One of the best ways to ensure good health for you and your loved ones is to stress the importance of exercise as more than a tool to help with weight control. From Alzheimer’s disease to colon cancer to Type II diabetes, exercise therapy can help with a wide range of diseases. It is especially vital in the fight against heart failure, which is closely tied to lung function. This is why my research has led me to study the genetics and lung fluid balance in both healthy patients and patients with either heart failure or cystic fibrosis.
Research Leading Up To Now
I set out on this research path at the University of Minnesota, as I was pursuing my Ph.D. in Exercise Science. While interning at Mayo Clinic I researched how common genetic variants of the Beta-2 receptor respond to stress hormones (and the one that opens airways up with common asthma medicine) and how they function in the heart and lungs during exercise. My pre-doctoral fellowship focused on the same thing – studying this genetic receptor and its response to exercise in a healthy person’s lungs and heart.
This led to my post-doctoral fellowship where I studied the same genetic receptor in the lung fluid balance of patients with heart failure. Studying healthy patients was a good starting point and laid the foundation for much of the work in heart failure patients. In the post-doctoral study we sought to determine if we could predict who is more likely to develop pulmonary edema as their heart fails and if we can guide therapy using their genetics. I received a $2.2 million grant from the National Institute of Health (which we still have) that allowed us to take another step further in this research. The grant called for us to study the original Beta-2 receptor in addition to the gene in front of it and the gene behind it (in a molecular pathway) – three genes in total. The goal was to study how these three interact in trying to get water out of the lungs.
Here’s where it gets a bit complicated, so bear with me for some medical talk. We are looking at genetic variation of phenylethanolamine-N-methyltransferase (PNMT – this makes adrenaline in the body), the beta-2 adrenergic receptor (B2AR, this responds to adrenaline and signals Na+ channels to open) and epithelial Na+ channels (ENaC which clear Na+ and water out of the lungs). Our thinking is that if someone has a functional gene of PNMT, B2AR and ENaC – this will naturally protect them from getting pulmonary edema.
Two Diseases in the Same Pathway
This research has led me to where I am today, including the two main points of research in our lab. The first focus is the heart failure study where we look at how different genes influence lung fluid balance. The second line of study is in cystic fibrosis. We study how exercise improves the lungs of patients with cystic fibrosis, as well as their hearts and vessels. The same pathway in the lung is doing lots of different things for two different diseases.
Cystic fibrosis is a dry lung disease. Those who suffer from cystic fibrosis don’t have chloride channels that work correctly, so there’s hyper-absorption of sodium away from their lungs. Because of this, water leaves the lungs too quickly. In heart failure, you want the lungs to stay dry. You want water to leave the lungs even as the heart efficiency fails more and more. With cystic fibrosis, it’s the opposite. We want the lungs to stay wet.
We’re studying the pathways in the lungs that actually control fluid balance. For example, when sodium leaves the lungs too quickly, it brings water with it and dries out the lungs prematurely. Just exercising can help block this water from leaving the lung, which is good in cystic fibrosis. Exercise can really hit those pathways and keep their lungs wetter. Many of the drugs used by cystic fibrosis patients target the same pathways and have the same effect as exercise but at a greater cost. Less study has been done on these pathways during exercise.
Here are three tips for a healthy heart that I’ve found to be helpful in my own life:
1.Exercise. I can’t emphasize the importance of exercise enough. Focus less on weight and more on the joy of movement and the good that goes on inside the body. What’s interesting is cystic fibrosis patients who exercise live longer and have a better quality of life. This is true of most diseases, regardless of changes in body weight.
2.Adequate sleep. Getting a proper night’s rest will reduce stress, which will lead to a happier and healthier life.
3.Own a pet. Do this if it is at all possible. Though the exact mechanisms haven’t been fully described, studies show that pet owners tend to have lower blood pressure, respond better to mental stress, and live longer.
Additional literature on the subject of my research can be found on the National Institute of Health site here, here and here. For more information on our work at the Clinical Exercise Physiology Laboratory, please visit cehd.umn.edu/kin/research/cepl.
Eric Snyder, Ph.D.