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Abstract Rationale Higher African genetic ancestry has been associated with lower lung function, among individuals from specific racial-ethnic groups. The influence and interactions of genetic variation and ancestry in lung function is poorly understood. This study investigates ancestry-associated loci influencing lung function via admixture mapping and fine-scale allelic association. Methods 512 African American patients with asthma (≥12 years) from the Severe Asthma Research Program and Collaborative Study on the Genetics of Asthma (SARP/CSGA) cohorts were genotyped on the OmniExpress and HumanHap1M arrays or had whole-genome sequencing (WGS). For admixture mapping, global ancestry was inferred using ADMIXTURE and local ancestry estimated using RFMix v1.5.4 with CEU (N = 99) and YRI (N = 108) references across 15,095 local ancestry segments. Peak regions and contiguous segments (p < 10-3) were fine mapped in SARP using local ancestry estimated from WGS with MAF ≥0.03. The Local Ancestry Adjusted Allelic Association (LAAA) model was used to fine map local genetic effect, local ancestry effect, and the interaction between the two, adjusted for age, sex, height, BMI, cohort, and percentage global African ancestry. SNPs with local genetic or interaction p < 10⁻³ were tested for replication in 282 adolescent/adult participants from the Best African Response to Asthma Drugs (BARD) cohort genotyped with the MEGA array imputed to TOPMed (MAF ≥0.03). Results Mean African genetic ancestry was 81.3% in SARP and 80.1% in BARD. In SARP, African genetic ancestry was inversely associated with lung function (FEV₁:β = −7.9, p = 0.005; FVC:β = −9.0, p = 0.004), with stronger effects in females (FEV₁: β = −9.3, p = 0.003; FVC: β = −11.4, p = 0.001) than males (FEV₁:β = −6.4, p = 0.237; FVC:β = −5.7, p = 0.340). Similar total and sex-specific associations were identified in BARD. Admixture mapping in SARP/CSGA identified significant peaks for maximum FVC (p < 1.87 × 10⁻4) on chromosomes 8 and 17 near RP1 and RBFOX3, and near-significant peaks on chromosome 5 near IQGAP2, SNRPCP2, SV2C and for the maximum FEV₁/FVC ratio on chromosome 10 near PCDH15. Fine mapping identified the top SNP on chromosome 8 (rs73587686; p-allele-dose=9.0x10-5; RGS20; q11.23), with 62 additional SNPs overlapping RGS20. SNP rs7825816 was also identified in SARP (β = 2.35, p-allele-dose =1.03 × 10⁻4) and replicated in BARD (β = 1.15, p-allele-dose =0.03). In BARD, LAAA also identified eight additional SNPs (p ≤ 0.05) in the same LD block (chr8:53914976-53918297) overlapping with RGS20, ATP6V1H, and TCEA1. Conclusions We identified multiple chromosomal regions associated with lung function in asthma patients of predominantly African genetic ancestry. Lung function associations were strongest at genetic variation near a key that was replicated in an independent asthma cohort. This abstract is funded by: R01 K08 HL118128, R01 HL142992, R01 NR013700, R01 HL69167, R01 HL161674, HL69116, HL69167, HL69170, HL69174, U10 HL109164, U10 HL109257, U10 HL109146, U10 HL109172, U10 HL109250, U10 HL109250, U10 HL109250, U10 HL109168, U10 HL109152, U10 HL109086-04, U10 HL098115, HL098102, HL098096, HL098075, HL098090, HL098177, HL098098, HL098107, HL098112, HL098103, and K12 HL89992

