Physiology of nitric oxide in skeletal muscle

Acute dietary nitrate supplementation does not attenuate oxidative stress or the hemodynamic response during submaximal exercise in hypobaric hypoxia

The purpose of this study was to investigate changes in oxidative stress, arterial oxygen saturation (SaO2), blood pressure (BP), and heart rate (HR) during exercise in hypobaric hypoxia following acute dietary nitrate supplementation. Nine well-trained (maximal oxygen consumption, 60.8 ± 7.8 mL·kg−1·min−1) males (age, 29 ± 7 years) visited the laboratory on 3 occasions, each separated by 1 week. Visit 1 included a maximal aerobic cycling test and five 5-min increasing-intensity exercise bouts in a normobaric environment (1600 m). A single dose of either a nitrate-depleted placebo (PL) or a nitrate-rich beverage (NR; 12.8 mmol nitrate) was consumed 2.5 h prior to exercise during visits 2 and 3 (3500 m) in a double-blind, placebo-controlled, crossover study consisting of a 5-min cycling warm-up and 4 bouts, each 5 min in duration, separated by 4-min periods of passive rest. Exercise wattages were determined during visit 1 and corresponded to 25%, 40%, 50%, 60%, and 70% of normobaric maximal oxygen consumption. Catalase and 8-isoprostane were measured before and after exercise (immediately before and 1 h postexercise, respectively). NR increased plasma nitrite (1.53 ± 0.83 μmol·L−1) compared with PL (0.88 ± 0.56 μmol·L−1) (p < 0.05). In both conditions, postexercise (3500 m) 8-isoprostane (PL, 23.49 ± 3.38 to 60.90 ± 14.95 pg·mL−1; NR, 23.23 ± 4.12 to 52.11 ± 19.76 pg·mL−1) and catalase (PL, 63.89 ± 25.69 to 128.15 ± 41.80 mmol·min−1·mL−1; NR, 78.89 ± 30.95 to 109.96 ± 35.05 mmol·min−1·mL−1) were elevated compared with baseline resting values (p < 0.05). However, both 8-isoprostane and catalase were similar in the 2 groups (PL and NR) (p = 0.217 and p = 0.080, respectively). We concluded that an acute, pre-exercise dose of dietary nitrate yielded no beneficial changes in oxidative stress, SaO2, BP, or HR in healthy, aerobically fit men exercising at 3500 m.

Neuronal nitric oxide synthase (nNOS) splice variant function: Insights into nitric oxide signaling from skeletal muscle

Defects in neuronal nitric oxide synthase (nNOS) splice variant localization and signaling in skeletal muscle are a firmly established pathogenic characteristic of many neuromuscular diseases, including Duchenne and Becker muscular dystrophy (DMD and BMD, respectively). Therefore, substantial efforts have been made to understand and therapeutically target skeletal muscle nNOS isoform signaling. The purpose of this review is to summarize recent salient advances in understanding of the regulation, targeting, and function of nNOSμ and nNOSβ splice variants in normal and dystrophic skeletal muscle, primarily using findings from mouse models. The first focus of this review is how the differential targeting of nNOS splice variants creates spatially and functionally distinct nitric oxide (NO) signaling compartments at the sarcolemma, Golgi complex, and cytoplasm. Particular attention is given to the functions of sarcolemmal nNOSμ and limitations of current nNOS knockout models. The second major focus is to review current understanding of cGMP-mediated nNOS signaling in skeletal muscle and its emergence as a therapeutic target in DMD and BMD. Accordingly, we address the preclinical and clinical successes and setbacks with the testing of phosphodiesterase 5 inhibitors to redress nNOS signaling defects in DMD and BMD. In summary, this review of nNOS function in normal and dystrophic muscle aims to advance understanding how the messenger NO is harnessed for cellular signaling from a skeletal muscle perspective.

Time-Trial Performance in World-Class Speed Skaters After Chronic Nitrate Ingestion

PURPOSE

Nitrate supplementation can increase tolerance to high-intensity work rates; however, limited data exist on the recovery of performance. The authors tested whether 5 d of nitrate supplementation could improve repeated time-trial performance in speed skating.

METHODS

Using a double-blind, placebo-controlled, crossover design, 9 international-level short-track speed skaters ingested 1 high (juice blend, ∼6.5 mmol nitrate; HI) or low dose (juice blend, ∼1 mmol nitrate; LO) per day on days 1-4. After a double dose of either HI or LO on day 5, athletes performed 2 on-ice 1000-m time trials, separated by 35 min, to simulate competition races. Differences between HI and LO were compared with the smallest practically important difference.

RESULTS

Salivary [nitrate] and [nitrite] were higher in HI than LO before the first (nitrate: 81%, effect size [ES]: 1.76; nitrite: 72%, ES: 1.73) and second pursuits (nitrate: 81%, ES: 1.92; nitrite: 71%, ES: 1.78). However, there was no difference in performance in the first (LO: 90.92 [4.08] s; HI: 90.95 [4.06] s, ES: 0.01) or the second time trial (LO: 91.16 [4.06] s; HI: 91.55 [4.40] s, ES: 0.09). Plasma [lactate] measured after the trials (LO: 14.8 [1.1] mM; HI: 14.8 [1.2] mM, ES: 0.01) and at the end of the recovery period (LO: 9.8 [2.1] mM; HI: 10.2 [1.9] mM, ES: 0.05) was not different between treatments.

CONCLUSION

Five days of high-dose nitrate supplementation did not change physiological responses and failed to improve single and repeated time-trial performances in world-class short-track speed skaters. These data suggest that nitrate ingestion up to 6.5 mmol does not enhance recovery from supramaximal exercise in world-class athletes.

Dystrophin R16/17-syntrophin PDZ fusion protein restores sarcolemmal nNOSμ

Background

Loss of sarcolemmal nNOSμ is a common manifestation in a wide variety of muscle diseases and contributes to the dysregulation of multiple muscle activities. Given the critical role sarcolemmal nNOSμ plays in muscle, restoration of sarcolemmal nNOSμ should be considered as an important therapeutic goal.

Methods

nNOSμ is anchored to the sarcolemma by dystrophin spectrin-like repeats 16 and 17 (R16/17) and the syntrophin PDZ domain (Syn PDZ). To develop a strategy that can independently restore sarcolemmal nNOSμ, we engineered an R16/17-Syn PDZ fusion construct and tested whether this construct alone is sufficient to anchor nNOSμ to the sarcolemma in three different mouse models of Duchenne muscular dystrophy (DMD).

Results

Membrane-associated nNOSμ is completely lost in DMD. Adeno-associated virus (AAV)-mediated delivery of the R16/17-Syn PDZ fusion construct successfully restored sarcolemmal nNOSμ in all three models. Further, nNOS restoration was independent of the dystrophin-associated protein complex.

Conclusions

Our results suggest that the R16/17-Syn PDZ fusion construct is sufficient to restore sarcolemmal nNOSμ in the dystrophin-null muscle.

Electronic supplementary material

The online version of this article (10.1186/s13395-018-0182-x) contains supplementary material, which is available to authorized users.

The Effect of Acute Taurine Ingestion on Human Maximal Voluntary Muscle Contraction

PURPOSE

This study aimed to examine the effect of taurine ingestion on maximal voluntary muscle torque and power in trained male athletes with different caffeine habits.

METHODS

Fourteen male athletes 21.8 ± 2.5 yr old were separated into caffeine and noncaffeine consumers to control for the effect of caffeine withdrawal on muscle function. On separate occasions, participants performed four isokinetic or three maximal isometric knee extensions with and without taurine (40 mg·kg body mass) after a double-blind, counterbalanced design. Muscle contractile performances were compared between the first sets as well as between the sets where these variables scored best.

RESULTS

In response to isokinetic contraction, taurine treatment in the noncaffeine consumers resulted in a significant fall in first (-16.1%; P = 0.013) and best peak torque (-5.0%; P = 0.016) as well as in first (-17.7%; P = 0.015) and best power output (-8.0%; P = 0.008). In the caffeine consumers deprived of caffeine, taurine intake improved best power (5.2%; P = 0.045). With respect to the isometric variables, there was a significant decrease in the first (-5.1%; P = 0.002) and best peak torque (-4.3%; P = 0.032) in the noncaffeine group, but no effect in the group of caffeine consumers deprived of caffeine. Taurine ingestion increased blood taurine levels but had no effect on plasma amino acid levels.

