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Moutachi D, Hyzewicz J, Roy P, Lemaitre M, Bachasson D, Amthor H, Ritvos O, Li Z, Furling D, Agbulut O, Ferry A. Treadmill running and mechanical overloading improved the strength of the plantaris muscle in the dystrophin-desmin double knockout (DKO) mouse. J Physiol 2024; 602:3641-3660. [PMID: 38980963 DOI: 10.1113/jp286425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/24/2024] [Indexed: 07/11/2024] Open
Abstract
Limited knowledge exists regarding the chronic effect of muscular exercise on muscle function in a murine model of severe Duchenne muscular dystrophy (DMD). Here we determined the effects of 1 month of voluntary wheel running (WR), 1 month of enforced treadmill running (TR) and 1 month of mechanical overloading resulting from the removal of the synergic muscles (OVL) in mice lacking both dystrophin and desmin (DKO). Additionally, we examined the effect of activin receptor administration (AR). DKO mice, displaying severe muscle weakness, atrophy and greater susceptibility to contraction-induced functional loss, were exercised or treated with AR at 1 month of age and in situ force production of lower leg muscle was measured at the age of 2 months. We found that TR and OVL increased absolute maximal force and the rate of force development of the plantaris muscle in DKO mice. In contrast, those of the tibialis anterior (TA) muscle remained unaffected by TR and WR. Furthermore, the effects of TR and OVL on plantaris muscle function in DKO mice closely resembled those in mdx mice, a less severe murine DMD model. AR also improved absolute maximal force and the rate of force development of the TA muscle in DKO mice. In conclusion, exercise training improved plantaris muscle weakness in severely affected dystrophic mice. Consequently, these preclinical results may contribute to fostering further investigations aimed at assessing the potential benefits of exercise for DMD patients, particularly resistance training involving a low number of intense muscle contractions. KEY POINTS: Very little is known about the effects of exercise training in a murine model of severe Duchenne muscular dystrophy (DMD). One reason is that it is feared that chronic muscular exercise, particularly that involving intense muscle contractions, could exacerbate the disease. In DKO mice lacking both dystrophin and desmin, characterized by severe lower leg muscle weakness, atrophy and fragility in comparison to the less severe DMD mdx model, we found that enforced treadmill running improved absolute maximal force of the plantaris muscle, while that of tibialis anterior muscle remained unaffected by both enforced treadmill and voluntary wheel running. Furthermore, mechanical overloading, a non-physiological model of chronic resistance exercise, reversed plantaris muscle weakness. Consequently, our findings may have the potential to alleviate concerns and pave the way for exploring the prescription of endurance and resistance training as a viable therapeutic approach for the treatment of dystrophic patients. Additionally, such interventions may serve in mitigating the pathophysiological mechanisms induced by physical inactivity.
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Affiliation(s)
- Dylan Moutachi
- Sorbonne Université, INSERM U974, Centre de Recherche en Myologie, Paris, France
| | - Janek Hyzewicz
- Integrare Research Unit UMRS951, Université Paris-Saclay, Univ Evry, Inserm, Genethon, Evry, France
| | - Pauline Roy
- Sorbonne Université, INSERM U974, Centre de Recherche en Myologie, Paris, France
| | - Mégane Lemaitre
- Sorbonne Université, INSERM U974, Centre de Recherche en Myologie, Paris, France
| | - Damien Bachasson
- Institute of Myology, Neuromuscular Investigation Center, Neuromuscular Physiology and Evaluation Laboratory, Paris, France
| | - Helge Amthor
- Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1179, Montigny-le-Bretonneux, France
| | - Olli Ritvos
- Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Zhenlin Li
- Sorbonne Université, Institut de Biologie Paris-Seine, UMR CNRS 8256, Inserm ERL U1164, Biological Adaptation and Ageing, Paris, France
| | - Denis Furling
- Sorbonne Université, INSERM U974, Centre de Recherche en Myologie, Paris, France
| | - Onnik Agbulut
- Sorbonne Université, Institut de Biologie Paris-Seine, UMR CNRS 8256, Inserm ERL U1164, Biological Adaptation and Ageing, Paris, France
| | - Arnaud Ferry
- Sorbonne Université, INSERM U974, Centre de Recherche en Myologie, Paris, France
- Université Paris Cité, Paris, France
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Ó Murchú SC, O'Halloran KD. BREATHE DMD: boosting respiratory efficacy after therapeutic hypoxic episodes in Duchenne muscular dystrophy. J Physiol 2024; 602:3255-3272. [PMID: 38837229 DOI: 10.1113/jp280280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/12/2024] [Indexed: 06/07/2024] Open
Abstract
Duchenne muscular dystrophy (DMD) is a fatal genetic neuromuscular disorder, characterised by progressive decline in skeletal muscle function due to the secondary consequences of dystrophin deficiency. Weakness extends to the respiratory musculature, and cardiorespiratory failure is the leading cause of death in men with DMD. Intermittent hypoxia has emerged as a potential therapy to counteract ventilatory insufficiency by eliciting long-term facilitation of breathing. Mechanisms of sensory and motor facilitation of breathing have been well delineated in animal models. Various paradigms of intermittent hypoxia have been designed and implemented in human trials culminating in clinical trials in people with spinal cord injury and amyotrophic lateral sclerosis. Application of therapeutic intermittent hypoxia to DMD is considered together with discussion of the potential barriers to progression owing to the complexity of this devastating disease. Notwithstanding the considerable challenges and potential pitfalls of intermittent hypoxia-based therapies for DMD, we suggest it is incumbent on the research community to explore the potential benefits in pre-clinical models. Intermittent hypoxia paradigms should be implemented to explore the proclivity to express respiratory plasticity with the longer-term aim of preserving and potentiating ventilation in pre-clinical models and people with DMD.
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Affiliation(s)
- Seán C Ó Murchú
- Department of Physiology, University College Cork, Cork, Ireland
| | - Ken D O'Halloran
- Department of Physiology, University College Cork, Cork, Ireland
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Savas-Kalender D, Kurt-Aydin M, Acarol FO, Tarsuslu T, Yis U. Dual task impact on functional mobility and interaction of functional level and balance in patients with Duchenne muscular dystrophy. Gait Posture 2024; 108:282-288. [PMID: 38171184 DOI: 10.1016/j.gaitpost.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/14/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Dystrophin, a protein crucial for various brain regions governing higher-order functions like learning and memory is notably absent in individuals with Duchenne muscular dystrophy (DMD). This absence of dystrophin in the brain is believed to underlie cognitive challenges in DMD. Cognitive and motor challenges observed in DMD could potentially hinder the execution of dual tasks. RESEARCH QUESTION Is there a significant correlation between dual-task performance, functional mobility, and balance in children with DMD? METHOD The study included 28 participants (14 DMD, 14 typical development). Timed Up and Go (TUG) test results were recorded for single and dual-task conditions (motor-motor, cognitive-motor). Functional level was assessed using Motor Function Measurement-32 (MFM-32), Brooke Upper Extremity Scale, and Vignos Scale. Balance was evaluated using Balance Master System and Pediatric Functional Reach Test (PFRT). RESULTS Significant differences in TUG test scores across conditions were observed in both DMD and typical development groups (p < 0.05). Children with DMD exhibited longer completion times compared to typical development children (p < 0.05). Among children with DMD, there was a significant correlation between TUG scores in different task conditions and balance assessment (p < 0.05, r = 0.571 to -0.819). Lower MFM-32 scores in DMD children were correlated with worse TUG performance across conditions (p < 0.05, r = 0.586 to -0.868). SIGNIFIANCE This study sheds light on the multifaceted nature of dual-tasking challenges in individuals with DMD, thereby contributing to a deeper understanding of the implications for rehabilitation strategies.
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Affiliation(s)
| | - Merve Kurt-Aydin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkiye
| | | | - Tulay Tarsuslu
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkiye
| | - Uluc Yis
- Department of Pediatric Neurology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkiye
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4
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Sheikhzadeh F, Khajehnasiri N, Khalaj-Kondori M, Ramouz A, Sadeghian R. Wnt1 gene expression in the heart left ventricle as a response to the various durations of the intensive exercise: An experimental study. Endocr Regul 2024; 58:168-173. [PMID: 39121475 DOI: 10.2478/enr-2024-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024] Open
Abstract
Objective. Myocardial fibrosis is a devastating condition causing millions of deaths yearly. Several factors, such as aging, cause myocardial fibrosis. The Wnt/β-catenin pathway is one of the critical intracellular signaling for the development of cardiac fibrosis. Molecular and cellular mechanism of myocardial fibrosis induced by intensive exercise is not well-understood. The current study evaluates the effects of short- and long-term intensive exercise on the Wnt1 gene expression in a heart left ventricle in an animal model. Methods. Twenty-one male Wistar rats (mean weight 250±50 g) were divided into three groups (n=7): 1) control group (C); 2) short-term regular intensive exercise group (S-RIE, high-intensity exercise for one month six days weekly for 60 min with speed of 35 m/min), and 3) long-term regular intensive exercise group (L-RIE, high-intensity exercise for six months six days daily for 60 min with speed of 35 m/min). The heart left ventricle was isolated at the end of the experiment, and the relative gene expression of the Wnt1 gene was measured by the Real-Time PCR. Results. The L-RIE group showed a significant increase in the Wnt1 expression compared to the S-RIE and the control group. Although no difference was observed in the Wnt1 mRNA level in the S-RIE group compared to the control group, Wnt1 mRNA level increased in the L-RIE group compared to the S-RIE group. Conclusion. The exercise duration was of a great importance in the Wnt1 gene expression. Regular intensive exercise may be involved in the formation of the myocardial fibrosis by increasing the expression of the Wnt1 gene.
