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Wåhlin-Larsson, Britta
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Publications (10 of 13) Show all publications
Ericson, H., Skoog, T., Johansson, M. & Wåhlin-Larsson, B. (2018). Resistance training is linked to heightened positive motivational state and lower negative affect among healthy women aged 65–70. Journal of Women & Aging, 30(5), 366-381
Open this publication in new window or tab >>Resistance training is linked to heightened positive motivational state and lower negative affect among healthy women aged 65–70
2018 (English)In: Journal of Women & Aging, ISSN 0895-2841, E-ISSN 1540-7322, Vol. 30, no 5, p. 366-381Article in journal (Refereed) Published
Abstract [en]

Resistance training (RT) improves overall health, but the psychological effects of RT in healthy old adults have not been tested. The aim of this study was to investigate a sample of 65–70-year-old healthy and physically active women to assess their sense of coherence, health-related quality of life, hope, and affect, before and after taking part in a 24-week RT intervention (N = 14), compared to controls (N = 18). Findings showed a significant increase in hope (p = 0.013) and a significant decrease in negative affect (p = 0.002). Starting RT after age 65 does not appear to negatively impact on women’s psychological health but seems to be associated with important psychological health benefits.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Healthy aging, hope, negative affect, psychological outcomes, resistance training
National Category
Public Health, Global Health, Social Medicine and Epidemiology Geriatrics
Research subject
Sports Science
Identifiers
urn:nbn:se:oru:diva-57052 (URN)10.1080/08952841.2017.1301720 (DOI)000443902100002 ()28375777 (PubMedID)2-s2.0-85017094736 (Scopus ID)
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2019-02-15Bibliographically approved
Wåhlin-Larsson, B., Wilkinson, D. J., Strandberg, E., Hosford-Donovan, A., Atherton, P. J. & Kadi, F. (2017). Mechanistic Links Underlying the Impact of C-Reactive Protein on Muscle Mass in Elderly. Cellular Physiology and Biochemistry, 44(1), 267-278
Open this publication in new window or tab >>Mechanistic Links Underlying the Impact of C-Reactive Protein on Muscle Mass in Elderly
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2017 (English)In: Cellular Physiology and Biochemistry, ISSN 1015-8987, E-ISSN 1421-9778, Vol. 44, no 1, p. 267-278Article in journal (Refereed) Published
Abstract [en]

BACKGROUND/AIMS: Mechanisms underlying the relationship between systemic inflammation and age-related decline in muscle mass are poorly defined. The purpose of this work was to investigate the relationship between the systemic inflammatory marker CRP and muscle mass in elderly and to identify mechanisms by which CRP mediates its effects on skeletal muscle, in-vitro.

METHODS: Muscle mass and serum CRP level were determined in a cohort of 118 older women (67±1.7 years). Human muscle cells were differentiated into myotubes and were exposed to CRP. The size of myotubes was determined after immunofluorescent staining using troponin. Muscle protein synthesis was assessed using stable isotope tracers and key signalling pathways controlling protein synthesis were determined using western-blotting.

RESULTS: We observed an inverse relationship between circulating CRP level and muscle mass (β= -0.646 (95% CI: -0.888, -0.405) p<0.05) and demonstrated a reduction (p < 0.05) in the size of human myotubes exposed to CRP for 72 h. We next showed that this morphological change was accompanied by a CRP-mediated reduction (p < 0.05) in muscle protein fractional synthetic rate of human myotubes exposed to CRP for 24 h. We also identified a CRP-mediated increased phosphorylation (p<0.05) of regulators of cellular energy stress including AMPK and downstream targets, raptor and ACC-β, together with decreased phosphorylation of Akt and rpS6, which are important factors controlling protein synthesis.

CONCLUSION: This work established for the first time mechanistic links by which chronic elevation of CRP can contribute to age-related decline in muscle function.