Background: Segmental arterial mediolysis (SAM) is a non-inflammatory vasculopathy that primarily affects the abdominal visceral arteries leading to hemorrhage, ischemia, or pseudoaneurysms. Its presentation can be mimicked by other vasculopathies including vasculitis involving the medium-sized blood vessels making it difficult to diagnose. Case Presentation: A 55-year-old woman presented with a two-hour history of sudden-onset, severe epigastric pain radiating to the chest. She was noted to be hypotensive with low hemoglobin 8.8 g/dL suspicious for a hemorrhagic cause. Her case was complicated by elevated international normalized ratio 3.7 in the setting of warfarin therapy for the mechanical mitral valve. The remainder of her complete blood count, complete metabolic panel, inflammatory markers, autoantibody serologies, and infectious testing were negative. Abdominal computed tomography angiogram revealed hemoperitoneum, bilateral renal infarctions, a large mesenteric hematoma, aneurysmal disease of the common hepatic and inferior mesenteric arteries, thrombosis and proximal dissection of the superior mesenteric artery, acute thrombosis of the left external iliac vein, and multiple sites of arterial extravasation from the pancreaticoduodenal artery and its branches. Mesenteric artery angiogram showed multivessel visceral artery aneurysms and stenoses characteristic of SAM for which she underwent transcatheter arterial embolization of the bleeding vascular bed. We provide a narrative literature review with a focus on common presentations and differentiating characteristics of vasculopathies that can involve medium-sized blood vessels. It is important to accurately diagnose SAM and its potential mimics as management strategies differ. Conclusions: SAM presents with medium vessel vasculopathy without vasculitis. Differentiation from mimics can be difficult but aided by familiarity of their characteristic findings and differentiating clinical characteristics.

Lactococcosis has emerged as an economically and ecologically significant disease in aquatic animals worldwide. This study employed multilocus sequence typing (MLST) to investigate the genetic diversity of Lactococcus spp. strains from Brazilian fish species and evaluate their phylogenetic relationships with global isolates to elucidate potential epidemiological connections involving multiple host species and distinct geographic regions. A total of 55 isolates from different laboratories had their DNA extracted, followed by the amplification and sequencing of the internal fragments of seven housekeeping genes (als, atpA, tuf, gapC, gyrB, rpoC and galP). Sequence types (STs) and clonal complexes (CCs) were defined. An unrooted neighbor-joining phylogenetic tree was generated using allele profiles from this study and those previously reported from other aquatic animal species. The isolates comprised 29 STs (11 previously reported, 18 novel ones), which were grouped into species-specific CCs: CC5 (L. formosensis); CC4, CC17, CC62 (L. garvieae); CC24, CC29, CC97 (L. petauri). Considerable genetic divergence was observed, with L. formosensis and L. garvieae forming heterogeneous populations, while L. petauri was more homogeneous. These findings describe the MLST structure of the sampled isolates and should be interpreted as hypothesis-generating rather than population-level estimates of genotype prevalence. Phylogenetics confirmed groupings within the CCs and revealed additional phylogenetic clustering patterns. In conclusion, the Brazilian Lactococcus spp. strains analyzed in this study constitute a genetically diverse population based on their STs. MLST and phylogenetic analysis demonstrated genetic relatedness between the L. garvieae and L. formosensis isolates from this study and those from other aquatic animal species. In contrast, all the STs identified for L. petauri in this study were unrelated to the MLST lineages responsible for outbreaks in Brazilian Nile tilapia (Oreochromis niloticus) and North American rainbow trout (Oncorhynchus mykiss). This suggests that piscine L. petauri populations in the Americas evolved from distinct ancestral origins.

ABSTRACT Objective This study examines the knowledge, beliefs, and perceptions of asthma among caregivers in Bogotá, Colombia, a middle‐income country (MIC). It provides insights into how these factors influence self‐management and adherence. Methods Trained facilitators conducted focus groups composed of caregivers of asthmatic children. Interview data were analyzed and coded using a process of open coding transcription, followed by inductive thematic‐based coding. The basic codes were then elaborated into a framework of thematic categories within NVivo. Results Sixteen caregivers were divided into two focus groups. Knowledge, beliefs, and perceptions about asthma and inhalation therapy, interactions between caregivers and other individuals, the use of traditional and natural medicine, and the availability of essential medications for asthma therapy were highlighted by the participant caregivers. Although some of the issues identified in these topics are similar to those described in high‐income countries, there are some differences, particularly regarding the fears of patients developing addiction to medications due to the use of inhalation therapy in childhood, the lifelong requirement of inhalation therapy, and the use of traditional versus natural medicine. Conclusions The present study's findings provide insights into how caregivers understand asthma and its treatment in their children. These insights can serve as a basis for more targeted and effective educational interventions in Colombia and other countries with similar socio‐economic and cultural conditions.

