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Physiological Reports

Wiley

Preprints posted in the last 30 days, ranked by how well they match Physiological Reports's content profile, based on 35 papers previously published here. The average preprint has a 0.04% match score for this journal, so anything above that is already an above-average fit.

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Cardiorespiratory and Cardiac Biomarker Responses to Five Anesthetic Regimens in Rats

Correa, L. d. J.; Minassa, V. S.; Jara, B. T.; de Moura, B. A. A.; Batista, T. J.; Coitinho, J. B.; do Bem, D. A. M. G.; Santos, L. d.; Paton, J. F. R.; McBryde, F. D.; Harres, V. B.; Felippe, I. S. A.; Sampaio, K. N.

2026-04-08 physiology 10.64898/2026.04.07.716572 medRxiv
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General anesthetics enable invasive experimentation but can affect cardiovascular and respiratory physiology, biasing preclinical outcomes. We compared five anesthetic regimens in adult male Wistar rats, tribromoethanol (TBE, 250 mg/kg i.p.), chloral hydrate (CH, 400 mg/kg i.p.), ketamine-xylazine (KX, 80/10 mg/kg i.p.), thiopental (TP, 80 mg/kg i.p.), and isoflurane (ISO, 4% induction, 2% maintenance), to investigate integrated cardiorespiratory and biochemical markers. Femoral arterial catheterization allowed continuous blood pressure (BP) and derived heart rate (HR) recordings, while ventilation was assessed through pletysmography at baseline (awake), during induction, and recovery phases of anesthesia. Variability was evaluated in the time and frequency domains, including HR, systolic blood pressure (SBP), and spontaneous baroreflex sensitivity. In an independent cohort of rats, butyrylcholinesterase (BChE), CK-MB, cTnI, and LDH were measured. Baseline BP was unchanged by TBE and TP, whereas all anesthetics affected HR. Minute ventilation and breathing frequency were reduced with all agents, while tidal volume decreased with KX and TBE only. LDH and cTnI were unaffected, BChE was reduced by KX, TBE, and ISO, and CK-MB increased with CH and KX. Variability analysis showed that all anesthetics depressed pulse-interval and SBP variability and shifted spectral power toward higher frequencies, while baroreflex sensitivity and effectiveness were consistently reduced. During recovery, KX and TP restored most variability indices, whereas CH, TBE, and ISO showed persistent suppression. These findings highlight distinct profiles of cardiovascular depression and biomarker responses across anesthetics and underscore the importance of accounting for autonomic variability when selecting different anesthetics in experimental protocols. HighlightsO_LIFive anesthetic regimens were tested in rats. C_LIO_LIAll anesthetics reduced ventilation, and KX and TBE also reduced tidal volume. C_LIO_LICH and KX increased CKMB, while KX, TBE and ISO reduced BChE. C_LIO_LIAll anesthetics reduced blood pressure variability and baroreflex sensitivity. C_LIO_LIVariability recovered with TP and KX, whereas CH, TBE and ISO showed persistent suppression. C_LI

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Chronic therapy with α1A-adrenergic agonist reverses RV failure and mitochondrial dysfunction

Li, O. Y.; Swigart, P. M.; Reddy, N.; Myagmar, B.-E.; Bat-Erdene, E.; Simpson, P. C.; Baker, A. J.

2026-03-20 physiology 10.64898/2026.03.18.712768 medRxiv
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Right ventricular failure (RVF) is a serious disease with a high mortality but no effective pharmacologic treatments. We reported RVF was reversed by chronic treatment with an 1A-adrenergic receptor (1A-AR) agonist. Recent studies suggest mitochondrial dysfunction contributes to RVF. Therefore, we investigated if reversal of RVF by chronic 1A-AR agonist treatment involved improved mitochondrial function. A mouse model of RVF caused by pulmonary artery constriction (PAC) for 2 wk was chronically treated for a further 2 wk. with a low dose of the 1A-AR agonist A61603 (10 ng/kg/day) or vehicle (no drug control). RV dysfunction was assessed from the fractional shortening of the RV outflow tract (RVOT FS). RVOT FS for sham controls (46.5 {+/-} 1.3 %, n = 9) was reduced 4 wk after PAC (27.6 {+/-} 1.5 %, n = 13, P < 0.0001), but was higher after PAC plus 2 wk A61603 treatment (34.5 {+/-} 0.6 %, n = 14, P < 0.001). RV myocardial respiration rate (O2 consumption) for sham controls (776 {+/-} 51 pM/s/mg, n = 9) was reduced 4 wk after PAC (493 {+/-} 28 pM/s/mg, n = 15, P <0.0001), but was higher after PAC plus 2 wk A61603 treatment (634 {+/-} 30 pM/s/mg, n = 11, P <0.05). RV myocardial ATP level for sham controls (3.3 {+/-} 0.1 mM, n = 10) was reduced 4 wk after PAC (1.9 {+/-} 0.1 mM, n = 6, P < 0.0001), but was higher after PAC plus 2 wk A61603 treatment (2.6 {+/-} 0.13 mM, n = 7, P < 0.01). In conclusion, reversal of RVF after chronic A61603 treatment involved reversal of mitochondrial dysfunction. Consistent with our previous studies, this study suggests that the 1A-AR is a therapeutic target to treat RVF. HighlightsRV failure is reported to involve mitochondrial dysfunction which might impair RV contraction by decreasing cardiomyocyte ATP level. Using the pulmonary artery constriction model of RV failure, we found that chronic treatment with an 1A-adrenergic receptor agonist increased RV myocardial respiration rate, increased RV myocardial ATP level, and increased RV function. These findings suggest that the 1A-adrenergic receptor is a therapeutic target for treating RV failure, and that the mechanism involves improved RV cardiomyocyte bioenergetic status.

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Inhibition of NLRP3 Differentially Regulates Blood Pressure and Inflammation in Male versus Female DOCA-Salt Sprague Dawley Rats

Elmarakby, A. A.; Liss, C. M.; Sullivan, K.; Hanson, P.; Belanger, K. M.; Mohamed, R.; Mattson, D. L.; Taylor, E. B.; Ryan, M. J.; Sullivan, J. C.

