Delivery and utilisation of oxygen are critical determinants of skeletal muscle function, and therefore aerobic performance. Angiogenesis, the process of microvascular bed expansion, may be initiated by several tissue-level stimuli (e.g. of haemodynamic, myogenic or metabolic origin), which are typically present during dynamic exercise. Understanding the relative contribution of these distinct physiological stimuli to skeletal muscle remodelling is needed to develop effective therapeutic strategies to alleviate impaired tissue oxygen supply. In the present study, we uncoupled the predominantly mechanotransductive (i.e. elevated vascular shear stress and cyclical muscle activation) and predominantly chemotransductive (i.e. local tissue hypoxia) stimuli present during exercise by exposing C57b6 mice to either indirect muscle stimulation (10 Hz; ST) or systemic hypoxia (10% oxygen; H), for 7 days, respectively. Furthermore, we combined these stimuli (H+ST) to determine whether the effects were additive. After 7 days of intervention, the tibialis anterior muscle was sampled for histological quantification of microvascular supply and metabolomics analysis. We showed that ST promoted a significant angiogenic response within the muscle whereas H did not. Interestingly, the combined H+ST group had a blunted angiogenic response. Branch-chain amino acid levels were significantly decreased following ST, H and H+ST, consistent with an increased metabolic requirement for ATP, which represents an energy deficit. Proximate metabolites of the glycolytic pathway were significantly reduced following hypoxia, but not stimulation. Together, these observations are commensurate with mechanotransduction triggering structural remodelling of muscle that preserves the metabolome of muscle tissue, whereas chemotransduction inhibits the angiogenic response induced by ST, possibly as a consequence of altered glycolytic metabolism. KEY POINTS: Angiogenesis, the process of microvascular bed expansion, may be initiated by several tissue-level stimuli (e.g. haemodynamic, myogenic or metabolic in origin), which are typically present during dynamic exercise. There has been controversy about the structural (capillary) response of skeletal muscle to altered O2 status, involving decreased supply (hypoxia) or increased demand (activity). Here, we demonstrate that 7 days of activation of skeletal muscle by indirect electrical stimulation led to significant expansion of the capillary bed. However, a similar adaptive structural response was not observed following hypoxia. When combining indirect stimulation and hypoxia, hypoxia appears to blunt structural remodelling. Proximate metabolites of the glycolytic pathway were significantly reduced following hypoxia, but not stimulation. Together, these observations suggest that mechanotransduction (via indirect stimulation) triggers structural remodelling of muscle that preserves the metabolome of muscle tissue, whereas chemotransduction (via hypoxia) inhibits the angiogenic response induced by stimulation, possibly because of altered glycolytic metabolism.

Muscle oxygenation critically depends on capillary number and distribution within a tissue. Despite the development of numerous morphometric indices to quantify these attributes, many lack sensitivity or validation against local oxygen tension ( P O 2 ${{P}_{{{{\mathrm{O}}}_2}}}$ ) in muscle fibres, leading to uncertainty about their physiological relevance and utility for gauging adaptive changes. We assessed six local supply indices to determine which best correlated with and predicted calculated fibre P O 2 ${{P}_{{{{\mathrm{O}}}_2}}}$ , using high-throughput histological analysis and image-based computational modelling of oxygen transport on digitised rat tibialis anterior sections: capillary contacts (CCi), individual capillary-to-fibre ratio (C:Fi), capillary-to-fibre perimeter exchange (CFPEi), local capillary-to-fibre ratio (LCFRi), local capillary density (LCDi) and a novel index, Dmax, i, which averages the maximum diffusion distances from capillary domains that overlap a fibre. LCDi and Dmax, i exhibited the strongest correlations with fibre P O 2 ${{P}_{{{{\mathrm{O}}}_2}}}$ (linear correlation: 0.8874 and -0.9054, respectively; P < 0.0001). Distance-correlation analysis confirmed both indices as robust predictors of fibre oxygenation (distance correlation: 0.85 and 0.79, respectively; P < 0.0001), demonstrating their ability to capture a curvilinear relationship that plateaus as mean fibre P O 2 ${{P}_{{{{\mathrm{O}}}_2}}}$ approaches the capillary source P O 2 ${{P}_{{{{\mathrm{O}}}_2}}}$ (P < 0.0001). Partial least squares and tree-ensemble regressions further identified both indices as the most sensitive and critical predictors of fibre P O 2 ${{P}_{{{{\mathrm{O}}}_2}}}$ (P < 0.001), suggesting they are less likely to miss early pathophysiological or adaptive responses. These findings support the use of theoretically validated morphometric indices in research and clinical applications, to enhance understanding of fundamental muscle physiology and improve the diagnosis and treatment of muscle-related pathology. KEY POINTS: Assessing muscle oxygenation is fundamental to understanding muscle function and its adaptive or pathological responses. Many indices are used to describe capillary O2 supply in skeletal muscle, but their physiological relevance in assessing local oxygenation remains uncertain. Using computational modelling of oxygen transport and machine learning, we evaluated six supply indices for their sensitivity in predicting fibre P O 2 ${{P}_{{{{\mathrm{O}}}_2}}}$ . Area-based indices (LCDi and Dmax, i) were identified as the most robust predictors of oxygenation and therefore better descriptors of pathophysiological and adaptive responses. These findings are expected to improve both research and clinical assessments of muscle health, streamlining methodologies and enhancing the diagnostic potential for muscle-related pathologies.

