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长时间运动时的过度通气和肺气体交换的控制:III/IV 类肌梭传入反馈的作用。

Control of hyperpnoea and pulmonary gas exchange during prolonged exercise: The role of group III/IV muscle afferent feedback.

机构信息

Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA.

Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, Salt Lake City, UT, USA.

出版信息

J Physiol. 2024 Oct;602(20):5375-5389. doi: 10.1113/JP286993. Epub 2024 Sep 24.

Abstract

It remains unclear whether feedback from group III/IV muscle afferents is of continuous significance for regulating the pulmonary response during prolonged (>5 min), steady-state exercise. To elucidate the influence of these sensory neurons on hyperpnoea, gas exchange efficiency, arterial oxygenation and acid-base balance during prolonged locomotor exercise, 13 healthy participants (4 females; 21 (3) years, : 46 (8) ml/kg/min) performed consecutive constant-load cycling bouts at ∼50% (20 min), ∼75% (20 min) and ∼100% (5 min) of with intact (CTRL) and pharmacologically attenuated (lumbar intrathecal fentanyl; FENT) group III/IV muscle afferent feedback from the legs. Pulmonary responses were continuously recorded and arterial blood (radial catheter) periodically collected throughout the exercise. Pulmonary gas exchange efficiency was evaluated using the alveolar-arterial difference ( ). There were no differences in any of the variables of interest between conditions before the start of the exercise. Pulmonary ventilation was up to 20% lower across all intensities during FENT compared to CTRL exercise (P < 0.001) and this hypoventilation was accompanied by an up to 10% lower arterial and a 2-4 mmHg higher (both P < 0.001). The exercise-induced widening of was up to 25% larger during FENT compared to CTRL (P < 0.001). Importantly, the differences developed within the first minute of each stage and persisted, or further increased, throughout the remainder of each bout. These findings reflect a critical and time-independent significance of feedback from group III/IV leg muscle afferents for continuously regulating the ventilatory response, gas exchange efficiency, arterial oxygenation and acid-base balance during human locomotion. KEY POINTS: Feedback from group III/IV leg muscle afferents reflexly contributes to hyperpnoea during short duration (i.e. <5 min) locomotor exercise. Whether continuous feedback from these sensory neurons is obligatory to ensure adequate pulmonary responses during steady-state exercise of longer duration remains unknown. Lumbar intrathecal fentanyl was used to attenuate the central projection of group III/IV leg muscle afferents during prolonged locomotor exercise (i.e. 45 min) at intensities ranging from 50% to 100% of . Without affecting the metabolic rate, afferent blockade compromised pulmonary ventilation and gas exchange efficiency, consistently impairing arterial oxygenation and facilitating respiratory acidosis throughout exercise. These findings reflect the time-independent significance of feedback from group III/IV muscle afferents for regulating exercise hyperpnoea and gas exchange efficiency, and thus for optimizing arterial oxygenation and acid-base balance, during prolonged human locomotion.

摘要

目前尚不清楚 III/IV 组肌传入神经的反馈是否对调节长时间(>5 分钟)、稳定状态下运动期间的肺反应持续具有重要意义。为了阐明这些感觉神经元对长时间运动性运动时过度通气、气体交换效率、动脉氧合和酸碱平衡的影响,13 名健康参与者(4 名女性;21(3)岁, : 46(8)ml/kg/min)在完整(CTRL)和药理学减弱(腰部鞘内芬太尼;FENT)腿部 III/IV 组肌传入神经反馈的情况下,连续进行了连续的恒负荷自行车运动,持续时间分别为 50%(20 分钟)、75%(20 分钟)和~100%(5 分钟)。在运动过程中,连续记录肺部反应,并定期从桡动脉导管采集动脉血。使用肺泡-动脉 差异( )评估肺气体交换效率。在开始运动之前,在任何感兴趣的变量方面,两种情况下均无差异。与 CTRL 运动相比,FENT 期间所有强度的肺通气均降低了 20%(P<0.001),并且这种通气不足伴随着动脉 降低了 10%, 升高了 2-4mmHg(均 P<0.001)。与 CTRL 相比,FENT 期间运动引起的 增宽增加了 25%(P<0.001)。重要的是,这些差异在每个阶段的最初一分钟内发展,并在每个回合的其余时间内持续存在,或进一步增加。这些发现反映了 III/IV 组腿部肌肉传入神经的反馈对于在人类运动期间持续调节通气反应、气体交换效率、动脉氧合和酸碱平衡具有关键且独立于时间的意义。关键点:III/IV 组腿部肌肉传入神经的反馈在短时间(即 <5 分钟)运动性运动期间有助于过度通气。在持续时间较长(>5 分钟)的稳定状态运动期间,这些感觉神经元的连续反馈是否是确保充分的肺部反应所必需的仍不清楚。在 50%至 100% ( )的强度范围内,在长时间(即 45 分钟)的运动过程中,使用鞘内芬太尼减弱 III/IV 组腿部肌肉传入神经的中枢投射。在不影响代谢率的情况下,传入神经阻滞会损害肺通气和气体交换效率,始终会损害运动期间的动脉氧合并促进呼吸性酸中毒。这些发现反映了 III/IV 组肌肉传入神经的反馈对于调节运动性过度通气和气体交换效率的时间独立性意义,从而对于优化长时间人体运动期间的动脉氧合和酸碱平衡具有重要意义。

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