AM. Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans. J Appl Physiol 107: 1144 -1155, 2009. First published August 6, 2009; doi:10.1152/japplphysiol.00722.2009.-Pharmacological sodium nitrate supplementation has been reported to reduce the O2 cost of submaximal exercise in humans. In this study, we hypothesized that dietary supplementation with inorganic nitrate in the form of beetroot juice (BR) would reduce the O 2 cost of submaximal exercise and enhance the tolerance to high-intensity exercise. In a double-blind, placebo (PL)-controlled, crossover study, eight men (aged 19 -38 yr) consumed 500 ml/day of either BR (containing 11.2 Ϯ 0.6 mM of nitrate) or blackcurrant cordial (as a PL, with negligible nitrate content) for 6 consecutive days and completed a series of "step" moderate-intensity and severe-intensity exercise tests on the last 3 days. On days 4 -6, plasma nitrite concentration was significantly greater following dietary nitrate supplementation compared with PL (BR: 273 Ϯ 44 vs. PL: 140 Ϯ 50 nM; P Ͻ 0.05), and systolic blood pressure was significantly reduced (BR: 124 Ϯ 2 vs. PL: 132 Ϯ 5 mmHg; P Ͻ 0.01). During moderate exercise, nitrate supplementation reduced muscle fractional O2 extraction (as estimated using nearinfrared spectroscopy). The gain of the increase in pulmonary O 2 uptake following the onset of moderate exercise was reduced by 19% in the BR condition (BR: 8.6 Ϯ 0.7 vs. PL: 10.8 Ϯ 1.6 ml ⅐ min Ϫ1 ⅐ W Ϫ1 ; P Ͻ 0.05). During severe exercise, the O 2 uptake slow component was reduced (BR: 0.57 Ϯ 0.20 vs. PL: 0.74 Ϯ 0.24 l/min; P Ͻ 0.05), and the time-to-exhaustion was extended (BR: 675 Ϯ 203 vs. PL: 583 Ϯ 145 s; P Ͻ 0.05). The reduced O2 cost of exercise following increased dietary nitrate intake has important implications for our understanding of the factors that regulate mitochondrial respiration and muscle contractile energetics in humans. exercise economy; muscle efficiency; O2 uptake; exercise performance; fatigue A FUNDAMENTAL TENET OF HUMAN exercise physiology is a predictable oxygen (O 2 ) cost for a given submaximal work rate. Upon the initiation of moderate-intensity exercise [i.e., exercise performed at work rates below the gas exchange threshold (GET)], pulmonary O 2 uptake (V O 2 ), which closely reflects O 2 consumption in the skeletal muscles (2, 29, 38), rises in an exponential fashion to attain a "steady state" within ϳ2-3 min in healthy humans (64). The steady-state increase in V O 2 is linearly related to the increase in external work rate; is essentially independent of factors such as age, health status or aerobic fitness; and approximates 10 ml O 2 ⅐min Ϫ1 ⅐W Ϫ1 of external power output during cycle ergometry (i.e., 10 ml ⅐min Ϫ1 ⅐W Ϫ1 ; Ref. 36). During supra-GET exercise, V O 2 dynamics become more complex, owing, in part, to the development of a delayed-onset V O 2 "slow component", which elevates the O 2 cost of exercise above 10 ml⅐min Ϫ1 ⅐W Ϫ1 (36, 64). Whereas it is known ...
Diabetes is now regarded as an epidemic, with the population of patients expected to rise to 380 million by 2025. Tragically, this will lead to approximately 4 million people around the world losing their sight from diabetic retinopathy, the leading cause of blindness in patients aged 20 to 74 years. The risk of development and progression of diabetic retinopathy is closely associated with the type and duration of diabetes, blood glucose, blood pressure, and possibly lipids. Although landmark cross-sectional studies have confirmed the strong relationship between chronic hyperglycaemia and the development and progression of diabetic retinopathy, the underlying mechanism of how hyperglycaemia causes retinal microvascular damage remains unclear. Continued research worldwide has focussed on understanding the pathogenic mechanisms with the ultimate goal to prevent DR. The aim of this paper is to introduce the multiple interconnecting biochemical pathways that have been proposed and tested as key contributors in the development of DR, namely, increased polyol pathway, activation of protein kinase C (PKC), increased expression of growth factors such as vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1), haemodynamic changes, accelerated formation of advanced glycation endproducts (AGEs), oxidative stress, activation of the renin-angiotensin-aldosterone system (RAAS), and subclinical inflammation and capillary occlusion. New pharmacological therapies based on some of these underlying pathogenic mechanisms are also discussed.
Objective. To determine whether MPO contributes to oxidative stress and disease activity in RA and whether it produces hypochlorous acid in SF.Methods. Plasma and where possible SF were collected from 77 RA patients while 120 healthy controls supplied plasma only. MPO and protein carbonyls were measured by ELISAs. 3-Chlorotyrosine in proteins and allantoin in plasma were measured by mass spectrometry.Results. Plasma MPO concentrations were significantly higher in patients with RA compared with healthy controls [10.8 ng/ml, inter-quartile range (IQR): 7.214.2; P < 0.05], but there was no significant difference in plasma MPO protein concentrations between RA patients with high disease activity (HDA; DAS-28 >3.2) and those with low disease activity (LDA; DAS-28 43.2) (HDA 27.9 ng/ml, 20.234.1 vs LDA 22.1 ng/ml, 16.934.9; P > 0.05). There was a significant relationship between plasma MPO and DAS-28 (r = 0.35; P = 0.005). Plasma protein carbonyls and allantoin were significantly higher in patients with RA compared with the healthy controls. MPO protein was significantly higher in SF compared with plasma (median 624.0 ng/ml, IQR 258.42433.0 vs 30.2 ng/ml, IQR 25.150.9; P < 0.0001). The MPO present in SF was mostly active. 3-Chlorotyrosine, a specific biomarker of hypochlorous acid, was present in proteins from SF and related to the concentration of MPO (r = 0.69; P = 0.001). Protein carbonyls in SF were associated with MPO protein concentration (r = 0.40; P = 0.019) and 3-chlorotyrosine (r = 0.66; P = 0.003). Conclusion.MPO is elevated in patients with RA and promotes oxidative stress through the production of hypochlorous acid.
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