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Dombrecht D, Van Daele U, Van Asbroeck B, Schieffelers DR, Guns PJ, van Breda E. Skeletal muscle wasting after burn is regulated by a decrease in anabolic signaling in the early flow phase. Burns 2023; 49:1574-1584. [PMID: 37833149 DOI: 10.1016/j.burns.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/14/2023] [Accepted: 08/10/2023] [Indexed: 10/15/2023]
Abstract
Following burns a sustained catabolic stress response is activated, resulting in skeletal muscle wasting. A better understanding of the underlying mechanisms of postburn skeletal muscle wasting is essential for the development of preventive and/or therapeutic strategies. Six weeks old female rats underwent a sham, 10% or 40% total body surface area scald burn. Ten days post-injury, severely burned animals gained significantly less weight compared to sham treated and minor burned animals, reflected in a significantly lower ratio of muscle to total body weight for Soleus (SOL) and Extensor Digitorum Longus (EDL) in the severely burned group. Postburn, total fiber number was significantly lower in EDL, while in SOL the amount of type1 fibers significantly increased and type2 fibers significantly decreased. No signs of mitochondrial dysfunction (COX/SDH) or apoptosis (caspase-3) were found. In SOL and EDL, eEF2 and pAKT expression was significantly lower after severe burn. MURF1,2,3 and Atrogin-1 was significantly higher in SOL, whilst in EDL MURF1,2,3 was significantly lower postburn. In both muscles, FOXO3A was significantly lower postburn. This study identified postburn changes in muscle anthropomorphology and proteins involved in pathways regulating protein synthesis and breakdown, with more pronounced catabolic effects in SOL.
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Affiliation(s)
- Dorien Dombrecht
- Department of Rehabilitation Sciences & Physiotherapy, Research Group MOVANT, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Ulrike Van Daele
- Department of Rehabilitation Sciences & Physiotherapy, Research Group MOVANT, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium; Oscare, Organisation for Burns, Scar After-Care and Research, 2170 Antwerp, Belgium.
| | - Birgit Van Asbroeck
- Department of Rehabilitation Sciences & Physiotherapy, Research Group MOVANT, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - David R Schieffelers
- Department of Rehabilitation Sciences & Physiotherapy, Research Group MOVANT, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Eric van Breda
- Department of Rehabilitation Sciences & Physiotherapy, Research Group MOVANT, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium.
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Song J, Clark A, Wade CE, Wolf SE. Skeletal muscle wasting after a severe burn is a consequence of cachexia and sarcopenia. JPEN J Parenter Enteral Nutr 2021; 45:1627-1633. [PMID: 34296448 PMCID: PMC9293203 DOI: 10.1002/jpen.2238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Muscle wasting is common and persistent in severely burned patients, worsened by immobilization during treatment. In this review, we posit two major phenotypes of muscle wasting after severe burn, cachexia and sarcopenia, each with distinguishing characteristics to result in muscle atrophy; these characteristics are also likely present in other critically ill populations. An online search was conducted from the PubMed database and other available online resources and we manually extracted published articles in a systematic mini review. We describe the current definitions and characteristics of cachexia and sarcopenia and relate these to muscle wasting after severe burn. We then discuss these putative mechanisms of muscle atrophy in this condition. Severe burn and immobilization have distinctive patterns in mediating muscle wasting and muscle atrophy. In considering these two pathological phenotypes (cachexia and sarcopenia), we propose two independent principal causes and mechanisms of muscle mass loss after burns: (1) inflammation-induced cachexia, leading to proteolysis and protein degradation, and (2) sarcopenia/immobility that signals inhibition of expected increases in protein synthesis in response to protein loss. Because both are present following severe burn, these should be considered independently in devising treatments. Discussing cachexia and sarcopenia as independent mechanisms of severe burn-initiated muscle wasting is explored. Recognition of these associated mechanisms will likely improve outcomes.