Neuromotor control of sighs consists of two phases: Phase I, which resembles a preceding eupneic breath, and Phase II, an extra inspiration superimposed on Phase I. The diaphragm muscle (DIAm)—the primary inspiratory muscle in mammals—is activated during multiple behaviors, including sighs, and its activity can be quantified using electromyography (EMG). Although the biphasic structure of sighs has been described using airflow and pressure signals, how these phases are represented in DIAm EMG activity—and the underlying dynamics of DIAm motor unit (MU) recruitment—remains unclear. Previously we described that eupnea consists of a period of MU recruitment followed by a period of sustained MU activity before derecruitment. We hypothesize that during sighs Phase I follows a similar trajectory of MU recruitment as eupnea while Phase II reflects superimposed additional MU recruitment. DIAm EMG was recorded using fine wire electrodes in awake Sprague-Dawley rats (n=6) of both sexes. To determine the period of DIAm MU recruitment during both Phase I and Phase II, a stationarity analysis was performed. The stationarity analysis uses a reverse arrangement test applied to sequential, non-overlapping 10-ms bins across a longer analysis window. Because DIAm MU discharge rates rarely exceed 100 Hz, it is unlikely that a single MU fires more than once within each 10-ms window; thus, non-stationarity reflects MU recruitment rather than changes in discharge rate. An average of 17 ± 4 sighs per animal were identified (range: 10-20), with a frequency of 2.8 ± 0.1 min-1. Sighs had a burst duration of 1300 ± 405 ms, much longer than the burst duration of eupneic breaths (~598 ± 111 ms). During sighs there were two distinct periods of MU recruitment reflected by non-stationarity of the EMG signal. The MU recruitment duration of Phase I was significantly shorter than Phase II (100 ± 28 ms vs. 179 ± 53 ms, p = 0.041). The onset-to-peak duration during sighs averaged 489 ± 135 ms, with the duration of Phase I lasting longer than Phase II (298 ± 119 ms vs 179 ± 56 ms). It is important to note that Phase II is characterized by rapid, continuous recruitment throughout its duration. In contrast, Phase I had a longer overall duration, although the period of MU recruitment was relatively brief—similar to eupneic breathing. Using EMG stationarity in awake animals allowed us to characterize these underlying MU patterns without altering ventilation or disrupting the intact of the respiratory system. These results indicate that sighs reflect a distinct pattern generator superimposed on that generating eupneic breathing. It remains unclear whether sighs are triggered (e.g., reflexes) or spontaneously generated. Funding: NIH NHLBI 5R01HL146114 and NIA 5R01AG044615 This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

Brain-derived neurotrophic factor (BDNF) signals through its high-affinity full length tropomyosin receptor kinase-B (TrkB.FL). One key downstream target of BDNF/TrkB.FL signaling is phosphorylation of the transcription factor cyclic AMP response element-binding (CREB) protein at serine 133 (pCREBS133). We hypothesized that a positive feedback loop exists in the spinal cord in which BDNF/TrkB.FL induces pCREBS133 which then transcriptionally targets pro-BDNF expression. To test this hypothesis, we employed a loss of function approach using a novel chemogenetic rat model (TrkBF616A) with a knock-in allele sensitive to the selective kinase inhibitor 1NMPP1 to inhibit TrkB.FL kinase activity. In female and male TrkBF616A rats, we then examined the effects of 1NMPP1 (orally through drinking water) induced TrkB.FL kinase inhibition on BDNF levels in the cervical (CSC) and lumbar (LSC) spinal cord. The spinal cord was collected at two time points at 0700 and 010 reflecting the trough and peak timepoints of endogenous BDNF expression. BDNF levels were quantified using ELISA. We found in the CSC, BDNF levels did not vary across timepoints in either 1NMPP1 or vehicle treated groups. However, 1NMPP1-induced TrkB.FL inhibition significantly reduced BDNF levels at both timepoints (P=0.004). This reduction suggests that cervical circuits rely on continuous CREB-dependent support of BDNF expression and that inhibiting TrkB.FL disrupts this loop throughout the day. In the LSC, control rats displayed time of day-dependent variations in BDNF with lower levels at 0700 compared to 0100 (P=0.02). In contrast, 1NMPP1-induced inhibition of TrkB.FL reduced BDNF levels at 0100—when BDNF normally peaks in the LSC (P=0.01). This nighttime specific deficit supports the idea that activity-driven pCREBS133 activation is necessary to elevate BDNF during the active phase and that blocking TrkB.FL signaling disrupts this pCREBS133-mediated positive feedback. Overall, these results support a positive feedback that is region- and time-specific and involves BDNF/TrkB.FL signaling inducing pCREBS133 phosphorylation which then targets pro-BDNF expression in the spinal cord. Supported by NIH grants HL146114 and AG44615. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