CONCLUSIONS

Taurine ingestion is detrimental to maximal voluntary muscle power and both maximal isokinetic and isometric peak torque in noncaffeine consumers, whereas taurine ingestion in caffeine-deprived caffeine consumers improves maximal voluntary muscle power but has no effect on other aspects of contractile performance.

CRISPR-Induced Deletion with SaCas9 Restores Dystrophin Expression in Dystrophic Models In Vitro and In Vivo

Duchenne muscular dystrophy (DMD), a severe hereditary disease affecting 1 in 3,500 boys, mainly results from the deletion of exon(s), leading to a reading frameshift of the DMD gene that abrogates dystrophin protein synthesis. Pairs of sgRNAs for the Cas9 of Staphylococcus aureus were meticulously chosen to restore a normal reading frame and also produce a dystrophin protein with normally phased spectrin-like repeats (SLRs), which is not usually obtained by skipping or by deletion of complete exons. This can, however, be obtained in rare instances where the exon and intron borders of the beginning and the end of the complete deletion (patient deletion plus CRISPR-induced deletion) are at similar positions in the SLR. We used pairs of sgRNAs targeting exons 47 and 58, and a normal reading frame was restored in myoblasts derived from muscle biopsies of 4 DMD patients with different exon deletions. Restoration of the DMD reading frame and restoration of dystrophin expression were also obtained in vivo in the heart of the del52hDMD/mdx. Our results provide a proof of principle that SaCas9 could be used to edit the human DMD gene and could be considered for further development of a therapy for DMD.

Measurement of nitrate and nitrite in biopsy-sized muscle samples using HPLC

Studies of rats have indicated that skeletal muscle plays a central role in whole-body nitrate ( NO3- )/nitrite ( NO2- )/nitric oxide (NO) metabolism. Extending these results to humans, however, is challenging due to the small size of needle biopsy samples. We therefore developed a method to precisely and accurately quantify NO3- and NO2- in biopsy-sized muscle samples. NO3- and NO2- were extracted from rat soleus samples using methanol combined with mechanical homogenization + ultrasound, bead beating, pulverization at liquid N₂ temperature or pulverization + 0.5% Triton X-100. After centrifugation to remove proteins, NO3- and NO2- were measured using HPLC. Mechanical homogenization + ultrasound resulted in the lowest NO3- content (62 ± 20 pmol/mg), with high variability [coefficient of variation (CV) >50%] across samples from the same muscle. The NO2- / NO3- ratio (0.019 ± 0.006) was also elevated, suggestive of NO3- reduction during tissue processing. Bead beating or pulverization yielded lower NO2- and slightly higher NO3- levels, but reproducibility was still poor. Pulverization + 0.5% Triton X-100 provided the highest NO3- content (124 ± 12 pmol/mg) and lowest NO2- / NO3- ratio (0.008 ± 0.001), with the least variability between duplicate samples (CV ~15%). These values are consistent with literature data from larger rat muscle samples analyzed using chemiluminescence. Samples were stable for at least 5 wk at -80°C, provided residual xanthine oxidoreductase activity was blocked using 0.1 mmol/l oxypurinol. We have developed a method capable of measuring NO3- and NO2- in <1 mg of muscle. This method should prove highly useful in investigating the role of skeletal muscle in NO3- / NO2- /NO metabolism in human health and disease. NEW & NOTEWORTHY Measurement of nitrate and especially nitrite in small, i.e., biopsy-sized, muscle samples is analytically challenging. We have developed a precise, accurate, and convenient method for doing so using an affordable commercial HPLC system.

The role of nitrite in muscle function, susceptibility to contraction injury, and fatigability in sickle cell mice

Sickle cell disease (SCD) patients can have limited exercise capacity and muscle dysfunction characterized by decreased force, atrophy, microvascular abnormalities, fiber distribution changes, and skeletal muscle energetics abnormalities. Growing evidence suggests that in SCD there is alteration in nitric oxide (NO) availability/signaling and that nitrate/nitrite can serve as a NO reservoir and enhance muscle performance. Here, we examined effects of nitrite on muscle strength, exercise capacity, and on contractile properties of fast-(extensor digitorum longus, EDL) and slow-twitch (soleus) muscles in SCD mice. Compared to controls, homozygotes (sickling) had decreased grip strength, impaired wheel running performance, and decreased muscle mass of fast-twitch, but not slow-twitch muscle. Nitrite treatment yielded increases in nitrite plasma levels in controls, heterozygotes, and homozygotes but decreases in muscle nitrite levels in heterozygotes and homozygotes. Regardless of genotype, nitrite yielded increases in grip strength, which were coupled with increases in specific force in EDL, but not in soleus muscle. Further, nitrite increased EDL, but not soleus, fatigability in all genotypes. Conversely, in controls, nitrite decreased, whereas in homozygotes, it increased EDL susceptibility to contraction-induced injury. Interestingly, nitrite yielded no changes in distances ran on the running wheel. These differential effects of nitrite in fast- and slow-twitch muscles suggest that its ergogenic effects would be observed in high-intensity/short exercises as found with grip force increases but no changes on wheel running distances. Further, the differential effects of nitrite in homozygotes and control animals suggests that sickling mice, which have altered NO availability/signaling, handle nitrite differently than do control animals.

Dietary Nitrate Enhances the Contractile Properties of Human Skeletal Muscle

We review recent studies of the effects of dietary nitrate on human muscle contractile function and discuss possible underlying mechanisms.

Dietary nitrate, a source of nitric oxide (NO), improves the contractile properties of human muscle. We present the hypothesis that this is due to nitrosylation of the ryanodine receptor and increased NO signaling via the soluble guanyl cyclase-cyclic guanosine monophosphate-protein kinase G pathway, which together increase the free intracellular Ca²⁺ concentration along with the Ca²⁺ sensitivity of the myofilaments themselves.

Long-term effects of NO3- on the relationship between oxygen uptake and power after three weeks of supplemented HIHVT

The aim of this study was to investigate the later effects of daily NO3- supplementation over 3 wk of training on the relationship between O₂ uptake and power at different intensities with an incremental test (IT), a double-wingate test (WT), and an endurance capacity test at 80% W_max (ECT) before and after the supplementation period. Seventeen male recreational athletes participated in this double-blind placebo (PL)-controlled study. Subjects participated in a 3-wk intermittent high-intensity, high-volume training period with 45 intervals of W_max - 10 W and an active recovery period of 10 W in between with dietary NO3- (NaNO₃) or placebo supplementation (NaCl) (both 8.5 mg·kg^-1·day^-1) on a cycle ergometer. During a training session, plasma [ NO3- ] ( P < 0.001) and plasma [ NO2- ] ( P < 0.01) were higher in nitrate (N), whereas in pre- and posttests mean plasma [ NO3- ] and [ NO2- ] were not different between groups. In the WT [48 h after cessation of supplementation (C)], the ratio between V̇o₂ and power decreased in N ( P < 0.01) with no changes in PL. Endurance capacity (4-5 days after C) similarly increased in both groups ( P < 0.01). However, the total oxygen consumption decreased by 5% ( P < 0.01) in N, with no change in PL. The slope of V̇o₂·W^-1 in IT (5-7 days after C) decreased in N ( P < 0.01), whereas no changes were found in PL. During low- and moderate-intensity workloads, no changes and differences in V̇o₂ could be detected. We conclude that nitrate supplementation causes a sustaining reduction of the oxygen cost per watt during exercise with a large recruitment of type II muscle fibers without affecting endurance capacity. NEW & NOTEWORTHY Because most studies focused on the acute effects of NO3- supplementation on exercise performance during a supplementation period, the sustainability of the effects of the NO3- supplementation remain unknown. We followed the development of V̇o₂/W at different intensities during the first week after cessation of daily NO3- supplementation over 3 wk. The results indicate that NO3- supplementation has a long-term effect for at least 7 days after cessation during heavy all-out workloads without affecting endurance capacity.