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Affiliation(s)
- Farzam Sheikhzadeh
- 1Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Nazli Khajehnasiri
- 2Department of Biological Sciences, Faculty of Basic Sciences, Higher Education Institute of Rab-Rashid, Tabriz, Iran
| | - Mohammad Khalaj-Kondori
- 1Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Ali Ramouz
- 3General, Visceral and Transplant Surgery Department, Universitat, Klinikum Heidelberg, Heidelberg, Germany
| | - Reihaneh Sadeghian
- 4Clinical Research Development Unit, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Yamauchi N, Tamai K, Kimura I, Naito A, Tokuda N, Ashida Y, Motohashi N, Aoki Y, Yamada T. High-intensity interval training in the form of isometric contraction improves fatigue resistance in dystrophin-deficient muscle. J Physiol 2023; 601:2917-2933. [PMID: 37184335 DOI: 10.1113/jp284532] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/10/2023] [Indexed: 05/16/2023] Open
Abstract
Duchenne muscular dystrophy is a genetic muscle-wasting disorder characterized by progressive muscle weakness and easy fatigability. Here we examined whether high-intensity interval training (HIIT) in the form of isometric contraction improves fatigue resistance in skeletal muscle from dystrophin-deficient mdx52 mice. Isometric HIIT was performed on plantar flexor muscles in vivo with supramaximal electrical stimulation every other day for 4 weeks (a total of 15 sessions). In the non-trained contralateral gastrocnemius muscle from mdx52 mice, the decreased fatigue resistance was associated with a reduction in the amount of peroxisome proliferator-activated receptor γ coactivator 1-α, citrate synthase activity, mitochondrial respiratory complex II, LC3B-II/I ratio, and mitophagy-related gene expression (i.e. Pink1, parkin, Bnip3 and Bcl2l13) as well as an increase in the phosphorylation levels of Src Tyr416 and Akt Ser473, the amount of p62, and the percentage of Evans Blue dye-positive area. Isometric HIIT restored all these alterations and markedly improved fatigue resistance in mdx52 muscles. Moreover, an acute bout of HIIT increased the phosphorylation levels of AMP-activated protein kinase (AMPK) Thr172, acetyl CoA carboxylase Ser79, unc-51-like autophagy activating kinase 1 (Ulk1) Ser555, and dynamin-related protein 1 (Drp1) Ser616 in mdx52 muscles. Thus, our data show that HIIT with isometric contractions significantly mitigates histological signs of pathology and improves fatigue resistance in dystrophin-deficient muscles. These beneficial effects can be explained by the restoration of mitochondrial function via AMPK-dependent induction of the mitophagy programme and de novo mitochondrial biogenesis. KEY POINTS: Skeletal muscle fatigue is often associated with Duchenne muscular dystrophy (DMD) and leads to an inability to perform daily tasks, profoundly decreasing quality of life. We examined the effect of high-intensity interval training (HIIT) in the form of isometric contraction on fatigue resistance in skeletal muscle from the mdx52 mouse model of DMD. Isometric HIIT counteracted the reduced fatigue resistance as well as dystrophic changes in skeletal muscle of mdx52 mice. This beneficial effect could be explained by the restoration of mitochondrial function via AMP-activated protein kinase-dependent mitochondrial biogenesis and the induction of the mitophagy programme in the dystrophic muscles.
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Affiliation(s)
- Nao Yamauchi
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Katsuyuki Tamai
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Iori Kimura
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Azuma Naito
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Nao Tokuda
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yuki Ashida
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
- The Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Norio Motohashi
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshitsugu Aoki
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takashi Yamada
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Savaş D, Tarsuslu T. Reliability and validity of the Turkish version of the Upper Limb Short Questionnaire in Duchenne muscular dystrophy. Somatosens Mot Res 2022; 40:56-61. [PMID: 36538388 DOI: 10.1080/08990220.2022.2157391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to evaluate the construct validity and reliability of the Turkish version of the Upper Limb Short Questionnaire in Duchenne muscular dystrophy. MATERIALS AND METHODS A total of 41 children with Duchenne muscular dystrophy have participated in the study. Upper and lower extremities functional levels were assessed with Vignos Scale and Brooke Upper Extremity Functional Rating Scale, respectively. The construct validity of the questionnaire was determined using the correlation between the Upper Limb Short Questionnaire and ABILHAND-Kids. The Cronbach alpha value was calculated to determine internal consistency. To determine test-retest reliability, 17 randomly selected children were evaluated seven days after the first evaluation, and the 'Intraclass Correlation Coefficient' value was calculated. RESULTS There was a moderate level of positive correlation between the Upper Limb Short Questionnaire scores and the Vignos Scale (r = 0.52, p < 0.001) and the Brooke Upper Extremity Functional Rating Scale (r = 0.65, p < 0.001). There was a strong correlation between the Upper Limb Short Questionnaire and ABILHAND-Kids in the negative direction (r= -0.80, p < 0.001). Internal consistency of the ULSQ was fairly high (Cronbach's alpha = 0.785) and test-retest reliability was good (ICC = 0.86). CONCLUSION The Turkish version of Upper Limb Short Questionnaire is a valid and reliable scale for children with Duchenne muscular dystrophy. It can be a useful tool in the UE clinical evaluation of children with Duchenne muscular dystrophy.
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Affiliation(s)
- Dilan Savaş
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Tülay Tarsuslu
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
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7
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Su Y, Song Y. The new challenge of “exercise + X″ therapy for Duchenne muscular dystrophy—Individualized identification of exercise tolerance and precise implementation of exercise intervention. Front Physiol 2022; 13:947749. [PMID: 35991169 PMCID: PMC9389311 DOI: 10.3389/fphys.2022.947749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/07/2022] [Indexed: 12/05/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is an X-linked recessive fatal muscular disease. Gene therapy, cell therapy, and drug therapy are currently the most widely used treatments for DMD. However, many experiments on animals and humans suggested that appropriate exercise could improve the effectiveness of such precision medicine treatment, thereby improving patient’s muscle quality and function. Due to the striated muscle damage of DMD individuals, there are still many debates about whether DMD animals or patients can exercise, how to exercise, when to exercise best, and how to exercise effectively. The purpose of this review is to summarize and investigate the scientific basis and efficacy of exercise as an adjuvant therapy for DMD gene therapy, cell therapy and drug therapy, as well as to present the theoretical framework and optional strategies of “exercise + X″″ combination therapy.
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Affiliation(s)
- Yuhui Su
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
- Institute of Physical Education, Jilin Normal University, Siping, China
| | - Yafeng Song
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
- *Correspondence: Yafeng Song,
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8
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Kilroy EA, Ignacz AC, Brann KL, Schaffer CE, Varney D, Alrowaished SS, Silknitter KJ, Miner JN, Almaghasilah A, Spellen TL, Lewis AD, Tilbury K, King BL, Kelley JB, Henry CA. Beneficial impacts of neuromuscular electrical stimulation on muscle structure and function in the zebrafish model of Duchenne muscular dystrophy. eLife 2022; 11:62760. [PMID: 35324428 PMCID: PMC8947762 DOI: 10.7554/elife.62760] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
Abstract
Neuromuscular electrical stimulation (NMES) allows activation of muscle fibers in the absence of voluntary force generation. NMES could have the potential to promote muscle homeostasis in the context of muscle disease, but the impacts of NMES on diseased muscle are not well understood. We used the zebrafish Duchenne muscular dystrophy (dmd) mutant and a longitudinal design to elucidate the consequences of NMES on muscle health. We designed four neuromuscular stimulation paradigms loosely based on weightlifting regimens. Each paradigm differentially affected neuromuscular structure, function, and survival. Only endurance neuromuscular stimulation (eNMES) improved all outcome measures. We found that eNMES improves muscle and neuromuscular junction morphology, swimming, and survival. Heme oxygenase and integrin alpha7 are required for eNMES-mediated improvement. Our data indicate that neuromuscular stimulation can be beneficial, suggesting that the right type of activity may benefit patients with muscle disease.
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Affiliation(s)
- Elisabeth A Kilroy
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Amanda C Ignacz
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Kaylee L Brann
- School of Biology and Ecology, University of Maine, Orono, United States
| | - Claire E Schaffer
- School of Biology and Ecology, University of Maine, Orono, United States
| | - Devon Varney
- School of Biology and Ecology, University of Maine, Orono, United States
| | | | - Kodey J Silknitter
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Jordan N Miner
- Department of Chemical and Biomedical Engineering, University of Maine, Orono, United States
| | - Ahmed Almaghasilah
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States
| | - Tashawna L Spellen
- School of Biology and Ecology, University of Maine, Orono, United States
| | - Alexandra D Lewis
- School of Biology and Ecology, University of Maine, Orono, United States
| | - Karissa Tilbury
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States.,Department of Chemical and Biomedical Engineering, University of Maine, Orono, United States
| | - Benjamin L King
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States.,Department of Molecular and Biomedical Sciences, University of Maine, Orono, United States
| | - Joshua B Kelley
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States.,Department of Molecular and Biomedical Sciences, University of Maine, Orono, United States
| | - Clarissa A Henry
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, United States.,School of Biology and Ecology, University of Maine, Orono, United States
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9
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Henson SE, Lang SM, Khoury PR, Tian C, Rutter MM, Urbina EM, Ryan TD, Taylor MD, Alsaied T. The Effect of Adiposity on Cardiovascular Function and Myocardial Fibrosis in Patients With Duchenne Muscular Dystrophy. J Am Heart Assoc 2021; 10:e021037. [PMID: 34569261 PMCID: PMC8649129 DOI: 10.1161/jaha.121.021037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Patients with Duchenne muscular dystrophy (DMD) develop cardiomyopathy because of a dystrophin deficiency causing fibrofatty replacement of the myocardium. Corticosteroid use and mobility limitations place these patients at risk for increased adiposity. We sought to determine the association of adiposity with cardiovascular dysfunction in patients with DMD. Methods and Results This was a retrospective review of patients with DMD who underwent both cardiac magnetic resonance imaging and dual‐energy x‐ray absorptiometry within 1 year. The cardiac magnetic resonance imaging parameters included left ventricular ejection fraction and the presence of late gadolinium enhancement (LGE positive [LGE+]). The adiposity indices, measured by dual‐energy x‐ray absorptiometry, included percentage of body fat, whole body fat mass indexed to height, and body mass index. A total of 324 patients were identified. Fifty‐two percent had LGE+, and 36% had cardiac dysfunction (left ventricular ejection fraction <55%). Patients with cardiac dysfunction had higher whole body fat mass indexed to height and body mass index on univariate analysis (mean difference between patients with and without cardiac dysfunction: +2.9 kg/m, P=0.001; and +1.5 kg/m2, P=0.03, respectively). whole body fat mass indexed to height remained independently associated with cardiac dysfunction on multivariable analysis after adjusting for age, LGE+, and corticosteroid duration. High whole body fat mass indexed to height and percentage of body fat were associated with LGE+ on univariate analysis (mean difference between patients with and without LGE+: +2.0 kg/m, P=0.02; and +2.4%, P=0.02, respectively). Using multivariable analysis, including age and cardiac dysfunction, high percentage of body fat remained independently associated with LGE+. Conclusions This study demonstrates an independent association of adiposity with cardiac dysfunction and LGE+ in patients with DMD. Preventing adiposity may mitigate the later development of ventricular dysfunction in DMD.
