低氧暴露诱导肌萎缩发生的机制探讨

高海拔地区常伴随着诸多不利环境因素,使初上高原者处于应激状态,对机体代谢系统产生一系列不良影响,其中之一就是诱发骨骼肌萎缩。肌萎缩是一种肌肉功能减退的反应,表现为肌纤维横截面积减小,肌纤维类型转变和肌肉力量、耐力下降。高原环境造成的肌萎缩与低氧环境密切相关。高原训练是竞技体育中一种提高氧运输能力、心脏供血能力及最大摄氧量的有效训练方式,但此过程中造成的骨骼肌质量丢失会影响运动员力量和耐力的发挥,不利于运动表现;同时,随着高原旅游和低氧减肥的兴起,世居平原大众进入高原后发生的肌量丢失和肌力下降也会影响其健康状态。低氧暴露所诱发的肌萎缩程度由低氧浓度和暴露时长所决定,是一个多器官、多组织参与的整体调控骨骼肌蛋白代谢失衡的过程,且在不同类型的肌纤维中表现不同。但目前关于低氧暴露导致肌萎缩的机制还不完全清楚。因此,本文将就该问题相关研究进展进行综述,以期进一步阐明低氧诱导肌萎缩的生物学机制,从而利用低氧刺激更好地提高运动成绩和服务大众健康。     

自噬途径在低氧暴露诱导骨骼肌萎缩中的调节作用机制

该研究拟通过在体和离体实验观察低氧暴露诱导肌萎缩现象,并探究其作用机制是否与自噬途径有关.SD大鼠进行低氧(氧浓度为12.4％)暴露干预.4周后,测量体质量、瘦体质量、体成分、趾长伸肌(EDL)湿重,观察肌纤维形态,计算肌纤维横截面积(FCSA),PCR芯片分析自噬差异表达基因功能.在低氧环境下使用自噬抑制剂3-MA干...     

低氧影响蛋白质合成和分解的平衡诱导骨骼肌萎缩

暴露在低氧环境下,可能会引起胃肠功能障碍和摄食量下降,打破骨骼肌蛋白质合成和分解平衡,造成骨骼肌萎缩。为探讨低氧环境下骨骼肌的萎缩是低氧环境引起的还是低氧诱发的摄食量减少所致,本研究检测大鼠腓肠肌中低氧时蛋白质合成与分解相关基因的蛋白质表达。将21只雄性SD大鼠,随机分为3组：常氧对照组、低氧组（氧浓度为12.4%,模拟海拔4 000 m高度）和配对组（大鼠的摄食量与低氧组前1 d的摄食量相同）,每组7只,每天记录大鼠体重和摄食量。4周后,HE染色法观察腓肠肌肌纤维形态,Western印迹测试相关蛋白质水平。低氧组和配对组摄食量在低氧干预初期,较常氧对照组有显著性下降(P<0.05),干预后期差异不明显;干预期间,低氧组大鼠体重平均增加量(102.10 g)、体重(341.20 ± 16.75 g)、肌肉总量（226.83 ± 8.33 g）和腓肠肌肌纤维横截面积(12.67 ± 1.83 mm)较常氧对照组（128.00 g;377.50 ± 20.75 g;260.50 ± 9.35 g;15.78 ± 2.38 mm）和配对组（119.40 g;375.86 ± 11.30 g;262.29 ± 7.90 g;15.71 ± 2.82 mm）均显著下降,配对组较常氧对照组无显著性差异;4周干预后,与常氧对照组相比,低氧组大鼠腓肠肌中与低氧相关的HIF1α显著增加(1.42 ± 0.19, P<0.05),Akt和p-Akt/Akt显著降低 (1.44 ± 0.13; 0.47 ± 0.08, P<0.05),配对组上述3种指标相对表达量均无显著性差异;在蛋白质合成方面,低氧组mTOR较常氧对照组显著下降(0.63 ± 0.18, P<0.05),配对组较常氧对照组差异不明显;低氧组腓肠肌中,4EBP1(1.14 ± 0.14)和p70S6K1(1.14 ± 0.11)较配对组显著下降(P<0.05)。在蛋白质分解方面,低氧组p-FoxO1和p-FoxO1/FoxO1比值较常氧对照组显著下降(0.71 ± 0.15; 0.78 ± 0.14, P<0.05);低氧组大鼠腓肠肌中,Atrogin1、MuRF1、Beclin1、LC3Ⅰ及LC3Ⅱ/Ⅰ比值均高于常氧对照组(1.35 ± 0.12; 1.30 ± 0.22; 1.17 ± 0.11; 1.03 ± 0.11; 1.35 ± 0.13, P<0.05);配对组与常氧对照组间无明显差异。低氧环境下骨骼肌中蛋白质合成相关基因表达减少,蛋白质分解相关基因表达增加,造成骨骼肌萎缩,体重下降,此变化与摄食量减少无关。     