Place, publisher, year, edition, pages
Karger, 2017
Keywords
Ageing; AMPK; Akt/mTOR; Chronic Inflammation; CRP; Myoblast; Protein Synthesis; Skeletal Muscle Cell; Old women
National Category
Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy) Physiology
Identifiers
urn:nbn:se:oru:diva-62772 (URN)10.1159/000484679 (DOI)000423087200020 ()29130969 (PubMedID)2-s2.0-85033489852 (Scopus ID)
Note

Funding Agency:

Swedish National Center for Research in Sports  P2012/0102  P2014-0117

Available from: 2017-11-23 Created: 2017-11-23 Last updated: 2018-02-06Bibliographically approved
Nilsson, A., Wåhlin-Larsson, B. & Kadi, F. (2017). Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women. PLoS ONE, 12(4), Article ID e0175496.
Open this publication in new window or tab >>Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women
2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 4, article id e0175496Article in journal (Refereed) Published
Abstract [en]

Introduction: Whether amount of time spent in sedentary activities influences on clustered metabolic risk in elderly, and to what extent such an influence is independent of physical activity behavior, remain unclear. Therefore, the aim of the study was to examine cross-sectional associations of objectively assessed physical activity and sedentary behavior on metabolic risk outcomes in a sample of elderly community-dwelling women.

Methods: Metabolic risk outcomes including waist circumference, systolic and diastolic blood pressures, fasting levels of plasma glucose, HDL-cholesterol and triglycerides were assessed in 120 community-dwelling older women (65-70 yrs). Accelerometers were used to retrieve daily sedentary time, breaks in sedentary time, daily time in light (LPA) and moderate-to-vigorous physical activity (MVPA), and total amount of accelerometer counts. Multivariate regression models were used to examine influence of physical activity and sedentary behavior on metabolic risk outcomes including a clustered metabolic risk score.

Results: When based on isotemporal substitution modeling, replacement of a 10-min time block of MVPA with a corresponding time block of either LPA or sedentary activities was associated with an increase in clustered metabolic risk score (beta = 0.06 to 0.08, p < 0.05), and an increase in waist circumference (beta = 1.78 to 2.19 p < 0.01). All associations indicated between sedentary time and metabolic risk outcomes were lost once variation in total accelerometer counts was adjusted for.

Conclusions: Detrimental influence of a sedentary lifestyle on metabolic health is likely explained by variations in amounts of physical activity rather than amount of sedentary time per se. Given our findings, increased amounts of physical activity with an emphasis on increased time in MVPA should be recommended in order to promote a favorable metabolic health profile in older women.

Place, publisher, year, edition, pages
Public Library of Science, 2017
National Category
Geriatrics
Identifiers
urn:nbn:se:oru:diva-57672 (URN)10.1371/journal.pone.0175496 (DOI)000399375800060 ()28388679 (PubMedID)2-s2.0-85017105236 (Scopus ID)
Note

Funding Agency:

Swedish National Centre for Research  P2012/102  P2014-117  P2015-120

Available from: 2017-05-16 Created: 2017-05-16 Last updated: 2017-11-29Bibliographically approved
Hosford-Donovan, A., Nilsson, A., Wåhlin-Larsson, B. & Kadi, F. (2016). Observational and mechanistic links between C-reactive protein and blood pressure in elderly women. Maturitas, 89, 52-57
Open this publication in new window or tab >>Observational and mechanistic links between C-reactive protein and blood pressure in elderly women
2016 (English)In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 89, p. 52-57Article in journal (Refereed) Published
Abstract [en]

It is hypothesized that chronic systemic inflammation contributes to the age-related decline in cardiovascular function. The aim of the present study was to combine an assessment of the relationship between the serum level of C-reactive protein (CRP) and systolic and diastolic blood pressure in 108 elderly women (65 and 70 years) with an in-vitro exploration of the effects of CRP on the proliferative and angiogenic potential of endothelial cells exposed to serum in elderly women. Based on the median CRP level in our population, LowCRP (CRP<1.3mg/L) and HighCRP (>1.3mg/L) groups were identified. Body mass index, waist circumference, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher in the HighCRP group than in the LowCRP group (p<0.05). The influence of CRP on SBP and DBP remained significant after adjustments for BMI and use of antihypertensive medication (p<0.05). When adjusting for waist circumference the observed influence of CRP on SPB was attenuated (p=0.062). We next evaluated the ability to form capillary tubes (angiogenesis assay) and the proliferation rate of endothelial cells exposed to the sera of elderly women. Increased serum CRP levels were associated with an increased doubling time of endothelial cells (R(2)=0.39; p<0.05) and decreased capillary tube length (R(2)=0.30; p<0.05), indicating a reduction in the proliferation rate of endothelial cells and angiogenic potential. In conclusion, chronic inflammation influences blood pressure in elderly women and compromises endothelial cell function, thus contributing to the age-related decline in vascular health.