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Affiliation(s)
- Juquan Song
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Audra Clark
- Department of Surgery, University of Texas, Southwestern Medical Center, Dallas, Texas, USA
| | - Charles E Wade
- Center for Translational Injury Research and Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Steven E Wolf
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
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Chen CA, Huang YC, Lo JJ, Wang SH, Huang SH, Wu SH. Hyperbaric Oxygen Therapy Attenuates Burn-Induced Denervated Muscle Atrophy. Int J Med Sci 2021; 18:3821-3830. [PMID: 34790058 PMCID: PMC8579280 DOI: 10.7150/ijms.65976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/07/2021] [Indexed: 11/14/2022] Open
Abstract
Background: Neuronal apoptosis and inflammation in the ventral horn of the spinal cord contribute to denervated muscle atrophy post-burn. Hyperbaric oxygen therapy (HBOT) exerts anti-inflammation and neuroprotection. Furthermore, hypoxia-inducible factor (HIF)-1α has been reported to promote inflammation and apoptosis. We investigated the therapeutic potential of HBOT and the role of HIF-1α post-burn. Methods: Sprague-Dawley rats were divided into three groups: a control group, an untreated burn group receiving burn and sham treatment, and a HBOT group receiving burn injury and HBOT. The burn injury was induced with 75ºC ± 5ºC at the right hindpaw. HBOT (100% oxygen at 2.5 atmosphere, 90 min/day) and sham HBOT (21% oxygen at 1 atmosphere, 90 min/day) was started on day 28 after burn injury and continued for 14 treatments (days 28-41). Incapacitance (hind limb weight bearing) testing was conducted before burn and weekly after burn. At day 42 post-burn, the gastrocnemius muscle and the spinal cord ventral horn were analyzed. Results: HBOT improved burn-induced weight bearing imbalance. At day 42 post-burn, less gastrocnemius muscle atrophy and fibrosis were noted in the HBOT group than in the untreated burn group. In the ventral horn, HBOT attenuated the neuronal apoptosis and glial activation post-burn. The increases in phosphorylated AKT/mTOR post-burn were reduced after HBOT. HBOT also inhibited HIF-1α signaling, as determined by immunofluorescence and western blot. Conclusions: HBOT reduces burn-induced neuronal apoptosis in the ventral horn, possibly through HIF-1α signaling.
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Affiliation(s)
- Chin-An Chen
- Department of Anesthesiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung Medical University, Taiwan
| | - Yi-Chen Huang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jing-Jou Lo
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Hung Wang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Hyperbaric Oxygen Therapy Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Hua Wu
- Department of Anesthesiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung Medical University, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Wise AK, Hromatka KA, Miller KR. Energy Expenditure and Protein Requirements Following Burn Injury. Nutr Clin Pract 2019; 34:673-680. [PMID: 31418486 DOI: 10.1002/ncp.10390] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Severe burn injuries have long been known to have a profound effect on metabolic equilibrium that can persist after resolution of the cutaneous injuries. Following burn injury, metabolism is a dynamic state resulting in the need for frequent interval reassessment over the course of the care continuum. The acute phase of injury transitions to chronic alterations in macronutrient utilization characterized by futile energy cycling and disproportionate catabolism of skeletal muscle. Protein supplementation appears to be preferentially distributed to the burn wound rather than the skeletal muscle pool. Accurate assessment of caloric and protein requirements is extremely difficult in these patients but is an essential step in efforts to attenuate functional impairment. Indirect calorimetry should be utilized to determine caloric requirements, but trophic feeding strategies are preferred in the initial resuscitative phase to prevent overfeeding while maintaining enteric and immune function. Controversy persists regarding optimal protein targets, and weight-based estimates remain the norm. Exogenous protein and caloric provision performed in isolation is insufficient to optimize outcomes and should be incorporated within a multidisciplinary approach to include muscle loading and pharmaceutical adjuncts.
