation time, the force-frequency relationship, and the response to a fatiguing protocol. The percentage of type I ("slow twitch") and type II ("fast twitch") fibers was also quantified. Patients with OSAS showed a greater GG fatigability than did control subjects (ANOVA, p < 0.001). Interestingly, this abnormality was entirely corrected by CPAP. Likewise, the percentage of type II fibers was significantly higher in patients with OSAS (59 +/- 4%) than in control subjects (39 +/- 4%, p < 0.001) and, again, these structural changes were corrected by CPAP (40 +/- 3%, p < 0.001). These results show that the function and structure of the GG is abnormal in patients with OSAS. Because these abnormalities are corrected by CPAP, we suggest that they are likely a consequence, not a cause, of the disease.
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Affiliation(s)
- M Carrera
- The Serveis de Pneumología, ORL, Anatomía Patológica, and Unitat de Investigació (REUNI), Hospital Universitari Son Dureta, Palma de Mallorca, Spain
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van Lunteren E, Moyer M. Peptide toxin blockers of voltage-sensitive K+ channels: inotropic effects on diaphragm. J Appl Physiol (1985) 1999; 86:1009-16. [PMID: 10066717 DOI: 10.1152/jappl.1999.86.3.1009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Agents that block many types of K+ channels (e.g., the aminopyridines) have substantial inotropic effects in skeletal muscle. Specific blockers of ATP-sensitive and Ca2+-activated K+ channels, on the other hand, do not, or minimally, alter the force of nonfatigued muscle, consistent with a predominant role for voltage-gated K+ channels in regulating muscle force. To test this more directly, we examined the effects of peptide toxins, which in other tissues specifically block voltage-gated K+ channels, on rat diaphragm in vitro. Twitch force was increased in response to alpha-, beta-, and gamma-dendrotoxin and tityustoxin Kalpha (17 +/- 6, 22 +/- 5, 42 +/- 14, and 13 +/- 5%; P < 0.05, < 0.01, < 0.05, < 0.05, respectively) but not in response to delta-dendrotoxin or BSA (in which toxins were dissolved). Force during 20-Hz stimulation was also increased significantly by alpha-, beta-, and gamma-dendrotoxin and tityustoxin Kalpha. Among agents, increases in twitch force correlated with the degree to which contraction time was prolonged (r = 0.88, P < 0.02). To determine whether inotropic effects could be maintained during repeated contractions, muscle strips underwent intermittent 20-Hz train stimulation for a duration of 2 min in presence or absence of gamma-dendrotoxin. Force was significantly greater with than without gamma-dendrotoxin during repetitive stimulation for the first 60 s of repetitive contractions. Despite the approximately 55% higher value for initial force in the presence vs. absence of gamma-dendrotoxin, the rate at which fatigue occurred was not accelerated by the toxin, as assessed by the amount of time over which force declined by 25 and 50%. These data suggest that blocking voltage-activated K+ channels may be a useful therapeutic strategy for augmenting diaphragm force, provided less toxic blockers of these channels can be found.
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Affiliation(s)
- E van Lunteren
- Departments of Medicine and Neurosciences, Cleveland Veterans Affairs Medical Center and Case Western Reserve University, Cleveland, Ohio 44106, USA.
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Cantillon D, Bradford A. Effect of gender on rat upper airway muscle contractile properties. RESPIRATION PHYSIOLOGY 1998; 113:147-56. [PMID: 9832233 DOI: 10.1016/s0034-5687(98)00055-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Obstructive sleep apnoea arises due to upper airway (UA) collapse which is normally counteracted by contraction of UA muscles such as the sternohyoids and geniohyoids. The disorder has a marked male predominance but the effect of gender on UA muscle contractile properties is unknown and these properties have not been compared for the sternohyoid and geniohyoid muscles in the same species. Isometric contractile characteristics were determined using strips of sternohyoid and geniohyoid muscle from male and female rats in Krebs solution at 30 degrees C. For both muscles, there were no differences between male and female contractile kinetics, twitch or tetanic tension, tension-length or tension-frequency relationship or endurance. In both males and females, sternohyoid twitch and tetanic tension was greater than geniohyoid. Sternohyoid endurance was less than geniohyoid but contractile kinetics, tension-length and tension-frequency relationships were similar. Therefore, gender does not affect UA muscle contractile properties and sternohyoid tension is greater and endurance less than that of the geniohyoid.