低氧影响蛋白质合成和分解的平衡诱导骨骼肌萎缩

暴露在低氧环境下,可能会引起胃肠功能障碍和摄食量下降,打破骨骼肌蛋白质合成和分解平衡,造成骨骼肌萎缩。为探讨低氧环境下骨骼肌的萎缩是低氧环境引起的还是低氧诱发的摄食量减少所致,本研究检测大鼠腓肠肌中低氧时蛋白质合成与分解相关基因的蛋白质表达。将21只雄性SD大鼠,随机分为3组：常氧对照组、低氧组（氧浓度为12.4%,模拟海拔4 000 m高度）和配对组（大鼠的摄食量与低氧组前1 d的摄食量相同）,每组7只,每天记录大鼠体重和摄食量。4周后,HE染色法观察腓肠肌肌纤维形态,Western印迹测试相关蛋白质水平。低氧组和配对组摄食量在低氧干预初期,较常氧对照组有显著性下降(P<0.05),干预后期差异不明显;干预期间,低氧组大鼠体重平均增加量(102.10 g)、体重(341.20 ± 16.75 g)、肌肉总量（226.83 ± 8.33 g）和腓肠肌肌纤维横截面积(12.67 ± 1.83 mm)较常氧对照组（128.00 g;377.50 ± 20.75 g;260.50 ± 9.35 g;15.78 ± 2.38 mm）和配对组（119.40 g;375.86 ± 11.30 g;262.29 ± 7.90 g;15.71 ± 2.82 mm）均显著下降,配对组较常氧对照组无显著性差异;4周干预后,与常氧对照组相比,低氧组大鼠腓肠肌中与低氧相关的HIF1α显著增加(1.42 ± 0.19, P<0.05),Akt和p-Akt/Akt显著降低 (1.44 ± 0.13; 0.47 ± 0.08, P<0.05),配对组上述3种指标相对表达量均无显著性差异;在蛋白质合成方面,低氧组mTOR较常氧对照组显著下降(0.63 ± 0.18, P<0.05),配对组较常氧对照组差异不明显;低氧组腓肠肌中,4EBP1(1.14 ± 0.14)和p70S6K1(1.14 ± 0.11)较配对组显著下降(P<0.05)。在蛋白质分解方面,低氧组p-FoxO1和p-FoxO1/FoxO1比值较常氧对照组显著下降(0.71 ± 0.15; 0.78 ± 0.14, P<0.05);低氧组大鼠腓肠肌中,Atrogin1、MuRF1、Beclin1、LC3Ⅰ及LC3Ⅱ/Ⅰ比值均高于常氧对照组(1.35 ± 0.12; 1.30 ± 0.22; 1.17 ± 0.11; 1.03 ± 0.11; 1.35 ± 0.13, P<0.05);配对组与常氧对照组间无明显差异。低氧环境下骨骼肌中蛋白质合成相关基因表达减少,蛋白质分解相关基因表达增加,造成骨骼肌萎缩,体重下降,此变化与摄食量减少无关。     

