Joyner, Michael J.

Age‐related mitochondrial dysfunction is paralleled by reductions in gene transcripts and expression of proteins involved in cellular ATP production. Short‐term endurance exercise has been shown to enhance muscle protein synthesis in the elderly. We determined the impact of long‐term endurance exercise on gene expression and protein abundance of numerous proteins involved in cellular energetics. Vastus lateralis tissue was biopsied from 11 young sedentary (YS), 10 old sedentary (OS), 11 young trained (YT), and 11 old trained (OT) subjects. Trained subjects vigorously exercised ¡Ý 1 hr/d, ¡Ý five d/wk for ¡Ý 4 years. Large‐scale measurement of relative protein abundance was performed using isobaric tags for relative and absolute quantitation (iTRAQ) reagents and tandem mass spectrometry. Gene transcript levels were measured by high‐density oligonucleotide microarrays. Ingenuity Pathway Analysis was used to determine canonical pathways that were altered by age. Of the 33 proteins involved in cellular ATP production 27 were less abundant in OS vs. YS, while only 4 of these proteins were less abundant in OT vs. YT. Genes involved in glycolysis and oxidative phosphorylation were underexpressed in OS vs. YS, with no effects of age in OT vs. YT. CONCLUSIONS: Long‐term vigorous endurance exercise ameliorates the detrimental effects of old age on muscle gene and protein expression in humans.

Orthostatic stress such as head‐up tilt (HUT) elicits a wide range of HR and BP responses among healthy individuals. In this study, we evaluated cardiovascular dynamics of subjects with different HR responses to HUT but without autonomic dysfunction. We measured BP (brachial artery) and HR (ECG) during 5 min of 60° HUT in 76 healthy young individuals, while norepinephrine (NE) was assayed during the final 30 s. We then chose 30 individuals based on the extremes of HR responses to HUT: 15 with the highest (ΔHR≥ 20 bpm) and 15 with the lowest response (ΔHR ≤10 bpm). Age and BMI were not different between groups; however, gender distribution was different (high: 5F, 10 M; low: 10F, 5M). Peak HR during HUT was 87.2±10.4 bpm in the high and 69.1±14.1 bpm in the low group (P< 0.05). Baseline HR was not different between groups. High HR responders had lower SBP at baseline (120.9±9.4 vs. 129.4±11.0 mmHg) and during HUT (119.9±9.7 vs. 131.4±13.1 mmHg). High HR responders also had higher plasma NE response to HUT (ΔNE: 156.9±82.1 vs. 89.0±48.0 pg/ml; P< 0.05). Higher HR with lower BP during HUT is consistent with normal baroreflex mechanisms of integration. Although inter‐individual variability appears to be a fundamental part of cardiovascular regulation, the mechanisms of these differences and the gender discrepancy requires further investigation. Supported by K23 RR17520, HL46493, NS32352, KL2 RR024151 ‐01.

The ganglionic blocker trimethaphan (TMP) is no longer produced; alternatives are needed to inhibit baroreflex control of the circulation during systemic hemodynamic studies. We tested the hypothesis that combination anti‐cholinergic glycopyrrolate (Gly) and α2 receptor agonist dexmedetomidine (Dex) would inhibit baroreflex buffering in response to vasodilation to a similar degree as ganglionic blockade with TMP. In 2 separate trials, 5 males received an I.V. bolus and infusion of Gly‐Dex, and 11 males received TMP infusion. To offset the fall in blood pressure with TMP, phenylephrine (PE) was used to raise pressure to pre‐TMP baseline. Terbutaline was then infused for 15 minutes at 2 doses (33 and 67 ng/kg/min). Heart rate (HR), blood pressure (BP, oscillometric cuff for Gly‐Dex, brachial arterial line for TMP+PE), and cardiac output (CO, acetylene breathing) were recorded. Resting HR was higher with Gly‐Dex (mean ± SEM: 93±7mmHg) than TMP+PE (74±3mmHg, p<0.001) but resting BP, CO, stroke volume (SV), and total peripheral resistance (TPR) were similar between Gly‐Dex and TMP+PE. The cardiovascular responses to terbutaline were similar between Gly‐Dex and TMP+PE, except for the increase in CO which was significantly greater in the TMP + PE group. We conclude that Gly‐Dex is a viable pharmacologic alternative to TMP in physiologic measures of BP and TPR during vasodilator infusions.