Neuromotor control of diaphragm muscle (DIAm) involves size-dependent recruitment of phrenic motor neurons (PhMNs). To accomplish breathing, only smaller PhMNs innervating slow (type S) and fast, fatigue resistant (type FR) DIAm motor units are recruited. Thus, smaller PhMNs and type S and FR DIAm motor units are very active in sustaining ventilation throughout life. Larger PhMNs innervating more fatigable fast (type FF) motor units are very infrequently recruited for higher force, expulsive behaviors. Previously, we reported that smaller PhMNs have higher mitochondrial volume densities (MVD) reflecting their more frequent activation. Mitochondria are essential for maintaining energetic support and cellular homeostasis. We hypothesized that to sustain higher MVD, mitochondrial biogenesis is higher in smaller compared to larger PhMNs. In female and male Sprague Dawley rats (~3 months of age) PhMNs were retrogradely labeled by intrapleural injection of cholera toxin B (CTB). After 3 days, mitochondria in the cervical spinal cord were labeled by subdural injection of MitoTracker Red. The cervical spinal cord was collected and labeled PhMNs and mitochondria were imaged by high-resolution confocal microscopy and reconstructed in 3D. As previously reported, we found a significant negative correlation between MVD and PhMN somal surface area. By immunohistochemistry, we found an increased nuclear to cytosolic ratio of pCREBS1333 in smaller PhMNs compared to larger PhMNs. PGC1α and TFAM expression was also higher in smaller PhMNs. These findings support size-dependent differences in pCREBS133–PGC1α–TFAM pathway promoting mitochondrial biogenesis. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

Mitochondria are organelles essential for maintaining energetic support and cellular homeostasis. In phrenic motor neurons (PhMNs), mitochondria support the high level of activity necessary to sustain neuromotor control of the diaphragm muscle during breathing. Previously, we observed that small PhMNs recruited during breathing have higher mitochondrial volume density (MVD) compared to large PhMNs that are recruited infrequently during higher force airway clearance behaviors. In support, we also found that the maximum velocity of the succinate dehydrogenase activity (SDHmax) was higher in small PhMNs compared to large PhMNs. However, total mitochondrial volume was comparable across PhMNs of varying size. This suggests that the total ATP demands of PhMNs do not vary with size. The distribution of mitochondria likely reflects the demands of ATP consumption. In airway smooth muscle cells, mitochondria are not homogeneously distributed, with a higher density in the perinuclear region. In addition, mitochondria appear to be localized in close proximity to the endoplasmic reticulum (ER) most likely to support cytosolic and mitochondrial Ca 2+ regulation. The ER is also clustered in the perinuclear compartment of cells. Perinuclear clustering of mitochondria most likely reflects the higher ATP consumption close to the nucleus. We hypothesized that MVD is higher in the perinuclear region of PhMNs compared to more distal compartments. PhMNs of young (6 month), female and male Fisher 344 rats were retrogradely labeled by intrapleural injection of Alexa 488-conjugated cholera toxin B (CTB). Three days later, mitochondria were labeled by subdural injection of MitoTracker Red CMXRos. Spinal cord tissue was collected following transcranial perfusion with 4% paraformaldehyde, sectioned longitudinally at 70 µm, and mounted onto slides. Mosaics of labeled PhMNs and mitochondria were acquired in 3D (Z optical slices of 0.5 μm) using a 60x Plan Apo oil-immersion objective (NA 1.40). Using a concentric (10 mm) shell method for analysis, MVD was quantified relative to the distance relative to the nuclear membrane of PhMNs. Our results show a disproportionately higher MVD within the perinuclear region compared to more distal regions of PhMNs. This perinuclear distribution of mitochondria was found across PhMNs of varying size. These results suggest that energetic requirements of nucleus and ER are major drivers of mitochondrial biogenesis. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