Effects of a single dose of beetroot juice on cycling time trial performance at ventilatory thresholds intensity in male triathletes

Background

Beetroot juice (BJ) is classified as a high-level supplement for improving sports performance. There is some controversy over the benefits of BJ supplementation for endurance exercise performance, especially when referring to well-trained athletes. This study examines the effects of acute BJ supplementation on cardioventilatory responses, exercise economy/efficiency, slow component of oxygen uptake, time trial performance, blood lactate, energy consumption, and carbohydrate and fat oxidation.

Methods

Twelve well-trained, male triathletes (aged 21–47 yr) were assigned in a randomized, double-blind, crossover design to receive 70 ml of BJ (6.5 mmol NO₃⁻) or placebo (PL). Three hours after taking the supplement, participants completed an endurance test on a cycle ergometer at a constant work rate (W) corresponding to first ventilatory threshold (VT1) (30 min) and second ventilatory threshold (VT2) time trial (~ 15 min).

Results

Maximal oxygen uptake was 54.78 ± 3.13 mL·min^− 1·kg^− 1, and gross efficiency was > 22% at each load intensity and experimental condition. No significant interaction effect (supplement*intensity) was observed on any of the cardioventilatory variables, efficiency/economy, VT2 time trial, energy expenditure, carbohydrate oxidation and fat oxidation (p > 0.05).

Conclusion

Our findings do not support an improvement in the variables examined in response to acute BJ supplementation. Probably, higher doses are needed for improving time trial performance in male triathletes during a cycle ergometer test conducted at a load intensity equivalent to the first and second ventilatory threshold.

The Effect of Nitrate Supplementation on Exercise Tolerance and Performance: A Systematic Review and Meta-Analysis

Van De Walle, GP and Vukovich, MD. The effect of nitrate supplementation on exercise tolerance and performance: a systematic review and meta-analysis. J Strength Cond Res 32(6): 1796-1808, 2018-The purpose of this article was to systematically review the current literature and evaluate the overall efficacy of nitrate supplementation on exercise tolerance and performance by meta-analysis. Studies were eligible for inclusion if they met the following criteria: (a) were an experimental trial published in an English peer-reviewed journal; (b) compared the effects of inorganic nitrate consumption with a non-bioactive supplement control or placebo; (c) used a quantifiable measure of exercise performance; and (d) was carried out in apparently healthy participants without disease. A total of 29 studies were identified that investigated the effects of nitrate supplementation on exercise tolerance or performance in accordance with the criteria outlined. Analysis using time to exhaustion as the outcome variable revealed a significant effect of nitrate supplementation on exercise tolerance (ES = 0.28; 95% confidence interval [CI]: 0.08-0.47; p = 0.006) compared with placebo. Analysis using time to complete a specific distance as the outcome variable revealed no significant effect of nitrate supplementation on exercise performance (ES = -0.05; 95% CI: -0.28 to 0.17; p = 0.64) compared with placebo. Nitrate supplementation is likely to improve exercise tolerance and capacity that may improve exercise performance. More research is required to determine the optimal dose and duration of nitrate supplementation. It would also be important to consider the type of athlete performing the exercise and the duration, intensity, and mode of the exercise performed because these factors are likely to influence the efficacy of nitrate supplementation.

Nitric oxide-dependent attenuation of noradrenaline-induced vasoconstriction is impaired in the canine model of Duchenne muscular dystrophy

KEY POINTS

We developed a novel method to study sympatholysis in dogs. We showed abolishment of sarcolemmal nNOS, and reduction of total nNOS and total eNOS in the canine Duchenne muscular dystrophy (DMD) model. We showed sympatholysis in dogs involving both nNOS-derived NO-dependent and NO-independent mechanisms. We showed that the loss of sarcolemmal nNOS compromised sympatholysis in the canine DMD model. We showed that NO-independent sympatholysis was not affected in the canine DMD model.

ABSTRACT

The absence of dystrophin in Duchenne muscular dystrophy (DMD) leads to the delocalization of neuronal nitric oxide synthase (nNOS) from the sarcolemma. Sarcolemmal nNOS plays an important role in sympatholysis, a process of attenuating reflex sympathetic vasoconstriction during exercise to ensure blood perfusion in working muscle. Delocalization of nNOS compromises sympatholysis resulting in functional ischaemia and muscle damage in DMD patients and mouse models. Little is known about the contribution of membrane-associated nNOS to blood flow regulation in dystrophin-deficient DMD dogs. We tested the hypothesis that the loss of sarcolemmal nNOS abolishes protective sympatholysis in contracting muscle of affected dogs. Haemodynamic responses to noradrenaline in the brachial artery were evaluated at rest and during contraction in the absence and presence of NOS inhibitors. We found sympatholysis was significantly compromised in DMD dogs, as well as in normal dogs treated with a selective nNOS inhibitor, suggesting that the absence of sarcolemmal nNOS underlies defective sympatholysis in the canine DMD model. Surprisingly, inhibition of all NOS isoforms did not completely abolish sympatholysis in normal dogs, suggesting sympatholysis in canine muscle also involves NO-independent mechanism(s). Our study established a foundation for using the dog model to test therapies aimed at restoring nNOS homeostasis in DMD.

Role of neuronal nitric oxide synthase (nNOS) in Duchenne and Becker muscular dystrophies - Still a possible treatment modality?

Neuronal nitric oxide synthase (nNOS) is involved in nitric oxide (NO) production and suggested to play a crucial role in blood flow regulation of skeletal muscle. During activation of the muscle, NO helps attenuate the sympathetic vasoconstriction to accommodate increased metabolic demands, a phenomenon known as functional sympatholysis. In inherited myopathies such as the dystrophinopathies Duchenne and Becker muscle dystrophies (DMD and BMD), nNOS is lost from the sarcolemma. The loss of nNOS may cause functional ischemia contributing to skeletal and cardiac muscle cell injury. Effects of NO is augmented by inhibiting degradation of the second messenger cyclic guanosine monophosphate (cGMP) using sildenafil and tadalafil, both of which inhibit the enzyme phosphodiesterase 5 (PDE5). In animal models of DMD, PDE5-inhibitors prevent functional ischemia, reduce post-exercise skeletal muscle pathology and fatigue, show amelioration of cardiac muscle cell damage and increase cardiac performance. However, effect on clinical outcomes in DMD and BMD patients have been disappointing with minor effects on upper limb performance and none on ambulation. This review aims to summarize the current knowledge of nNOS function related to functional sympatholysis in skeletal muscle and studies on PDE5-inhibitor treatment in nNOS-deficient animal models and patients.

The Effect of Beetroot Juice Supplementation on Dynamic Apnea and Intermittent Sprint Performance in Elite Female Water Polo Players

Nitrate-rich beetroot juice is thought to have ergogenic effects, particularly in conditions where oxygen availability is limited. Whether these effects also apply to elite athletes is currently unknown. The aim of this study was to assess the effects of beetroot juice supplementation on dynamic apnea and intermittent sprint performance in elite female water polo players. In a double-blinded, randomized, crossover manner, the Dutch National female water polo team (N = 14) was subjected to two 6-day supplementation periods (1 and 2), with either 140 ml/day of nitrate-rich (BR; ∼800 mg/day nitrate) or nitrate-depleted (PLA) beetroot juice. Following blood sampling on Day 6, the athletes performed a maximal-distance front crawl swimming test without breathing (dynamic apnea test). In addition, intermittent sprint performance was assessed by performing 16 swim sprints of 15 m, in a 4 × 4 block with 30-s recovery between blocks (intermittent test). Distance covered during the dynamic apnea test did not differ between BR (49.5 ± 7.8 m) and PLA (46.9 ± 9.1 m, p = .178). However, when correcting for test order, the distance covered was significantly larger in BR versus PLA when BR was ingested in Period 2 (50.1 ± 8.5 vs. 42.8 ± 5.7 m, p = .002), whereas no difference was observed when BR was ingested in Period 1 (48.8 ± 7.4 vs. 52.3 ± 10.4 m, p = .10). The time to complete the intermittent test was not different between BR and PLA (316.0 ± 7.9 vs. 316.3 ± 6.9 s, p = .73). In conclusion, beetroot juice supplementation does not improve intermittent performance in elite female water polo players, but there may be a potential for ergogenic effects during dynamic apnea.