Biallelic mutations in multiple EGF domain protein 10 (MEGF10) gene cause EMARDD (early myopathy, areflexia, respiratory distress and dysphagia) in humans, a severe recessive myopathy, associated with reduced numbers of PAX7 positive satellite cells. To better understand the role of MEGF10 in satellite cells, we overexpressed human MEGF10 in mouse H-2kb-tsA58 myoblasts and found that it inhibited fusion. Addition of purified extracellular domains of human MEGF10, with (ECD) or without (EGF) the N-terminal EMI domain to H-2kb-tsA58 myoblasts, showed that the ECD was more effective at reducing myoblast adhesion and fusion by day 7 of differentiation, yet promoted adhesion of myoblasts to non-adhesive surfaces, highlighting the importance of the EMI domain in these behaviours. We additionally tested the role of Megf10 in vivo using transgenic mice with reduced (Megf10+/-) or no (Megf10-/-) Megf10. We found that the extensor digitorum longus muscle had fewer anti-Pax7 stained cell nuclei and was less able to undergo hypertrophy in response to muscle overload concomitant with a lower level of satellite cell activation. Taken together, our data suggest that MEGF10 may promote satellite cell adhesion and survival and prevent premature fusion helping to explain its role in EMARDD.

Among active species red muscle has an extremely high capillary density (CD), and at the other extreme white muscle has among the lowest recorded CD. Although broadly similar to the microcirculation in other vertebrate groups, structural plasticity and physiological adaptations accommodate both low blood pressure and a range of thermal environments. Convective delivery of materials to and from cells relies on adequate blood volume and vascular tone. Capillaries play a key role in the relationship between intravascular and interstitial compartments, and the forces that affect fluid movement between them, with unusually high permeability challenging accepted mechanisms.