Place, publisher, year, edition, pages
Clare, Ireland: Elsevier, 2016
Keywords
Aging, angiogenesis, CRP, endothelial cell, hypertension, inflammation
National Category
Geriatrics Obstetrics, Gynecology and Reproductive Medicine
Research subject
Geriatrics; Obstetrics and Gynaecology
Identifiers
urn:nbn:se:oru:diva-51134 (URN)10.1016/j.maturitas.2016.04.016 (DOI)000376829600010 ()27180160 (PubMedID)2-s2.0-84964649115 (Scopus ID)
Note

Funding Agency:

Swedish National Centre for Research P2012/0102  P2014-0117

Available from: 2016-07-01 Created: 2016-07-01 Last updated: 2017-11-28Bibliographically approved
Strandberg, E., Edholm, P., Ponsot, E., Wåhlin-Larsson, B., Hellmén, E., Nilsson, A., . . . Kadi, F. (2015). Influence of combined resistance training and healthy diet on muscle mass in healthy elderly women: a randomized controlled trial. Journal of applied physiology, 119(8), 918-925
Open this publication in new window or tab >>Influence of combined resistance training and healthy diet on muscle mass in healthy elderly women: a randomized controlled trial
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2015 (English)In: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 119, no 8, p. 918-925Article in journal (Refereed) Published
Abstract [en]

The delivery of efficient nonpharmacological treatment to prevent the loss of muscle mass in older adults is a major challenge, and information on the combined effects of training and diet is particularly important. Here we aimed to evaluate the effects of 24 wk of resistance training combined with a healthy dietary approach (n-6/n-3 ratio < 2) in a population of healthy and physically active older women (65-70 years). The three-armed randomized controlled trial included a resistance training + healthy diet group (RT-HD), a resistance training group (RT), and controls (CON). All subjects included in the study were physically active and had low levels of serum inflammatory markers. In accordance with the dietary goals, the n-6/n-3 ratio dietary intake significantly decreased only in RT-HD by 42%. An increase in 1 repetition maximum in leg extension occurred in RT (+20.4%) and RT-HD (+20.8%), but not in CON. Interestingly, leg lean mass significantly increased only in RT-HD (+1.8%). While there were no changes in serum C-reactive protein and IL-6 levels, a significant decrease in serum level of the pro-inflammatory precursor arachidonic acid (-5.3 +/- 9.4%) together with an increase in serum n-3 docosahexaenoic acid (+8.3%) occurred only in RT-HD. Altogether, this study demonstrates that the effects of resistance training on muscle mass in healthy older adults can be optimized by the adoption of a healthy diet.

Place, publisher, year, edition, pages
American Physiological Society, 2015
Keywords
aging, C-reactive protein, exercise, fatty acids, inflammation, skeletal muscle
National Category
Sport and Fitness Sciences Physiology
Research subject
Physiology
Identifiers
urn:nbn:se:oru:diva-46442 (URN)10.1152/japplphysiol.00066.2015 (DOI)000362959800009 ()26338453 (PubMedID)2-s2.0-84946046698 (Scopus ID)
Note

Funding Agency:

Swedish National Center for Research in Sports P2012/0102 P2014-0117

Available from: 2015-11-10 Created: 2015-11-10 Last updated: 2019-03-26Bibliographically approved
Oskarsson, E., Wåhlin-Larsson, B. & Ulfberg, J. (2014). Reduced daytime intramuscular blood flow in patients with restless legs syndrome/Willis-Ekbom disease. Psychiatry and Clinical Neurosciences, 68(8), 640-643
Open this publication in new window or tab >>Reduced daytime intramuscular blood flow in patients with restless legs syndrome/Willis-Ekbom disease
2014 (English)In: Psychiatry and Clinical Neurosciences, ISSN 1323-1316, E-ISSN 1440-1819, Vol. 68, no 8, p. 640-643Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to examine possible signs of impairment of the microcirculation in the lower extremities of female patients suffering from primary restless legs syndrome (RLS)/Willis-Ekbom disease.