2026-03-20 physiology 10.64898/2026.03.17.712521 medRxiv
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BackgroundDeoxycorticosterone acetate (DOCA)-salt induces greater increases in blood pressure (BP) and a more pro-inflammatory T cell profile in males compared to females. T cells contribute to DOCA-salt hypertension, however, the mechanisms driving T cell activation remain unclear. The NLRP3 inflammasome has been implicated in DOCA hypertension in male mice. Little is known regarding NLRP3 in females. The goal of the current study was to test the hypothesis that NLRP3 contributes to greater increases in BP and renal inflammation with DOCA in males vs. females. MethodsRenal NLRP3 protein levels were measured in normotensive and hypertensive male and female subjects and in male and female Sprague Dawley uni-nephrectomized (UNX) control and DOCA-salt rats. Additional 11-wk-old Sprague Dawley rats were UNX and randomized to: 1) DOCA + vehicle or 2) DOCA + the NLRP3 inhibitor MCC950 (10 mg/kg/day in saline) from 11-14 wks of age. At 14-wks-of-age rats were euthanized, terminal plasma samples and remaining kidneys were collected for flow cytometric analysis of T cells. ResultsRenal NLRP3 levels were significantly greater in hypertensive males and females vs. normotensive controls. DOCA increased BP in both sexes, with greater elevations in males. MCC950 attenuated DOCA-induced increases in BP in male, but not female rats. MCC950 decreased circulating and renal CD4 and Th17 cells in both sexes, although the effect was greater in males. ConclusionDespite both males and females exhibiting an increase in NLRP3 in hypertension, NLRP3 contributes to BP elevations only in DOCA-salt males.

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Contribution of murine strain background to Na+ reabsorption in the kidney

Whelan, S. C. M.; Mutchler, S. M.; Mitton-Fry, S.; Parsi, L.; Balaji, S.; Kleyman, T. R.; Shi, S.

2026-03-20 physiology 10.64898/2026.03.17.712246 medRxiv
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Kidneys play an essential role in balancing fluid and electrolyte levels. Two mouse strains, C57Bl/6 and 129S2/SV, are routinely used to study renal physiology in laboratory settings, and prior observations suggest that significant differences in salt and water handling exist between them. This study aims to further establish the sources of these observed differences at both expressional and functional levels, in male and female mice. At baseline, male 129S2/SV mice displayed decreased Na+ and increased K+ plasma concentrations compared to C57Bl/6 males, while no statistical differences were observed between female mice. Interestingly, 129S2/SV male mice had lower glomerular density than C57Bl/6 males. Immunoblotting shows that 129S2/SV mice of both sexes had increased expression of NHE3 and NKCC2 compared to their C57Bl/6 counterparts. Both total and phosphorylated NCC were more abundant in female mice as compared to males, indicating sexual dimorphism. Furthermore, 129S2/SV females had higher expression of total and phosphorylated NCC compared to C57Bl/6 females. In contrast, the expression of SGLT2, ENaC subunits, and Na+/K+-ATPase were comparable between C57Bl/6 and 129S2/SV mice of both sexes. When challenged with diuretics intended to block NKCC2, NCC or ENaC, 129S2/SV male mice responded with a smaller diuresis and natriuresis than their C57Bl/6 counterparts. Taken together, our data suggest that differential expression of key Na+ transporters along the nephron contributes to differences in Na+/K+ homeostasis between these two mouse strains. NEW & NOTEWORTHYWe assessed the influence of genetic background on the expression of key Na+ transporters along the nephron in two commonly used inbred mouse strains, C57Bl/6 and 129S2/SV. We found that the kidney expression of NHE3, NKCC2, and NCC are strain dependent. Additionally, murine strain significantly contributes to the diuretic responses induced by hydrochlorothiazide, amiloride, and furosemide.

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A Theoretical Framework for the Hemodynamic Role of Sarcomere Length Dynamics During the Isovolumic Phases of the Left Ventricle

KATO, S.; KISHIDA, K.; HIMENO, Y.; Amano, A.

2026-03-18 physiology 10.64898/2026.03.16.712012 medRxiv
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The left ventricle (LV) exhibits torsional deformation during systole, and mechanical relaxation begins during the isovolumic phase. Recent advances in imaging techniques, such as MRI, have revealed that myocardial tissue deformation and sarcomere length changes occur during the isovolumic relaxation phase, even when the chamber volume remains constant. Although such ventricular deformation during the isovolumic phase is considered important for blood ejection and filling efficiency, its mechanistic contribution to contraction and relaxation remains unresolved. In this study, we hypothesized that sarcomere length dynamics during the isovolumic phase affect the isovolumic contraction and relaxation time (IVCT and IVRT) by regulating the contraction force via the force-velocity relationship of ventricular myocytes. To investigate this hypothesis, we focused on experimentally reported differences in the relationship between sarcomere length and LV volume across the endocardial and epicardial layers, as described by Rodriguez et al. We constructed and compared two types of hemodynamic models within the same integrated framework consisting of a circulation model, a LV model, and a myocardial cell contraction model by Negroni-Lascano et al., which differ only in how sarcomere length is determined: a volume-based length model (VL model), in which sarcomere length is uniquely determined by LV volume, and a volume-force-coupled length model (VFL model), in which sarcomere length is determined by the balance between LV volume and contraction force. Simulation results showed that in the VFL model, compared to the VL model, sarcomere length changed during the isovolumic phase, leading to a decrease in contractile force and shortening of IVRT, which may contribute to improved hemodynamic efficiency. These results indicate that sarcomere length dynamics can mechanically regulate force decay during isovolumic relaxation, even under constant left ventricular volume. This study provides a theoretical framework for understanding the contributions of different layers within the LV wall to diastolic function during the isovolumic relaxation phase.

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Physiological consequences of acute heat exposure in mid-gestation on placental, foetal and maternal blood flow using a mouse model.

Francis, S.; Murdoch, C. E.