BACKGROUND: Women with heart failure and reduced ejection fraction (HFrEF) have greater symptoms and a lower quality of life compared with men; however, the role of noncardiac mechanisms remains poorly resolved. We hypothesized that differences in skeletal muscle pathology between men and women with HFrEF may explain clinical heterogeneity. METHODS: Muscle biopsies from both men (n=22) and women (n=16) with moderate HFrEF (New York Heart Association classes I-III) and age- and sex-matched controls (n=18 and n=16, respectively) underwent transcriptomics (RNA-sequencing), myofiber structural imaging (histology), and molecular signaling analysis (gene/protein expression), with serum inflammatory profiles analyzed (enzyme-linked immunosorbent assay). Two-way ANOVA was conducted (interaction sex and condition). RESULTS: RNA-sequencing identified 5629 differentially expressed genes between men and women with HFrEF, with upregulated terms for catabolism and downregulated terms for mitochondria in men. mRNA expression confirmed an effect of sex (P<0.05) on proatrophic genes related to ubiquitin proteasome, autophagy, and myostatin systems (higher in all men versus all women), whereas proanabolic IGF1 expression was higher (P<0.05) in women with HFrEF only. Structurally, women compared with men with HFrEF showed a pro-oxidative phenotype, with smaller but higher numbers of type I fibers, alongside higher muscle capillarity (P-interaction<0.05) and higher type I fiber areal density (P-interaction<0.05). Differences in gene/protein expression of regulators of muscle phenotype were detected between sexes, including HIF1 alpha, ESR1, VEGF (vascular endothelial growth factor), and PGC1 alpha expression (P<0.05), and for upstream circulating factors, including VEGF, IL (interleukin)-6, and IL-8 (P<0.05). CONCLUSIONS: Sex differences in muscle pathology in HFrEF exist, with men showing greater abnormalities compared with women related to the transcriptome, fiber phenotype, capillarity, and circulating factors. These preliminary data question whether muscle pathology is a primary mechanism contributing to greater symptoms in women with HFrEF and highlight the need for further investigation.

AbstractThis study compared cardiovascular and metabolic responses during concentric and eccentric stepping. Eight participants (5 m, 3f; 22 ± 2 years) performed maximal concentric and eccentric ramp incremental tests on a modified stepping ergometer. Subsequently, three randomized 15‐min constant‐power tests were performed (1) concentric stepping at 90% of the concentric lactate threshold (LT), (2) eccentric stepping at the same power, and (3) eccentric stepping at the same oxygen uptake (V̇O2). At equivalent power (36 ± 6 W, p = 0.62), eccentric stepping resulted in 46 ± 8% lower V̇O2, 16 ± 6% lower heart rate (HR), and 11 ± 5% lower mean arterial blood pressure compared to concentric (p < 0.01). Matching V̇O2 required 65 ± 19% more power during eccentric stepping (p < 0.01). During this test, eccentric V̇O2 and HR continued to increase, resulting in a 22 ± 29% higher V̇O2 and 19 ± 16% higher HR in the final minute (p < 0.001). Reduced cardiorespiratory demand during eccentric stepping at the same power as concentric demonstrates a higher eccentric power is required to produce the same V̇O2. However, despite being below the concentric LT, eccentric V̇O2 and HR continued to increase past the predicted steady state, indicating a higher exercise intensity.

AimsP atients with heart failure and reduced ejection fraction (HFrEF) exhibit skeletal muscle pathology, which contributes to symptoms and decreased quality of life. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve clinical outcomes in HFrEF but their mechanism of action remains poorly understood. We aimed, therefore, to determine whether SGLT2i influence skeletal muscle pathology in patients with HFrEF. Methods and resultsM uscle biopsies from 28 male patients with HFrEF (New York Heart association class I-III) treated with SGLT2i (>12 months) or without SGLT2i were compared. Comprehensive analyses of muscle structure (immunohistochemistry), transcriptome (RNA sequencing), and metabolome (liquid chromatography-mass spectrometry) were performed, and serum inflammatory profiling (ELISA). Experiments in mice (n = 16) treated with SGLT2i were also performed. Myofiber atrophy was similar to 20% less in patients taking SGLT2i (p = 0.07). Transcriptomics and follow-up measures identified a unique signature in patients taking SGLT2i related to beneficial effects on atrophy, metabolism, and inflammation. Metabolomics identified influenced tryptophan metabolism in patients taking SGLT2i: kynurenic acid was 24% higher and kynurenine was 32% lower (p < 0.001). Serum profiling identified that SGLT2i treatment was associated with lower (p < 0.05) pro-inflammatory cytokines by 26-64% alongside downstream muscle interleukin (IL)-6-JAK/STAT3 signalling (p = 008 and 0.09). Serum IL-6 and muscle kynurenine were correlated (R = 0.65; p < 0.05). Muscle pathology was lower in mice treated with SGLT2i indicative of a conserved mammalian response to treatment. Conclusions Treatment with SGLT2i influenced skeletal muscle pathology in patients with HFrEF and was associated with anti-atrophic, anti-inflammatory, and pro-metabolic effects. These changes may be regulated via IL-6-kynurenine signalling. Together, clinical improvements following SGLT2i treatment in patients with HFrEF may be partly explained by their positive effects on skeletal muscle pathology. [GRAPHICS] .

