Search

New Findings: What is the central question of this study? How does chronic stress impact cerebrovascular function and does metabolic syndrome accelerate the cerebrovascular adaptations to stress? What role does exercise training have in preventing cerebrovascular changes to stress and metabolic syndrome? What is the main finding and its importance? Stressful conditions lead to pathological adaptations of the cerebrovasculature via an oxidative nitric oxide pathway, and the presence of metabolic syndrome produces a greater susceptibility to stress-induced cerebrovascular dysfunction. The results also provide insight into the mechanisms that may contribute to the influence of stress and the role of exercise in preventing the negative actions of stress on cerebrovascular function and structure., Abstract: Chronic unresolvable stress leads to the development of depression and cardiovascular disease. There is a high prevalence of depression with the metabolic syndrome (MetS), but to what extent the MetS concurrent with psychological stress affects cerebrovascular function is unknown. We investigated the differential effect of MetS on cerebrovascular structure/function in rats (16-17 weeks old) following 8 weeks of unpredictable chronic mild stress (UCMS) and whether exercise training could limit any cerebrovascular dysfunction. In healthy lean Zucker rats (LZR), UCMS decreased (28%, P < 0.05) ex vivo middle cerebral artery (MCA) endothelium-dependent dilatation (EDD), but changes in MCA remodelling and stiffness were not evident, though cerebral microvessel density (MVD) decreased (30%, P < 0.05). The presence of UCMS and MetS (obese Zucker rats; OZR) decreased MCA EDD (35%, P < 0.05) and dilatation to sodium nitroprusside (20%, P < 0.05), while MCA stiffness increased and cerebral MVD decreased (31%, P < 0.05), which were linked to reduced nitric oxide and increased oxidative levels. Aerobic exercise prevented UCMS impairments in MCA function and MVD in LZR, and partly restored MCA function, stiffness and MVD in OZR. Our data suggest that the benefits of exercise with UCMS were due to a reduction in oxidative stress and increased production of nitric oxide in the cerebral vessels. In conclusion, UCMS significantly impaired MCA structure and function, but the effects of UCMS were more substantial in OZR vs. LZR. Importantly, aerobic exercise when combined with UCMS prevented the MCA dysfunction through subtle shifts in nitric oxide and oxidative stress in the cerebral microvasculature., (© 2018 The Authors. Experimental Physiology © 2018 The Physiological Society.)

New Findings: What is the central question of this study? Tumour necrosis factor-α (TNFα) has been shown to impair vascular function, but the impact of thoracic aorta perivascular adipose tissue (tPVAT)-derived TNFα on tPVAT and aortic function in metabolic syndrome is unknown. What is the main finding and its importance? Release of TNFα by tPVAT causes production of reactive oxygen species in tPVAT through activation of an NADPH-oxidase 2 (NOX2)-dependent pathway, activates production of aortic reactive oxygen species and mediates aortic stiffness, potentially through matrix metalloproteinase 9 activity. Neutralization of TNFα and/or inhibition of NOX2 blocks the tPVAT-induced impairment of aortic function. These data partly implicate tPVAT NOX2 and TNFα in mediating the vascular pathology of metabolic syndrome., Abstract: Perivascular adipose tissue (PVAT) is recognized for its vasoactive effects, but it is unclear how metabolic syndrome impacts thoracic aorta (t)PVAT and the subsequent effect on functional and structural aortic stiffness. Thoracic aorta and tPVAT were removed from 16- to 17-week-old lean (LZR, n = 16) and obese Zucker rats (OZR, n = 16). The OZR presented with aortic endothelial dysfunction, assessed by wire myography, and increased aortic stiffness, assessed by elastic modulus. The OZR tPVAT exudate further exacerbated the endothelial dysfunction, reducing nitric oxide and endothelium-dependent relaxation (P < 0.05). Additionally, OZR tPVAT exudate had increased MMP9 activity (P < 0.05) and further increased the elastic modulus of the aorta after 72 h of co-culture (P < 0.05). We found that the observed aortic dysfunction caused by OZR tPVAT was mediated through increased production and release of tumour necrosis factor-α (TNFα; P < 0.01), which was dependent on tPVAT NADPH-oxidase 2 (NOX2) activity. The OZR tPVAT release of reactive oxygen species and subsequent aortic dysfunction were inhibited by TNFα neutralization and/or inhibition of NOX2. Additionally, we found that OZR tPVAT had reduced activity of the active sites of the 20S proteasome (P < 0.05) and reduced superoxide dismutase activity (P < 0.01). In conclusion, metabolic syndrome causes tPVAT dysfunction through an interplay between TNFα and NOX2 that leads to tPVAT-mediated aortic stiffness by activation of aortic reactive oxygen species and increased MMP9 activity., (© 2018 The Authors. Experimental Physiology © 2018 The Physiological Society.)

