title: Phrenic nerve stimulation protects against mechanical ventilation-induced diaphragm dysfunction in rats.
abstract: BACKGROUND
  We investigated a novel application of phrenic nerve stimulation (PNS) in diaphragm dysfunction induced by mechanical ventilation (MV).
  
  
  METHODS
  Twenty-one Sprague-Dawley rats were assigned randomly to 3 groups: spontaneous breathing, 18-h controlled MV, and 18-h controlled MV with PNS. Upon completion of the experimental protocol, diaphragm contractility, gene expression of insulin-like growth factor-1 (IGF-1) and ubiquitin ligases, and serum IGF-1 levels were analyzed.
  
  
  RESULTS
  Compared with the spontaneously breathing rats, impaired diaphragm contractile function, including force-related properties and force-frequency responses, were pronounced with MV. Furthermore, MV suppressed IGF-1 and induced muscle ring finger 1 mRNA expression in the diaphragm. In contrast, PNS counteracted MV-induced gene expression changes in the diaphragm and restored diaphragm function.
  
  
  CONCLUSIONS
  PNS exerted a protective effect against MV-induced diaphragm dysfunction by counteracting altered expression of IGF-1 and ubiquitin ligase in the diaphragm.
authors.affiliation: Department of Anesthesiology, First People's Hospital, School of Medicine, Shanghai Jiaotong University, 100 Hai Ning Road, Shanghai, 200080, China.
authors.forename: Meirong
authors.initials: M
authors.lastname: Yang
authors.forename: Haitao
authors.initials: H
authors.lastname: Wang
authors.forename: Guangwei
authors.initials: G
authors.lastname: Han
authors.forename: Lianhua
authors.initials: L
authors.lastname: Chen
authors.forename: Lina
authors.initials: L
authors.lastname: Huang
authors.forename: Jihong
authors.initials: J
authors.lastname: Jiang
authors.forename: Shitong
authors.initials: S
authors.lastname: Li
mesh_terms: D000818:Animals; D001703:Biophysics; D003964:Diaphragm / Q000378:metabolism / Q000473:pathology; D004195:Disease Models, Animal; D004599:Electric Stimulation Therapy / Q000379:methods*; D005786:Gene Expression Regulation / Q000502:physiology; D066298:In Vitro Techniques; D007334:Insulin-Like Growth Factor I / Q000235:genetics / Q000378:metabolism; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D009124:Muscle Proteins / Q000235:genetics / Q000378:metabolism; D009135:Muscular Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D010791:Phrenic Nerve / Q000502:physiology*; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D012121:Respiration, Artificial / Q000009:adverse effects*; D044843:SKP Cullin F-Box Protein Ligases / Q000235:genetics / Q000378:metabolism; D000070584:Tripartite Motif Proteins; D044767:Ubiquitin-Protein Ligases / Q000235:genetics / Q000378:metabolism
chemical_list: D009124:Muscle Proteins; D012333:RNA, Messenger; D000070584:Tripartite Motif Proteins; D007334:Insulin-Like Growth Factor I; C486692:Fbxo32 protein, rat; D044843:SKP Cullin F-Box Protein Ligases; C499086:Trim63 protein, rat; D044767:Ubiquitin-Protein Ligases
keywords: diaphragm; electric stimulation therapy; mechanical ventilation; muscle weakness; phrenic nerve