AbstractExercise involves a complex interaction of factors influencing muscle performance, where variations in recruitment pattern (e.g., endurance vs. resistance training) may differentially modulate the local tissue environment (i.e., oxygenation, blood flow, fuel utilization). These exercise stimuli are potent drivers of vascular and metabolic change. However, their relative contribution to adaptive remodelling of skeletal muscle and subsequent performance is unclear. Using implantable devices, indirect electrical stimulation (ES) of locomotor muscles of rat at different pacing frequencies (4, 10 and 40 Hz) was used to differentially recruit hindlimb blood flow and modulate fuel utilization. After 7 days, ES promoted significant remodelling of microvascular composition, increasing capillary density in the cortex of the tibialis anterior by 73%, 110% and 55% for the 4 Hz, 10 and 40 Hz groups, respectively. Additionally, there was remodelling of the whole muscle metabolome, including significantly elevated amino acid turnover, with muscle kynurenic acid levels doubled by pacing at 10 Hz (P < 0.05). Interestingly, the fatigue index of skeletal muscle was only significantly elevated in 10 Hz (58% increase) and 40 Hz (73% increase) ES groups, apparently linked to improved capillary distribution. These data demonstrate that manipulation of muscle recruitment pattern may be used to differentially expand the capillary network prior to altering the metabolome, emphasising the importance of local capillary supply in promoting exercise tolerance.

Heart failure with preserved ejection fraction (HFpEF) is a major clinical problem, with limited treatments. HFpEF is characterized by a distinct, but poorly understood, skeletal muscle pathology, which could offer an alternative therapeutic target. In a rat model, we identified impaired myonuclear accretion as a mechanism for low myofiber growth in HFpEF following resistance exercise. Acute caloric restriction rescued skeletal muscle pathology in HFpEF, whereas cardiac therapies had no effect. Mechanisms regulating myonuclear accretion were dysregulated in patients with HFpEF. Overall, these findings may have widespread implications in HFpEF, indicating combined dietary with exercise interventions as a beneficial approach to overcome skeletal muscle pathology.

Microvascular integrity is disrupted following spinal cord injury (SCI) by both primary and secondary insults. Changes to neuronal structures are well documented, but little is known about how the capillaries change and recover following injury. Spatiotemporal morphological information is required to explore potential treatments targeting the microvasculature post-SCI to improve functional recovery. Sprague-Dawley rats were given a T10 moderate/severe (200 kDyn) contusion injury and were perfuse-fixed at days 2, 5, 15, and 45 post-injury. Unbiased stereology following immunohistochemistry in four areas (ventral and dorsal grey and white matter) across seven spinal segments (n = 4 for each group) was used to calculate microvessel density, surface area, and areal density. In intact sham spinal cords, average microvessel density across the thoracic spinal cord was: ventral grey matter: 571 ± 45 mm−2, dorsal grey matter: 484 ± 33 mm−2, ventral white matter: 90 ± 8 mm−2, dorsal white matter: 88 ± 7 mm−2. Post-SCI, acute microvascular disruption was evident, particularly at the injury epicentre, and spreading three spinal segments rostrally and caudally. Damage was most severe in grey matter at the injury epicentre (T10) and T11. Reductions in all morphological parameters (95–99% at day 2 post-SCI) implied vessel regression and/or collapse acutely. Transmission electron microscopy (TEM) revealed disturbed aspects of neurovascular unit fine structure at day 2 post-SCI (n = 2 per group) at T10 and T11. TEM demonstrated a more diffuse and disrupted basement membrane and wider intercellular clefts at day 2, suggesting a more permeable blood spinal cord barrier and microvessel remodelling. Some evidence of angiogenesis was seen during recovery from days 2 to 45, indicated by increased vessel density, surface area, and areal density at day 45. These novel results show that the spinal cord microvasculature is highly adaptive following SCI, even at chronic stages and up to three spinal segments from the injury epicentre. Multiple measures of gross and fine capillary structure from acute to chronic time points provide insight into microvascular remodelling post-SCI. We have identified key vascular treatment targets, namely stabilising damaged capillaries and replacing destroyed vessels, which may be used to improve functional outcomes following SCI in the future.