Purpose: Although studies suggest elevated adrenergic activity paralleling metabolic syndrome in OZRs, the moderate hypertension and modest impact on organ perfusion question the multi-scale validity of these data., Methods: To understand how adrenergic function contributes to vascular reactivity in OZR, we utilized a multi-scale approach to investigate pressure responses, skeletal muscle blood flow, and vascular reactivity following adrenergic challenge., Results: For OZR, adrenergic challenge resulted in increased pressor responses vs LZRs, mediated via α 1 receptors, with minimal contribution by either ROS or NO bioavailability. In situ gastrocnemius muscle of OZR exhibited blunted functional hyperemia, partially restored with α 1 inhibition, although improved muscle performance and VO 2 required combined treatment with TEMPOL. Within OZR in situ cremaster muscle, proximal arterioles exhibited a more heterogeneous constriction to adrenergic challenge, biased toward hyperresponsiveness, vs LZR. This increasingly heterogeneous pattern was mirrored in ex vivo arterioles, mediated via α 1 receptors, with roles for ROS and NO bioavailability evident in hyperresponsive vessels only., Conclusions: These results support the central role of the α 1 adrenoreceptor for augmented pressor responses and elevations in vascular resistance, but identify an increased heterogeneity of constrictor reactivity in OZR that is presently of unclear purpose., (© 2016 John Wiley & Sons Ltd.)

This review summarizes material presented in "Adaptive Outcomes of Microvascular Networks to Obesity and Type II Diabetes/Insulin Resistance" on July 30, 2016, at the Joint Meeting of the American Physiological Society and the Physiological Society, in Dublin, Ireland. We discuss the poor predictive power of traditional markers of vascular dysfunction for functional outcomes of muscle fatigue-resistance and active hyperemia within the setting of elevated peripheral vascular disease risk. Using the obese Zucker rat model of the metabolic syndrome, we describe how blood flow distribution at arteriolar bifurcations (γ) is altered with PVD risk reflecting increased spatial heterogeneity of distribution within networks. The ability of the microvasculature to compensate for increased heterogeneity is attenuated in OZR, creating a condition wherein the inability to match perfusion to local demand is entrenched and made more difficult to overcome. This appears to be an incremental process, as multiple models of increased PVD risk manifest incremental shifts to the spatial and temporal behavior of γ. These data suggest that γ, a superior predictor of functional outcomes for skeletal muscle, may represent a broadly applicable concept that can inform us about system behavior, with health and increased disease/disease risk, and with imposition of therapeutic regimens., (© 2016 John Wiley & Sons Ltd.)

Although researchers have studied burnout as a condition that can affect the ability to effectively serve clients, little has been written about frustration as a potential contributor to burnout. This study examines factors associated with frustration among case managers who work in aging services. A model of individual, organizational, and community factors that may relate to job frustrations is developed. Data from a sample of 103 case managers are analyzed, with type of job frustration categorized as agency-based (internal to the agency) or community-based (external to the agency). Community-based frustrations were cited by 78% of respondents; moreover, these were related to geographic regions in the state, with case managers in rural regions identifying these significantly more often than those in urban regions. The study indicates a need to attend to the lack of resources available in the environments in which case managers work as a potential source of frustration, especially in rural communities.

Although acknowledged as separate entities in the neurologic literature, central neurofibromatosis and peripheral neurofibromatosis, which is also known as von Recklinghausen's disease, have not been commonly distinguished by otologists as two separate diseases. An NIH Conference statement has reclassified these diseases as neurofibromatosis-1 and neurofibromatosis-2. Genetic, biochemical, and clinical variants of these two related diseases are presented and discussed. Patients with bilateral acoustic neuromas may have either the central or peripheral form of the disease; central neurofibromatosis is much more rare than the peripheral form of the disease.