推拿对失神经骨骼肌萎缩大鼠的治疗作用及其机制*

目的:探讨推拿对失神经骨骼肌萎缩大鼠的治疗作用及其机制。方法:48只雄性SD大鼠随机分为模型组(n=24)和推拿组(n=24),通过切断右侧胫神经制备腓肠肌萎缩大鼠模型。术后第2日开始给推拿组大鼠手术侧腓肠肌给予手法干预,模型组不予干预。两组分别在0 d、7 d、14 d、21 d四个时间点各处死6只大鼠,取大鼠双侧腓肠肌,称重后计算各组大鼠腓肠肌湿重比;HE染色测定肌纤维截面积和直径,实时荧光定量PCR检测腓肠肌中miR-23a、Akt、MuRF1、MAFbx基因相对表达量。结果:与0 d比较,模型组和推拿组大鼠腓肠肌湿重比、肌纤维截面积和直径呈现进行性下降的趋势,其中7 d、14 d、21 d推拿组腓肠肌湿重比、肌纤维截面积和直径均显著高于模型组(P＜0.05,P＜0.01);与0 d比较,模型组和推拿组MuRF1、MAFbx、Akt mRNA表达均呈现先升后降的趋势,其中7 d、21 d推拿组MuRF1 mRNA表达均显著低于模型组(P＜0.05,P＜0.01),7 d、14 d、21 d推拿组MAFbx mRNA表达均显著低于模型组(P＜0.01,P＜0.05,P＜0.01),7 d、14 d、21 d推拿组Akt mRNA表达均显著高于模型组(P＜0.05,P＜0.01);与0 d比较,模型组和推拿组21 d时miR-23a mRNA表达升高,推拿组miR-23a mRNA表达显著高于模型组(P＜0.05)。结论:推拿能延缓失神经骨骼肌的萎缩,其机制可能与上调miR-23a、Akt基因的表达,下调 MuRF1、MAFbx基因的表达,使蛋白降解速度受到抑制,从而减轻骨骼肌蛋白的降解程度有关。     

锌指蛋白对肌肉发育的调节

骨骼肌已经成为研究发育的很多基本原理的一个理想模型。对肌肉发育机制的研究加深了我们对细胞决定、细胞分化、形态发生以及生长和分化的拮抗作用等生命现象的认识。在骨骼肌的发育过程中 ,从中胚层的肌肉祖先细胞产生成肌细胞以及从成肌细胞分化成多核肌细胞的每一步骤都是由转录因子来调节的。锌指蛋白 (ｚｉｎｃｆｉｎｇｅｒｐｒｏｔｅｉｎ)是80年代中期发现的一类ＤＮＡ结合蛋白 ,在真核生物中 ,锌指蛋白可能是最大的一类ＤＮＡ结合蛋白 ,并且由锌指蛋白调控基因表达是发育和其他过程的一个非常普遍的现象。在最近的几年中 ,发现某些…     

不同低氧暴露对大鼠有氧代谢潜能的影响

目的:同时从血液运氧能力和骨骼肌氧化能力的角度,观察不同低氧暴露对机体有氧代谢潜能的影响。方法:雄性SD大鼠30只,随机分成3组(n=10):常氧对照组、12h低氧暴露组(间歇低氧暴露组)和24h低氧暴露组(持续低氧暴露组)。氧浓度为13.6%。6周后测试红细胞(RBC)、血红蛋白(Hb)、红细胞压积(Hct)、2,3-二磷酸甘油酸(2,3-DPG)和腓肠肌柠檬酸合成酶(CS)、琥珀酸脱氢酶(SDH)、苹果酸脱氢酶(MDH)活性。结果:持续低氧能显著提高RBC、Hb、Hct、2,3-DPG和腓肠肌CS、SDH、MDH活性;间歇低氧除了显著提高Hb外,其它指标无明显变化。结论:持续低氧暴露同时提高机体运氧能力和骨骼肌氧化能力,可以充分提高机体有氧代谢潜能;间歇低氧暴露只能提高血氧容量,对血氧亲和力和骨骼肌氧化能力没有影响,提高机体有氧代谢潜能的效果不如持续低氧暴露。     

间断性低氧对大鼠淋巴细胞转化的影响

目的: 探讨间断性低氧对机体免疫反应的影响.方法: 以模拟海拔高度间断性低氧(4 h/d)模型观察大鼠脾淋巴细胞对丝裂原(Con A)的反应性.结果: 与对照相比,5 km急性低氧4 h大鼠淋巴细胞的转化率下降25.43%(P<0.05) ,间断性低氧2、5、15 d后淋巴细胞转化率分别为97.03%、104.5%和99.55%,与对照组无明显差异.2 km间断性低氧(4 h/d)1、2、5、15 d,大鼠脾淋巴细胞转化率分别为93.19%、96.43%、99.03%和100.54%,与对照组无明显差异.脾单个核细胞DNA含量显示, 5 km急性低氧4 h DNA含量明显下降(76.22%±7.06%,P<0.05),间断性低氧5 d和15 d后与对照组无显著差异.结论: 急性低氧抑制淋巴细胞的转化,并随低氧的加重而增加,重复间断性低氧暴露其抑制作用减弱,引起大鼠淋巴细胞转化产生适应.推测免疫适应与HPA轴的适应有关.     