To celebrate its centenary year, Journal of Experimental Biology (JEB) commissioned a collection of articles examining the past, present and future of experimental biology. This Commentary closes the collection by considering the important research opportunities and challenges that await us in the future. We expect that researchers will harness the power of technological advances, such as '-omics' and gene editing, to probe resistance and resilience to environmental change as well as other organismal responses. The capacity to handle large data sets will allow high-resolution data to be collected for individual animals and to understand population, species and community responses. The availability of large data sets will also place greater emphasis on approaches such as modeling and simulations. Finally, the increasing sophistication of biologgers will allow more comprehensive data to be collected for individual animals in the wild. Collectively, these approaches will provide an unprecedented understanding of 'how animals work' as well as keys to safeguarding animals at a time when anthropogenic activities are degrading the natural environment.

Journal of Experimental Biology is celebrating 100 years of discovery in 2023 and, as part of our reflections, we are inviting Journal Editors to tell us their thoughts about the journal and to look to the future. In this Conversation, Monitoring Editor Stuart Egginton tells us why he thinks comparative physiology has a lot to offer the biomedical field and that he would advise his younger self to trust his instincts more.

Key points Spinal treatment can restore diaphragm function in all animals 1 month following C2 hemisection induced paralysis. Greater recovery occurs the longer after injury the treatment is applied. Through advanced assessment of muscle mechanics, innovative histology and oxygen tension modelling, we have comprehensively characterized in vivo diaphragm function and phenotype. Muscle work loops reveal a significant deficit in diaphragm functional properties following chronic injury and paralysis, which are normalized following restored muscle activity caused by plasticity-induced spinal reconnection. Injury causes global and local alterations in diaphragm muscle vascular supply, limiting oxygen diffusion and disturbing function. Restoration of muscle activity reverses these alterations, restoring oxygen supply to the tissue and enabling recovery of muscle functional properties. There remain metabolic deficits following restoration of diaphragm activity, probably explaining only partial functional recovery. We hypothesize that these deficits need to be resolved to restore complete respiratory motor function. Months after spinal cord injury (SCI), respiratory deficits remain the primary cause of morbidity and mortality for patients. It is possible to induce partial respiratory motor functional recovery in chronic SCI following 2 weeks of spinal neuroplasticity. However, the peripheral mechanisms underpinning this recovery are largely unknown, limiting development of new clinical treatments with potential for complete functional restoration. Utilizing a rat hemisection model, diaphragm function and paralysis was assessed and recovered at chronic time points following trauma through chondroitinase ABC induced neuroplasticity. We simulated the diaphragm's in vivo cyclical length change and activity patterns using the work loop technique at the same time as assessing global and local measures of the muscles histology to quantify changes in muscle phenotype, microvascular composition, and oxidative capacity following injury and recovery. These data were fed into a physiologically informed model of tissue oxygen transport. We demonstrate that hemidiaphragm paralysis causes muscle fibre hypertrophy, maintaining global oxygen supply, although it alters isolated muscle kinetics, limiting respiratory function. Treatment induced recovery of respiratory activity normalized these effects, increasing oxygen supply, restoring optimal diaphragm functional properties. However, metabolic demands of the diaphragm were significantly reduced following both injury and recovery, potentially limiting restoration of normal muscle performance. The mechanism of rapid respiratory muscle recovery following spinal trauma occurs through oxygen transport, metabolic demand and functional dynamics of striated muscle. Overall, these data support a systems-wide approach to the treatment of SCI, and identify new targets to mediate complete respiratory recovery.