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Affiliation(s)
- Sarah E Henson
- Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH
| | - Sean M Lang
- Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH.,Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH
| | - Philip R Khoury
- Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH.,Heart Institute Research Core Cincinnati Children's Hospital Medical Center Cincinnati OH
| | - Cuixia Tian
- Neurology, Cincinnati Children's Hospital Medical Center Cincinnati OH.,Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH
| | - Meilan M Rutter
- Endocrinology, Cincinnati Children's Hospital Medical Center Cincinnati OH.,Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH
| | - Elaine M Urbina
- Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH.,Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH
| | - Thomas D Ryan
- Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH.,Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH
| | - Michael D Taylor
- Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH.,Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH
| | - Tarek Alsaied
- Pediatric Cardiology and Heart Institute, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh Pittsburgh PA
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10
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Hamm SE, Fathalikhani DD, Bukovec KE, Addington AK, Zhang H, Perry JB, McMillan RP, Lawlor MW, Prom MJ, Vanden Avond MA, Kumar SN, Coleman KE, Dupont JB, Mack DL, Brown DA, Morris CA, Gonzalez JP, Grange RW. Voluntary wheel running complements microdystrophin gene therapy to improve muscle function in mdx mice. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2021; 21:144-160. [PMID: 33850950 PMCID: PMC8020351 DOI: 10.1016/j.omtm.2021.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 02/25/2021] [Indexed: 12/12/2022]
Abstract
We tested the hypothesis that voluntary wheel running would complement microdystrophin gene therapy to improve muscle function in young mdx mice, a model of Duchenne muscular dystrophy. mdx mice injected with a single dose of AAV9-CK8-microdystrophin or vehicle at age 7 weeks were assigned to three groups: mdxRGT (run, gene therapy), mdxGT (no run, gene therapy), or mdx (no run, no gene therapy). Wild-type (WT) mice were assigned to WTR (run) and WT (no run) groups. WTR and mdxRGT performed voluntary wheel running for 21 weeks; remaining groups were cage active. Robust expression of microdystrophin occurred in heart and limb muscles of treated mice. mdxRGT versus mdxGT mice showed increased microdystrophin in quadriceps but decreased levels in diaphragm. mdx final treadmill fatigue time was depressed compared to all groups, improved in mdxGT, and highest in mdxRGT. Both weekly running distance (km) and final treadmill fatigue time for mdxRGT and WTR were similar. Remarkably, mdxRGT diaphragm power was only rescued to 60% of WT, suggesting a negative impact of running. However, potential changes in fiber type distribution in mdxRGT diaphragms could indicate an adaptation to trade power for endurance. Post-treatment in vivo maximal plantar flexor torque relative to baseline values was greater for mdxGT and mdxRGT versus all other groups. Mitochondrial respiration rates from red quadriceps fibers were significantly improved in mdxGT animals, but the greatest bioenergetic benefit was observed in the mdxRGT group. Additional assessments revealed partial to full functional restoration in mdxGT and mdxRGT muscles relative to WT. These data demonstrate that voluntary wheel running combined with microdystrophin gene therapy in young mdx mice improved whole-body performance, affected muscle function differentially, mitigated energetic deficits, but also revealed some detrimental effects of exercise. With microdystrophin gene therapy currently in clinical trials, these data may help us understand the potential impact of exercise in treated patients.
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Affiliation(s)
- Shelby E Hamm
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
| | - Daniel D Fathalikhani
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
| | - Katherine E Bukovec
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
| | - Adele K Addington
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
| | - Haiyan Zhang
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
| | - Justin B Perry
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
| | - Ryan P McMillan
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
| | - Michael W Lawlor
- Department of Pathology and Laboratory Medicine and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Mariah J Prom
- Department of Pathology and Laboratory Medicine and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Mark A Vanden Avond
- Department of Pathology and Laboratory Medicine and Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Suresh N Kumar
- Department of Pathology and Laboratory Medicine and Children's Hospital of Wisconsin Research Institute Imaging Core, Milwaukee, WI 53226, USA
| | - Kirsten E Coleman
- Powell Gene Therapy Center Toxicology Core, University of Florida, Gainesville, FL 32610, USA
| | - J B Dupont
- Translational Gene Therapy for Genetic Diseases, INSERM UMR1089, IRS2 Nantes Biotech, Université de Nantes, Nantes 44200, France
| | - David L Mack
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98104, USA.,Institute for Stem Cell and Regenerative Medicine, School of Medicine, University of Washington, Seattle, WA 98107, USA
| | - David A Brown
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
| | | | | | - Robert W Grange
- Department of Human Nutrition, Foods, and Exercise and Metabolism Core, Virginia Tech, Blacksburg, VA 24060, USA
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11
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Van Pelt DW, Kharaz YA, Sarver DC, Eckhardt LR, Dzierzawski JT, Disser NP, Piacentini AN, Comerford E, McDonagh B, Mendias CL. Multiomics analysis of the mdx/mTR mouse model of Duchenne muscular dystrophy. Connect Tissue Res 2021; 62:24-39. [PMID: 32664808 DOI: 10.1080/03008207.2020.1791103] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE/AIM Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease characterized by extensive muscle weakness. Patients with DMD lack a functional dystrophin protein, which transmits force and organizes the cytoskeleton of skeletal muscle. Multiomic studies have been proposed as a way to obtain novel insight about disease processes from preclinical models, and we used this approach to study pathological changes in dystrophic muscles. MATERIALS AND METHODS We evaluated hindlimb muscles of male mdx/mTR mice, which lack a functional dystrophin protein and have deficits in satellite cell abundance and proliferative capacity. Wild type (WT) C57BL/6 J mice served as controls. Muscle fiber contractility was measured, along with changes in the transcriptome using RNA sequencing, and in the proteome, metabolome, and lipidome using mass spectrometry. RESULTS While mdx/mTR mice displayed gross pathological changes and continued cycles of degeneration and regeneration, we found no differences in permeabilized fiber contractility between strains. However, there were numerous changes in the transcriptome and proteome related to protein balance, contractile elements, extracellular matrix, and metabolism. There was only a 53% agreement in fold-change data between the proteome and transcriptome. Numerous changes in markers of skeletal muscle metabolism were observed, with dystrophic muscles exhibiting elevated glycolytic metabolites such as 6-phosphoglycerate, fructose-6-phosphate and glucose-6-phosphate, fructose bisphosphate, phosphorylated hexoses, and phosphoenolpyruvate. CONCLUSIONS These findings highlight the utility of multiomics in studying muscle disease, and provide additional insight into the pathological changes in dystrophic muscles that might help to indirectly guide evidence-based nutritional or exercise prescription in DMD patients.
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Affiliation(s)
- Douglas W Van Pelt
- Department of Rehabilitation Sciences, College of Health Sciences, University of Kentucky , Lexington, KY, USA
| | - Yalda A Kharaz
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool , Liverpool, UK
| | - Dylan C Sarver
- Department of Orthopaedic Surgery, University of Michigan Medical School , Ann Arbor, MI, USA
| | - Logan R Eckhardt
- Department of Orthopaedic Surgery, University of Michigan Medical School , Ann Arbor, MI, USA
| | - Justin T Dzierzawski
- Department of Orthopaedic Surgery, University of Michigan Medical School , Ann Arbor, MI, USA
| | | | - Alex N Piacentini
- Research Institute, Hospital for Special Surgery , New York, NY, USA
| | - Eithne Comerford
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool , Liverpool, UK
| | - Brian McDonagh
- Department of Physiology, School of Medicine, National University of Ireland , Galway, Ireland
| | - Christopher L Mendias
- Department of Orthopaedic Surgery, University of Michigan Medical School , Ann Arbor, MI, USA.,Research Institute, Hospital for Special Surgery , New York, NY, USA.,Department of Physiology & Biophysics, Weill Cornell Medical College , New York, NY, USA
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12
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Hu X, Pickle NT, Grabowski AM, Silverman AK, Blemker SS. Muscle Eccentric Contractions Increase in Downhill and High-Grade Uphill Walking. Front Bioeng Biotechnol 2020; 8:573666. [PMID: 33178672 PMCID: PMC7591807 DOI: 10.3389/fbioe.2020.573666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/21/2020] [Indexed: 01/26/2023] Open
Abstract
In Duchenne muscular dystrophy (DMD), one of the most severe and frequent genetic diseases in humans, dystrophic muscles are prone to damage caused by mechanical stresses during eccentric contractions. Eccentric contraction during walking on level ground likely contributes to the progression of degeneration in lower limb muscles. However, little is known about how the amount of muscle eccentric contractions is affected by uphill/downhill sloped walking, which is often encountered in patients’ daily lives and poses different biomechanical demands than level walking. By recreating the dynamic musculoskeletal simulations of downhill (−9°, −6°, and −3°), uphill (+3°, +6°, and +9°) and level walking (0°) from a published study of healthy participants, negative muscle mechanical work, as a measure of eccentric contraction, of 35 lower limb muscles was quantified and compared. Our results indicated that downhill walking overall induced more (32% at −9°, 19% at −6°, and 13% at −3°) eccentric contractions in lower limb muscles compared to level walking. In contrast, uphill walking led to eccentric contractions similar to level walking at low grades (+3° and +6°), but 17% more eccentric contraction at high grades (+9°). The changes of muscle eccentric contraction were largely predicted by the changes in both joint negative work and muscle coactivation in sloped walking. As muscle eccentric contractions play a critical role in the disease progression in DMD, this study provides an important baseline for future studies to safely improve rehabilitation strategies and exercise management for patients with DMD and other similar conditions.