Brain derived neurotrophic factor (BDNF) signals through its high-affinity full-length tropomyosin receptor kinase-B (TrkB.FL) and plays role in maintaining the survival and function of phrenic motor neurons (PhMNs), neuromuscular transmission and synaptic activity. Disruption of this pathway is a hallmark of several neurodegenerative diseases associated with dysfunction and death of PhMNs with impaired mitochondrial function. BDNF/TrkB.FL signaling phosphorylates CREB at serine 133 (pCREBS133) and promotes its nuclear localization in cervical ventral horn of rats, however its downstream molecular pathway has not yet been established. Recently, we demonstrated that in human airway smooth muscle cells, pCREBS133, as a transcription factor, binds to the CRE sequence in the PGC1a promoter and activates its expression. PGC1a co-transcriptionally activates mitochondrial transcription factor A (TFAM) expression promoting mitochondrial DNA (mtDNA) replication and mitochondrial biogenesis. In the present study, we hypothesized that BDNF/TrkB.FL signaling promotes pCREBS133 phosphorylation and transcriptional activation of PGC1a and downstream expression of TFAM, leading to mitochondrial biogenesis. In this study, we employed a loss of function approach using a novel chemogenetic rat model (TrkBF616A) with a knock-in allele sensitive to the selective kinase inhibitor 1NMPP1 to inhibit TrkB.FL kinase activity. One group of female and male rats were treated intrathecally at C4 with either artificial cerebrospinal fluid (aCSF) or BDNF (450 ng/ 300 g b.w.; diluted in aCSF) for 40 mins, followed by collection of C3-C6 cervical ventral horn. In a second group, female and male rats were treated with 1NMPP1 (25 uM; i.p.) or the vehicle DMSO for 2 h. After 2 h, both groups were treated intrathecally with BDNF for 40 min and the C3-C6 cervical ventral horn collected. Intrathecal BDNF increased the pTrkB.FLY817 autophosphorylation and downstream phosphorylation of pCREBS133. Bioinformatic analysis identified a putative binding site of pCREBS133 on PGC1a promoter, which was confirmed by Chromatin immunoprecipitation (ChIP) assay. Consistent with this, BDNF treatment increased the expression of PGC1a and downstream TFAM, with an increase in mtDNA copy number. 1NMPP1 inhibition of TrkB.FL kinase (blunted BDNF-induced pTrkB.FLY817 phosphorylation) inhibited downstream activation of the pCREBS133/PGC1a/TFAM signaling cascade. Additionally, 1NMPP1 treatment blunted the BDNF-induced increase in mtDNA copy number. We conclude that BDNF/TrKB.FL signaling mediates mitochondrial biogenesis in the cervical ventral horn suggesting that interventions targeting this pathway could be a therapeutic strategy for neurodegenerative diseases. This research was funded by NIH Grants HL146114 & AG44615. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

By 2045, more than three quarters of global cancer deaths are projected to occur in low- and middle-income countries (LMICs); however, the global availability of cancer care remains constrained by high costs and inequitable access. Value-based frameworks that integrate clinical benefit with affordability, feasibility, and equity are essential to better guide research prioritization, resource allocation, and regulatory policies in LMICs. A key component of a value-based approach is the generation of high-quality, locally relevant data to support evidence-based implementation of cancer prevention and control strategies. Herein, we provide three contemporary examples from JCO Global Oncology which demonstrate how economic evaluation in cancer research can address locally relevant, health system–specific questions.