Mammalian motor systems adapt to the demands of their environment. For example, muscle fibre types change in response to increased load or endurance demands. However, for adaptations to be effective, motoneurons must adapt such that their properties match those of the innervated muscle fibres. We used a rat model of chronic functional overload to assess adaptations to both motoneuron size and a key modulatory synapse responsible for amplification of motor output, C-boutons. Overload of Extensor Digitorum Longus (EDL) muscles was induced by removal of their synergists, Tibialis Anterior (TA) muscles. Following 21 days survival, EDL muscles showed an increase in fatigue resistance and a decrease in force output, indicating a shift to a slower phenotype. These changes were reflected by a decrease in motoneuron size. However, C-bouton complexes remained largely unaffected by overload. The C-boutons themselves, quantified by expression of vesicular acetylcholine transporter, were similar in size and density in the control and overload conditions. Expression of the post-synaptic voltage-gated potassium channel (K V 2.1) was also unchanged. Small conductance calcium activated potassium channels (SK3) were expressed in most EDL motoneurons, despite this being an almost exclusively fast motor pool. Overload induced a decrease in the proportion of SK3 + cells, however there was no change in density or size of clusters. We propose that reductions in motoneuron size may promote early recruitment of EDL motoneurons, but that C-bouton plasticity is not necessary to increase the force output required in response to muscle overload.

The motor unit comprises a variable number of muscle fibres that connect through myelinated nerve fibres to a motoneuron (MN), the central drivers of activity. At the simplest level of organisation there exist phenotypically distinct MNs that activate corresponding muscle fibre types, but within an individual motor pool there typically exists a mixed population of fast and slow firing MNs, innervating groups of Type II and Type I fibres, respectively. Characterising the heterogeneity across multiple levels of motor unit organisation is critical to understanding changes that occur in response to physiological and pathological perturbations. Through a comprehensive assessment of muscle histology and ex vivo function, mathematical modelling and neuronal tracing, we demonstrate regional heterogeneities at the level of the MN, muscle fibre type composition and oxygen delivery kinetics of the rat extensor digitorum longus (EDL) muscle. Specifically, the EDL contains two phenotypically distinct regions: a relatively oxidative medial and a more glycolytic lateral compartment. Smaller muscle fibres in the medial compartment, in combination with a greater local capillary density, preserve tissue O2 partial pressure (PO2 ) during modelled activity. Conversely, capillary supply to the lateral compartment is calculated to be insufficient to defend active muscle PO2 but is likely optimised to facilitate metabolite removal. Simulation of in vivo muscle length change and phasic activation suggest that both compartments are able to generate similar net power. However, retrograde tracing demonstrates (counter to previous observations) that a negative relationship between soma size and C-bouton density exists. Finally, we confirm a lack of specificity of SK3 expression to slow MNs. Together, these data provide a reference for heterogeneities across the rat EDL motor unit and re-emphasise the importance of sampling technique.

OBJECTIVE:Adequacy of the microcirculation is essential for maintaining repetitive skeletal muscle function while avoiding fatigue. It is unclear, however, whether capillary remodelling after different angiogenic stimuli is comparable in terms of vessel distribution and consequent functional adaptations. We determined the physiological consequences of two distinct mechanotransductive stimuli: (1) overload-mediated abluminal stretch (OV); (2) vasodilator-induced shear stress (prazosin, PR).METHODS:In situ EDL fatigue resistance was determined after 7 or 14 days of intervention, in addition to measurements of femoral artery flow. Microvascular composition (muscle histology) and oxidative capacity (citrate synthase activity) were quantified, and muscle PO2 calculated using advanced mathematical modelling.RESULTS:Compared to controls, capillary-to-fiber ratio was higher after OV14 (134%, p < .001) and PR14 (121%, p < .05), although fatigue resistance only improved after overload (7 days: 135%, 14 days: 125%, p < .05). In addition, muscle overload improved local capillary supply indices and reduced CS activity, while prazosin treatment failed to alter either index of aerobic capacity.CONCLUSION:Targeted capillary growth in response to abluminal stretch is a potent driver of improved muscle fatigue resistance, while shear stress-driven angiogenesis has no beneficial effect on muscle function. In terms of capillarity, more is not necessarily better.