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Affiliation(s)
- Xiao Hu
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States
| | - Nathaniel T Pickle
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, United States
| | - Alena M Grabowski
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States.,Department of Veterans Affairs, VA Eastern Colorado Healthcare System, Denver, CO, United States
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, United States
| | - Silvia S Blemker
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States.,Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA, United States.,Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, United States
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13
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Siciliano G, Chico L, Lo Gerfo A, Simoncini C, Schirinzi E, Ricci G. Exercise-Related Oxidative Stress as Mechanism to Fight Physical Dysfunction in Neuromuscular Disorders. Front Physiol 2020; 11:451. [PMID: 32508674 PMCID: PMC7251329 DOI: 10.3389/fphys.2020.00451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/09/2020] [Indexed: 12/12/2022] Open
Abstract
Neuromuscular diseases (NMDs) are a group of often severely disabling disorders characterized by dysfunction in one of the main constituents of the motor unit, the cardinal anatomic-functional structure behind force and movement production. Irrespective of the different pathogenic mechanisms specifically underlying these disease conditions genetically determined or acquired, and the related molecular pathways involved in doing that, oxidative stress has often been shown to play a relevant role within the chain of events that induce or at least modulate the clinical manifestations of these disorders. Due to such a putative relevance of the imbalance of redox status occurring in contractile machinery and/or its neural drive in NMDs, physical exercise appears as one of the most important conditions able to positively interfere along an ideal axis, going from a deranged metabolic cell homeostasis in motor unit components to the reduced motor performance profile exhibited by the patient in everyday life. If so, it comes out that it would be important to identify a proper training program, suitable for load and type of exercise that is able to improve motor performance in adaptation and response to such a homeostatic imbalance. This review therefore analyzes the role of different exercise trainings on oxidative stress mechanisms, both in healthy and in NMDs, also including preclinical studies, to elucidate at which extent these can be useful to counteract muscle impairment associated to the disease, with the final aim of improving physical functions and quality of life of NMD patients.
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Affiliation(s)
- Gabriele Siciliano
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Lucia Chico
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Annalisa Lo Gerfo
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Costanza Simoncini
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Erika Schirinzi
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| | - Giulia Ricci
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
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14
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Lanza G, Pino M, Fisicaro F, Vagli C, Cantone M, Pennisi M, Bella R, Bellomo M. Motor activity and Becker's muscular dystrophy: lights and shadows. PHYSICIAN SPORTSMED 2020; 48:151-160. [PMID: 31646922 DOI: 10.1080/00913847.2019.1684810] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Becker's disease is an inherited muscular dystrophy caused by mutations in the gene coding for the dystrophin protein that leads to quantitative and/or qualitative protein dysfunction and consequent muscle degeneration. Studies in animal models demonstrate that, while eccentric or high-intensity training are deleterious for dystrophic muscles, low-intensity aerobic training may slowdown the disease process and progression. Based on these preclinical data, the available studies in patients with Becker's muscular dystrophy undergoing workout on a cycle ergometer or on a treadmill, at a heart rate ≤65% of their maximal oxygen uptake, showed that aerobic exercise counteracts physical deterioration and loss of functional abilities. These findings suggest an improvement of physical performance through an increase of muscle strength, fatigue resistance, and dexterity capacities, without substantial evidence of acceleration of muscular damage progression. Therefore, individually tailored mild-to-moderate intensity aerobic exercise should be considered as part of the management of these patients. However, further research is necessary to define specific and standardized guidelines for the prescription of type, intensity, frequency, and duration of motor activities. In this review, we provided a summary of the impact of physical activity both in animal models and in patients with Becker's muscular dystrophy, with the intent to identify trends and gaps in knowledge. The potential therapeutic implications and future research directions have been also highlighted.
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Affiliation(s)
- Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
- Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
| | - Marcello Pino
- School of Human and Social Science, University Kore of Enna, Enna, Italy
| | - Francesco Fisicaro
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Carla Vagli
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Mariagiovanna Cantone
- Department of Neurology, Sant'Elia Hospital, ASP Caltanissetta, Caltanissetta, Italy
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Maria Bellomo
- School of Human and Social Science, University Kore of Enna, Enna, Italy
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15
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Corrigan MC, Foulds RA. Evaluation of admittance control as an alternative to passive arm supports to increase upper extremity function for individuals with Duchenne muscular dystrophy. Muscle Nerve 2020; 61:692-701. [PMID: 32128840 DOI: 10.1002/mus.26848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/26/2020] [Accepted: 02/29/2020] [Indexed: 02/04/2023]
Abstract
The degree of upper extremity active range of motion provided by an admittance control robot compared with a commercially available passive arm support for individuals with DMD who have limited arm function was investigated in this study. The reachable workspace evaluation was used to assess active range of motion provided by both devices. A visual analog scale was also used to secure participant-reported outcome measures. The admittance control robot significantly increased reachable surface area scores compared with the passive arm support for the dominant arm (Wilcoxon T = 5, P = .022, r2 = 0.263) and for the nondominant arm (paired-samples t test, t(9) = 4.66, P = .001, r2 = 0.71). The admittance control robot also significantly decreased participant-reported exertion compared with the passive arm support. Results of this study substantiated the benefits of admittance control for individuals with DMD compared with a commercially available passive arm support.
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Affiliation(s)
- Madeline C Corrigan
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
| | - Richard A Foulds
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
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16
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Muscular Dystrophy and Rehabilitation Interventions with Regenerative Treatment. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2020. [DOI: 10.1007/s40141-019-00255-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Abstract
PURPOSE This study reports the respiratory muscle training effect on strength and endurance in individuals with Duchenne muscular dystrophy. METHODS Articles published from 1984 to 2017 were reviewed. Six articles met the inclusion criteria that included within-subject control or between-subject control group, participants with a diagnosis of only Duchenne muscular dystrophy, participation in respiratory muscle training intervention, and outcome measures of endurance and strength. Effect sizes were calculated for each study and overall, weighted mean effect sizes for strength and endurance outcome measures. RESULTS There was a large effect for improving respiratory endurance and a moderate effect for muscle strength. However, these effects were not significant. CONCLUSION Findings justify further exploration of the potential benefits of respiratory muscle training for individuals with Duchenne muscular dystrophy.
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18
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Abstract
INTRODUCTION Duchenne muscular dystrophy (DMD) is a neuromuscular disease caused by a dystrophin protein deficiency. Dystrophin functions to stabilize and protect the muscle fiber during muscle contraction; thus, the absence of functional dystrophin protein leads to muscle injury. DMD patients experience progressive muscle necrosis, loss of function, and ultimately succumb to respiratory failure or cardiomyopathy. Exercise is known to improve muscle health and strength in healthy individuals as well as positively affect other systems. Because of this, exercise has been investigated as a potential therapeutic approach for DMD. METHODS This review aims to provide a concise presentation of the exercise literature with a focus on dystrophin-deficient muscle. Our intent was to identify trends and gaps in knowledge with an appreciation of exercise modality. RESULTS After compiling data from mouse and human studies, it became apparent that endurance exercises such as a swimming and voluntary wheel running have therapeutic potential in limb muscles of mice and respiratory training was beneficial in humans. However, in the comparatively few long-term investigations, the effect of low-intensity training on cardiac and respiratory muscles was contradictory. In addition, the effect of exercise on other systems is largely unknown. CONCLUSIONS To safely prescribe exercise as a therapy to DMD patients, multisystemic investigations are needed including the evaluation of respiratory and cardiac muscle.
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19
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Ravel-Chapuis A, Al-Rewashdy A, Bélanger G, Jasmin BJ. Pharmacological and physiological activation of AMPK improves the spliceopathy in DM1 mouse muscles. Hum Mol Genet 2019; 27:3361-3376. [PMID: 29982462 DOI: 10.1093/hmg/ddy245] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/28/2018] [Indexed: 12/26/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) is a debilitating multisystemic disorder caused by a triplet repeat expansion in the 3' untranslated region of dystrophia myotonica protein kinase mRNAs. Mutant mRNAs accumulate in the nucleus of affected cells and misregulate RNA-binding proteins, thereby promoting characteristic missplicing events. However, little is known about the signaling pathways that may be affected in DM1. Here, we investigated the status of activated protein kinase (AMPK) signaling in DM1 skeletal muscle and found that the AMPK pathway is markedly repressed in a DM1 mouse model (human skeletal actin-long repeat, HSALR) and patient-derived DM1 myoblasts. Chronic pharmacological activation of AMPK signaling in DM1 mice with 5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside (AICAR) has multiple beneficial effects on the DM1 phenotype. Indeed, a 6-week AICAR treatment of DM1 mice promoted expression of a slower, more oxidative phenotype, improved muscle histology and corrected several events associated with RNA toxicity. Importantly, AICAR also had a dose-dependent positive effect on the spliceopathy in patient-derived DM1 myoblasts. In separate experiments, we also show that chronic treatment of DM1 mice with resveratrol as well as voluntary wheel running also rescued missplicing events in muscle. Collectively, our findings demonstrate the therapeutic potential of chronic AMPK stimulation both physiologically and pharmacologically for DM1 patients.
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Affiliation(s)
- Aymeric Ravel-Chapuis
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ali Al-Rewashdy
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Guy Bélanger
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Bernard J Jasmin
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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20
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Atamturk H, Atamturk A. Therapeutic effects of aquatic exercises on a boy with Duchenne muscular dystrophy. J Exerc Rehabil 2018; 14:877-882. [PMID: 30443536 PMCID: PMC6222151 DOI: 10.12965/jer.1836408.204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/16/2018] [Indexed: 12/19/2022] Open
Abstract
Participation in physical activities benefits individuals with disabilities in terms of addressing their social and psychological needs in order for the purposes of quality living. This study reports the findings from a case study conducted with a boy who has Duchenne muscular dystrophy (DMD) in a swimming pool located in the campus of a private university in North Cyprus. The current study reports the adjustments made in the swimming pool in accordance with the needs of the participant, how service quality was increased to cater for these needs and in what ways the participant benefited from the aquatic program. This qualitative investigation aims to shed light onto how aquatic therapy has affected the boy with DMD physically, psychologically, and socially from the parents’ perspectives. The results revealed that aquatic therapy had beneficial effects on the participant with DMD in terms of socialization, relaxation, quality of life and self-perception.