Methods: This study was performed in eight female patients, mean age 48 years (range 21-65), diagnosed with primary RLS but otherwise healthy. Eight healthy female control subjects, mean age 47 years (range 27-64), were also included in the study. Laser Doppler flowmetry was used to determine intramuscular blood flow by placing an optical single fiber in the tibialis anterior muscle belly. The studies were performed between 08.00 and 10.00 hours and 20.00 and 22.00 hours. Blood flow was expressed in perfusion units.

Results: The median intramuscular blood flow in the RLS patients' tibialis anterior muscles, recorded from both legs, was significantly higher in the morning, at 17.9 perfusion units, than in the evening, at 12.1 perfusion units (P = 0.004). Corresponding values for the healthy controls were 13.1 perfusion units and 12.0 perfusion units, a non-significant difference. The relative fold changes of microcirculation in the RLS group compared to healthy age-matched controls were 0.7 +/- 0.3 and 1.1 +/- 0.6, respectively (P = 0.04).

Conclusion: Our results suggest that in female patients with primary RLS, the microcirculation in the tibialis anterior muscle is higher in the morning compared with in the evening.

Keywords
intramuscular blood flow, laser Doppler flowmetry, microvascular disease, restless legs syndrome, Willis-Ekbom disease
National Category
Neurology Sport and Fitness Sciences
Research subject
Neurology
Identifiers
urn:nbn:se:oru:diva-36534 (URN)10.1111/pcn.12170 (DOI)000340376500007 ()
Available from: 2014-09-16 Created: 2014-09-15 Last updated: 2017-12-05Bibliographically approved
Wåhlin-Larsson, B., Carnac, G. & Kadi, F. (2014). The influence of systemic inflammation on skeletal muscle in physically active elderly women. Age (Omaha), 36(5), 9718
Open this publication in new window or tab >>The influence of systemic inflammation on skeletal muscle in physically active elderly women
2014 (English)In: Age (Omaha), ISSN 0161-9152, E-ISSN 1574-4647, ISSN 0161-9152, Vol. 36, no 5, p. 9718-Article in journal (Refereed) Published
Abstract [en]

The biological mechanisms responsible for the decline in skeletal muscle mass during aging remain unknown. It is hypothesized that elevations in the level of the acute phase C-reactive protein (CRP) negatively affect skeletal muscle mass in elderly. We examined the relationship between serum CRP and muscle mass in a population of active elderly women (65-70 years; n =23). Though all subjects were physically active, serum CRP levels were negatively associated to the amount of time spent in moderate-to-vigorous physical activity (R (2) = 0.20, P = 0.032) and to skeletal muscle mass (R (2)  = 0.28, P = 0.009). We further aimed to determine the potential mechanisms behind the action of systemic inflammation on skeletal muscle by exposing myoblasts isolated from vastus lateralis to the different sera from each elderly woman. The doubling time (DT) of myoblasts increased when cells were exposed to sera with high CRP levels (R (2) = 0.27, P = 0.011), indicating that CRP contributes to the impairment of the proliferative rate of myoblasts in elderly. In order to further confirm our findings, we incubated human myoblasts in exogenous CRP. Exposition to exogenous CRP induced an increase in myoblast DT by 1.21-fold (P = 0.007) and a reduction in the expression of the proliferation marker ki-67 confirming the negative influence of CRP on myoblast proliferative rate. Collectively, these findings highlight the contribution of the systemic inflammatory status in the age-related decline in skeletal muscle function.