Key pointsCapillary rarefaction is hypothesized to contribute to impaired exercise tolerance in cardiovascular disease, but it remains a poorly exploited therapeutic target for improving skeletal muscle performance.Using an abdominal aortic coarctation rat model of compensatory cardiac hypertrophy, we determine the efficacy of aerobic exercise for the prevention of, and mechanical overload for, restoration of hindlimb muscle fatigue resistance and microvascular impairment in the early stages of heart disease.Impaired muscle fatigue resistance was found after development of cardiac hypertrophy, but this impairment was prevented by low‐intensity aerobic exercise and recovered after mechanical stretch due to muscle overload.Changes in muscle fatigue resistance were closely related to functional (i.e. perfused) microvascular density, independent of arterial blood flow, emphasizing the critical importance of optimal capillary diffusion for skeletal muscle function.Pro‐angiogenic therapies are an important tool for improving skeletal muscle function in the incipient stages of heart disease.AbstractMicrovascular rarefaction may contribute to declining skeletal muscle performance in cardiac and vascular diseases. It remains uncertain to what extent microvascular rarefaction occurs in the earliest stages of these conditions, if impaired blood flow is an aggravating factor and whether angiogenesis restores muscle performance. To investigate this, the effects of aerobic exercise (voluntary wheel running) and functional muscle overload on the performance, femoral blood flow (FBF) and microvascular perfusion of the extensor digitorum longus (EDL) were determined in a chronic rat model of compensatory cardiac hypertrophy (CCH, induced by surgically imposed abdominal aortic coarctation). CCH was associated with hypertension (P = 0.001vs. Control) and increased relative heart mass (P< 0.001). Immediately upon placing the aortic band (i.e. before development of CCH), post‐fatigue test FBF was reduced (P< 0.003), coinciding with attenuated fatigue resistance (P = 0.039) indicating an acute arterial perfusion constraint on muscle performance. While FBF was normalized during CCH in chronic groups(P> 0.05) fatigue resistance remained reduced (P = 0.039) and was associated with reduced (P = 0.009) functional capillarity after development of CCH without intervention, indicating a microvascular limitation to muscle performance. Normalization of functional capillarity after aerobic exercise (P = 0.065) and overload (P = 0.329) in CCH coincided with restoration to control levels of muscle fatigue resistance (P> 0.999), although overload‐induced EDL hypertrophy (P = 0.027) and wheel‐running velocity and duration (bothP< 0.05) were attenuated after aortic banding. These data show that reductions in skeletal muscle performance during CCH can be countered by improving functional capillarity, providing a therapeutic target to improve skeletal muscle function in chronic diseases.

Placenta growth factor (PlGF) is a pro-inflammatory angiogenic mediator that promotes many pathologies including diabetic complications and atherosclerosis. Widespread endothelial dysfunction precedes the onset of these conditions. As very little is known of the mechanism(s) controlling PlGF expression in pathology we investigated the role of hyperglycaemia in the regulation of PlGF production in endothelial cells. Hyperglycaemia stimulated PlGF secretion in cultured primary endothelial cells, which was suppressed by IGF-1-mediated PI3K/Akt activation. Inhibition of PI3K activity resulted in significant PlGF mRNA up-regulation and protein secretion. Similarly, loss or inhibition of Akt activity significantly increased basal PlGF expression and prevented any further PlGF secretion in hyperglycaemia. Conversely, constitutive Akt activation blocked PlGF secretion irrespective of upstream PI3K activity demonstrating that Akt is a central regulator of PlGF expression. Knock-down of the Forkhead box O-1 (FOXO1) transcription factor, which is negatively regulated by Akt, suppressed both basal and hyperglycaemia-induced PlGF secretion, whilst FOXO1 gain-of-function up-regulated PlGF in vitro and in vivo. FOXO1 association to a FOXO binding sequence identified in the PlGF promoter also increased in hyperglycaemia. This study identifies the PI3K/Akt/FOXO1 signalling axis as a key regulator of PlGF expression and unifying pathway by which PlGF may contribute to common disorders characterised by endothelial dysfunction, providing a target for therapy.