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Affiliation(s)
- Hakan Atamturk
- Department of Physical Education, Faculty of Sports Sciences, Near East University, North Nicosia, Northern Cyprus
| | - Arda Atamturk
- Faculty of Medicine, Near East University, North Nicosia, Northern Cyprus
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21
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Weber DR, Hadjiyannakis S, McMillan HJ, Noritz G, Ward LM. Obesity and Endocrine Management of the Patient With Duchenne Muscular Dystrophy. Pediatrics 2018; 142:S43-S52. [PMID: 30275248 PMCID: PMC6460463 DOI: 10.1542/peds.2018-0333f] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 01/24/2023] Open
Abstract
Duchenne muscular dystrophy (DMD) is associated with an increased risk of endocrine complications due to the effects of prolonged glucocorticoid therapy as well as progressive muscle weakness. Categories of complications include obesity and its comorbidities, short stature, pubertal delay, and adrenal insufficiency. Obesity prevention is important for long-term management of patients with DMD. Preventing glucocorticoid-induced weight gain fosters patient mobility, ease of transfer, and reduces sleep-disordered breathing. Metabolic complications from obesity (glucose intolerance, dyslipidemia) also can be avoided. Short stature and pubertal delay may negatively affect self-esteem and peer relationships, and careful monitoring of growth and pubertal development can allow anticipatory counseling. Adrenal insufficiency, a potentially life-threatening complication associated with prolonged glucocorticoid use, must be recognized so as to allow prompt treatment. In this article, we provide a summary of current guidance to ensure comprehensive endocrine management is followed in patients with DMD.
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Affiliation(s)
- David R Weber
- Golisano Children's Hospital, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Stasia Hadjiyannakis
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada; and
| | - Hugh J McMillan
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada; and
| | - Garey Noritz
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
| | - Leanne M Ward
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada; and
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22
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Heydemann A. Skeletal Muscle Metabolism in Duchenne and Becker Muscular Dystrophy-Implications for Therapies. Nutrients 2018; 10:nu10060796. [PMID: 29925809 PMCID: PMC6024668 DOI: 10.3390/nu10060796] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/14/2018] [Accepted: 06/16/2018] [Indexed: 02/06/2023] Open
Abstract
The interactions between nutrition and metabolism and skeletal muscle have long been known. Muscle is the major metabolic organ—it consumes more calories than other organs—and therefore, there is a clear need to discuss these interactions and provide some direction for future research areas regarding muscle pathologies. In addition, new experiments and manuscripts continually reveal additional highly intricate, reciprocal interactions between metabolism and muscle. These reciprocal interactions include exercise, age, sex, diet, and pathologies including atrophy, hypoxia, obesity, diabetes, and muscle myopathies. Central to this review are the metabolic changes that occur in the skeletal muscle cells of muscular dystrophy patients and mouse models. Many of these metabolic changes are pathogenic (inappropriate body mass changes, mitochondrial dysfunction, reduced adenosine triphosphate (ATP) levels, and increased Ca2+) and others are compensatory (increased phosphorylated AMP activated protein kinase (pAMPK), increased slow fiber numbers, and increased utrophin). Therefore, reversing or enhancing these changes with therapies will aid the patients. The multiple therapeutic targets to reverse or enhance the metabolic pathways will be discussed. Among the therapeutic targets are increasing pAMPK, utrophin, mitochondrial number and slow fiber characteristics, and inhibiting reactive oxygen species. Because new data reveals many additional intricate levels of interactions, new questions are rapidly arising. How does muscular dystrophy alter metabolism, and are the changes compensatory or pathogenic? How does metabolism affect muscular dystrophy? Of course, the most profound question is whether clinicians can therapeutically target nutrition and metabolism for muscular dystrophy patient benefit? Obtaining the answers to these questions will greatly aid patients with muscular dystrophy.
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Affiliation(s)
- Ahlke Heydemann
- Department of Physiology and Biophysics, University of Illinois at Chicago, Chicago, IL 60612, USA.
- Center for Cardiovascular Research, The University of Illinois at Chicago, Chicago, IL 60612, USA.
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23
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McPherson AC, McAdam L, Keenan S, Schwellnus H, Biddiss E, DeFinney A, English K. A feasibility study using solution-focused coaching for health promotion in children and young people with Duchenne muscular dystrophy. Dev Neurorehabil 2018; 21:121-130. [PMID: 28272972 DOI: 10.1080/17518423.2017.1289271] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate the feasibility and acceptability of a coaching intervention (Solution-Focused Coaching in pediatric rehabilitation [SFC-Peds]) related to physical activity and diet in males with Duchenne muscular dystrophy. METHODS A pre-post design was employed. Participants had five coaching sessions over 8 weeks. The first session was face-to-face, followed by four virtual sessions. Feasibility criteria included recruitment rates, attrition, and intervention fidelity. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were employed to look at outcome trends. The acceptability was assessed using a survey. RESULTS Five males (11-19 years) participated. All feasibility criteria were met. Clinically significant increases were observed for GAS and COPM scores. Participants reported SFC-Peds to be acceptable. Broad barriers and facilitators to coaching success were identified. CONCLUSIONS A SFC-Peds intervention for health promotion is feasible and acceptable in children with DMD and their families. A rigorous efficacy study assessing SFC-Peds intervention is warranted.
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Affiliation(s)
- Amy C McPherson
- a Bloorview Research Institute , Toronto , Ontario , Canada.,b Dalla Lana School of Public Health and Rehabilitation Sciences Institute, University of Toronto , Toronto , Ontario , Canada
| | - Laura McAdam
- a Bloorview Research Institute , Toronto , Ontario , Canada.,c Department of Paediatrics , University of Toronto , Toronto, Ontario , Canada
| | - Sarah Keenan
- a Bloorview Research Institute , Toronto , Ontario , Canada.,d Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Heidi Schwellnus
- a Bloorview Research Institute , Toronto , Ontario , Canada.,d Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Elaine Biddiss
- a Bloorview Research Institute , Toronto , Ontario , Canada.,e The Institute of Biomaterials & Biomedical Engineering and Rehabilitation Sciences Institute, University of Toronto , Toronto , Ontario , Canada
| | - Andrea DeFinney
- d Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
| | - Kirsten English
- d Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada
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24
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Gaiad TP, Oliveira MX, Lobo AR, Libório LR, Pinto PAF, Fernandes DC, Santos AP, Ambrósio CE, Machado ASD. Low-intensity training provokes adaptive extracellular matrix turnover of a muscular dystrophy model. J Exerc Rehabil 2017; 13:693-703. [PMID: 29326902 PMCID: PMC5747205 DOI: 10.12965/jer.1735094.547] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 12/05/2017] [Indexed: 11/22/2022] Open
Abstract
Recommendations of therapeutic exercise in Duchenne muscular dystrophy are still controversial. The hypothesis that a low-intensity training (LIT) protocol leads to muscle adaptations on mdx mice model was tested. Dystrophic male mice with 8 weeks old were separated in exercised (mdxE, n= 8) and sedentary (mdxC, n= 8) groups. Wild-type mice were used as control (WT, n= 8) group. Exercised group underwent a LIT protocol (9 m/min, 30 min, 3 days/wk, 60 days) on a horizontal treadmill. At day 60 all animals were analyzed regarding parameters of markers of muscle lesion and extracellular matrix turnover of muscle tissue by collagens fibers on tibial anterior muscle. Histomorphometry attested that centrally located nuclei fibers and the coefficient of variance of minimal Feret’s diameter was similar in mdxE and mdxC groups (P= 1.000) and both groups presented higher mean values than WT group (P< 0.001). Fraction area of collagen fibers of mdxE group was lower than mdxC group (P= 0,027) and similar to WT group (P= 0,751). Intramuscular area of Col3 of the mdxE group was higher than mdxC and WT groups (P<0.001). Intramuscular area of Col1 on the mdxE group was similar to the mdxC group (P= 1.000) and both groups were higher than WT group (P< 0.001). LIT protocol had not influenced muscle injuries resulting from the dystrophin-deficiency membrane fragility. Although, LIT had provoked adaptations on extracellular matrix bringing higher elastic feature to dystrophic muscle tissue.
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Affiliation(s)
- Thaís P Gaiad
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Murilo X Oliveira
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Adalfredo R Lobo
- Institute of Agriculture Scinces, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Unaí, Brazil
| | - Lívia R Libório
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Priscilla A F Pinto
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Danielle C Fernandes
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Ana Paula Santos
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | - Alex Sander D Machado
- Faculty of Medicine FAMED, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
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Rovira M, Arrey G, Planas JV. Exercise-Induced Hypertrophic and Oxidative Signaling Pathways and Myokine Expression in Fast Muscle of Adult Zebrafish. Front Physiol 2017; 8:1063. [PMID: 29326600 PMCID: PMC5741866 DOI: 10.3389/fphys.2017.01063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/04/2017] [Indexed: 12/11/2022] Open
Abstract
Skeletal muscle is a plastic tissue that undergoes cellular and metabolic adaptations under conditions of increased contractile activity such as exercise. Using adult zebrafish as an exercise model, we previously demonstrated that swimming training stimulates hypertrophy and vascularization of fast muscle fibers, consistent with the known muscle growth-promoting effects of exercise and with the resulting increased aerobic capacity of this tissue. Here we investigated the potential involvement of factors and signaling mechanisms that could be responsible for exercise-induced fast muscle remodeling in adult zebrafish. By subjecting zebrafish to swimming-induced exercise, we observed an increase in the activity of mammalian target of rapamycin (mTOR) and Mef2 protein levels in fast muscle. We also observed an increase in the protein levels of the mitotic marker phosphorylated histone H3 that correlated with an increase in the protein expression levels of Pax7, a satellite-like cell marker. Furthermore, the activity of AMP-activated protein kinase (AMPK) was also increased by exercise, in parallel with an increase in the mRNA expression levels of pgc1α and also of pparda, a β-oxidation marker. Changes in the mRNA expression levels of slow and fast myosin markers further supported the notion of an exercise-induced aerobic phenotype in zebrafish fast muscle. The mRNA expression levels of il6, il6r, apln, aplnra and aplnrb, sparc, decorin and igf1, myokines known in mammals to be produced in response to exercise and to signal through mTOR/AMPK pathways, among others, were increased in fast muscle of exercised zebrafish. These results support the notion that exercise increases skeletal muscle growth and myogenesis in adult zebrafish through the coordinated activation of the mTOR-MEF2 and AMPK-PGC1α signaling pathways. These results, coupled with altered expression of markers for oxidative metabolism and fast-to-slow fiber-type switch, also suggest improved aerobic capacity as a result of swimming-induced exercise. Finally, the induction of myokine expression by swimming-induced exercise support the hypothesis that these myokines may have been produced and secreted by the exercised zebrafish muscle and acted on fast muscle cells to promote metabolic remodeling. These results support the use of zebrafish as a suitable model for studies on muscle remodeling in vertebrates, including humans.