Myostatin信号通路在4周离心耐力运动改善2型糖尿病大鼠骨骼肌萎缩中的作用

目的：观察4周离心耐力运动对2型糖尿病大鼠代谢障碍及肌萎缩的影响,探讨myostatin/Smad3/atrogin-1信号通路在肌萎缩中的作用。方法：9周高脂饲养联合STZ注射建立2型糖尿病大鼠模型。将普通饲料组大鼠随机分为对照组（C,n=6）和运动组（E,n=9;将2型糖尿病模型组大鼠随机分为糖尿病对照组（D,n=8）和糖尿病运动组（DE,n=12）。运动方案：坡度-5°,跑速16 m/min,每次60 min、每日一次,每周训练5 d,连续4周。最后一次运动后禁食12 h,测定空腹血糖（FBG）、空腹胰岛素（FINS）,计算稳态模式胰岛素抵抗指数（HOMA-IR）和胰岛素敏感指数（ISI）,进行葡萄糖耐量试验。取比目鱼肌观察肌萎缩现象并检测myostatin、Smad3、p-Smad3和atrogin-1表达情况。结果：①与对照组相比,糖尿病组大鼠体重、比目鱼肌质量/胫骨长和肌纤维平均横截面积、FINS和ISI显著降低（P<0.01）,FBG、HOMA-IR和血糖曲线下面积（AUC_BG）以及myostatin、Smad3、p-Smad3、atrogin-1表达均显著升高（P<0.01）。②4周离心运动后,与糖尿病组相比,糖尿病运动组大鼠肌纤维平均横截面积显著升高（P<0.01）,AUC_BG、HOMA-IR及myostatin、p-Smad3、atrogin-1表达显著降低（P<0.05,P<0.01）。结论：myostatin/Smad3/atrogin-1信号通路上调是导致2型糖尿病肌萎缩的重要原因,4周离心耐力运动可能通过下调myostatin、p-Smad3和atrogin-1表达抑制肌萎缩,进而改善2型糖尿病代谢障碍,提高胰岛素敏感性。     

Acupuncture ameliorated skeletal muscle atrophy induced by hindlimb suspension in mice

Preventing skeletal muscle atrophy is critical for maintaining quality of life, but it is often a challenging goal for the elderly and patients with severe conditions. We hypothesized that acupuncture in place of exercise training is an alternative non-pharmacological intervention that can help to prevent muscle atrophy. To elucidate the effects of acupuncture on skeletal muscle atrophy caused by hindlimb suspension (HS), we performed acupuncture on mice according to two different methods: acupuncture with electrical stimulation (EA: electroacupuncture) and without electrical stimulation (MA: manual acupuncture). A needle was retained in the gastrocnemius muscle for 30 min every day for 2 weeks in the EA and MA groups. In the EA group, 30 min of repetitive electrical stimulation (1 Hz, 1 ms pulse width, 6.5 mA intensity) was also applied. HS significantly reduced muscle mass and the cross-sectional area of the soleus muscles. This HS-induced reduction was significantly improved in the EA group, although the level of improvement remained insufficient when compared with the control group. We found that the mRNA expression levels of atrogin-1 and MuRF1, which play a principal role in muscle-specific degradation as E3 ubiquitin ligases, were significantly increased in the HS group compared to the control group. EA and MA reduced the HS-induced upregulation of atrogin-1 (p < 0.01 in EA and MA) and MuRF1 (p < 0.01 in EA) mRNAs. We also found that the expression levels of PI3K, Akt1, TRPV4, adenosine A1 receptor, myostatin, and SIRT1 mRNAs tended to be increased by HS. EA and MA further increased the HS-induced upregulation of Akt1 (p < 0.05 in MA) and TRPV4 (p < 0.05 in MA) mRNAs. We concluded that acupuncture partially prevented skeletal muscle atrophy. This effect might be due to an increase in protein synthesis and a decrease in protein degradation.     