PPARα-independent effects of nitrate supplementation on skeletal muscle metabolism in hypoxia

Hypoxia is a feature of many disease states where convective oxygen delivery is impaired, and is known to suppress oxidative metabolism. Acclimation to hypoxia thus requires metabolic remodelling, however hypoxia tolerance may be aided by dietary nitrate supplementation. Nitrate improves tissue oxygenation and has been shown to modulate skeletal muscle tissue metabolism via transcriptional changes, including through the activation of peroxisome proliferator-activated receptor alpha (PPARα), a master regulator of fat metabolism. Here we investigated whether nitrate supplementation protects skeletal muscle mitochondrial function in hypoxia and whether PPARα is required for this effect. Wild-type and PPARα knockout (PPARα^−/−) mice were supplemented with sodium nitrate via the drinking water or sodium chloride as control, and exposed to environmental hypoxia (10% O₂) or normoxia for 4 weeks. Hypoxia suppressed mitochondrial respiratory function in mouse soleus, an effect partially alleviated through nitrate supplementation, but occurring independently of PPARα. Specifically, hypoxia resulted in 26% lower mass specific fatty acid-supported LEAK respiration and 23% lower pyruvate-supported oxidative phosphorylation capacity. Hypoxia also resulted in 24% lower citrate synthase activity in mouse soleus, possibly indicating a loss of mitochondrial content. These changes were not seen, however, in hypoxic mice when supplemented with dietary nitrate, indicating a nitrate dependent preservation of mitochondrial function. Moreover, this was observed in both wild-type and PPARα^−/− mice. Our results support the notion that nitrate supplementation can aid hypoxia tolerance and indicate that nitrate can exert effects independently of PPARα.

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Hypoxic exposure suppresses mitochondrial respiration in mouse skeletal muscle.

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Loss of citrate synthase activity suggests decreased mitochondrial content.

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Dietary inorganic nitrate partially protects against hypoxia-induced changes.

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Nitrate protects independently of peroxisome proliferator-activated receptor α.

Systemic AAV Micro-dystrophin Gene Therapy for Duchenne Muscular Dystrophy

Duchenne muscular dystrophy (DMD) is a lethal muscle disease caused by dystrophin gene mutation. Conceptually, replacing the mutated gene with a normal one would cure the disease. However, this task has encountered significant challenges due to the enormous size of the gene and the distribution of muscle throughout the body. The former creates a hurdle for viral vector packaging and the latter begs for whole-body therapy. To address these obstacles, investigators have invented the highly abbreviated micro-dystrophin gene and developed body-wide systemic gene transfer with adeno-associated virus (AAV). Numerous microgene configurations and various AAV serotypes have been explored in animal models in many laboratories. Preclinical data suggests that intravascular AAV micro-dystrophin delivery can significantly ameliorate muscle pathology, enhance muscle force, and attenuate dystrophic cardiomyopathy in animals. Against this backdrop, several clinical trials have been initiated to test the safety and tolerability of this promising therapy in DMD patients. While these trials are not powered to reach a conclusion on clinical efficacy, findings will inform the field on the prospects of body-wide DMD therapy with a synthetic micro-dystrophin AAV vector. This review discusses the history, current status, and future directions of systemic AAV micro-dystrophin therapy.

Automated quantification of microvascular perfusion

OBJECTIVE

Changes in microvascular perfusion have been reported in many diseases, yet the functional significance of altered perfusion is often difficult to determine. This is partly because commonly used techniques for perfusion measurement often rely on either indirect or by-hand approaches.

METHODS

We developed and validated a fully automated software technique to measure microvascular perfusion in videos acquired by fluorescence microscopy in the mouse gastrocnemius. Acute perfusion responses were recorded following intravenous injections with phenylephrine, SNP, or saline.

RESULTS

Software-measured capillary flow velocity closely correlated with by-hand measured flow velocity (R²  = 0.91, P < 0.0001). Software estimates of capillary hematocrit also generally agreed with by-hand measurements (R²  = 0.64, P < 0.0001). Detection limits range from 0 to 2000 μm/s, as compared to an average flow velocity of 326 ± 102 μm/s (mean ± SD) at rest. SNP injection transiently increased capillary flow velocity and hematocrit and made capillary perfusion more steady and homogenous. Phenylephrine injection had the opposite effect in all metrics. Saline injection transiently decreased capillary flow velocity and hematocrit without influencing flow distribution or stability. All perfusion metrics were temporally stable without intervention.

CONCLUSIONS

These results demonstrate a novel and sensitive technique for reproducible, user-independent quantification of microvascular perfusion.

Role of defective Ca2+ signaling in skeletal muscle weakness: Pharmacological implications

The misbehaving attitude of Ca²⁺ signaling pathways could be the probable reason in many muscular disorders such as myopathies, systemic disorders like hypoxia, sepsis, cachexia, sarcopenia, heart failure, and dystrophy. The present review throws light upon the calcium flux regulating signaling channels like ryanodine receptor complex (RyR1), SERCA (Sarco-endoplasmic Reticulum Calcium ATPase), DHPR (Dihydropyridine Receptor) or Cav1.1 and Na+/Ca²⁺ exchange pump in detail and how remodelling of these channels contribute towards disturbed calcium homeostasis. Understanding these pathways will further provide an insight for establishing new therapeutic approaches for the prevention and treatment of muscle atrophy under stress conditions, targeting calcium ion channels and associated regulatory proteins.

Gender differences in the relationships between chronic kidney disease, asymmetric dimethylarginine, and sleep quality: The HEIJO-KYO cohort

The association between chronic kidney disease (CKD), serum levels of asymmetric dimethylarginine (ADMA), and sleep quality has not been studied in large populations. In this cross-sectional study of 1115 elderly individuals (mean age, 71.9 years), we measured serum levels of ADMA, and objective and subjective sleep quality using actigraphy and a standardized self-reported questionnaire, respectively. Multivariable analysis adjusted for potential confounders revealed that in females, compared with the non-CKD/low-ADMA group (n=312), sleep efficiency was significantly lower in the CKD/high-ADMA group (n=52) by 3.5% for objective sleep quality [95% confidence interval (CI), 1.1-5.9] and by 4.2% (95% CI, 0.3-8.0) for subjective sleep quality but not in the non-CKD/high-ADMA (n=179) and CKD/low-ADMA (n=36) groups. In males, no significant associations between CKD, ADMA levels, and sleep quality were observed. Wake time after sleep onset was significantly longer by 11.3 min (95% CI, 3.0-19.6) for objective sleep quality and by 25.9 min (95% CI, 4.9-46.9) for subjective sleep quality in the CKD/high-ADMA group than in the non-CKD/low-ADMA group in females but not in males. Mediation analysis revealed a significant effect of serum ADMA levels on the association between renal function and parameters of sleep quality among females. In conclusions, both objective and subjective sleep quality were poorer in elderly females with CKD/high-ADMA than in those with non-CKD/low-ADMA, but not in males. Association between CKD and sleep disturbances might be mediated by ADMA levels.

The Effect of Dietary Nitrate Supplementation on Endurance Exercise Performance in Healthy Adults: A Systematic Review and Meta-Analysis

BACKGROUND

Recent research into the use of dietary nitrates and their role in vascular function has led to it becoming progressively more popular amongst athletes attempting to enhance performance.

OBJECTIVE

The objective of this review was to perform a systematic review and meta-analysis of the literature to evaluate the effect of dietary nitrate (NO₃^-) supplementation on endurance exercise performance. An additional aim was to determine whether the performance outcomes are affected by potential moderator variables.

DATA SOURCES

Relevant databases such as Cochrane Library, Embase, PubMed, Ovid, Scopus and Web of Science were searched for the following search terms 'nitrates OR nitrate OR beetroot OR table beet OR garden beet OR red beet AND exercise AND performance' from inception to October 2015.