Keywords
Aging; Skeletal muscle; Inflammation; CRP; Myoblast; Physical activity
National Category
Geriatrics Sport and Fitness Sciences
Research subject
Geriatrics
Identifiers
urn:nbn:se:oru:diva-38665 (URN)10.1007/s11357-014-9718-0 (DOI)000343801300020 ()25311555 (PubMedID)
Note

Funding Agency:

Swedish National Center for Research in Sports

Available from: 2014-11-25 Created: 2014-11-17 Last updated: 2018-08-29Bibliographically approved
Marklund, P., Mattsson, C. M., Wåhlin-Larsson, B., Ponsot, E., Lindvall, B., Lindvall, L., . . . Kadi, F. (2013). Extensive inflammatory cell infiltration in human skeletal muscle in response to an ultraendurance exercise bout in experienced athletes. Journal of applied physiology, 114(1), 66-72
Open this publication in new window or tab >>Extensive inflammatory cell infiltration in human skeletal muscle in response to an ultraendurance exercise bout in experienced athletes
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2013 (English)In: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 114, no 1, p. 66-72Article in journal (Refereed) Published
Abstract [en]

The impact of a 24-h ultraendurance exercise bout on systemic and local muscle inflammatory reactions was investigated in nine experienced athletes. Blood and muscle biopsies were collected before (Pre), immediately after the exercise bout (Post), and after 28 h of recovery (Post28). Circulating blood levels of leukocytes, creatine kinase (CK), C-reactive protein (CRP), and selected inflammatory cytokines were assessed together with the evaluation of the occurrence of inflammatory cells (CD3(+), CD8(+), CD68(+)) and the expression of major histocompatibility complex class I (MHC class I) in skeletal muscle. An extensive inflammatory cell infiltration occurred in all athletes, and the number of CD3(+), CD8(+), and CD68(+) cells were two- to threefold higher at Post28 compared with Pre (P < 0.05). The inflammatory cell infiltration was associated with a significant increase in the expression of MHC class I in muscle fibers. There was a significant increase in blood leukocyte count, IL-6, IL-8, CRP, and CK at Post. At Post28, total leukocytes, IL-6, and CK had declined, whereas IL-8 and CRP continued to increase. Increases in IL-1β and TNF-α were not significant. There were no significant associations between the magnitude of the systemic and local muscle inflammatory reactions. Signs of muscle degenerative and regenerative events were observed in all athletes with various degrees of severity and were not affected by the 24-h ultraendurance exercise bout. In conclusion, a low-intensity but very prolonged single-endurance exercise bout can generate a strong inflammatory cell infiltration in skeletal muscle of well-trained experienced ultraendurance athletes, and the amplitude of the local reaction is not proportional to the systemic inflammatory response.

