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Functional magnetic resonance imaging (fMRI) suggests that the hypoxic ventilatory response is facilitated by the AMP-activated protein kinase (AMPK), not at the carotid bodies, but within a subnucleus (Bregma -7.5 to -7.1 mm) of the nucleus tractus solitarius that exhibits right-sided bilateral asymmetry. Here, we map this subnucleus using cFos expression as a surrogate for neuronal activation and mice in which the genes encoding the AMPK-α1 (Prkaa1) and AMPK-α2 (Prkaa2) catalytic subunits were deleted in catecholaminergic cells by Cre expression via the tyrosine hydroxylase promoter. Comparative analysis of brainstem sections, relative to controls, revealed that AMPK-α1/α2 deletion inhibited, with right-sided bilateral asymmetry, cFos expression in and thus activation of a neuronal cluster that partially spanned three interconnected anatomical nuclei adjacent to the area postrema: SolDL (Bregma -7.44 mm to -7.48 mm), SolDM (Bregma -7.44 mm to -7.48 mm) and SubP (Bregma -7.48 mm to -7.56 mm). This approximates the volume identified by fMRI. Moreover, these nuclei are known to be in receipt of carotid body afferent inputs, and catecholaminergic neurons of SubP and SolDL innervate aspects of the ventrolateral medulla responsible for respiratory rhythmogenesis. Accordingly, AMPK-α1/α2 deletion attenuated hypoxia-evoked increases in minute ventilation (normalised to metabolism), reductions in expiration time, and increases sigh frequency, but increased apnoea frequency during hypoxia. The metabolic response to hypoxia in AMPK-α1/α2 knockout mice and the brainstem and spinal cord catecholamine levels were equivalent to controls. We conclude that within the brainstem an AMPK-dependent, hypoxia-responsive subnucleus partially spans SubP, SolDM and SolDL, namely SubSol-HIe, and is critical to coordination of active expiration, the hypoxic ventilatory response and defence against apnoea.
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http://dx.doi.org/10.1007/s00424-024-02957-6 | DOI Listing |
JCI Insight
September 2025
Department of Physiology and Neurobiology, University of Connecticut, Storrs, United States of America.
Dravet syndrome (DS) is an early-onset epilepsy caused by loss of function mutations in the SCN1A gene, which encodes Nav1.1 channels that preferentially regulate activity of inhibitory neurons early in development. DS is associated with a high incidence of sudden unexpected death in epilepsy (SUDEP) by a mechanism that may involve respiratory failure.
View Article and Find Full Text PDFAnesthesiology
October 2025
Mayo Clinic College of Medicine and Science, Jacksonville, Florida.
Medicine (Baltimore)
September 2025
Department of Chest Diseases, Health Ministry of the Turkish Republic, Bursa City Hospital, Bursa, Türkiye.
Using high-flow nasal cannula (HFNC) in patients with hypoxemic respiratory failure to avoid intubation raises concerns about its potential to increase mortality due to delayed intubation. Identifying at-risk patients is essential. While the literature predicts risk with oxygen-based indices (ROX, SpO2/FiO2, PaO2/FiO2), we aimed to detect ventilation insufficiency.
View Article and Find Full Text PDFJ Physiol
September 2025
Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile.
Cardiorespiratory responses to physical exercise are expected to meet the organism's metabolic demands. As carotid body (CB) glomus cells have been proposed as metabolic sensors, we sought to determine their contribution to peak oxygen uptake ( ) during exercise in rats. Adult male Wistar Kyoto rats underwent bilateral co-injection of two adeno-associated viruses (AAVs) at the CB bifurcation (AVV-TH-Cre-SV40 and AVV-hSyn-DREADD(Gi)-mCherry).
View Article and Find Full Text PDFBMC Pediatr
September 2025
Department of Anaesthesiology, Shenzhen Children's Hospital of China Medical University, Shenzhen, China.
Background: Transnasal humidified rapid-insufflation ventilatory exchange is a novel ventilation modality which can provide very high flow (up to 70 l/min) heated and humidified gas with adjustable temperatures (31-37 °C) and oxygen concentrations (21-100%). However its application in sedated gastroscopy in children has received little attention.
Objective: To observe transnasal humidified rapid-insufflation ventilatory exchange in sedated gastroscopy in children and its effect on the incidence of hypoxemia.