Impaired phosphorylation of ACE2 Ser680 by AMPK in pulmonary endothelium leads to a labile ACE2 and hence is associated with the pathogenesis of PH. Thus, AMPK regulation of the vasoprotective ACE2 is a potential target for PH treatment.

Intermittent hypoxia, a feature of obstructive sleep apnoea, potentiates ventilatory hypoxic responses, alters heart rate variability and produces hypertension, partially owing to an enhanced carotid body responsiveness to hypoxia. Since oxidative stress is a potential mediator of both chemosensory and cardiorespiratory alterations, we hypothesised that an antioxidant treatment may prevent these alterations.Accordingly, we studied the effects of ascorbic acid (1.25 g?L -1 drinking water) on plasma lipid peroxidation, nitrotyrosine and inducible nitric oxide synthase (iNOS) immunoreactivity in the carotid body, ventilatory and carotid chemosensory responses to acute hypoxia, heart rate variability and arterial blood pressure in male Sprague-Dawley rats exposed to 5% O 2 ; 12 episodes?h -1; 8 h?day -1 or sham condition for 21 days.Intermittent hypoxia increased plasma lipid peroxidation, nitrotyrosine and iNOS expression in the carotid body, enhanced carotid chemosensory and ventilatory hypoxic responses, modified heart rate variability and produced hypertension. Ascorbic acid prevented the increased plasma lipid peroxidation and nitrotyrosine formation within the carotid body, and the enhanced carotid chemosensory and ventilatory responses to hypoxia, as well as heart rate variability alterations and hypertension.The present results support an essential role for oxidative stress in the generation of carotid body chemosensory potentiation and systemic cardiorespiratory alterations induced by intermittent hypoxia.

Chronic intermittent hypoxia (CIH), a main feature of obstructive sleep apnoea (OSA), increases hypoxic ventilatory responses and elicits hypertension, partially attributed to an enhance carotid body (CB) responsiveness to hypoxia. As inflammation has been involved in CIHinduced hypertension and chemosensory potentiation, we tested whether ibuprofen may block CB chemosensory and cardiorespiratory alterations induced by CIH in a rat model of OSA.We studied the effects of ibuprofen (40 mg?kg -1 ?day -1 ) on immunohistochemical interleukin (IL)-1b and tumour necrosis factor (TNF)-a levels in the CB, the number of c-fos-positive neurons in the nucleus tractus solitarii (NTS), CB chemosensory and ventilatory responses to hypoxia, and arterial blood pressure in male rats either exposed for 21 days to 5% O 2 (12 episodes?h ) or kept under sham condition. CIH increased CB TNF-a and IL-1b and c-fos-positive neurons in the NTS, enhanced carotid chemosensory and ventilatory hypoxic responses, and produced hypertension. Ibuprofen prevented CB cytokine overexpression and CIH-induced increases in c-fos-positive neurons in the NTS, the enhanced hypoxic ventilatory responses and hypertension, but failed to impede the CB chemosensory potentiation.Results suggest that pro-inflammatory cytokines may contribute to the CIH-induced cardiorespiratory alterations, acting at several levels of the hypoxic chemoreflex and cardiovascular control pathways. KEYWORDS: Hypertension, hypoxia, inflammation, obstructive sleep apnoea O bstructive sleep apnoea (OSA) syndrome, a rising worldwide health problem, is characterised by chronic intermittent hypoxia (CIH), which is considered the main risk factor for developing hypertension and other cardiovascular diseases [1][2][3]. It has been proposed that oxidative stress, inflammation and sympathetic activation are involved in OSA-induced hypertension [3][4][5][6]. A growing body of evidence suggests that CIH enhances carotid body (CB) chemosensory responses to hypoxia contributing to the OSA-induced hypertension [6][7][8][9]. Indeed, OSA patients and animals exposed to CIH show potentiated ventilatory, sympathetic and cardiovascular responses to acute hypoxia [6][7][8][9][10]. Furthermore, recordings of carotid chemosensory discharges in situ and in vitro have shown that CIH selectively increases basal chemosensory discharges in normoxia and potentiates the chemosensory responses to acute hypoxia in rats and cats [9,[11][12][13].The repetitive episodes of hypoxia-reoxygenation during CIH exposure elicits oxidative stress due to the accumulation of reactive oxygen species (ROS), which are involved in the potentiation of the hypoxic CB chemosensory responses [9,11,13,14] and in the pathological consequences observed in animals exposed to CIH, and in OSA patients [3-5, 8, 9, 13]. Recently, we found that ascorbic acid supplementation, which impedes the systemic and local CB oxidative stress in the rat exposed to CIH for 21 days, prevented enhanced CB chemosensory and ventilatory responses to h...

1. The most usual form of chronic hypoxia in humans is the intermittent hypoxia resulting from obstructive sleep apnoea (OSA). The OSA syndrome is a highly prevalent sleep breathing disorder that is considered an independent risk factor for hypertension and cardiovascular diseases. Endothelial dysfunction, oxidative stress, inflammation and sympathetic activation have been proposed as potential mechanisms involved in the onset of the hypertension. However, evidence for a unique pathogenic mechanism has been difficult to establish in OSA patients because of concomitant comorbidities. Thus, animal models have been developed to study the pathological consequences of exposure to chronic intermittent hypoxia (CIH). 2. Because OSA patients and animals exposed to CIH show augmented ventilatory, sympathetic and cardiovascular responses to acute hypoxia, it has been proposed that enhanced carotid body responsiveness to hypoxia is involved in the autonomic changes induced by OSA and in the development of the hypertension. Recently, this proposal has received further support from recordings of carotid body chemosensory neural discharges in situ and in vitro showing that exposure of animals to CIH increases basal carotid body chemosensory discharges and enhances the chemosensory response to hypoxia. 3. In the present brief review, we discuss the evidence supporting an important role for the carotid body in the progression of cardiorespiratory changes induced by OSA and the contribution of oxidative stress, endothelin-1 and pro-inflammatory molecules in the potentiation of the carotid body chemosensory function induced by CIH.

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