The vascular effects of prostacyclin and contribution of endothelial derived nitric oxide (NO) to prostacyclin mediated dilation are unknown in aging. A pilot study was performed in healthy older subjects (n=6, 61–73 years old) and younger controls (n=6, 19–45 years old) that were matched for BMI. Subjects underwent brachial artery catheterization and received escalating doses of epoprostenol (PGI 2 2.5, 5, 10 ng/100ml forearm tissue/min) followed by sodium nitroprusside (SNP 0.25, 0.5, 1 mcg/100ml forearm tissue/min) after PGI 2 washout. SNP and PGI 2 were repeated after NO synthase inhibition with N G ‐Monomethyl‐L arginine acetate (L‐NMMA 1mg/min after 50mg load). Using venous occlusion plethysmography, forearm vascular conductance (FVC) was calculated using mean arterial pressure (MAP), as FVC= (FBF/MAP X 100). Percent change in FVC from baseline after PGI 2 was lower in the aging individuals (47, 160, 227 % change FVC) compared to younger controls (85, 218, 327 %change FVC) (p=0.039), L‐NMMA reduced baseline FVC similarly, and the dilator response to PGI 2 was no longer significant between groups. SNP effects were not significant between groups and unaffected by L‐NMMA. This data suggests a reduced effect to prostacyclin in the aging individual may be due to a reduction in the contribution of endothelial derived NO. Support provided by HL‐46493 and UL1‐RR24150.

Epinephrine is a sympathomimetic which is derived from phenylalanine and tyrosine. The final step of epinephrine synthesis, the conversion from norepinephrine, relies on phenylethanolamine N‐methyltransferase (PNMT). The beta‐2 adrenergic receptor (ADRB2) binds to epinephrine and has several common functional polymorphisms including a Glycine (Gly) for Arginine (Arg) substitution at amino acid 16. We assessed the effect of the gene‐to‐gene interaction of these proteins on the ventricular response to exercise in healthy humans (n=69, age=29±6yrs, ht=174±10cm, wt=71±13kg). We found that within the 2*1 haplotype of the 5′FR, which has previously demonstrated greater epinephrine synthesis compared to 2*7 haplotype, the Arg16 genotype demonstrates lower stroke volume (SV) than the Gly16 genotype despite similar epinephrine levels and synthesis rates (Arg16= 75±5, Gly16=89±6ml/beat). Similarly, within the 2*7 haplotype of the 5′FR, which has demonstrated attenuated epinephrine synthesis compared to 2*1, the Arg16 genotype demonstrates a smaller SV than the Gly16 genotype (Arg16= 59±3, Gly16=78±6ml/beat). Additionally, the Arg16 and Gly16 subjects within the 2*1 haplotype of PNMT have greater stroke volume than their ADRB2 counterparts of the 2*7 haplotype of PNMT. These data demonstrate an interaction between the genes that encode PNMT and ADRB2 on the ventricular response to exercise.

Heart failure (HF) patients have reduced cardiac reserve and increased work of breathing (WOB)., Increased demand for locomotor muscle blood flow (i.e. activities of daily living) may result in competition between respiratory and locomotor vascular beds. We hypothesized that HF patients would demonstrate improved locomotor blood flow with respiratory muscle unloading during moderate activity. We studied 10 HF patients (EF=30±8%) and 10 controls during two 10 min. cycling sessions at 60% VO 2 max. Session 1 (S1): 5 min of normal breathing (NB) and 5 min respiratory muscle unloading with a ventilator. Session 2 (S2): 5 min NB and 5 min of respiratory muscle loading with inspiratory resistance. Measurements included: leg blood flow (LBF), cardiac output (CO), and inspiratory pleural pressure time integral as an index of the WOB. During S1, WOB was reduced similarly in both groups (HF: 50±60%; CTL: 50±56%, p<0.05 for both). In HF, CO was reduced (9.6±1.4 vs 8.2±2.1 L/min, p<0.05) and LBF increased (4.9±2.6 vs 6.2±2.9 L/min, p<0.01). In CTL, there was no change in CO (14.7±3.1 vs 14.8±5.0 L/min) or LBF (10.9±5.6 vs 10.3±5.2 L/min). During S2, WOB was increased similarly in both groups (HF: 111±75%, CTL: 110±85%, p<0.01 for both). In HF, there was no change in CO (10.0±1.3 vs 10.3±2.5 L/min) or LBF (5.0±1.8 vs 4.9±1.4 L/min). In CTL, CO increased (15.4±4.3 vs 16.9±4.7 L/min, p<0.01) with no change in LBF (10.7±5.3 vs 10.3±5.6 L/min). These data suggest that the respiratory muscles of HF patients preferentially recruit blood flow away from the locomotor muscles during moderate intensity, whole body exercise.