2026-04-07 physiology 10.64898/2026.04.06.713526 medRxiv
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Pregnant women are particularly susceptible to adverse outcomes from environmental heat, yet the physiological effects of acute heat exposure during pregnancy remain poorly understood. Some physiological changes are monitored in humans; however, investigation of underlying molecular mechanisms requires invasive methods that can only be ethically applied in mammalian models. Moreover, research with animal models has largely focused on early and lethal teratogenic effects of heat exposure and lacks longitudinal physiological monitoring, detailed parameterisation of heating regimes and in-depth investigation of underlying mechanisms. Here we used a mouse model to investigate the impact of a controlled acute heat exposure at mid-gestation (E12{middle dot}5), slowly elevating core body temperature (CBT) over 210mins to raise CBT by [~]1{degrees}C. Using high-frequency ultrasound and morphological analyses, we observed delayed alterations in placental and foetal cerebral blood flow indicative of a brain-sparing response, alongside reduced placental labyrinth zone size. Additionally, maternal cardiac function was impaired, accompanied by cardiac and renal fibrosis and elevated circulating soluble Flt-1 levels, an anti-angiogenic biomarker of gestational hypertension. These findings demonstrate that brief heat stress at mid-gestation can induce lasting effects on placental function and maternal cardiovascular health in a mammalian model, highlighting potential risks for pregnancy outcomes under increasing global temperatures. Together this data suggests that an acute exposure to heat elevating core body temperature by 1{middle dot}2{degrees}C can induce a long-term impact on both placenta and maternal health in a mouse model. It will be important to understand the molecular changes which underpin the pathophysiology and whether this is translated to humans.

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Electromechanical Dynamics and Myogenic Responses in Cerebral Smooth Muscle Cells and Capillary Pericytes

Khakpour, N.; Sancho, M.; Klug, N. R.; Ferris, H. R.; Dabertrand, F.; Nelson, M. T.; Tsoukias, N. M.

2026-04-06 physiology 10.64898/2026.04.03.715998 medRxiv
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Cerebral blood flow (CBF) control is essential for normal brain function and is disrupted in pathological conditions. Arterial diameters are tightly regulated to provide on demand increases in blood flow in regions of neuronal activity. Pericytes (PCs) exhibit robust myogenic tone and may also respond to neuronal activity to fine-tune local resistance and blood flow. Thus, mural control of microcirculatory resistance may extend beyond arteries and arterioles. Yet, PCs electrophysiology and contractility have not been thoroughly characterized, and this prohibits an integrated view of brain blood flow control. In this study, we develop a detailed mathematical model of mural cell electrophysiology, Ca2+ dynamics and biomechanics. The model is informed by electrophysiological data in smooth muscle cells (SMCs) or PCs and predictions are compared against pressure-induced responses in isolated arterioles and capillaries, respectively. Simulations recapitulate myogenic constrictions and examine differences in contractile dynamics as we move from arterioles to proximal and distal capillaries. In arteriole-to-capillary transitional (ACT) zone PCs, increased mechanosensitivity, more Ca2+ influx through non-selective cation (NSC) channels and/or a higher sensitivity of the contractile apparatus to Ca2+ can compensate for reduced L-type voltage-operated (VOCC) Ca2+ influx and allow for robust constrictions at the lower operating pressures of capillaries relative to the arterioles. A significant Ca2+ influx through NSC relative to VOCC, however, can decouple the PCs contractile apparatus from electrical signaling. Vasoactivity to chemomechanical stimuli along the arteriole to capillary axis is progressively driven by VOCC-independent Ca2+ influx and Ca2+ sensitization with slow kinetics. The proposed cell model can form the basis for detailed multiscale and multicellular models that will examine physiological function at a single vessel or vascular network levels and investigate CBF control in health and in disease. Key pointsO_LIA mural cell model of electrophysiology, calcium (Ca2+) dynamics and biomechanics is informed by data and adapted for modeling cerebral arteriole smooth muscle cells and capillary pericytes. C_LIO_LIIon channel activities are characterized by patch-clamp electrophysiology in isolated cerebral smooth muscle cell and pericytes, and capillary and arteriole electromechanical responses to transmural pressure changes are assessed using novel ex vivo preparations. C_LIO_LIMyogenic constrictions in arterioles can be reproduced by pressure-induced non-selective cation channel (NSC) activation that depolarizes the cell, opens L-type Ca2+ channels (VOCCs) and increases Ca2+ influx. C_LIO_LIRobust myogenic constrictions in arteriole-to-capillary transition (ACT) zone pericytes may reflect significant Ca2+ influx through NSC, increased mechanosensitivity, or higher sensitivity of the contractile apparatus to Ca2+, potentially compensating for reduced VOCC density relative to arteriolar smooth muscle. C_LIO_LIA significant contribution of NSC relative to VOCC in Ca2+ influx, can decouple the contractile apparatus from electrical signaling. C_LIO_LIThe model shows how gradients in ionic activities, mechanosensitivity and/or Ca2+ sensitivity can alter contractile phenotype and electromechanical coupling along the arteriole to capillary continuum. C_LIO_LIThe proposed model can form the basis for detailed multiscale and multicellular models that will investigate cerebral blood flow control in health and in disease. C_LI

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15-Hydroxyeicosatetraenoic Acid and GPR39 Together Orchestrate Coronary Autoregulation: A Comprehensive Metabolomic Analysis

Le, D. E.; Kajimoto, M.; Zhao, Y.; Methner, C.; Cao, Z.; Cianciulli, A.; Semeraro, T.; Trist, I. M. L.; Franchi, J.; Marcheselli, C.; Parazzoli, A.; Micheli, F.; Kaul, S.

2026-03-23 physiology 10.64898/2025.12.23.696315 medRxiv
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BackgroundCoronary autoregulation is the ability of the normal heart to maintain constant coronary blood flow (CBF) over a wide range of coronary driving pressures (CDP). Despite being vital for survival, the mechanism of coronary autoregulation is unknown. We hypothesized that GPR39, present in vascular smooth muscle cells, together with its endogenous agonist 15-hydroxyeicosatetraenoic acid (15-HETE) orchestrate coronary autoregulation. MethodsWe created coronary stenoses of varying degrees in open-chest, anesthetized dogs where we measured CBF and CDP. In a subset of animals, coronary venous blood was sampled for eicosanoid, adenosine, endothelin-1, polyunsaturated fatty acids, and prostaglandins levels. Stenoses were recreated during intravenous administration of VC108, a specific GPR39 antagonist and systemic, pulmonary, and coronary hemodynamics measured. ResultsGPR39 was identified in coronary arterioles by immunohistochemistry and in heart tissue by western blot. In-vivo, 15-HETE correlated linearly with CDP over the autoregulatory range (r2=0.47, p=0.0024). Apart from 6-keto PGF1 no other metabolite had any relation with CDP. Prior to administration of VC108, CBF did not change within the autoregulatory range. VC108 had no effect of systemic and pulmonary hemodynamics but increased CBF (p=0.02 versus vehicle) by decreasing coronary microvascular resistance (p=0.01 versus vehicle), indicating that GPR39 participates in control of normal coronary vascular tone. With VC108, coronary autoregulation was abolished and CBF became CDP dependent (r2=0.96, p=0.004). ConclusionGPR39 and its endogenous agonist 15-HETE together orchestrate coronary autoregulation when CDP is reduced. These novel findings provide a mechanism for coronary autoregulation and could direct pharmacological treatment of various coronary syndromes in humans.