STUDY SELECTION

Studies were included if a placebo versus dietary nitrate-only supplementation protocol was able to be compared, and if a quantifiable measure of exercise performance was ≥30 s (for a single bout of exercise or the combined total for multiple bouts).

STUDY APPRAISAL AND SYNTHESIS

The literature search identified 1038 studies, with 47 (76 trials) meeting the inclusion criteria. Data from the 76 trials were extracted for inclusion in the meta-analysis. A fixed-effects meta-analysis was conducted for time trial (TT) (n = 28), time to exhaustion (TTE) (n = 22) and graded-exercise test (GXT) (n = 8) protocols. Univariate meta-regression was used to assess potential moderator variables (exercise type, dose duration, NO₃^- type, study quality, fitness level and percentage nitrite change).

RESULTS

Pooled analysis identified a trivial but non-significant effect in favour of dietary NO₃^- supplementation [effect size (ES) = -0.10, 95 % Cl = -0.27 to 0.06, p > 0.05]. TTE trials had a small to moderate statistically significant effect in favour of dietary NO₃^- supplementation (ES = 0.33, 95 % Cl = 0.15-0.50, p < 0.01). GXT trials had a small but non-significant effect in favour of dietary NO₃^- supplementation in GXT performance measures (ES = 0.25, 95 % Cl = -0.06 to 0.56, p > 0.05). No significant heterogeneity was detected in the meta-analysis. No statistically significant effects were observed from the meta-regression analysis.

CONCLUSION

Dietary NO₃^- supplementation is likely to elicit a positive outcome when testing endurance exercise capacity, whereas dietary NO₃^- supplementation is less likely to be effective for time-trial performance. Further work is needed to understand the optimal dosing strategies, which population is most likely to benefit, and under which conditions dietary nitrates are likely to be most effective for performance.

7-nitroindazol-loaded nanoemulsions: Preparation, characterization and its improved inhibitory effect on nitric oxide synthase-1

Nitric oxide (NO) participates in several physiological processes such as maintenance of blood pressure, host defense, neurotransmission, inhibition of platelet aggregation and learning and memory. NO is also involved in several diseases or dysfunctions in the cardiovascular, central nervous and musculoskeletal systems. NO also has been shown to be a major player in sepsis. NOS-1-derived NO has been shown to be a relevant species in physiology but also is an important element in pathology. There exist some NOS-1 inhibitors and among of them, 7-nitroindazole has been used for its in vivo selectivity. However, 7-NI has a very short half-life (∼2 h) and a poor water solubility. In this study, we describe the preparation and characterization of 7-NI-loaded nanoemulsions (NE_7-NI). The chemical stability of 7-NI was greatly increased and the drug release rate could be controlled after nanoemulsification. NE_7-NI reduced NO production in a long-lasting manner in vascular smooth muscle cells and skeletal muscle, without cytotoxicity. Our results evidenced that nanoemulsification approach increases the effective action time of 7-NI, rendering a suitable dosage form, which may be an interesting tool to study the role of NOS-1 in physiology and disease.

The effects of Capn1 gene inactivation on the differential expression of genes in skeletal muscle

Protein turnover is required for muscle growth and regeneration and several proteolytic enzymes, including the calpains, degrade myofibrillar proteins during this process. In a previous experiment, phenotypic differences were observed between μ-calpain knockout (KO) and wild type (WT) mice, including nutrient accretion and fiber type differences. These changes were particularly evident as the animals aged. Thus, we utilized 18 mice (9 KO and 9 WT) to compare transcript abundance to identify differentially expressed genes (DEGs) at 52 wk of age. A total of 55 genes were differentially expressed, including adiponectin, phosphoenolpyruvate carboxykinase 1, uncoupling protein 1, and lysine deficient protein kinase 2. These genes were analyzed for over- and underrepresented gene ontology (GO) terms. Several GO terms, including response to cytokine, response to interferon-beta, regulation of protein phosphorylation, and hydrolase activity, were identified as overrepresented. Pathways related to taurine biosynthesis, nitric oxide synthase signaling, amyloid processing, and L-cysteine degradation were also identified. Our results are consistent with previous experiments, in that identified DEGs may explain, at least in part, some of the phenotypic differences between μ-calpain KO and WT mice. Clearly muscle growth and maintenance are complex, multifaceted processes. Genes affected by the silencing of the μ-calpain gene have been identified, but the relationship between μ-calpain and these pathways requires further investigation.

Dietary Flavanols: A Review of Select Effects on Vascular Function, Blood Pressure, and Exercise Performance

An individual's diet affects numerous physiological functions and can play an important role in reducing the risk of cardiovascular disease. Epidemiological and clinical studies suggest that dietary flavanols can be an important modulator of vascular risk. Diets and plant extracts rich in flavanols have been reported to lower blood pressure, especially in prehypertensive and hypertensive individuals. Flavanols may act in part through signaling pathways that affect vascular function, nitric oxide availability, and the release of endothelial-derived relaxing and constricting factors. During exercise, flavanols have been reported to modulate metabolism and respiration (e.g., maximal oxygen uptake, O₂ cost of exercise, and energy expenditure), and reduce oxidative stress and inflammation, resulting in increased skeletal muscle efficiency and endurance capacity. Flavanol-induced reductions in blood pressure during exercise may decrease the work of the heart. Collectively, these effects suggest that flavanols can act as an ergogenic aid to help delay the onset of fatigue. More research is needed to better clarify the effects of flavanols on vascular function, blood pressure regulation, and exercise performance and establish safe and effective levels of intake. Flavanol-rich foods and food products can be useful components of a healthy diet and lifestyle program for those seeking to better control their blood pressure or to enhance their physical activity. Key teaching points • Epidemiological and clinical studies indicate that dietary flavanols can reduce the risk of vascular disease. • Diets and plant extracts rich in flavanols have been reported to lower blood pressure and improve exercise performance in humans. • Mechanisms by which flavanols may reduce blood pressure function include alterations in signaling pathways that affect vascular function, nitric oxide availability, and the release of endothelial-derived relaxation and constriction factors. • Mechanisms by which flavanols may enhance exercise performance include modulation of metabolism and respiration (e.g., maximal oxygen uptake, O₂ cost of exercise, and energy expenditure) and reduction of oxidative stress and inflammation. These effects can result in increased skeletal muscle efficiency and endurance capacity. • Further research is needed to clarify the amount, timing, and frequency of flavanol intake for blood pressure regulation and exercise performance.

Nutritional status and muscle dysfunction in chronic respiratory diseases: stable phase versus acute exacerbations

Nutritional abnormalities are frequent in different chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis (CF), interstitial fibrosis and lung cancer, having important clinical consequences. However, nutritional abnormalities often remained underdiagnosed due to the relative lack of awareness of health professionals. Therefore, systematic anthropometry or even better, assessment of body composition, should be performed in all patients with chronic respiratory conditions, especially following exacerbation periods when malnutrition becomes more accentuated. Nutritional abnormalities very often include the loss of muscle mass, which is an important factor for the occurrence of muscle dysfunction. The latter can be easily detected with the specific assessment of muscle strength and endurance, and also negatively influences patients' quality of life and prognosis. Both nutritional abnormalities and muscle dysfunction result from the interaction of several factors, including tobacco smoking, low physical activity-sedentarism, systemic inflammation and the imbalance between energy supply and requirements, which essentially lead to a negative balance between protein breakdown and synthesis. Therapeutic approaches include improvements in lifestyle, nutritional supplementation and training. Anabolic drugs may be administered in some cases.

miR-708-5p and miR-34c-5p are involved in nNOS regulation in dystrophic context

Background

Duchenne (DMD) and Becker (BMD) muscular dystrophies are caused by mutations in the DMD gene coding for dystrophin, a protein being part of a large sarcolemmal protein scaffold that includes the neuronal nitric oxide synthase (nNOS). The nNOS was shown to play critical roles in a variety of muscle functions and alterations of its expression and location in dystrophic muscle fiber leads to an increase of the muscle fatigability. We previously revealed a decrease of nNOS expression in BMD patients all presenting a deletion of exons 45 to 55 in the DMD gene (BMDd45-55), impacting the nNOS binding site of dystrophin. Since several studies showed deregulation of microRNAs (miRNAs) in dystrophinopathies, we focused on miRNAs that could target nNOS in dystrophic context.

