. 2018. Increased FXYD1 and PGC-1a mRNA after blood flowrestricted running is related to fibre typespecific AMPK signalling and oxidative stress in human muscle. Acta Physiol 223, e13045.Blood flow restriction (BFR) has been utilized in physiology for centuries, from William Harvey's (1578-1657) initial use of a tourniquet to describe in detail the systemic circulation of blood, to the use in the last 40 years in the investigation of cardiovascular reflex responses, angiogenesis, skeletal muscle metabolism and fatigue. Recent investigation has largely focussed on the adaptive potential of BFR exercise training, with particular reference to skeletal muscle strength and hypertrophy and its use in the rehabilitation process. Others have continued to explore the potential for BFR in enhancing the skeletal muscle signalling response and subsequent improvement to whole body exercise performance. Adding to this latter aspect, the paper by Christiansen et al 1 in this issue of Acta Physiologica provides further convincing evidence on the potential for BFR exercise to augment skeletal muscle signalling responses, particularly related to the physiological mechanisms associated with fatigue resistance and mitochondrial capacity. In their study, recreational athletes (with a reasonable VO 2max of~57 mL min À1 kg À1 ) completed interval sessions consisting of three sets of three 2-minute running bouts. In an interesting experimental design, these were performed alone, with BFR and under normobaric hypoxic conditions (F I O 2 of 14%). By ensuring the level of skeletal muscle hypoxia (deoxygenation measured by NIRS) was consistent between the BFR and hypoxic conditions the investigators were able to ascertain whether hypoxia per se was involved in the adaptive process (as might be have been expected with the use of BFR). The exciting and novel observations were that BFR augmented the increase in mRNA expression of the Na + ,K + -ATPase (NKA) complex ancillary protein phospholemman-1 (FXYD1), which contributes to the maintenance of transmembrane Na + and K + ion gradients, critical in preserving skeletal muscle membrane excitability and thus contractile function. 2 They also demonstrated that BFR augmented the expression of specific isoforms of peroxisome proliferator-activated receptor-c coactivator 1a (PGC-1a), which is widely considered to be the key factor mediating exercise training-induced adaptations in mitochondrial capacity. 3 Interestingly, the augmented upregulation of these transcripts was unrelated to the severity of muscle hypoxia, lactate accumulation and activation of Ca 2+ /calmodulindependent protein kinase (CaMKII). Instead, the key physiological signals were related to the level of oxidative stress and fibre type specific 5 0 AMP-activated protein kinase (AMPK) signalling. This study clearly improves our understanding of the physiological stressors involved in the regulation of NKA and PGC-1a expression, and how these stressors can be influenced by BFR. The study also adds support to the debate on the potent...