Antecendents to HIF discovery - Nobel Prize 2019: The relation between O2 delivery and tissue oxygen consumption

This is a subsection from a review in which the concept that oxygen delivery determines cellular oxygen consumption was first presented before the cells' oxygen sensing discovery was made (HIF mechanism - Nobel Prize 2019).

Fetal circulatory responses to oxygen lack.
Jensen A, Berger R.
J Dev Physiol. 1991 Oct;16(4):181-207.

Department of Obstetrics and Gynaecology, University of Giessen, Germany.

https://www.researchgate.net/publication/21344116_Fetal_circulatory_response_to_oxygen_lack -

Abstract:

The knowledge on fetal and neonatal circulatory physiology accumulated by basic scientists and clinicians over the years has contributed considerably to the recent decline of perinatal morbidity and mortality. This review will summarize the peculiarities of the fetal circulation, the distribution of organ blood flow during normoxemia, and that during oxygen lack caused by various experimental perturbations. Furthermore, the relation between oxygen delivery and tissue metabolism during oxygen lack as well as evidence to support a new concept will be presented along with the principal cardiovascular mechanisms involved. Finally, blood flow and oxygen delivery to the principal fetal organs will be examined and discussed in relation to organ function. The fetal circulatory response to hypoxemia and asphyxia is a centralization of blood flow in favour of the brain, heart, and adrenals and at the expense of almost all peripheral organs, particularly of the lungs, carcass, skin and scalp. This response is qualitatively similar but quantitatively different under various experimental conditions. However, at the nadir of severe acute asphyxia the circulatory centralization cannot be maintained. Then there is circulatory decentralization, and the fetus will experience severe brain damage if not expire unless immediate resuscitation occurs. Future work in this field will have to concentrate on the important questions, what factors determine this collapse of circulatory compensating mechanisms in the fetus, how does it relate to neuronal damage, and how can the fetal brain be pharmacologically protected against the adverse effects of asphyxia.

此部分系一篇综述的子节段，其中首次提出了氧气输送决定细胞氧气消耗的概念，该概念在细胞氧气感应发现（HIF机制，2019年诺贝尔奖）之前得以阐述。胎儿对氧气的循环反应尚不充分。Jensen A, Berger R. 发表于《发育生理学杂志》（J Dev Physiol.），1991年10月第16卷第4期，181-207页。德国吉森大学妇产科。https://www.researchgate.net/publication/21344116_Fetal_circulatory_response_to_oxygen_lack

摘要：

多年以来，基础科学家和临床医生对胎儿和新生儿循环生理学的认识积累，对近年来围产期发病率和死亡率的大幅下降作出了重大贡献。本综述将总结胎儿循环的特殊性、正常氧合状态下的器官血流分布，以及由各种实验干扰引起的氧气缺乏时的器官血流分布。此外，将展示氧气输送与组织代谢在氧气缺乏期间的关系以及支持新概念的证据，并探讨涉及的主要心血管机制。最后，将探讨主要胎儿器官的血流和氧气输送，并讨论其与器官功能的关系。胎儿对缺氧和窒息的循环反应表现为优先将血流集中供应大脑、心脏和肾上腺，而牺牲几乎所有外周器官，尤其是肺、躯体、皮肤和头皮。这种反应在不同实验条件下在定性上相似但在定量上有所不同。然而，在严重急性窒息的最低点，循环集中化无法维持。随后出现循环分散化，如果未能立即进行复苏，胎儿将经历严重的脑损伤，甚至可能死亡。未来在此领域的研究必须集中关注以下重要问题：哪些因素决定了胎儿循环补偿机制的崩溃，这与神经元损伤有何关联，以及如何通过药物治疗保护胎儿大脑免受窒息的负面影响。