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Affiliation(s)
- Mireia Rovira
- Departament de Biologia Cel·lular, Facultat de Biologia, Fisiologia i Immunologia, Universitat de Barcelona, Barcelona, Spain
| | - Gerard Arrey
- Departament de Biologia Cel·lular, Facultat de Biologia, Fisiologia i Immunologia, Universitat de Barcelona, Barcelona, Spain
| | - Josep V Planas
- Departament de Biologia Cel·lular, Facultat de Biologia, Fisiologia i Immunologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona, Barcelona, Spain
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Proteome analysis in dystrophic mdx mouse muscle reveals a drastic alteration of key metabolic and contractile proteins after chronic exercise and the potential modulation by anti-oxidant compounds. J Proteomics 2017; 170:43-58. [PMID: 28966053 DOI: 10.1016/j.jprot.2017.09.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/05/2017] [Accepted: 09/15/2017] [Indexed: 11/21/2022]
Abstract
Weakness and fatigability are typical features of Duchenne muscular dystrophy patients and are aggravated in dystrophic mdx mice by chronic treadmill exercise. In the present study, we describe, the pattern of differentially abundant spots that is associated to the worsening of dystrophy phenotype induced by chronic exercise. Our proteomic analysis pointed out 34 protein spots with different abundance between sedentary and exercised mdx mice. These proteins belong mostly to glucose metabolism, energy production and sarcomere structure categories. Interestingly exercise induced an increase of typical fast twitch fiber proteins (Troponin T fast skeletal muscle, Troponin I fast skeletal muscle and Myozenin-1) combined with an increase of several glycolytic enzymes. Concerning energy transfer, Adenylate kinase, showed a marked decrease when compared with non-exercised mdx. The decline of this enzyme correlates with increased Creatin kinase enzyme, suggesting that a compensatory energy metabolism mechanism could be activated in mdx mouse skeletal muscle following exercise. In addition, we analysed muscles from exercised mdx mice treated with two natural anti-oxidant compounds, apocynin and taurine, that in our previous study, were proved to be beneficial on some pathology related parameters, and we showed that these compounds can counteract exercise-induced changes in the abundance of several proteins. SIGNIFICANCE Mdx mouse model of Duchenne muscular dystrophy shows a phenotype of the disorder milder than in human sufferers. This phenotype can be worsened by a different protocols of chronic exercise. These protocols can mimic the muscle progressive damage observed in humans, can allow studying the effects of inadequate training on dystrophic muscles and have been largely used to assess the ability of a drug to reduce the damage induced by exercise. In this study, we describe for the first time, the pattern of protein variation associated with the worsening of dystrophy phenotype induced by chronic exercise. Our proteomic analysis pointed out 34 protein spots with different amount between sedentary and exercised mdx mice. These proteins belong mostly to glucose metabolism, energy production and sarcomere structure categories and their variation indicates that mdx exercised muscle are not able to carry out the metabolic changes associated to fast-to-slow transition typically observed in aerobically trained muscle.
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Aimo A, Giannoni A, Castiglione V, Mancuso M, Siciliano G, Piepoli MF, Passino C, Emdin M. Neurohormonal modulation for treatment of cardiac involvement in dystrophinopathies and mitochondrial disease. Eur J Prev Cardiol 2017; 24:1718-1724. [DOI: 10.1177/2047487317725018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alberto Giannoni
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | | | | | | | - Claudio Passino
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Michele Emdin
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Hyzewicz J, Ruegg UT, Takeda S. Comparison of Experimental Protocols of Physical Exercise for mdx Mice and Duchenne Muscular Dystrophy Patients. J Neuromuscul Dis 2015; 2:325-342. [PMID: 27858750 PMCID: PMC5240598 DOI: 10.3233/jnd-150106] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Duchenne Muscular Dystrophy (DMD) is caused by mutations in the gene coding for dystrophin and leads to muscle degeneration, wheelchair dependence and death by cardiac or respiratory failure. Physical exercise has been proposed as a palliative therapy for DMD to maintain muscle strength and prevent contractures for as long as possible. However, its practice remains controversial because the benefits of training may be counteracted by muscle overuse and damage. The effects of physical exercise have been investigated in muscles of dystrophin-deficient mdx mice and in patients with DMD. However, a lack of uniformity among protocols limits comparability between studies and translatability of results from animals to humans. In the present review, we summarize and discuss published protocols used to investigate the effects of physical exercise on mdx mice and DMD patients, with the objectives of improving comparability between studies and identifying future research directions.
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Affiliation(s)
- Janek Hyzewicz
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Shin'ichi Takeda
- Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
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Mechanical Overloading Increases Maximal Force and Reduces Fragility in Hind Limb Skeletal Muscle from Mdx Mouse. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 185:2012-24. [DOI: 10.1016/j.ajpath.2015.03.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 01/30/2015] [Accepted: 03/09/2015] [Indexed: 12/20/2022]
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Hu X, Blemker SS. Musculoskeletal simulation can help explain selective muscle degeneration in Duchenne muscular dystrophy. Muscle Nerve 2015; 52:174-82. [DOI: 10.1002/mus.24607] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Xiao Hu
- Department of Biomedical Engineering; University of Virginia; 415 Lane Road Charlottesville Virginia USA 22908
| | - Silvia S. Blemker
- Department of Biomedical Engineering; University of Virginia; 415 Lane Road Charlottesville Virginia USA 22908
- Department of Mechanical and Aerospace Engineering; University of Virginia; Charlottesville Virginia USA
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Alemdaroğlu I, Karaduman A, Yilmaz ÖT, Topaloğlu H. Different types of upper extremity exercise training in Duchenne muscular dystrophy: Effects on functional performance, strength, endurance, and ambulation. Muscle Nerve 2015; 51:697-705. [DOI: 10.1002/mus.24451] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 01/30/2023]
Affiliation(s)
- Ipek Alemdaroğlu
- Faculty of Health Sciences; Physiotherapy and Rehabilitation Department; Bezmialem Vakıf University; Fatih Istanbul Turkey
| | - Ayşe Karaduman
- Faculty of Health Sciences; Physiotherapy and Rehabilitation Department; Hacettepe University; Ankara Turkey
| | - Öznur Tunca Yilmaz
- Faculty of Health Sciences; Physiotherapy and Rehabilitation Department; Hacettepe University; Ankara Turkey
| | - Haluk Topaloğlu
- İhsan Doğramacı Children Hospital; Pediatric Neurology Department; Hacettepe University; Ankara Turkey
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Meriggioli MN, Roubenoff R. Prospect for pharmacological therapies to treat skeletal muscle dysfunction. Calcif Tissue Int 2015; 96:234-42. [PMID: 25363509 DOI: 10.1007/s00223-014-9926-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 10/23/2014] [Indexed: 12/25/2022]
Abstract
Skeletal muscle weakness is a leading cause of mobility disability in the elderly (sarcopenia), as a complication of acute or chronic illness (cachexia), and due to inherited or acquired muscle diseases (muscular dystrophies, myositides, etc.). As of now, there are no approved drugs that can reliably increase muscle strength and function. However, with our understanding of the regulation of myocyte signaling and homeostasis evolving rapidly, experimental treatments are now entering the clinic. We review the current status of clinical research in pharmacological therapies for muscle disorders.
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Affiliation(s)
- Matthew N Meriggioli
- Department of Musculoskeletal Translational Medicine, Novartis Institutes for Biomedical Research, 220 Massachusetts Avenue, Cambridge, MA, 02139, USA
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Abstract
PURPOSE To determine exercise response during cardiopulmonary exercise testing in children and adolescents with dystrophinopathies. METHODS Exercise response on the cardiopulmonary exercise test (CPET) was compared with a standard care test protocol. RESULTS Nine boys (aged 10.8 ± 4.7 years) with Becker muscular dystrophy (n = 6) and Duchenne muscular dystrophy (n = 3) were included. The feasibility of the CPET was similar to a standard care test protocol, and no serious adverse events occurred. In 67% of the subjects with normal or only mildly impaired functional capacity, the CPET could be used to detect moderate to severe cardiopulmonary exercise limitations. CONCLUSIONS The CPET seems to be a promising outcome measure for cardiopulmonary exercise limitations in youth with mild functional limitations. Further research with larger samples is warranted to confirm current findings and investigate the additional value of the CPET to longitudinal follow-up of cardiomyopathy and the development of safe exercise programs for youth with dystrophinopathies.
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Gordon BS, Lowe DA, Kostek MC. Exercise increases utrophin protein expression in the mdx mouse model of Duchenne muscular dystrophy. Muscle Nerve 2014; 49:915-8. [PMID: 24375286 DOI: 10.1002/mus.24151] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2013] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Duchenne muscular dystrophy (DMD) is a lethal genetic disease caused by mutations in the dystrophin gene resulting in chronic muscle damage, muscle wasting, and premature death. Utrophin is a dystrophin protein homologue that increases dystrophic muscle function and reduces pathology. Currently, no treatments that increase utrophin protein expression exist. However, exercise increases utrophin mRNA expression in healthy humans. Therefore, the purpose was to determine whether exercise increases utrophin protein expression in dystrophic muscle. METHODS Utrophin protein was measured in the quadriceps and soleus muscles of mdx mice after 12 weeks of voluntary wheel running exercise or sedentary controls. Muscle pathology was measured in the quadriceps. RESULTS Exercise increased utrophin protein expression 334 ± 63% in the quadriceps relative to sedentary controls. Exercise increased central nuclei 4 ± 1% but not other measures of pathology. CONCLUSIONS Exercise may be an intervention that increases utrophin expression in patients with DMD.