Dihydromyricetin resists inflammation-induced muscle atrophy via ryanodine receptor-CaMKK-AMPK signal pathway

Skeletal muscle plays a pivotal role in the maintenance of physical and metabolic health. Skeletal muscle atrophy usually results in physical disability, inferior quality of life and higher health care costs. The higher incidence of muscle atrophy in obese and ageing groups is due to increased levels of inflammatory factors during obesity and ageing. Dihydromyricetin, as a bioactive polyphenol, has been used for anti-inflammatory, anti-tumour and improving insulin sensitivity. However, there are no published reports demonstrated the dihydromyricetin effect on inflammation-induced skeletal muscle atrophy. In this study, we first confirmed the role of dihydromyricetin in inflammation-induced skeletal muscle atrophy in vivo and in vitro. Then, we demonstrated that dihydromyricetin resisted inflammation-induced skeletal muscle atrophy by activating Ca²⁺-CaMKK-AMPK through signal pathway blockers, Ca²⁺ probes and immunofluorescence. Finally, we clarified that dihydromyricetin activated Ca²⁺-CaMKK-AMPK signalling pathway through interaction with the ryanodine receptor, its target protein, by drug affinity responsive target stability (DARTS). Our results not only demonstrated that dihydromyricetin resisted inflammation-induced muscle atrophy via the ryanodine receptor-CaMKK-AMPK signal pathway but also discovered that the target protein of dihydromyricetin is the ryanodine receptor. Our results provided experimental data for the development of dihydromyricetin as a functional food and new therapeutic strategies for treating or preventing skeletal muscle atrophy.     

Protein synthesis in skeletal muscle measured at different times during a 24 hour period

Six groups of 5 male rats (starting body weight 109 g) were allowed free access to a conventional rat diet. At 4 hourly intervals, starting at 10.00 h muscle protein synthesis was measured. By relating the weights of the gastrocnemius and soleus muscles to the initial body weights of the animals (i.e., at 09.30, day 1), a linear increase in muscle weight throughout the day was demonstrated. The fractional rate of muscle protein synthesis varied from 16.8% per day to 20.3% per day in gastrocnemius muscle and from 17.9% per day and 22.1% per day in the soleus. It was calculated that the maximum error incurred in estimating daily muscle protein synthesis by extrapolation of the value at any one time was 6% in gastrocnemius and 9% in soleus. It is concluded that calculations of the average rate of muscle protein degradation based on the difference between the rates of synthesis and deposition are generally valid in rats allowed free access to an adequate diet.     

Overexpression of interleukin-15 induces skeletal muscle hypertrophy in vitro: implications for treatment of muscle wasting disorders

Interleukin-15 (IL-15) is a novel anabolic factor for skeletal muscle which inhibits muscle wasting associated with cancer (cachexia) in a rat model. To develop a cell culture system in which the mechanism of the anabolic action of IL-15 on skeletal muscle could be examined, the mouse C2 skeletal myogenic cell line was transduced with a retroviral expression vector for IL-15 and compared to sister cells transduced with a control vector. Overexpression of IL-15 induced fivefold higher levels of sarcomeric myosin heavy chain and alpha-actin accumulation in differentiated myotubes. Secreted factors from IL-15-overexpressing myogenic cells, but not from control cells, induced increased myofibrillar protein accumulation in cocultured control myotubes. IL-15 overexpression induced a hypertrophic myotube morphology similar to that described for cultured myotubes which overexpressed the well-characterized anabolic factor insulin-like growth factor-I (IGF-I). However, in contrast to IGF-I, the hypertrophic action of IL-15 on skeletal myogenic cells did not involve stimulation of skeletal myoblast proliferation or differentiation. IL-15 induced myotube hypertrophy at both low and high IGF-I concentrations. Furthermore, in contrast to IGF-I, which stimulated only protein synthesis under these culture conditions, IL-15 both stimulated protein synthesis and inhibited protein degradation in cultured skeletal myotubes. These findings indicate that IL-15 action on skeletal myogenic cells is distinct from that of IGF-I. Due to the ability of IGF-I to stimulate cell division and its association with several forms of cancer, controversy exists concerning the advisability of treating cachexia or age-associated muscle wasting with IGF-I. Administration of IL-15 or modulation of the IL-15 signaling pathway may represent an alternative strategy for maintaining skeletal muscle mass under these conditions.     

MTORC1 determines autophagy through ULK1 regulation in skeletal muscle

Autophagy impairment has been implicated in several muscle disorders and in age-related dysfunction. Although previous reports pointed to FOXO as a positive regulator of autophagy in skeletal muscle, it remained unclear what is triggering autophagy. We found that TSC muscle knockout (TSCmKO) mice, characterized by specific depletion of TSC1 in skeletal muscle, and thus constant activation of MTORC1, develop a late-onset myopathy marked by the accumulation of autophagic substrates. In those mice, autophagy induction is blocked despite FOXO activation because of constant MTORC1-dependent inhibition of ULK1. Treatment of TSCmKO mice with rapamycin is sufficient to restore autophagy and to alleviate, at least in part, the myopathy. Inversely, inactivation of the MTORC1 pathway in RPTOR-depleted muscles triggers LC3B lipidation in spite of FOXO inhibition. In conclusion, MTORC1 constitutes the master regulator of autophagy induction in skeletal muscle and its deregulation leads to pathologic alterations of muscle homeostasis.     

