Diaphragm muscle adaptation to sustained hypoxia: lessons from animal models with relevance to high altitude and chronic respiratory diseases

dc.contributor.authorO'Halloran, Ken D.
dc.contributor.authorLewis, Philip
dc.contributor.funderHealth Research Boarden
dc.date.accessioned2017-01-04T15:28:17Z
dc.date.available2017-01-04T15:28:17Z
dc.date.issued2016-12-12
dc.date.updated2017-01-04T15:21:10Z
dc.description.abstractThe diaphragm is the primary inspiratory pump muscle of breathing. Notwithstanding its critical role in pulmonary ventilation, the diaphragm like other striated muscles is malleable in response to physiological and pathophysiological stressors, with potential implications for the maintenance of respiratory homeostasis. This review considers hypoxic adaptation of the diaphragm muscle, with a focus on functional, structural, and metabolic remodeling relevant to conditions such as high altitude and chronic respiratory disease. On the basis of emerging data in animal models, we posit that hypoxia is a significant driver of respiratory muscle plasticity, with evidence suggestive of both compensatory and deleterious adaptations in conditions of sustained exposure to low oxygen. Cellular strategies driving diaphragm remodeling during exposure to sustained hypoxia appear to confer hypoxic tolerance at the expense of peak force-generating capacity, a key functional parameter that correlates with patient morbidity and mortality. Changes include, but are not limited to: redox-dependent activation of hypoxia-inducible factor (HIF) and MAP kinases; time-dependent carbonylation of key metabolic and functional proteins; decreased mitochondrial respiration; activation of atrophic signaling and increased proteolysis; and altered functional performance. Diaphragm muscle weakness may be a signature effect of sustained hypoxic exposure. We discuss the putative role of reactive oxygen species as mediators of both advantageous and disadvantageous adaptations of diaphragm muscle to sustained hypoxia, and the role of antioxidants in mitigating adverse effects of chronic hypoxic stress on respiratory muscle function.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationLewis, P. and O'Halloran, K. D. (2016) 'Diaphragm Muscle Adaptation to Sustained Hypoxia: Lessons from Animal Models with Relevance to High Altitude and Chronic Respiratory Diseases', Frontiers in Physiology, 7, 623 (11pp). doi:10.3389/fphys.2016.00623en
dc.identifier.doi10.3389/fphys.2016.00623
dc.identifier.endpage623-11en
dc.identifier.issn1664-042X
dc.identifier.journaltitleFrontiers in Physiologyen
dc.identifier.startpage623-1en
dc.identifier.urihttps://hdl.handle.net/10468/3425
dc.identifier.volume7en
dc.language.isoenen
dc.publisherFrontiers Mediaen
dc.rights© 2016 Lewis and O’Halloran. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectRedoxen
dc.subjectDiaphragm muscleen
dc.subjectReactive oxygen speciesen
dc.subjectCOPDen
dc.subjectAtrophyen
dc.titleDiaphragm muscle adaptation to sustained hypoxia: lessons from animal models with relevance to high altitude and chronic respiratory diseasesen
dc.typeArticle (peer-reviewed)en
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