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Affiliation(s)
- Bradley S Gordon
- University of South Carolina, Department of Exercise Science, Columbia, South Carolina, USA
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Svensson K, Handschin C. Modulation of PGC-1α activity as a treatment for metabolic and muscle-related diseases. Drug Discov Today 2014; 19:1024-9. [PMID: 24631683 DOI: 10.1016/j.drudis.2014.02.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 02/27/2014] [Indexed: 01/03/2023]
Affiliation(s)
- Kristoffer Svensson
- Biozentrum, University of Basel, Klingelbergstrasse 50/70, 4056 Basel, Switzerland
| | - Christoph Handschin
- Biozentrum, University of Basel, Klingelbergstrasse 50/70, 4056 Basel, Switzerland.
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36
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Vry J, Schubert IJ, Semler O, Haug V, Schönau E, Kirschner J. Whole-body vibration training in children with Duchenne muscular dystrophy and spinal muscular atrophy. Eur J Paediatr Neurol 2014; 18:140-9. [PMID: 24157400 DOI: 10.1016/j.ejpn.2013.09.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 09/14/2013] [Accepted: 09/23/2013] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Whole-body-vibration training is used to improve muscle strength and function and might therefore constitute a potential supportive therapy for neuromuscular diseases. OBJECTIVE To evaluate safety of whole-body vibration training in ambulatory children with Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA). METHODS 14 children with DMD and 8 with SMA underwent an 8-week vibration training programme on a Galileo MedM at home (3 × 3 min twice a day, 5 days a week). Primary outcome was safety of the training, assessed clinically and by measuring serum creatine kinase levels. Secondary outcome was efficacy as measured by changes in time function tests, muscle strength and angular degree of dorsiflexion of the ankles. RESULTS All children showed good clinical tolerance. In boys with DMD, creatine kinase increased by 56% after the first day of training and returned to baseline after 8 weeks of continuous whole-body vibration training. No changes in laboratory parameters were observed in children with SMA. Secondary outcomes showed mild, but not significant, improvements with the exception of the distance walked in the 6-min walking test in children with SMA, which rose from 371.3 m to 402.8 m (p < 0.01). INTERPRETATION Whole-body vibration training is clinically well tolerated in children with DMD and SMA. The relevance of the temporary increase in creatine kinase in DMD during the first days of training is unclear, but it is not related to clinical symptoms or deterioration.
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Affiliation(s)
- Julia Vry
- Department of Paediatrics and Adolescent Medicine, University Medical Centre Freiburg, Mathildenstraße 1, 79106 Freiburg, Germany.
| | - Isabel J Schubert
- Department of Paediatrics and Adolescent Medicine, University Medical Centre Freiburg, Mathildenstraße 1, 79106 Freiburg, Germany
| | | | - Verena Haug
- Department of Paediatrics and Adolescent Medicine, University Medical Centre Freiburg, Mathildenstraße 1, 79106 Freiburg, Germany
| | | | - Janbernd Kirschner
- Department of Paediatrics and Adolescent Medicine, University Medical Centre Freiburg, Mathildenstraße 1, 79106 Freiburg, Germany
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Ljubicic V, Burt M, Jasmin BJ. The therapeutic potential of skeletal muscle plasticity in Duchenne muscular dystrophy: phenotypic modifiers as pharmacologic targets. FASEB J 2013; 28:548-68. [PMID: 24249639 DOI: 10.1096/fj.13-238071] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Duchenne muscular dystrophy (DMD) is a life-limiting, neuromuscular disorder that causes progressive, severe muscle wasting in boys and young men. Although there is no cure, scientists and clinicians can leverage the fact that slower, more oxidative skeletal muscle fibers possess an enhanced degree of resistance to the dystrophic pathology relative to their faster, more glycolytic counterparts, and can thus use this knowledge when investigating novel therapeutic avenues. Several factors have been identified as powerful regulators of muscle plasticity. Some proteins, such as calcineurin, peroxisome proliferator-activated receptor (PPAR) γ coactivator 1α (PGC-1α), PPARβ/δ, and AMP-activated protein kinase (AMPK), when chronically stimulated in animal models, remodel skeletal muscle toward the slow, oxidative myogenic program, whereas others, such as receptor-interacting protein 140 (RIP140) and E2F transcription factor 1 (E2F1), repress this phenotype. Recent studies demonstrating that pharmacologic and physiological activation of targets that shift dystrophic muscle toward the slow, oxidative myogenic program provide appreciable molecular and functional benefits. This review surveys the rationale behind, and evidence for, the study of skeletal muscle plasticity in preclinical models of DMD and highlights the potential therapeutic opportunities in advancing a strategy focused on remodeling skeletal muscle in patients with DMD toward the slow, oxidative phenotype.
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Affiliation(s)
- Vladimir Ljubicic
- 1Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
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38
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AMP-activated protein kinase at the nexus of therapeutic skeletal muscle plasticity in Duchenne muscular dystrophy. Trends Mol Med 2013; 19:614-24. [PMID: 23891277 DOI: 10.1016/j.molmed.2013.07.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 06/26/2013] [Accepted: 07/01/2013] [Indexed: 12/22/2022]
Abstract
Recent studies have highlighted the potential of adenosine monophosphate-activated protein kinase (AMPK) to act as a central therapeutic target in Duchenne muscular dystrophy (DMD). Here, we review the role of AMPK as an important integrator of cell signaling pathways that mediate phenotypic plasticity within the context of dystrophic skeletal muscle. Pharmacological AMPK activation remodels skeletal muscle towards a slower, more oxidative phenotype, which is more pathologically resistant to the lack of dystrophin. Moreover, recent studies suggest that AMPK-activated autophagy may be beneficial for myofiber structure and function in mice with muscular dystrophy. Thus, AMPK may represent an ideal target for intervention because clinically approved pharmacological agonists exist, and because benefits can be derived via two independent yet, complementary biological pathways. The availability of several AMPK activators could therefore lead to the rapid development and implementation of novel and highly effective therapeutics aimed at altering the relentless progression of DMD.
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Baltgalvis KA, Call JA, Cochrane GD, Laker RC, Yan Z, Lowe DA. Exercise training improves plantar flexor muscle function in mdx mice. Med Sci Sports Exerc 2013; 44:1671-9. [PMID: 22460476 DOI: 10.1249/mss.0b013e31825703f0] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE We tested the hypothesis that low-intensity exercise in mdx mice improves plantar flexor muscle contractile function, resistance to fatigue, and mitochondrial adaptations without exacerbating muscular dystrophy. METHODS We subjected mdx mice to 12 wk of voluntary low-resistance wheel running (Run, n = 17) or normal cage activities (sedentary (Sed), n = 16) followed by in vivo analyses for plantar flexor torque generation and fatigue resistance or running capacity on a treadmill. Gastrocnemius muscles were further evaluated for exercise-induced mitochondrial adaptations and fiber type distribution and central nuclei. t-tests were used to determine differences between the Sed and Run groups. RESULTS Plantar flexor submaximal isometric torques and maximal isometric torque at multiple ankle joint angles and resistance to fatigue were greater in Run compared with Sed mdx mice (P G 0.05). Citrate synthase and A-hydroxyacyl-CoA dehydrogenase enzyme activities and cytochrome c oxidase IV protein expression in gastrocnemius muscles were greater in Run than in Sed mdx mice(P e 0.04), along with a trend of fiber type transformation from Type IIb to Type IIx fibers. Exercise training in mdx mice did not elevate serum creatine kinase levels but led to a significant reduction of centrally nucleated myofibers. CONCLUSIONS Voluntary low-resistance wheel running in mdx mice can result in skeletal muscle adaptation, leading to improved contractile function and reduced fatigability,with no indication that exercise was detrimental. This study supports the need for further investigation of low-intensity exercise as an early therapeutic intervention in ambulatory boys with Duchenne muscular dystrophy.
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Abstract
In this review, we present an overview of the role of exercise in neuromuscular disease (NMD). We demonstrate that despite the different pathologies in NMDs, exercise is beneficial, whether aerobic/endurance or strength/resistive training, and we explore whether this benefit has a similar mechanism to that of healthy subjects. We discuss further areas for study, incorporating imaginative and novel approaches to training and its assessment in NMD. We conclude by suggesting ways to improve future trials by avoiding previous methodological flaws and drawbacks in this field.
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Affiliation(s)
- Yaacov Anziska
- Department of Neurology, SUNY-Downstate Medical Center, 450 Clarkson Avenue, Box 1213, Brooklyn, New York, 11203, USA.
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41
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Berger J, Currie PD. Zebrafish models flex their muscles to shed light on muscular dystrophies. Dis Model Mech 2013; 5:726-32. [PMID: 23115202 PMCID: PMC3484855 DOI: 10.1242/dmm.010082] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Muscular dystrophies are a group of genetic disorders that specifically affect skeletal muscle and are characterized by progressive muscle degeneration and weakening. To develop therapies and treatments for these diseases, a better understanding of the molecular basis of muscular dystrophies is required. Thus, identification of causative genes mutated in specific disorders and the study of relevant animal models are imperative. Zebrafish genetic models of human muscle disorders often closely resemble disease pathogenesis, and the optical clarity of zebrafish embryos and larvae enables visualization of dynamic molecular processes in vivo. As an adjunct tool, morpholino studies provide insight into the molecular function of genes and allow rapid assessment of candidate genes for human muscular dystrophies. This unique set of attributes makes the zebrafish model system particularly valuable for the study of muscle diseases. This review discusses how recent research using zebrafish has shed light on the pathological basis of muscular dystrophies, with particular focus on the muscle cell membrane and the linkage between the myofibre cytoskeleton and the extracellular matrix.
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Affiliation(s)
- Joachim Berger
- Australian Regenerative Medicine Institute, EMBL Australia, Monash University, Clayton, Victoria 3800, Australia.