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Wnts are endothelial cell-derived PKD1/PKD2-dependent autocrine/paracrine vasodilators

Mbiakop, U. C.; Mackay, C.; Mata-Daboin, A.; Pontes, R. B.; Leo, M. D.; Jaggar, J. H.

2026-03-20 physiology 10.64898/2026.03.17.712518 medRxiv
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BackgroundWingless/Int-1 (Wnts) proteins are canonical Frizzled receptor ligands. Recent evidence indicates that some Wnts, including Wnt9b and Wnt5a, bind to polycystin 1 (PKD1), a transmembrane protein which can couple to polycystin 2 (PKD2) to form a non-selective cation channel. The functional significance of Wnts binding to PKD1 is unclear. Here, we tested the hypothesis that Wnts act through PKD1/PKD2 channels on endothelial cells (ECs) to regulate arterial contractility and blood pressure and investigated the cellular source and secretory regulation of vasoactive Wnt proteins. MethodsA wide variety of approaches, including inducible EC-specific PKD1 and PKD2 knockout mice, reverse-transcription polymerase chain reaction, Western blotting, immunofluorescence, pressurized artery myography, blood pressure measurements, patch-clamp electrophysiology, in vivo and in vitro Wnt and nitric oxide assays, and Wnt secretion assays. ResultsIntravascular Wnt9b or Wnt5a administration stimulates an EC PKD1/PKD2-dependent dilation in pressurized resistance-size arteries. Wnt9b and Wnt5a are present in serum and plasma and intravenous infusion rapidly stimulates a blood pressure reduction which requires EC PKD1. Wnts stimulate a PKD1-dependent non-selective cation current in ECs which through Ca2+ signaling activates endothelial nitric oxide synthase (eNOS) and small conductance Ca2+-activated K+ channels to induce vasodilation. Wnt9b acts solely via PKD1/PKD2 channels, whereas Wnt5a stimulates signaling through PKD1/PKD2, Frizzled-7 (Fzd-7), Dishevelled and c-Jun N-terminal kinase (JNK). Intravascular flow stimulates angiotensin II type 1 (AT1) receptors, which through Gq/11 and Porcupine activate Wnt9b and Wnt5a secretion in ECs. Wnts secreted in response to flow activate PKD1/PKD2 signaling in ECs and contribute to flow-mediated vasodilation. ConclusionsIntravascular flow activates AT1 receptors, which through Gq/11 and Porcupine stimulate Wnt9b and Wnt5a secretion in ECs. Wnt9b activates PKD1/PKD2 channels whereas Wnt5a stimulates both PKD1/PKD2 and Fzd-7 in ECs to induce vasodilation. Wnts contribute to flow-mediated autocrine/paracrine dilation and reduce blood pressure. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=92 SRC="FIGDIR/small/712518v1_ufig1.gif" ALT="Figure 1"> View larger version (27K): org.highwire.dtl.DTLVardef@158bad1org.highwire.dtl.DTLVardef@5113eforg.highwire.dtl.DTLVardef@f3b94eorg.highwire.dtl.DTLVardef@10ab479_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Maternal hypertension and cardiovascular medications dysregulate placental arterial tone

Tropea, T.; Cottrell, E. C.; Wallworth, R.; Khalil, N.; Johnstone, E.; Myers, J.; Brownbill, P.

2026-03-31 physiology 10.64898/2026.03.24.714086 medRxiv
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BackgroundAntihypertensive and cardioprotective medications are prescribed to pregnant women and include Ca2+ channel blockers (CCBs; amlodipine, nifedipine), - (doxazosin) and {beta}-(labetalol, bisoprolol, nebivolol) adrenergic receptor antagonists, and -adrenergic receptor agonists (methyldopa). These vasoactive drugs enter the fetal circulation, with unknown effects on the fetoplacental vasculature. We aimed to investigate whether cardiovascular medications modulate human fetoplacental vascular tone, which may impair or enhance placental perfusion. MethodsChorionic plate arteries (CPAs) were obtained from the placentas of women with normotensive pregnancy (N=28), with unmedicated hypertension (N=14), and those chronically medicated (N=61) with either amlodipine, nifedipine, labetalol or bisoprolol, or a combination of CCBs and labetalol. Using wire myography, ex vivo effects of amlodipine, nifedipine, labetalol, methyldopa, doxazosin, bisoprolol and nebivolol were tested in a concentration-dependent manner (10-11-10-5M) in pre-constricted CPAs isolated from the placentas of normotensive women. Differences in CPA vascular reactivity in response to chronic exposure to hypertension and/or cardiovascular medications was assessed by vasoconstriction to high potassium physiological solution (KPSS; 120mM) and to the thromboxane A2 mimetic (U46619; 10-10-2x10-6M), and relaxation to the nitric oxide donor, sodium nitroprusside (SNP; 10-10-10-5M). ResultsIn pre-constricted CPAs isolated from normotensive women, acute exposure to amlodipine, nifedipine, doxazosin and nebivolol promoted significant vasorelaxation (P<0.05). CPAs acutely exposed to labetalol, methyldopa (P<0.05) and bisoprolol (P<0.001) exhibited increased vasoconstriction compared to their respective diluent controls. CPAs from women with chronic hypertension and from those who had chronic labetalol treatment exhibited significantly reduced vasoconstriction to KPSS (P<0.05). CPAs from women with chronic hypertension and exposure to bisoprolol also had significantly attenuated vascular responses to U46619 and SNP (P<0.01 and P<0.01, respectively), compared to normal pregnancy. ConclusionsMaternal hypertension impairs vascular responses of the placenta. Cardiovascular medications prescribed during pregnancy may dysregulate placental vascular function. Further research is warranted to evaluate the relative safety of cardiovascular medications in pregnancy, as their distinct effects on fetoplacental vascular function may have important implications for maternal and fetal outcomes. Mechanistic studies alongside clinical correlations are essential to guide evidence-based prescribing.