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Affiliation(s)
- D Cantillon
- Department of Physiology, Royal College of Surgeons in Ireland, Dublin
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van Lunteren E, Brass EP. Metabolic profiles of cat and rat pharyngeal and diaphragm muscles. RESPIRATION PHYSIOLOGY 1996; 105:171-7. [PMID: 8931176 DOI: 10.1016/0034-5687(96)00043-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Pharyngeal muscles play important roles in the maintenance of upper airway patency during sleep. The present study determined the extent of heterogeneity among pharyngeal muscles and the diaphragm in their metabolic profiles, and examined whether differences among muscles may account for previously described differences in their fatigue resistance. Cat and rat sternohyoid, geniohyoid, genioglossus (cat only) and diaphragm muscle were assayed for activities of the mitochondrial enzyme citrate synthase (CS), the glycolytic enzyme phosphofructokinase (PFK) and the cytosolic enzyme lactate dehydrogenase (LDH). CS activity varied among muscles in both species, being highest for genioglossus in cat and highest for diaphragm in rat. PFK activity was highest for genioglossus in cat, but did not differ among muscles in rat. LDH activity was lower for the genioglossus than the sternohyoid and diaphragm in cat. CS and PFK activities correlated positively, and LDH activity correlated negatively, with in vitro fatigue resistance assessed after 5 min of repetitive stimulation in cat. These data indicate close relationships between metabolic profiles, particularly oxidative capacity, and fatigue resistance of pharyngeal muscles in relationship to each other and to the diaphragm.
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Affiliation(s)
- E van Lunteren
- Department of Medicine, Cleveland VA Medical Center, OH 44106, USA
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Ono T, Lowe AA, Ferguson KA, Pae EK, Fleetham JA. The effect of the tongue retaining device on awake genioglossus muscle activity in patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1996; 110:28-35. [PMID: 8686675 DOI: 10.1016/s0889-5406(96)70084-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Knowledge of how dental appliances alter upper airway muscle activity when they are used for the treatment of snoring and/or obstructive sleep apnea (OSA) is very limited. The purpose of this study was to define the effect of a tongue retaining device (TRD) on awake genioglossus (GG) muscle activity in 10 adult subjects with OSA and in 6 age and body mass index (BMI) matched symptom-free control subjects. The TRD is a custom-made appliance designed to allow the tongue to remain in a forward position between the anterior teeth by holding the tongue in an anterior bulb with negative pressure, during sleep. This pulls the tongue forward to enlarge the volume of the upper airway and to reduce upper airway resistance. In this study, two customized TRDs were used for each subject. The TRD-A did not have an anterior bulb but incorporated lingual surface electrodes to record the GG electromyographic (EMG) activity. The TRD-B contained an anterior bulb and two similar electrodes. The GG EMG activity was also recorded while patients used the TRD-B but were instructed to keep their tongue at rest outside the anterior bulb; this condition is hereafter referred to as TRD-X. The GG EMG activity and nasal airflow were simultaneously recorded while subjects used these customized TRDs during spontaneous awake breathing in both the upright and supine position. The following results were obtained and were consistent whether subjects were in the upright or the supine position. The GG EMG activity was greater with the TRD-B than with the TRD-A in control subjects (p < 0.05), whereas the GG EMG activity was less with the TRD-B than with the TRD-A in subjects with OSA (p < 0.01). Furthermore, there was no significant difference between the GG EMG activity of the TRD-A and the TRD-X in control subjects, whereas there was less activity with the TRD-X than with the TRD-A in subjects with OSA (p < 0.05). On the basis of these findings, it was concluded that the TRD has different effects on the awake GG muscle activity in control subjects and patients with OSA. The resultant change in the anatomic configuration of the upper airway caused by the TRD may be important in the treatment of OSA because such a change may alleviate the impaired upper airway function.
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Affiliation(s)
- T Ono
- Department of Clinical Dental Sciences, The Faculty of Dentistry, The University of British Columbia, Vancouver, B.C., Canada
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van Lunteren E, Vafaie H, Salomone RJ. Comparative effects of aging on pharyngeal and diaphragm muscles. RESPIRATION PHYSIOLOGY 1995; 99:113-25. [PMID: 7740199 DOI: 10.1016/0034-5687(94)00077-d] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We hypothesized that aging is associated with alterations in pharyngeal muscle structural and contractile properties. Sternohyoid and geniohyoid muscles from young (3-4 months) and old (20-21 months) Fischer 344 rats were compared with diaphragm muscle. The pharyngeal muscles had significantly lower proportions of slow oxidative (SO) fibers compared to the diaphragm, and the percentage of fast glycolytic (FG) fibers was significantly higher in the sternohyoid than in both the geniohyoid and the diaphragm. With senescence, there was a small but significant increase in the proportion of FG fibers and a corresponding reduction in the proportion of fast oxidative glycolytic (FOG) fibers in all three muscles. The sternohyoid muscle had significantly faster isometric contractile kinetics and lower fatigue indexes than the diaphragm. Aging was associated with significant worsening of sternohyoid endurance, but no significant alterations in sternohyoid twitch kinetics or diaphragm properties. These results indicate that in rats the pharyngeal dilator muscles have larger proportions of fast fibers, fast contractile kinetics and worse endurance than the diaphragm. Furthermore, aging was associated with a shift to a higher proportion of FG fibers with a concomitant reduction in proportion of FOG fibers, as well as a decline in pharyngeal muscle endurance.