Methods

By a screening of 617 miRNAs in BMDd45-55 muscular biopsies using TLDA and an in silico study to determine which one could target nNOS, we selected four miRNAs. In order to select those that targeted a sequence of 3′UTR of NOS1, we performed luciferase gene reporter assay in HEK393T cells. Finally, expression of candidate miRNAs was modulated in control and DMD human myoblasts (DMDd45-52) to study their ability to target nNOS.

Results

TLDA assay and the in silico study allowed us to select four miRNAs overexpressed in muscle biopsies of BMDd45-55 compared to controls. Among them, only the overexpression of miR-31, miR-708, and miR-34c led to a decrease of luciferase activity in an NOS1-3′UTR-luciferase assay, confirming their interaction with the NOS1-3′UTR. The effect of these three miRNAs was investigated on control and DMDd45-52 myoblasts. First, we showed a decrease of nNOS expression when miR-708 or miR-34c were overexpressed in control myoblasts. We then confirmed that DMDd45-52 cells displayed an endogenous increased of miR-31, miR-708, and miR-34c and a decreased of nNOS expression, the same characteristics observed in BMDd45-55 biopsies. In DMDd45-52 cells, we demonstrated that the inhibition of miR-708 and miR-34c increased nNOS expression, confirming that both miRNAs can modulate nNOS expression in human myoblasts.

Conclusion

These results strongly suggest that miR-708 and miR-34c, overexpressed in dystrophic context, are new actors involved in the regulation of nNOS expression in dystrophic muscle.

Electronic supplementary material

The online version of this article (10.1186/s13395-018-0161-2) contains supplementary material, which is available to authorized users.

L-Arginine Enhances Protein Synthesis by Phosphorylating mTOR (Thr 2446) in a Nitric Oxide-Dependent Manner in C2C12 Cells

Muscle atrophy may arise from many factors such as inactivity, malnutrition, and inflammation. In the present study, we investigated the stimulatory effect of nitric oxide (NO) on muscle protein synthesis. Primarily, C2C12 cells were supplied with extra L-arginine (L-Arg) in the culture media. L-Arg supplementation increased the activity of inducible nitric oxide synthase (iNOS), the rate of protein synthesis, and the phosphorylation of mTOR (Thr 2446) and p70S6K (Thr 389). L-NAME, an NOS inhibitor, decreased NO concentrations within cells and abolished the stimulatory effect of L-Arg on protein synthesis and the phosphorylation of mTOR and p70S6K. In contrast, SNP (sodium nitroprusside), an NO donor, increased NO concentrations, enhanced protein synthesis, and upregulated mTOR and p70S6K phosphorylation, regardless of L-NAME treatment. Blocking mTOR with rapamycin abolished the stimulatory effect of both L-Arg and SNP on protein synthesis and p70S6K phosphorylation. These results indicate that L-Arg stimulates protein synthesis via the activation of the mTOR (Thr 2446)/p70S6K signaling pathway in an NO-dependent manner.

Relation of nNOS isoforms to mitochondrial density and PGC-1alpha expression in striated muscles of mice

The expression of neuronal NO synthase (nNOS) alpha- and beta-isoforms in skeletal muscle is well documented but only little information is available about their regulation/functions. Using different mouse models, we now assessed whether the expression of nNOS-isoforms in muscle fibers is related to mitochondria content/activity and regulated by peroxisome proliferator-activated receptor gamma coactivator-1alpha (PGC-1alpha). Catalytic histochemistry revealed highest nNOS-concentrations to be present in type-2 oxidative muscle fibers. Differences in mitochondrial density between nNOS-KO-mice and WT-littermates established by morphometry after transmission electron microscopy were significant in the oxidative portion of the tibialis anterior muscle (TA) but not in rectus femoris muscle (RF) indicating an nNOS-dependent mitochondrial pool in TA. Quantitative immunoblotting displayed the nNOS alpha-isoform to preponderate in those striated muscles of C57BL/6-mice that comprise of many type-2 oxidative fibers, e.g. TA, while roughly even levels of the two nNOS-isoforms were expressed in those muscles that mainly consist of type-2 glycolytic fibers, e.g. RF. Differences in citrate synthase-activity in muscle homogenates between nNOS-KO-mice and WT-littermates were positively related to nNOS alpha-isoform levels. In transgenic-mice over-expressing muscular PGC-1alpha compared to WT-littermates, immunoblotting revealed a significant shift in nNOS-expression in favor of the alpha-isoform in six out of eight striated muscles (exceptions: soleus muscle and tongue) without consistent relationship to changes in the expression of mitochondrial markers. In summary, our study demonstrated the nNOS alpha-isoform expression to be related to mitochondrial content/activity and to be up-regulated by up-stream PGC-1alpha in striated muscles, particularly in those enriched with type-2 oxidative fibers implying a functional convergence of the two signaling systems in these fibers.

Micro-Dystrophin Gene Therapy Goes Systemic in Duchenne Muscular Dystrophy Patients

Whole-body systemic gene therapy is likely the most effective way to reduce greatly the disease burden of Duchenne muscular dystrophy (DMD), an X-linked inherited muscle disease that leads to premature death in early adulthood. Genetically, DMD is due to null mutation of the dystrophin gene, one of the largest genes in the genome. Recent studies have shown highly promising improvements in animal models with intravascular delivery of the engineered micro-dystrophin gene by adeno-associated virus (AAV). Several human trials are now started to advance AAV micro-dystrophin therapy to DMD patients. This is a historical moment for the entire field. Results from these trials will shape the future of neuromuscular disease gene therapy.

Tackling muscle fibrosis: From molecular mechanisms to next generation engineered models to predict drug delivery

Muscle fibrosis represents the end stage consequence of different diseases, among which muscular dystrophies, leading to severe impairment of muscle functions. Muscle fibrosis involves the production of several growth factors, cytokines and proteolytic enzymes and is strictly associated to inflammatory processes. Moreover, fibrosis causes profound changes in tissue properties, including increased stiffness and density, lower pH and oxygenation. Up to now, there is no therapeutic approach able to counteract the fibrotic process and treatments directed against muscle pathologies are severely impaired by the harsh conditions of the fibrotic environment. The design of new therapeutics thus need innovative tools mimicking the obstacles posed by the fibrotic environment to their delivery. This review will critically discuss the role of in vivo and 3D in vitro models in this context and the characteristics that an ideal model should possess to help the translation from bench to bedside of new candidate anti-fibrotic agents.

Laminin signals initiate the reciprocal loop that informs breast-specific gene expression and homeostasis by activating NO, p53 and microRNAs

How mammalian tissues maintain their architecture and tissue-specificity is poorly understood. Previously, we documented both the indispensable role of the extracellular matrix (ECM) protein, laminin-111 (LN1), in the formation of normal breast acini, and the phenotypic reversion of cancer cells to acini-like structures in 3-dimensional (3D) gels with inhibitors of oncogenic pathways. Here, we asked how laminin (LN) proteins integrate the signaling pathways necessary for morphogenesis. We report a surprising reciprocal circuitry comprising positive players: laminin-5 (LN5), nitric oxide (NO), p53, HOXD10 and three microRNAs (miRNAs) — that are involved in the formation of mammary acini in 3D. Significantly, cancer cells on either 2-dimensional (2D) or 3D and non-malignant cells on 2D plastic do not produce NO and upregulate negative players: NFκB, EIF5A2, SCA1 and MMP-9 — that disrupt the network. Introducing exogenous NO, LN5 or individual miRNAs to cancer cells reintegrates these pathways and induces phenotypic reversion in 3D. These findings uncover the essential elements of breast epithelial architecture, where the balance between positive- and negative-players leads to homeostasis.

Most animal cells can secrete molecules into their surroundings to form a supportive meshwork of large proteins, called the extracellular matrix. This matrix is connected to the cell membrane through receptors that can transmit signals to the cell nucleus to change the levels of small RNA molecules called microRNAs. These, in turn, can switch genes on and off in the nucleus.