We previously demonstrated a bimodal distribution of vasodilator responsiveness to adenosine (ADO) infusion in human subjects: one subgroup demonstrated robust vasodilator responses to ADO (ADO responders) and the other showed blunted responses (non‐responders). Furthermore, ADO receptor antagonism blunted ADO vasodilator responses only in ADO responders and blunted exercise vasodilation only at high workloads in both groups. To test the hypothesis that ADO transporter antagonism would augment vasodilator responsiveness to ADO and exercise only in ADO responders, we compared forearm vasodilation to intra‐arterial infusion of three doses of ADO to vasodilation during three workloads of forearm handgrip exercise before and after ADO transporter antagonism with dipyridamole (DYP) in 10 subjects. In ADO responders (n=5), the change in forearm vascular conductance above baseline (ml min −1 100mmHg −1 ) for the low, medium, and high doses of ADO, respectively, was 61 ± 15, 117 ± 35, 164 ± 47 before DYP and 160 ± 50, 171 ± 59, and 216 ± 87 after DYP. For non‐responders (n=5), these values were 20 ± 2, 36 ± 6, 57 ± 14 before DYP ( P < 0.05 vs. responders) and were 159 ± 40, 293 ± 53, and 377 ± 82 after DYP ( P > 0.05 vs. responders). ADO transporter blockade had no effect on exercise hyperemia in either group ( P > 0.05 for pre vs. post‐DYP). We conclude that there may be increased ADO transporter activity in non‐responders resulting in increased clearance of ADO from the interstitium and that, in both subgroups, ADO is not obligatory for exercise hyperemia.

Aging humans exhibit lower exercise blood flow (exercise hyperemia), but the vascular mechanisms mediating this remain unknown. In aging humans, agonist infusions suggest endothelial dysfunction, due in part to less nitric oxide (NO) and prostaglandin (PG) mediated vasodilation. Notably, in young adults inhibition of NO or PGs decreases exercise hyperemia by 20% and 12%, respectively. We tested the hypothesis that aging humans would exhibit an attenuated reduction in exercise hyperemia following inhibition of NO or PGs, due to less vasodilation from these signals. Eleven older males and females (55–76 years) performed dynamic forearm exercise for 20 minutes. Forearm blood flow (FBF) was measured beat‐to‐beat with Doppler ultrasound while saline or drugs were infused sequentially via brachial artery catheter in the exercising forearm. After achieving steady state exercise (min 5), L‐NAME (25 mg) was infused for 5 minutes to inhibit NO synthase. After 2 more minutes of exercise (saline), ketorolac (6 mg) was infused for 5 minutes to inhibit PGs, followed by 3 more minutes of exercise with saline. L‐NAME reduced exercise hyperemia by 13–18% in older subjects, whereas ketorolac had no net effect on blood flow. In the reverse drug order (n=6), ketorolac did not effect FBF, but L‐NAME reduced FBF by 10–13%. Our results suggest that in aging humans, the contribution of NO to exercise hyperemia may be modestly reduced, but the role of PGs mediating vasodilation is completely lost. Loss of vasodilating PGs along with diminished NO may contribute to lower blood flow in aging humans. Grant support: HL‐69692, HL‐46493, and GCRC RR‐00585.

The role of oxidative stress and antioxidant enzymes in the aging related dysfunction of EPCs has not been studied. We hypothesized that impaired antioxidant capacity contributes to dysfunction of EPCs. Early EPCs isolated from healthy young (24±3 year‐old, n=9) and aged (71±5 year‐old, n=9) males were examined. The levels of protein expression and enzymatic activity of glutathione peroxidase 1 (GPX1) were decreased significantly in the EPCs from aged individuals in compared to EPCs from young individuals (n=9, P<0.05). After 24 h of serum starvation EPC numbers in young group and aged group were 0.6±0.2 and 0.4±0.1, respectively (expressed as ratio to the cell number under normal culture conditions, n=6, P<0.05). H 2 O 2 (1mM) treatment for 24 h significantly decreased EPC number to 37±13% in aged, compared with young individuals (67±13%, n=3, P<0.05). Furthermore, under normal culture conditions the numbers of senescent β‐galactosidase (β‐gal) positive EPCs were not significantly different between young and aged subjects (46.1±8.4%, and 58.3±7.6, respectively, n=3). However, H 2 O 2 (50 μM) treatment significantly increased the β‐gal positive cells in aged EPCs (73±9%), compared with young EPCs (43±11%, n=3, P<0.05). These results suggest that EPCs of older individuals are more susceptible to oxidative stress induced by H 2 O 2 and serum starvation, resulting in decreased survival and increased senescence. Reduced expression of GPX1 may contribute to EPC dysfunction with aging.