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Affiliation(s)
- E van Lunteren
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
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26
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Hudgel DW. Obstructive Sleep Apnea and Pharyngeal Wall Collapsibility-To the Editor. Chest 1994. [DOI: 10.1378/chest.105.6.1916c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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van Lunteren E, Martin RJ. Pharyngeal dilator muscle contractile and endurance properties in neonatal piglets. RESPIRATION PHYSIOLOGY 1993; 92:65-75. [PMID: 8511409 DOI: 10.1016/0034-5687(93)90120-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Pharyngeal dilator muscles are critical for maintaining upper airway patency in the neonatal period. The present study examined in vitro the contractile properties of a pharyngeal dilator muscle, the sternohyoid, in 1-7-day-old piglets (n = 24). Isometric contraction and half-relaxation times were 36.7 +/- 1.1 and 30.9 +/- 1.2 msec, respectively. Twitch potentiation ('staircase phenomenon') and post-tetanic potentiation were noted following repetitive stimulation. During prolonged repetitive stimulation with a standard (40 Hz) fatigue test, muscle force declined gradually over time, with loss of half of the initial force occurring over 138 +/- 11 sec, and a 2-min fatigue index (ratio of force at 2 min to initial force) of 0.52 +/- 0.03. An additional 10 piglets were studied at ages of 14-20 days. Muscle from older piglets had comparable isometric twitch kinetics as that of younger animals. However, sternohyoid muscle from the older piglets had worse endurance than muscle from the younger animals, as indicated by a shorter time required for force to decrease by half (86 +/- 10 sec, P < 0.01) and a lower 2-min fatigue index (0.36 +/- 0.03, P < 0.01). These data indicate that for the sternohyoid muscle of the newborn piglet (a) physiological properties are consistent with moderate to fast contraction with good endurance, (b) force potentiates during repetitive twitch stimulation and following a brief period of tetanic stimulation, and (c) there is worsening of endurance but no change in isometric twitch kinetics with increasing age during the first weeks of life.
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Affiliation(s)
- E van Lunteren
- Department of Medicine (Pulmonary), Case Western Reserve University, University Hospitals of Cleveland, Ohio 44106
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Brozanski BS, Daood MJ, Watchko JF, LaFramboise WA, Guthrie RD. Postnatal expression of myosin isoforms in the genioglossus and diaphragm muscles. Pediatr Pulmonol 1993; 15:212-9. [PMID: 8469573 DOI: 10.1002/ppul.1950150406] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We studied the expression of myosin heavy chain (MHC) and native myosin isoforms in the genioglossus (GG) and costal diaphragm (DIA) muscles of the rat during postnatal development using both denaturing and nondenaturing gel electrophoresis. Primary myotubes in both fast and slow muscles homogeneously express slow as well as embryonic myosin. Since the adult GG is comprised primarily of fast MHC isoforms, whereas the adult DIA is characterized by a mixture of MHC slow and fast isoforms, we hypothesized that the GG and DIA would be subject to different temporal patterns of MHC isoform expression during postnatal development. Native myosin and MHC gels demonstrated a persistence of neonatal MHC (MHC neo) on day 25 in the GG, whereas this isoform was not detected beyond day 21 in the DIA. The MHC phenotype in GG of the adult demonstrated a predominance of MHC 2X (35% +/- 8) and MHC 2B (45% +/- 10) with a smaller proportion of MHC 2A (19% +/- 5). In contrast, the MHC phenotype in adult DIA was characterized by approximately equal proportions of MHC slow (25% +/- 3), MHC 2A (34% +/- 10), and MHC 2X (31% +/- 12) with a small percentage of MHC 2B (9% +/- 7). These data suggest that postnatal regulation of MHC expression in the GG and DIA is muscle specific.
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Affiliation(s)
- B S Brozanski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pennsylvania
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van Lunteren E. Muscles of the Pharynx: Structural and Contractile Properties. EAR, NOSE & THROAT JOURNAL 1993. [DOI: 10.1177/014556139307200107] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Erik van Lunteren
- Department of Medicine, Division of Pulmonary and Critical Care, Case Western Reserve University, Cleveland, OH 44106
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