In the laboratory, cells that build breast tissue and glands can be grown in gels containing extracellular matrix proteins called laminins. Under these conditions, ‘normal’ cells form organized clusters that resemble breast glands. However, if the communication between healthy cells and the extracellular matrix is interrupted, the cells can become disorganized and start to form clumps that resemble tumors, and if injected into mice, can form tumors. Conversely, if the interaction between the extracellular matrix and the cells is restored, each single cancer cell can – despite mutations – be turned into a healthy-looking cell. These cells form a normal-looking tissue through a process called reversion. Until now, it was not known which signals help normal breast tissue to form, and how cancerous cells revert into a ‘normal’ shape.

To investigate this, Furuta et al. used a unique series of breast cells from a woman who underwent breast reduction. The cells taken from the discarded tissue had been previously grown by a different group of researchers in a specific way to ensure that both normal and eventual cancer cells were from the same individual. Furuta et al. then put these cells in the type of laminin found in extracellular matrix. The other set of cells used consisted of the same cancerous cells that had been reverted to normal-looking cells.

Analysis of the three cell sets identified 60 genes that were turned down in reverted cancer cells to a level found in healthy cells, as well as 10 microRNAs that potentially target these 60 genes. A database search suggested that three of these microRNAs, which are absent in cancer cells, are necessary for healthy breast cells to form organized structures. Using this as a starting point, Furuta et al. discovered a signaling loop that was previously unknown and that organizes breast cells into healthy looking tissue.

This showed that laminins help to produce nitric oxide, an important signaling molecule that activates several specific proteins inside the breast cells and restores the levels of the three microRNAs. These, in turn, switch off two genes that are responsible for activating an enzyme that can chop the laminins. Since the two genes are deactivated in the reverted cancer cells, the laminins remain intact and the cells can form organized structures. These findings suggest that if any of the components of the loop were missing, the cells would start to form cancerous clumps again. Reverting the cancer cells in the presence of laminins, however, could help cancer cells to form ‘normal’ structures again.

These findings shed new light on how the extracellular matrix communicates with proteins in the nucleus to influence how single cells form breast tissues. It also shows that laminins are crucial for generating signals that regulate both form and function of specific tissues. A better understanding of how healthy and cancerous tissues form and re-form may in the future help to develop new cancer treatments.

Increasing vegetable intake to obtain the health promoting and ergogenic effects of dietary nitrate

Increased consumption of dietary nitrate increases plasma nitrate and nitrite concentrations, and has been shown to elicit cardio-protective effects and improve exercise performance. Nitrate consumption in the habitual diet is mainly dependent on nitrate-rich vegetables, such as green leafy and root vegetables, with total vegetable consumption accounting for approximately 50-85% of our daily nitrate intake. Whereas 'supplementation' with dietary nitrate in research studies has mainly been accomplished through the use of (concentrated) nitrate-rich beetroot juice, dietary strategies focusing on increased intake of nitrate-rich vegetables may represent a similarly effective alternative for increasing dietary nitrate intake and, as such, obtaining the associated cardiovascular health and ergogenic benefits.

Prolonged Effects of Elevated 17β-Estradiol on Physical Activity after Orchidectomy

The biological mechanisms regulating physical activity patterns appear to be linked to the sex hormones. Elucidation of these regulatory mechanisms may enhance individual physical activity patterns producing positive gains in health.

PURPOSE

The purpose of this study was to evaluate the prolonged effects of estrogen on wheel running distance, duration, and speed in orchidectomized mice.

METHODS

The physical activity patterns of 9-wk-old C57BL/6j male mice (n = 28) were observed. Wheel running distance, duration, and speed were assessed under physiological conditions for 7 d. Next, physical activity patterns were evaluated after bilateral orchidectomy (n = 14) or sham orchidectomy (n = 14) for an additional 7 d. Orchidectomized mice were provided estrogen containing capsules for three additional weeks; control mice were provided estrogen-free capsules. Wheel running distance, duration, and speed were analyzed by three two-way (treatment group-phase of study) analysis of variance tests.

RESULTS

Wheel running speed was unaffected by sex hormone status. Distance (mean ± SD = 6.74 ± 2.13 km at baseline) decreased significantly after orchidectomy (2.27 ± 1.55 km) and remained low after initial estrogen treatment (3.04 ± 1.05 km). Prolonged estrogen exposure sustained a significant elevation of daily distance (4.47 ± 1.87 km). Prolonged estrogen exposure recovered and significantly sustained wheel running duration (baseline, 248 ± 60 min; postorchidectomy, 102 ± 53 min; prolonged exposure, 170 ± 63 min).

CONCLUSIONS

Wheel running behavior was reduced significantly after orchidectomy and remained low after initial treatment with estrogens, but recovered to near control levels after 2 wk of exposure to estrogens. The estrogenic mechanism regulating wheel running behavior in male mice appears to induce an extensive but slow acting biological mechanism. Understanding the biological drive behind this mechanism may aid in developing useful therapeutic strategies to combat health issues related to physical inactivity.

Potential benefits of dietary nitrate ingestion in healthy and clinical populations: A brief review

This article provides an overview of the current literature relating to the efficacy of dietary nitrate (NO₃^-) ingestion in altering aspects of cardiovascular and metabolic health and exercise capacity in healthy and diseased individuals. The consumption of NO₃^--rich vegetables, such as spinach and beetroot, have been variously shown to promote nitric oxide bioavailability, reduce systemic blood pressure, enhance tissue blood flow, modulate muscle O₂ utilisation and improve exercise tolerance both in normoxia and in hypoxia, as is commonly observed in a number of disease states. NO₃^- ingestion may, therefore, act as a natural means for augmenting performance and attenuating complications associated with limited O₂ availability or transport, hypertension and the metabolic syndrome. Recent studies indicate that dietary NO₃^- might also augment intrinsic skeletal muscle contractility and improve the speed and power of muscle contraction. Moreover, several investigations suggest that NO₃^- supplementation may improve aspects of cognitive performance both at rest and during exercise. Collectively, these observations position NO₃^- as more than a putative ergogenic aid and suggest that increasing natural dietary NO₃^- intake may act as a prophylactic in countering the predations of senescence and certain cardiovascular-metabolic diseases.

Repeated-sprint performance and plasma responses following beetroot juice supplementation do not differ between recreational, competitive and elite sprint athletes

PURPOSE

There is an ongoing debate whether highly trained athletes are less responsive to the ergogenic properties of nitrate. We assessed the effects of nitrate supplementation on plasma nitrate and nitrite concentrations and repeated-sprint performance in recreational, competitive and elite sprint athletes.

METHODS

In a randomized double-blinded cross-over design, recreational cyclists (n = 20), national talent speed-skaters (n = 22) and Olympic-level track cyclists (n = 10) underwent two 6-day supplementation periods; 140 mL/d nitrate-rich (BR; ∼800 mg/d) and nitrate-depleted (PLA; ∼0.5 mg/d) beetroot juice. Blood samples were collected and three 30-s Wingate tests were performed.

RESULTS

Plasma nitrate and nitrite concentrations were higher following BR vs PLA (P < .001), with no differences between sport levels (all P > .10). Peak power over the three Wingates was not different between BR and PLA (1338 ± 30 vs 1333 ± 30 W; P = .62), and there was no interaction between treatment (BR-PLA) and Wingate number (1-2-3; P = .48). Likewise, mean power did not differ between BR and PLA (P = .86). In contrast, time to peak power improved by ∼2.8% following BR vs PLA (P = .007). This improvement in BR vs PLA was not different between Wingate 1, 2 and 3. Moreover, the effects of BR vs PLA did not differ between sport levels for any Wingate parameter (all P > .30).

CONCLUSION

The plasma and repeated-sprint performance responses to beetroot juice supplementation do not differ between recreational, competitive and elite sprint athletes. Beetroot juice supplementation reduces time to reach peak power, which may improve the capacity to accelerate during high-intensity and sprint tasks in recreational as well as elite athletes.