National Category
Medical and Health Sciences Sport and Fitness Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-31995 (URN)10.1152/japplphysiol.01538.2011 (DOI)000313051000009 ()23104690 (PubMedID)2-s2.0-84871782629 (Scopus ID)
Available from: 2013-10-14 Created: 2013-10-14 Last updated: 2019-03-26Bibliographically approved
Wåhlin Larsson, B. (2009). Skeletal muscle in Restless legs syndrome (RLS) and Obstructive sleep apnoea syndrome (OSAS). (Doctoral dissertation). Örebro: Örebro university
Open this publication in new window or tab >>Skeletal muscle in Restless legs syndrome (RLS) and Obstructive sleep apnoea syndrome (OSAS)
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Restless legs syndrome (RLS) and Obstructive sleep apnoea syndrome (OSAS) are two sleep disorders that affect daily life with symptoms such as sleepiness and fatigue. It was therefore hypothesised that the skeletal muscle could be affected as symptoms from skeletal muscle are common. The overall aim of the thesis was to investigate aerobic capacity and structure of skeletal muscle in patients with OSAS and RLS and an age matched control group to provide information regarding the underlying mechanisms. The specific aims were to investigate muscle fibre composition, capillary network, capillary proliferation and sings of local inflammation in musculus tibialis anterior of RLS and OSAS.OSAS and RLS patients had a significantly lower predicted VO2 max expressed in ml/min/kg compared with the control group and in the OSAS group apnoes-hyponea index (AHI) was inversely correlated to maximal oxygen uptake Fibre type composition and muscle fibre cross sectional area in the tibialis anterior muscle was equal in all groups with a predominant proportion of slow type I fibres and a smaller fibre area in slow type I fibres compared to fast type II fibres. The distribution of fast fibres (I/IIA, IIA) did not differ except for the group IIX and IIA/IIX where OSAS and RLS had a significantly higher percentage. OSAS patients had a significantly higher number of capillaries per fibre (CAF) for slow type I fibres and CAF per fibre area (CAFA) for fast type II fibres. CFPE- index (capillary to fibre perimeter exchange) and LC/PF-index (length of capillary/perimeter of fibre) were higher in both patient groups. Vascular endothelial growth factor (VEGF) and proliferating endothelial cells were analysed by double-immunofluorescence staining and were presented to a greater extent in the patient groups compared with the healthy controls. Based on normal amounts of T-cells and macrophages in the histological picture it was also demonstrated that local inflammation was not present in the tibialis anterior muscle of RLS and OSAS whish was also supported by the absence of expression of major histocompatibility complex class I molecules (MHC class I) on the surface of the tibialis anterior muscle fibres.In conclusion, the low predicted VO2 max together with higher percentage of type IIX and IIA/IIX muscle fibres indicates a low central capacity in the patient groups. The increased capillary network and the absence of inflammation indicate the occurrence of local hypoxia in tibialis anterior muscle in patients OSAS and RLS.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2009. p. 61
Series
Örebro Studies in Sport Sciences, ISSN 1654-7535 ; 3
Keywords
RLS, OSAS, aerobic capacity, skeletal muscle fibers, capillary, VEGF
National Category
Dentistry Sport and Fitness Sciences
Research subject
Sports Science
Identifiers
urn:nbn:se:oru:diva-6245 (URN)978-91-7668-661-4 (ISBN)
Public defence
2009-05-08, Hörsal P2, Prismahuset, Örebro Universitet, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-04-14 Created: 2009-04-14 Last updated: 2017-10-18Bibliographically approved
Wåhlin-Larsson, B., Ulfberg, J., Piehl-Aulin, K. & Kadi, F. (2009). The expression of vascular endothelial growth factor in skeletal muscle of patients with sleep disorders. Muscle and Nerve, 40(4), 556-561
Open this publication in new window or tab >>The expression of vascular endothelial growth factor in skeletal muscle of patients with sleep disorders
2009 (English)In: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 40, no 4, p. 556-561Article in journal (Refereed) Published
Abstract [en]

An increased capillary network has been observed in the skeletal muscle in patients with Restless Legs Syndrome (RLS) and Obstructive sleep apnea syndrome (OSAS). These changes could be due to upregulation of growth factors responsible for angiogenesis.

The aim of the study was to examine the occurrence and localization of VEGF and capillary proliferation in skeletal muscle of RLS (n=12), OSAS (n=12) and controls (n=11).

Double-immunofluorescence staining for capillaries (CD31) and VEGF, and proliferating cells (Ki-67), was carried out on biopsies taken from the tibialis anterior. The percentage of capillaries expressing VEGF (CD31,VEGF+)  was significantly higher in OSAS and RLS compared to controls. The percentage of proliferating capillaries (CD31,Ki-67+)  was significantly higher in OSAS compared with controls.

In conclusion our study shows the occurrence of proliferation of endothelial cells in skeletal muscle in RLS and OSAS, supporting an upregulation of VEGF located in capillaries probably due to local hypoxia.

Place, publisher, year, edition, pages
New York, NY: John Wiley & Sons, 2009
Keywords
VEGF, immunofluorescence, capillary, RLS, OSAS
National Category
Medical and Health Sciences Social Sciences Interdisciplinary Sport and Fitness Sciences
Research subject
Sports Science
Identifiers
urn:nbn:se:oru:diva-6213 (URN)10.1002/mus.21357 (DOI)000270794900006 ()
Available from: 2009-04-08 Created: 2009-04-08 Last updated: 2018-01-13Bibliographically approved
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