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Mental fatigue impairs cycling endurance performance and perception of effort, but not muscle activation

Souron, R.; Sarcher, A.; Lacourpaille, L.; Boulahouche, I.; Richier, C.; Mangin, T.; Gruet, M.; Doron, J.; Jubeau, M.; Pageaux, B.

2026-03-23 physiology 10.64898/2026.03.19.712281 medRxiv
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Mental fatigue is induced by prolonged engagement in cognitively demanding tasks and impairs endurance performance. The neuropsychophysiological mechanisms underlying this decreased performance remain unclear, with suggestion that mental fatigue may disrupt motor command and consequently muscle activation. We aimed to test this hypothesis in a repeated cross-over design study in which 18 participants completed two experimental sessions involving a time-to-exhaustion cycling test at 80% of peak power output. Each cycling task was preceded by 1h of a prolonged Stroop task (Stroop session) or a neutral control task (Control session). Perception of effort and surface electromyography from ten lower-limb muscles of the right leg were recorded at regular intervals during cycling. Mental fatigue was higher in the Stroop compared to the Control session (p = .002). Endurance cycling time was 111 {+/-} 160 s shorter in the Stroop than in the Control session (p = .009). No significant differences in electromyography parameters were observed between Stroop and Control sessions, for any muscle (p > .05). Perception of effort was higher in the Stroop session from the onset of the cycling task (p = .006), and the rate of increase in perception of effort was significantly higher in the Stroop than Control session (p = .031). Our findings do not support the hypothesis that mental fatigue alters motor control or increases central motor command, as no changes in muscle activation were detected. Conversely, our results reinforce the notion that prolonged cognitive engagement impairs endurance performance primarily through an increased perception of effort. Future research should consider combining surface electromyography with more sensitive neurophysiological techniques to investigate potential subtle changes in motor drive during dynamic, whole-body tasks under mental fatigue. Impact statementOur study confirms that mental fatigue induced by prolonged cognitive exertion impairs cycling endurance performance. By combining measurements of perceptual responses and multi-muscle surface EMG during the endurance task, we observed that the decreased endurance performance is related to an increased perceived effort in the presence of mental fatigue, not related to alterations in motor command.

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Deep phenotyping of blood cell data reveals novel clinical biomarkers

Chen, Y.-L.; Zhang, C.; Lucas, F.; Hadlock, J.; Foy, B. H.

2026-03-26 hematology 10.64898/2026.03.24.26349221 medRxiv
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Introduction The complete blood count with differential (CBD) is one of the most commonly performed blood tests worldwide, used in nearly all areas of medicine. Although modern CBD analyzers generate flow cytometry based single cell measurements,the resultant CBD markers are limited to coarse summary features, such as total cell counts and average cell sizes. This means, the markers cannotdetect subtle cell population shifts that may signal early stage pathogenesis. To test this, we evaluate whether AI based analysis of the raw single cell data underlying the CBD can be used to develop novel, clinically prognostic biomarkers, across patient settings. Method We developed two complementary methods for biomarker discovery using CBD tests and evaluated them with longitudinal data from an academic medical center. To create interpretable biomarkers, we clustered cells into physiologically meaningful subpopulations and performed robust statistical summarization. In tandem, self supervised autoencoders were developed to extract novel nonlinear markers. We evaluated the utility of these clustering (CLS) and autoencoder (AE) markers for patient prognostication across a range of outcomes (mortality, inpatient admission, and future disease development). Results Our study included 242,623 CBD samples from 127,545 patients. Both clustering and embedding approaches successfully generated hundreds of new clinical biomarkers. Many biomarkers showed strong prognostic associations for all cause mortality, inpatient admission, and development of anemia, cancer, or cardiovascular disease, with associations remaining significant after adjustment for demographics and clinical CBD markers. A large subset of these prognostic markers also showed high novelty, having low correlations to existing CBD markers, while also exhibiting significant correlations with broader physiologic signals, such as inflammatory, hormonal, infectious, and coagulopathic markers. Conclusion Collectively, these results demonstrate how modern AI techniques can allow for deeper phenotyping of routine clinical blood counts, generating novel biomarkers that capture more subtle physiologic signals than what are currently clinically utilized.

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sPRR signaling in macrophages via the AT1R/Yap/Taz axis to induce renal fibrosis

Feng, Y.; Zheng, H.; Xie, S.; Wang, F.; Luo, R.; Yang, T.

2026-04-07 pathology 10.64898/2026.04.03.716436 medRxiv
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BackgroundWithin the kidney, (pro) renin receptor (PRR) is abundantly expressed in the collecting duct (CD) and modulate physiological and pathophysiological processes. We have recently reported that activation of CD PRR mediates obstructive renal fibrosis in a mouse model of unilateral ureteral obstruction (UUO). The current study addresses the underlying mechanisms by examining the profibrotic pathway mediated by soluble PRR (sPRR)-dependent alternative macrophage activation. MethodsWe performed UUO or sham surgery on mice with CD-specific deletion of PRR (CD PRR KO) and floxed controls. After 7 days, we assessed fibrosis-related parameters, inflammatory cytokines, M1/M2 macrophage markers, other gene expression markers of kidney injury, and the concentration of plasma sPRR. We also administered vehicle or site-1 protease (S1P) inhibitor PF-429242 (PF) to C57BL/6 mice with UUO to determine the role of sPRR. Experiments were performed in vitro to examine the mechanism of sPRR-His-mediated macrophage M2 polarization and activation of potential target genes in bone-marrow-derived macrophages (BMDMs). ResultsCompared with the floxed control, CD PRR KO decreased macrophage accumulation, M2 polarization, and Yap/Taz expression while improving renal fibrosis and suppressing plasma sPRR levels following UUO. In BMDMs, sPRR-His treatment promoted macrophage M2 polarization, fibrosis, and Yap/Taz expression, which was dependent on angiotensin type 1 receptor (AT1R). ConclusionCD PRR-derived sPRR acts via ATR to promote macrophage M2 polarization and stimulates the AT1R/Yap/Taz axis, which leads to renal fibrosis during UUO.