Nitric oxide treatment attenuates muscle atrophy during hind limb suspension in mice

Debilitating muscle-disuse atrophy in aging or obesity has huge socioeconomic impact. Since nitric oxide (NO) mediates muscle satellite cell activation and induces hypertrophy with exercise in old mice, we tested whether treatment with the NO donor, isosorbide dinitrate (ISDN), during hind limb suspension would reduce atrophy. Mice were suspended 18 days, with or without daily ISDN (66mg/kg). Muscles were examined for atrophy (weight, fiber diameter); regulatory changes in atrogin-1 (a negative regulator of muscle mass), myostatin (inhibits myogenesis), and satellite cell proliferation; and metabolic responses in myosin heavy chains (MyHCs), liver lipid, and hypothalamic gene expression. Suspension decreased muscle weight and weight relative to body weight between 25-55%, and gastrocnemius fiber diameter vs.

CONTROLS

In young-adult mice, ISDN attenuated atrophy by half or more. In quadriceps, ISDN completely prevented the suspension-induced rise in atrogin-1 and drop in myostatin precursor, and attenuated the changes in MyHCs 1 and 2b observed in unloaded muscles without treatment. Fatty liver in suspended young-adult mice was also reduced by ISDN; suspended young mice had higher hypothalamic expression of the orexigenic agouti-related protein, Agrp than controls. Notably, a suspension-induced drop in muscle satellite cell proliferation by 25-58% was completely prevented (young mice) or attenuated (halved, in young-adult mice) by ISDN. NO-donor treatment has potential to attenuate atrophy and metabolic changes, and prevent regulatory changes during disuse and offset/prevent wasting in age-related sarcopenia or space travel. Increases in precursor proliferation resulting from NO treatment would also amplify benefits of physical therapy and exercise.

Sex and nitric oxide bioavailability interact to modulate interstitial Po2 in healthy rat skeletal muscle

Premenopausal women express reduced blood pressure and risk of cardiovascular disease relative to age-matched men. This purportedly relates to elevated estrogen levels increasing nitric oxide synthase (NOS) activity and NO-mediated vasorelaxation. We tested the hypotheses that female rat skeletal muscle would: 1) evince a higher O₂ delivery-to-utilization ratio (Q̇o₂/V̇o₂) during contractions; and 2) express greater modulation of Q̇o₂/V̇o₂ with changes to NO bioavailability compared with male rats. The spinotrapezius muscle of Sprague-Dawley rats (females = 8, males = 8) was surgically exposed and electrically-stimulated (180 s, 1 Hz, 6 V). OxyphorG4 was injected into the muscle and phosphorescence quenching employed to determine the temporal profile of interstitial Po₂ (Po_2is, determined by Q̇o₂/V̇o₂). This was performed under three conditions: control (CON), 300 µM sodium nitroprusside (SNP; NO donor), and 1.5 mM N^ω-nitro-l-arginine methyl ester (l-NAME; NOS blockade) superfusion. No sex differences were found for the Po_2is kinetics parameters in CON or l-NAME ( P > 0.05), but females elicited a lower baseline following SNP (males 42 ± 3 vs. females 36 ± 2 mmHg, P < 0.05). Females had a lower ΔPo_2is during contractions following SNP (males 22 ± 3 vs. females 17 ± 2 mmHg, P < 0.05), but there were no sex differences for the temporal response to contractions ( P > 0.05). The total NO effect (SNP minus l-NAME) on Po_2is was not different between sexes. However, the spread across both conditions was shifted to a lower absolute range for females (reduced SNP baseline and greater reduction following l-NAME). These data support that females have a greater reliance on basal NO bioavailability and males have a greater responsiveness to exogenous NO and less responsiveness to reduced endogenous NO. NEW & NOTEWORTHY Interstitial Po₂ (Po_2is; determined by O₂ delivery-to-utilization matching) plays an important role for O₂ flux into skeletal muscle. We show that both sexes regulate Po_2is at similar levels at rest and during skeletal muscle contractions. However, modulating NO bioavailability exposes sex differences in this regulation with females potentially having a greater reliance on basal NO bioavailability and males having a greater responsiveness to exogenous NO and less responsiveness to reduced endogenous NO.

Effects of beetroot juice supplementation on intermittent high-intensity exercise efforts

Beetroot juice contains high levels of inorganic nitrate (NO3-) and its intake has proved effective at increasing blood nitric oxide (NO) concentrations. Given the effects of NO in promoting vasodilation and blood flow with beneficial impacts on muscle contraction, several studies have detected an ergogenic effect of beetroot juice supplementation on exercise efforts with high oxidative energy metabolism demands. However, only a scarce yet growing number of investigations have sought to assess the effects of this supplement on performance at high-intensity exercise. Here we review the few studies that have addressed this issue. The databases Dialnet, Elsevier, Medline, Pubmed and Web of Science were searched for articles in English, Portuguese and Spanish published from 2010 to March 31 to 2017 using the keywords: beet or beetroot or nitrate or nitrite and supplement or supplementation or nutrition or "sport nutrition" and exercise or sport or "physical activity" or effort or athlete. Nine articles fulfilling the inclusion criteria were identified. Results indicate that beetroot juice given as a single dose or over a few days may improve performance at intermittent, high-intensity efforts with short rest periods. The improvements observed were attributed to faster phosphocreatine resynthesis which could delay its depletion during repetitive exercise efforts. In addition, beetroot juice supplementation could improve muscle power output via a mechanism involving a faster muscle shortening velocity. The findings of some studies also suggested improved indicators of muscular fatigue, though the mechanism involved in this effect remains unclear.

Redox Homeostasis in Age-Related Muscle Atrophy

Muscle atrophy and weakness, characterized by loss of lean muscle mass and function, has a significant effect on the independence and quality of life of older people. The cellular mechanisms that drive the age-related decline in neuromuscular integrity and function are multifactorial. Quiescent and contracting skeletal muscle can endogenously generate reactive oxygen and nitrogen species (RONS) from various cellular sites. Excessive RONS can potentially cause oxidative damage and disruption of cellular signaling pathways contributing to the initiation and progression of age-related muscle atrophy. Altered redox homeostasis and modulation of intracellular signal transduction processes have been proposed as an underlying mechanism of sarcopenia. This chapter summarizes the current evidence that has associated disrupted redox homeostasis and muscle atrophy as a result of skeletal muscle inactivity and aging.

Sex Differences in the Associations between L-Arginine Pathway Metabolites, Skeletal Muscle Mass and Function, and their Responses to Resistance Exercise, in Old Age

OBJECTIVES

The current study was designed to explore the associations between L-arginine metabolites and muscle mass and function in old age, which are largely unknown.

DESIGN

The study used a randomised, double-blind, placebo-controlled design.

SETTING

The study was carried out in a laboratory setting.

PARTICIPANTS

50 healthy older adults [median age 70 years (IQR 67-73); 27 males].

INTERVENTION

Participants undertook an 18-week resistance exercise program, and a nutritional intervention (fish oil vs. placebo).

MEASUREMENTS

Serum homoarginine, ornithine, citrulline, asymmetric dimethylarginine (ADMA), NG-monomethyl-L-arginine (L-NMMA), and symmetric dimethylarginine (SDMA), maximal voluntary contraction (MVC) and isokinetic torque of the knee extensors at 30° s-1 (MIT), muscle cross sectional area (MCSA) and quality (MQ) were measured at baseline and after the intervention.

RESULTS

No significant exercise-induced changes were observed in metabolite concentrations. There were significant sex differences in the associations between metabolites and muscle parameters. After adjusting for age, glomerular filtration rate and fish oil intervention, citrulline (P=0.002) and ornithine (P=0.022) were negatively associated with MCSA at baseline in males but not females. However, baseline citrulline was negatively correlated with exercise-induced changes in MVC (P=0.043) and MQ (P=0.026) amongst females. Furthermore, amongst males, baseline homoarginine was positively associated with exercise-induced changes in MVC (P=0.026), ADMA was negatively associated with changes in MIT (P=0.026), L-NMMA (p=0.048) and ornithine (P<0.001) were both positively associated with changes in MCSA, and ornithine was negatively associated with changes in MQ (P=0.039).

CONCLUSION

Therefore, barring citrulline, there are significant sex differences in the associations between L-arginine metabolites and muscle mass and function in healthy older adults. These metabolites might enhance sarcopenia risk stratification, and the success of exercise programs, in old age.