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Lovering RM, Brooks SV. Eccentric exercise in aging and diseased skeletal muscle: good or bad? J Appl Physiol (1985) 2013; 116:1439-45. [PMID: 23471953 DOI: 10.1152/japplphysiol.00174.2013] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Evidence is accumulating regarding the benefits of exercise in people who are more susceptible to injury, such as the elderly, or those with a neuromuscular disease, for example Duchenne muscular dystrophy (DMD). There appears to be a consensus that exercise can be safely performed in aging and diseased muscles, but the role of eccentric exercise is not as clear. Eccentric (lengthening) contractions have risks and benefits. Eccentric contractions are commonly performed on a daily basis, and high-force voluntary eccentric contractions are often employed in strength training paradigms with excellent results; however, high-force eccentric contractions are also linked to muscle damage. This minireview examines the benefits and safety issues of using eccentric exercise in at-risk populations. A common recommendation for all individuals is difficult to achieve, and guidelines are still being established. Some form of exercise is generally recommended with aging and even with diseased muscles, but the prescription (frequency, intensity, and duration) and type (resistance vs. aerobic) of exercise requires personal attention, as there is great diversity in the functional level and comorbidities in the elderly and those with neuromuscular disease.
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Affiliation(s)
- Richard M Lovering
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland; and
| | - Susan V Brooks
- Department of Molecular and Integrative Physiology, University of Michigan School of Medicine, Ann Arbor, Michigan
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Brereton D, Plochocki J, An D, Costas J, Simons E. The effects of glucocorticoid and voluntary exercise treatment on the development of thoracolumbar kyphosis in dystrophin-deficient mice. PLOS CURRENTS 2012; 4:e4ffdff160de8b. [PMID: 23145353 PMCID: PMC3493061 DOI: 10.1371/4ffdff160de8b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The development of spinal curvature deformities is a hallmark of muscular dystrophy. While glucocorticoid treatment has been shown to prolong muscle function in dystrophic mice, its effects on the development of dystrophinopathic spinal deformation are poorly understood. In this study, we test the effects of glucocorticoid treatment on the onset of thoracolumbar kyphosis in the dystrophin-deficient mdx mouse using voluntary running exercise to exacerbate muscle fibrosis. We measure the kyphotic index, erector spinae muscle fibrosis, and vertebral bone histomorphometry in 4-month-old mdx mice in four groups: sedentary control, exercise-treated (continuous voluntary access to an activity wheel), glucocorticoid-treated, and glucocorticoid + exercise-treated. Exercise treated mice were found to have significantly lower kyphotic index (i.e., greater kyphosis) and greater muscle fibrosis relative to controls (p < 0.05). However, the deleterious effect of exercise on KI and muscle fibrosis was prevented by glucocorticoid treatment. Some differences in bone histological parameters were observed between treatment groups, suggesting there is a complex relationship between dystrophic muscular changes and vertebral bone mass. Our findings indicate glucocorticoid treatment delays the onset of thoracodorsal spinal deformation in mdx mice.
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Affiliation(s)
- Daniel Brereton
- Arizona College of Osteopathic Medicine, Midwestern University
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Combined effect of AMPK/PPAR agonists and exercise training in mdx mice functional performance. PLoS One 2012; 7:e45699. [PMID: 23029189 PMCID: PMC3448675 DOI: 10.1371/journal.pone.0045699] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 08/20/2012] [Indexed: 02/03/2023] Open
Abstract
The present investigation was undertaken to test whether exercise training (ET) associated with AMPK/PPAR agonists (EM) would improve skeletal muscle function in mdx mice. These drugs have the potential to improve oxidative metabolism. This is of particular interest because oxidative muscle fibers are less affected in the course of the disease than glycolitic counterparts. Therefore, a cohort of 34 male congenic C57Bl/10J mdx mice included in this study was randomly assigned into four groups: vehicle solution (V), EM [AICAR (AMPK agonist, 50 mg/Kg-1.day-1, ip) and GW 1516 (PPARδ agonist, 2.5 mg/Kg-1.day-1, gavage)], ET (voluntary running on activity wheel) and EM+ET. Functional performance (grip meter and rotarod), aerobic capacity (running test), muscle histopathology, serum creatine kinase (CK), levels of ubiquitined proteins, oxidative metabolism protein expression (AMPK, PPAR, myoglobin and SCD) and intracellular calcium handling (DHPR, SERCA and NCX) protein expression were analyzed. Treatments started when the animals were two months old and were maintained for one month. A significant functional improvement (p<0.05) was observed in animals submitted to the combination of ET and EM. CK levels were decreased and the expression of proteins related to oxidative metabolism was increased in this group. There were no differences among the groups in the intracellular calcium handling protein expression. To our knowledge, this is the first study that tested the association of ET with EM in an experimental model of muscular dystrophy. Our results suggest that the association of ET and EM should be further tested as a potential therapeutic approach in muscular dystrophies.
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Markert CD, Case LE, Carter GT, Furlong PA, Grange RW. Exercise and duchenne muscular dystrophy: Where we have been and where we need to go. Muscle Nerve 2012; 45:746-51. [DOI: 10.1002/mus.23244] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Lou J, Bi W, Li W, Zhao Y, Liu S, Zheng J, Yan C. Muscle injury induced by different types of contractions in dystrophic mdx mice. J Muscle Res Cell Motil 2012; 32:411-9. [DOI: 10.1007/s10974-012-9284-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 01/31/2012] [Indexed: 02/07/2023]
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Ferraresi C, Hamblin MR, Parizotto NA. Low-level laser (light) therapy (LLLT) on muscle tissue: performance, fatigue and repair benefited by the power of light. ACTA ACUST UNITED AC 2012; 1:267-286. [PMID: 23626925 DOI: 10.1515/plm-2012-0032] [Citation(s) in RCA: 362] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The use of low level laser (light) therapy (LLLT) has recently expanded to cover areas of medicine that were not previously thought of as the usual applications such as wound healing and inflammatory orthopedic conditions. One of these novel application areas is LLLT for muscle fatigue and muscle injury. Since it is becoming agreed that mitochondria are the principal photoacceptors present inside cells, and it is known that muscle cells are exceptionally rich in mitochondria, this suggests that LLLT should be highly beneficial in muscle injuries. The ability of LLLT to stimulate stem cells and progenitor cells means that muscle satellite cells may respond well to LLLT and help muscle repair. Furthermore the ability of LLLT to reduce inflammation and lessen oxidative stress is also beneficial in cases of muscle fatigue and injury. This review covers the literature relating to LLLT and muscles in both preclinical animal experiments and human clinical studies. Athletes, people with injured muscles, and patients with Duchenne muscular dystrophy may all benefit.
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Affiliation(s)
- Cleber Ferraresi
- Laboratory of Electro-thermo-phototherapy, Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil; and Department of Biotechnology, Federal University of São Carlos, São Carlos, São Paulo 13565-905, Brazil
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Davoodi J, Markert CD, Voelker KA, Hutson SM, Grange RW. Nutrition strategies to improve physical capabilities in Duchenne muscular dystrophy. Phys Med Rehabil Clin N Am 2011; 23:187-99, xii-xiii. [PMID: 22239883 DOI: 10.1016/j.pmr.2011.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
There is no current cure for Duchenne muscular dystrophy (DMD), and palliative and prophylactic interventions to improve the quality of life of patients remain limited, with the exception of corticosteroids. This article describes 2 potential nutritional interventions for the treatment of DMD, green tea extract (GTE) and the branched-chain amino acid leucine, and their positive effects on physical activity. Both GTE and leucine are suitable for human consumption, are easily tolerated with no side effects, and, with appropriate preclinical data, could be brought forward to clinical trials rapidly.
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Affiliation(s)
- J Davoodi
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA
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Ljubicic V, Khogali S, Renaud JM, Jasmin BJ. Chronic AMPK stimulation attenuates adaptive signaling in dystrophic skeletal muscle. Am J Physiol Cell Physiol 2011; 302:C110-21. [PMID: 21940670 DOI: 10.1152/ajpcell.00183.2011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In the present study, we evaluated how a pharmacologically induced phenotype shift in dystrophic skeletal muscle would affect subsequent intracellular signaling in response to a complementary, adaptive physiological stimulus. mdx mice were treated with the AMP-activated protein kinase (AMPK) activator 5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside (AICAR; 500 mg·kg(-1)·day(-1)) for 30 days, and then one-half of the animals were subjected to a bout of treadmill running to induce acute AMPK and p38 MAPK signaling. The mRNA levels of phenotypic modifiers, including peroxisome proliferator-activated receptor-δ (PPARδ), PPARγ coactivator-1α (PGC-1α), receptor interacting protein 140 (RIP 140), and silent information regulator two ortholog 1 (SIRT1) were assessed in skeletal muscle, as well as the expression of the protein arginine methyltransferase genes PRMT1 and CARM1. We found unique AMPK and p38 phosphorylation and expression signatures between dystrophic and healthy muscle. In dystrophic skeletal muscle, treadmill running induced PPARδ, PGC-1α, and SIRT1 mRNAs, three molecules that promote the slow, oxidative myogenic program. In the mdx animals that received the chronic AICAR treatment, running-elicited AMPK and p38 phosphorylation was attenuated compared with vehicle-treated mice. Similarly, acute stress-evoked expression of PPARδ, PGC-1α, and SIRT1 was also blunted by chronic pharmacological AMPK stimulation. Skeletal muscle PRMT1 and CARM1 protein contents were higher in mdx mice compared with wild-type littermates. The acute running-evoked induction of PRMT1 and CARM1 mRNAs was also attenuated by the AICAR treatment. Our data demonstrate that prior pharmacological conditioning is a salient determinant in how dystrophic muscle adapts to subsequent complementary, acute physiological stress stimuli. These results provide insight into possible therapeutic applications of synthetic agonists in neuromuscular diseases, such as during chronic administration to Duchenne muscular dystrophy patients.
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Affiliation(s)
- Vladimir Ljubicic
- Department of Cellular and Molecular Medicine, Faculty of Medicine, and Center for Neuromuscular Disease, University of Ottawa, Ottawa, Ontario, Canada.
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