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Cardiac REDD1 alters glucose and fatty acid metabolic gene expression via an mTORC1-independent, PPAR alpha-dependent mechanism and drives hypertrophic growth

Wheeler, M.; Renick, J.; Fawbush, R.; McAlpin, E.; Stevens, S.; Sreedevi, K.; Warren, J.; Dennis, M.; Pfleger, J.

2026-03-18 cell biology 10.64898/2026.03.16.710895 medRxiv
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BackgroundRegulated in development and DNA damage 1 (REDD1) is a highly inducible molecule that plays a role in numerous physiological and pathophysiological processes. It is a well-established negative regulator of mammalian target of rapamycin complex 1 (mTORC1), which is critical for maintaining elevated fatty acid-to-glucose oxidation ratio in the heart. In addition, REDD1 deletion results in hyperglycemia, suggesting that REDD1 is critical for tissue glucose metabolism. The role of REDD1 in regulating cardiac glucose and/or fatty acid metabolism in response to physiologic or pathophysiologic cues, however, remains unexplored. MethodsHerein, we utilize AC16 cardiomyocytes with REDD1 deletion, as well as mice with global or cardiomyocyte-specific deletion of Redd1, and their respective controls. We also subject these mice cardiac pressure overload using transverse aortic constriction (TAC) for 2 weeks or sham operation as a control. To examine the molecular regulators of glucose oxidation, we utilized qPCR and western blotting to evaluate pyruvate dehydrogenase (PDH) kinase (PDK) and phospho-PDH (pPDH) levels, respectively. We also directly measured PDH activity and glucose-driven cellular respiration. To investigate the complete REDD1-dependent transcriptome and metabolome, we performed RNA-sequencing (RNA-Seq) and untargeted metabolomics, respectively. To determine if the observed gene expression changes were dependent upon transcription factor peroxisome proliferator-activated receptor alpha (PPAR), we utilized an established pharmacologic PPAR inhibitor, GW6471. Here, we measured PPAR activity directly, as well as the expression of its target genes. In order to determine if our observed effects were mTORC1-dependent, we utilized mTORC1-specific inhibitor, everolimus. Finally, we measured cardiac hypertrophy using gravimetric analyses (heart weight (HW)-to-body weight (BW) or HW-to-tibia length (TL) ratios) and histological analyses of cardiomyocyte cross sectional area (CSA). We also measured mRNA and protein levels of pathological hypertrophic markers Natriuretic Peptide B (Nppb) and Cardiac Ankyrin Repeat Protein (CARP), respectively. ResultsOur data demonstrate that physiological levels of glucose induce REDD1 expression in cardiomyocytes. Further, we show that in cardiomyocytes or the hearts of mice with REDD1 deletion, there is elevated PDK4 expression, as well as increased levels of pPDH (S300 and/or S293) and reduced PDH activity. Interestingly, everolimus treatment has no effect on these alterations. In vitro, we also observe elevated glycolysis and glycolytic capacity, and reduced maximal respiratory capacity (MRC) in the presence of glucose. Interestingly, our RNA-Seq data reveals the upregulation of genes involved in fatty acid catabolism. Further, we demonstrate that PPAR activity is enhanced, and everolimus treatment also has no effect on this parameter. Additionally, we show that treatment of cardiomyocytes with GW6471 normalizes the expression of its target genes (PDK4, ACSL1) and levels of pPDH (S300), that are elevated in cells with REDD1 deletion. Finally, we observe elevated REDD1 in the hearts of mice following TAC. Moreover, we show reduced HW/BW, HW/TL, cardiomyocyte CSA, and levels of cardiac Nppb and CARP in mice with cardiomyocyte Redd1 deletion subjected to TAC versus controls also subjected to TAC. Importantly, TAC-induced reductions in cardiac Pdk4 and pPDH (S293 and S300), are normalized to control levels in mice with Redd1 deletion subjected to TAC. ConclusionsTogether, our findings suggest that physiological glucose-induced and pathological pressure overload-induced REDD1 is required for enhancing glucose oxidation and suppressing fatty acid oxidation in cardiomyocytes. In this way, REDD1 supports cardiac hypertrophic growth. We also outline a mechanism whereby REDD1 inhibits PPAR activity, thereby inhibiting the expression of its target genes, including PDK4 and those involved in fatty acid oxidation. Finally, we demonstrate that these effects are independent of REDD1s ability to inhibit mTORC1.

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Breaking the seasonal barrier: feasibility of cuffless fingertip-based continuous blood pressure monitoring in older adults during winter exercise

Mizutani, N.; Nishizawa, S.; Enomoto, Y.; OKAMOTO, H.; Baba, R.; Misawa, A.; Takahashi, K.; Tada, Y.; LIN, Y.-C.; Shih, W.-P.

2026-04-16 health systems and quality improvement 10.64898/2026.04.14.26350440 medRxiv
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While the need for continuous blood pressure (BP) monitoring in Japan is high, there are no commercially available cuffless devices for personal daily monitoring use. Fingertip-based sensors are a promising alternative as they eliminate the discomfort of repeated cuff inflation. However, their reliability during winter has been a major technical limitation due to cold-induced peripheral vasoconstriction. This study aimed to address this issue by validating a novel fingertip-based continuous BP monitor used by exercising adults during summer and winter. Eleven community-dwelling older adults (mean age, 73.1 {+/-} 8.8 years) were included in this seasonal comparative study. During exercise, we compared a personal fingertip-based continuous monitor (ArteVu) with a standard oscillometric cuff device (Omron) in summer (mean, 26.5{degrees}C) and winter (mean, 7.4{degrees}C). The study also evaluated the device's accuracy during exercise-induced BP fluctuations and seasonal environmental changes. Awareness of the participants regarding BP management was also assessed using questionnaires. There were strong correlations for systolic BP (SBP) between summer and winter (r = 0.93 in summer; r = 0.88 in winter). Although the mean difference for the SBP was higher in winter than in summer (3.1 {+/-} 11.2 mmHg vs. 0.2 {+/-} 9.4 mmHg), the values remained within a clinically acceptable range for personal monitoring. Notably, 72.7% of participants reported that the ease of using the fingertip-based device significantly increased their awareness and motivation for daily BP management. This study confirms the feasibility of cuffless fingertip-based continuous BP monitoring across different seasons, including in winter. By overcoming the seasonal limitations, this device fills a critical gap in the Japanese health-monitoring market. Our findings support the development of smaller and more portable models, representing a shift from traditional "snapshot" cuff measurements to continuous and integrated lifestyle monitoring for older adults.

