Mechanisms & Properties of Exercise-Induced Cardioprotection
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Headrick, John
Haseler, Luke
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Abstract
Regular physical activity, or exercise, is beneficial in the maintenance of health and
wellbeing of the human body. With respect to the cardiovascular system, the potential benefits of
physical activity in the prevention, reduction of frequency and severity, and enhanced
rehabilitation, of heart disease are clear. However, many questions remain regarding factors such
as the mode, duration, and intensity of physical activity and the cardiac impacts of these variables.
Moreover, underlying mechanisms remain to be detailed. The current narrative from health
organisations and governments worldwide has been the mantra of ‘exercise is medicine’, with a
two-pronged approach: to enable the population to meet the minimum standards of daily physical
activity, and to limit the amount of extended sedentariness. What is clear is that very few meet
these standards, and heart disease, along with other associated chronic diseases attributed to a
lack of activity and suboptimal diet, remain top of the list for all-cause mortality and morbidity.
The issues pertaining to this problem are as broad as the benefits of exercise itself, and they include
behavioral and societal issues beyond the scope of this thesis. The experiments in this thesis aim
to specifically investigate the molecular underpinnings of the cardiac and systemic changes that
occur in the exercised body. With this knowledge, it is possible to proceed further with potential
solutions, such as: personalised exercise protocols for a specific health outcome, determination of
short-term, long-term, and lifelong effects of activity or inactivity, and development of agents that
may mimic or promote some of the benefits of exercise, especially for those unable to undertake
physical exertion.
The first experimental studies in this thesis investigated whether short-term voluntary wheelrunning
in 8-week old mice beneficially modulates myocardial ischemic tolerance, signaling
kinases, and gene expression patterns (Chapter 3). Transcriptome analysis can provide insight into
molecular mechanisms. Prior animal studies have utilised forced activity measures, such as
treadmill running, expecting increases in heat shock protein or any other canonical stress
responses. However, we employed voluntary wheel-running as a ‘low-stress’ method to assess
responses to ischaemia-reperfusion insult. Phenotypic results showed that 1 week of wheelrunning
improved left ventricular developed pressure recovery from 25 min ischaemia/45 min
reperfusion (by 47%) and reduced diastolic dysfunction (by 30%). Analysis of known pro-survival
proteins showed limited changes, with only a 30% increase in cytosolic ERK1/2, whilst there were
no differences in total Akt, GSK3β and phospho-Akt, -GSK3β and -ERK1/2. Microarray
interrogation identified significant changes (!1.3 fold expression change, "5% FDR) in 142 known
genes, the majority of which (92%) were repressed. Significantly modified pathways/networks
related to inflammatory/immune function (particularly interferon-dependent), together with cell
movement, growth, and death signalling. Of only 14 induced transcripts, 3 encoded interrelated sarcomeric proteins titin, #-actinin, and myomesin-2.
The next series of studies were designed to investigate the sensitivity of cardiac ischaemictolerance
to both activity and inactivity. Studies assessed cardiac effects of voluntary activity (14
days) in running-naïve mice (Active), 7 days of subsequent inactivity (Inactive), and brief (3 day)
restoration of running (Re-Active); and tested whether 'cardiac:activity coupling' reflects common
modulation of pro-survival (AKT, AMPK, ERK1/2, HSP27, EGFR) and -injury (GSK3
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Thesis (PhD Doctorate)
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Doctor of Philosophy (PhD)
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School Allied Health Sciences
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Subject
Cardioprotection
Inactivity physiology
Myocardial infarction