低氧习服大鼠骨骼肌毛细血管密度和血流供应的变化特点

目的：观察大鼠在低氧习服过程中,骨骼肌毛细血管密度和血流供应的变化规律。方法：大鼠在模拟海拔5000m低氧5、15和30d后,用肌球蛋白ATP酶（mATPase)组织化学方法显示骨骼肌Ⅰ、Ⅱ型纤维和毛细血管并进行图像分析;用放射性微球法测定骨骼肌血流量。结果：低氧5d组大鼠骨骼肌纤维即出现明显萎缩,15d和30d组大鼠毛细血管密度显著增高,但单位面积内毛细血管数/肌纤维数（C/F）的比值无明显变化。在所观测的时间内,各组大鼠骨骼肌血流量未见明显变化。结论：大鼠在低氧习服过程中,毛细血管并未发生真正的增生,而由于骨骼肌纤维出现萎缩,使毛细敌国管数目相对增多。     

Effect of atrophy and contractions on myogenin mRNA concentration in chick and rat myoblast omega muscle cells

Summary The skeletal rat myoblast omega (RMo) cell line forms myotubes that exhibit spontaneous contractions under appropriate conditions in culture. We examined if the RMo cells would provide a model for studying atrophy and muscle contraction. To better understand how to obtain contractile cultures, we examined levels of contraction under different growing conditions. The proliferation medium and density of plating affected the subsequent proportion of spontaneously contracting myotubes. Using a ribonuclease protection assay, we found that exponentially growing RMo myoblasts contained no detectable myogenin or herculin mRNA, while differentiating myoblasts contained high levels of myogenin mRNA but no herculin mRNA. There was no increase in myogenin mRNA concentration in either primary chick or RMo myotubes whose contractions were inhibited by depolarizing concentrations of potassium (K⁺). Thus, altered myogenin mRNA concentrations are not involved in atrophy of chick myotubes. Depolarizing concentrations of potassium inhibited spontaneous contractions in both RMo cultures and primary chick myotube cultures. However, we found that the myosin concentration of 6-d-old contracting RMo cells fed medium plus AraC was 11 ± 3 μg myosin/μg DNA, not significantly different from 12 ± 4 μg myosin/μg DNA (n=3), the myosin concentration of noncontracting RMo cells (treated with 12 mM K⁺ for 6 d). Resolving how RMo cells maintained their myosin content when contraction is inhibited may be impotrant for understanding atrophy.     

Modifications by chronic intermittent hypoxia and drug treatment on skeletal muscle metabolism

The energy metabolism was evaluated in gastrocnemius muscle from 3-month-old rats subjected to either mild or severe 4-week intermittent normobaric hypoxia. Furthermore, 4-week treatment with CNS-acting drugs, namely, -adrenergic (-yohimbine), vasodilator (papaverine, pinacidil), or oxygen-increasing (almitrine) agents was performed. The muscular concentration of the following metabolites was evaluated: glycogen, glucose, glucose 6-phosphate, pyruvate, lactate, lactateto-pyruvate ratio; citrate, -ketoglutarate, succinate, malate; aspartate, glutamate, alanine; ammonia; ATP, ADP, AMP, creatine phosphate. Furthermore the Vmax of the following muscular enzymes was evaluated: hexokinase, phosphofructokinase, pyruvate kinase, lactate dehydrogenase; citrate synthase, malate dehydrogenase; total NADH cytochrome c reductase; cytochrome oxidase. The adaptation to chronic intermittent normobaric mild or severe hypoxia induced alterations of the components in the anaerobic glycolytic pathway [as supported by the increased activity of lactate dehydrogenase and/or hexokinase, resulting in the decreased glycolytic substrate concentration consistent with the increased lactate production and lactate-to-pyruvate ratio] and in the mitochondrial mechanism [as supported by the decreased activity of malate dehydrogenase and/or citrate synthase resulting in the decreased concentration of some key components in the tricarboxylic acid cycle]. The effect of the concomitant pharmacological treatment suggests that the action of CNS-acting drugs could be also related to their direct influence on the muscular biochemical mechanisms linked to energy transduction.