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Carnitine deficiency alters fuel metabolism and voluntary wheel running in mice

Kingren, M. S.; Sadler, D. G.; Bolin, E.; Harville, I.; Sikes, J.; Lan, R.; Borsheim, E.; Porter, C.

2026-03-30 physiology 10.64898/2026.03.27.714765 medRxiv
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BackgroundCarnitine plays an obligatory role in energetics owing to its role in the translocation of long-chain fatty acids into the mitochondrion for oxidation. Here, we determined the metabolic and behavioral consequences of systemic carnitine deficiency (SCD) in mice. MethodsFemale C57BL/6J mice were randomized to receive normal drinking water (control, n = 8) or drinking water supplemented with mildronate 4g.L-1 (mildronate, n = 8) for 21 days. Body composition was assessed at baseline and post treatment. Metabolic and behavioral phenotyping was performed continuously over 72 hours following 14 days of control or mildronate treatment. Stable isotope were used to assess whole-body substrate oxidation. Carnitine subfractions were quantified in skeletal muscle and liver, as was mitochondrial respiratory function. Liver and muscle samples also underwent proteomic analysis. ResultsMildronate treatment depleted total carnitine in muscle and liver by [~]97% (P < 0.001) and [~]90% (P < 0.001), respectively. Carnitine depletion was accompanied by lower total energy expenditure (P = 0.01), attributable to lower voluntary wheel running (P = 0.01). Oxidation rates of palmitate (P < 0.01) but not octanoate were lower whereas rates of glucose oxidation were greater in carnitine depleted mice (P < 0.01). Mitochondrial respiratory capacity was unaltered by carnitine deficiency. Carnitine deficiency remodeled muscle and liver proteomes to support lipid oxidation and energy production. SummaryIn mice, carnitine deficiency is characterized by decreased long-chain fatty acid oxidation despite preserved mitochondrial respiratory capacity. Carnitine deficiency resulted in lower voluntary exercise and a concomitant reduction in energy expenditure.

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Inborn cardiorespiratory fitness and exercise training modulate brown adipose tissue function and plasticity in early life

Kingren, M. S.; Sadler, D. G.; Barre, M. C.; Treas, L. D.; Sikes, J. D.; Britton, S. L.; Koch, L.; Borsheim, E.; Porter, C.

2026-04-04 physiology 10.64898/2026.04.01.715665 medRxiv
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This study aimed to determine the impact of inborn metabolic fitness and early life exercise training on whole body and brown adipose tissue (BAT) energetics. We carried out comprehensive metabolic phenotyping on 4-week old rats bred for high (high-capacity runner, HCR) and low (low-capacity runner, LCR) running capacity following randomization to voluntary wheel running (VWR) or control (CRTL) for 6-weeks. High-resolution respirometry and untargeted proteomics were then employed to determine the impact of inborn fitness and early life exercise on BAT function. When accounting for differences in body mass, early life exercise (VWR) resulted in greater basal and total energy expenditure, irrespective of strain (P < 0.0001 for both). Both leak and uncoupling protein 1 (UCP1) dependent respiratory capacities in isolated BAT mitochondria were greater in rats randomized to VWR compared to CTRL in both HCR (P < 0.01) and LCR (P < 0.05) strains. Similarly, mitochondrial sensitivity to the UCP1 inhibitor GDP was greater in both HCR (P < 0.01) and LCR (P < 0.05) rats randomized to VWR versus control. The BAT proteome differed in CTRL HCR and LCR rats, were there was enrichment in proteins related to branched chain oxidation and mitochondrial fatty acid oxidation in HCR rats. VWR remodeled the BAT proteome, where 151 proteins were differentially expressed in LCR BAT and 209 differentially expressed in LCR BAT following VWR. In both stains, there was an enrichment in proteins related to metabolism mitochondrial function in response to VWR. However, when comparing strains, 39 proteins were differentially expressed in BAT in HCR rats compared to LCR rats in response to VWR. These proteins were related to carboxylic acid and amino acid metabolism. Collectively, inborn fitness impacts body mass and composition, exercise behaviors, and the BAT proteome in early life. Early life exercise alters whole body and BAT energetics irrespective of inborn fitness, augmenting basal and total energy expenditure and BAT thermogenic capacity and function.

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Empagliflozin targets a renal neuro-epithelial-immune axis in heart failure

Coelho, J. N.; Simonete, L. C.; Ribeiro-Silva, J. C.; Jesus, E. F.; Boaro, A.; Martins, F. L.; Correa, J. W. N.; Ferreira-Santos, L.; Silva dos Santos, D.; Antonio, E. L.; Serra, A. J.; Girardi, A. C.

2026-04-02 physiology 10.64898/2026.03.31.715595 medRxiv
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BackgroundPersistent neurohormonal activation is a key driver of maladaptive remodeling and disease progression in heart failure (HF). Sodium-glucose cotransporter 2 inhibitors (SGLT2is) confer robust renoprotective effects in HF; however, the extent to which these benefits involve modulation of renal neurohormonal activity remains unclear. We hypothesized that SGLT2i-mediated renoprotection in HF is associated with attenuation of excessive renal neurohormonal activation. MethodsMale rats with myocardial infarction-induced HF and sham controls were fed standard chow or chow containing empagliflozin (EMPA, 300 mg/kg) for four weeks, followed by assessment of renal inflammatory and neurohormonal markers. Parallel in vitro studies in THP-1 macrophages and HK-2 proximal tubule cells evaluated the direct effects of EMPA on norepinephrine (NE)-dependent tubular inflammatory signaling. ResultsHF rats displayed higher renal cortical renin gene expression and angiotensin II concentrations, which remained unaffected by EMPA. Conversely, EMPA normalized the elevated urinary NE excretion and renal cortical NE content observed in HF rats. Given the inflammatory role of sympathetic hyperactivity, we assessed renal macrophage polarization. EMPA-treated HF rats showed reduced expression of pro-inflammatory markers (Tnf, Ccr2, Nos2, Il-6) and increased expression of markers associated with a reparative macrophage profile (Arg1, Mrc1, CD163), supported by higher CD206 macrophages in kidney sections. While EMPA did not directly alter THP-1 macrophage activation in vitro, it significantly reduced NE-induced SGLT2 expression and interleukin-6 (IL-6) release by HK-2 human proximal tubule epithelial cells. ConclusionThese findings support a model in which SGLT2 inhibitors confer renoprotection in HF by suppressing renal sympathetic hyperactivity, independently of the intrarenal renin-angiotensin system, thereby disrupting a maladaptive renal neuro-epithelial-immune axis and promoting a reparative macrophage phenotype. CLINICAL PERSPECTIVE Whats new?O_LIThis study identifies a renal neuro-epithelial-immune axis underlying empagliflozin-mediated renoprotection in heart failure. C_LIO_LIEmpagliflozin reduces renal cortical and urinary norepinephrine levels in heart failure without altering intrarenal renin-angiotensin system activity, revealing a distinct neurohumoral target of SGLT2 inhibition. C_LIO_LIThis sympatholytic effect is associated with a shift in renal macrophages toward a reparative (M2) phenotype, without changes in total macrophage abundance. C_LIO_LIEmpagliflozin blocks norepinephrine-induced SGLT2 upregulation, limiting proximal tubular glucose reabsorption and IL-6 production, and linking sympathetic signaling to renal inflammation. C_LI What are the clinical implications?O_LIOur findings provide a mechanistic basis for the additive cardiorenal benefits of SGLT2 inhibitors in heart failure, beyond conventional RAS-directed therapies. C_LIO_LITargeting renal sympathetic-driven inflammation may help preserve kidney function and attenuate the progression of cardiorenal syndrome. C_LIO_LISuppression of a renal neuroinflammatory pathway may help explain the early and sustained benefits of SGLT2 inhibitors across heart failure phenotypes, including nondiabetic patients. C_LI

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A high-resolution mass spectrometry-based method for quantifying insulin-stimulated glucose uptake in mice following an intraperitoneal injection of tracer

Zhang, G.-F.; Slentz, D. H.; Lantier, L.; McGuinness, O. P.; Muoio, D. M.; Williams, A. S.

2026-04-02 physiology 10.64898/2026.03.31.714892 medRxiv
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ObjectiveA catheter-free, non-radiolabeled method that permits in vivo measurement of tissue-specific glucose uptake does not exist. To address this gap, we sought to develop and validate a new, higher throughput mass spectrometry (MS)-based method that combines an injection of insulin with a non-radiolabeled glucose tracer, 2-fluoro-2-deoxyglucose (2FDG), to determine insulin-stimulated tissue-specific glucose clearance in conscious, unrestrained mice. MethodsInjections of saline or insulin with 2FDG were coupled with LC-Q Exactive Hybrid Quadrupole-Orbitrap (LC) MS-based measures of plasma 2FDG and tissue (2-fluoro-2-deoxyglucose-6-phosphate) 2FDGP to determine glucose clearance in mice under several different conditions. ResultsThe newly developed method was first applied to a dose response experiment in mice. Next, the ability of this method to quantify changes in glucose clearance in response to an insulin stimulus was assessed, and glucose clearance was compared between chow and high fat fed mice. Results from these studies showed that insulin-stimulated skeletal muscle and heart glucose clearance can be estimated following a bolus injection of tracer, and these fluxes are blunted in diet-induced obese mice. The broad applicability of this approach was then demonstrated by assessing glucose clearance in a mouse model with anticipated changes in insulin-stimulated skeletal muscle glucose metabolism. ConclusionsThe results validated a new LC-MS method to quantify insulin-stimulated tissue-specific glucose clearance in vivo without the use of catheters or radiolabeled tracers. The method offers great potential because it is designed for application to pre-clinical studies seeking high throughput tests and/or assays that can be coupled with discovery technologies such as genomics, proteomics and metabolomics. HIGHLIGHTSO_LIIn vivo glucose clearance can be estimated by a new non-radiolabeled method. C_LIO_LIThe plasma tracer to tracee ratio is required to determine tissue tracer phosphorylation. C_LIO_LIMeasures of plasma glucose and tracer kinetics are critical for data interpretation. C_LIO_LIThe new method can be combined with omics technologies such as metabolomics. C_LI

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Mitochondrial and Cardiolipin Adaptations to Ventricular Assist Device Support in Pediatric Versus Adult Failing Myocardium

Conard, C.; Casa de Vito, M.; Nyarko, O. O.; Jonscher, R.; Phillips, E. K.; Chatfield, K. C.; Ambardekar, A. V.; Hoffman, J. R. H.; Auerbach, S. R.; Stone, M.; Stauffer, B. L.; Sucharov, C. C.; Sparagna, G. C.; Miyamoto, S. D.

2026-04-05 physiology 10.64898/2026.04.01.715996 medRxiv
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BackgroundVentricular assist devices (VADs) are used as treatment for end-stage heart failure in children and adults. We previously demonstrated decreased mitochondrial function and changes in cardiolipin, a mitochondrial phospholipid, in explanted pediatric and adult failing hearts. In this study, we tested the hypothesis that VAD unloading of failing hearts leads to positive changes in myocardial cardiolipin in both pediatric and adult hearts. MethodsVentricular tissue was collected from the same patient at time of VAD implantation and at transplant. Ejection fraction (EF), left ventricular internal diameter at end-diastole (LVIDd) and brain natriuretic peptide (BNP) were assessed pre- and post-VAD. Cardiolipin species from paired VAD core and explants were quantified using liquid chromatography mass spectrometry. Mitochondrial respiration was measured in ventricular tissue pre- and post-VAD in paired pediatric samples using the Oroboros Oxygraph-2k. ResultsVAD support led to increased EF and decreased LVIDd and BNP. The predominant cardiolipin species in cardiac mitochondria, tetralinoleoylcardiolipin, was positively remodeled in pediatric post-VAD myocardium, while adult post-VAD myocardium demonstrated significantly increased total cardiolipin and decreased oxidized cardiolipin but did not demonstrate the tetralinoleoylcardiolipin remodeling seen in pediatric hearts. In pediatric patients, VAD support resulted in significant increases in Complex I+II activity, and a trend toward increases in Complex I activity. ConclusionOur data demonstrate age-related differences in VAD-associated cardiolipin remodeling and suggest that improved mitochondrial function in pediatric VAD-supported hearts could be related to increased tetralinoleoylcardiolipin.