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Affiliation(s)
- Amy K Wise
- Department of Surgery, University of Louisville, Louisville, Kentucky, USA
| | | | - Keith R Miller
- Department of Surgery, University of Louisville, Louisville, Kentucky, USA
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Song J, Baer LA, Threlkeld MRS, Geng C, Wade CE, Wolf SE. Insulin and exercise improved muscle function in rats with severe burns and hindlimb unloading. Physiol Rep 2019; 7:e14158. [PMID: 31353827 PMCID: PMC6661272 DOI: 10.14814/phy2.14158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/11/2019] [Indexed: 12/03/2022] Open
Abstract
Prior work established that exercise alleviates muscle function loss in a clinically relevant rodent model mimicking the clinical sequelae of severely burned patients. On the basis of these data, we posit that pharmacologic treatment with insulin combined with exercise further mitigates loss of muscle function following severe burn with immobilization. Twenty-four Sprague-Dawley rats were assessed and trained to complete a climbing exercise. All rats followed a standardized protocol to mimic severe burn patients (40% total body surface area scald burn); all rats were immediately placed into a hindlimb unloading apparatus to simulate bedrest. The rats were then randomly assigned to four treatment groups: saline vehicle injection without exercise (VEH/NEX), insulin (5 U/kg) injection without exercise (INS/NEX), saline vehicle with daily exercise (VEH/EX), and insulin with daily exercise (INS/EX). The animals were assessed for 14 days following injury. The groups were compared for multiple variables. Isometric tetanic (Po) and twitch (Pt) forces were significantly elevated in the plantaris and soleus muscles of the INS/EX rats (P < 0.05). Genomic analysis revealed mechanistic causes with specific candidate changes. Molecular analysis of INS/EX rats revealed Akt phosphorylated by PDPK1 was increased with this treatment, and it further activated downstream signals mTOR, eEF2, and GSK3-β (P < 0.05). Furthermore, muscle RING-finger protein-1 (MuRF-1), an E3 ubiquitin ligase, was reduced in the INS/EX group (P < 0.05). Insulin and resistance exercise have a positive combined effect on the muscle function recovery in this clinically relevant rodent model of severe burn. Both treatments altered signaling pathways of increasing protein synthesis and decreasing protein degradation.
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Affiliation(s)
- Juquan Song
- Department of SurgeryUniversity of Texas Medical Branch and Shriners Hospitals for ChildrenGalvestonTexas
| | - Lisa A. Baer
- Department of SurgeryUniversity of Texas Health Science Center at HoustonHoustonTexas
| | | | - Calvin Geng
- Department of SurgeryUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Charles E. Wade
- Department of SurgeryUniversity of Texas Health Science Center at HoustonHoustonTexas
| | - Steven E. Wolf
- Department of SurgeryUniversity of Texas Medical Branch and Shriners Hospitals for ChildrenGalvestonTexas
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Burn Injury Has Skeletal Site-Specific Effects on Bone Integrity and Markers of Bone Remodeling. J Burn Care Res 2018; 37:367-378. [PMID: 27404166 DOI: 10.1097/bcr.0000000000000389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To further understand the mechanisms of perturbations in bone remodeling following severe burn injury, the biomechanical properties, genetic expression, and serological markers were evaluated in rodents at six time intervals within 6 weeks following injury. Moreover, these effects were observed in rodent tibia and lumbar vertebrae to explore possible skeletal site localization of this pathologic bone loss. Rodents underwent either thermal injury (100°C water, 30 seconds, 30% BSA) or sham burn. Bone mineral density was evaluated though peripheral quantitative computer tomography, and specialized apparatus measured the weight bearing capacity of tibia and lumbar vertebrae. Markers of bone resorption (RANK ligand, osteocalcin) and bone formation (osteoprotegerin, procollagenase type 1 alpha 2) were measured at 7, 14, and 21 days following injury, and serum RANK-ligand levels were observed at these time intervals. Rodent body mass, bone mineral density, and weight bearing capacity were negatively influenced both acutely and several weeks following burn injury. Moreover, a genetic expression profile favoring increased bone resorption and lower bone formation was demonstrated. Our serum analysis findings of significantly increased RANKL 1 and 2 weeks following injury support the increased expression of bone resorption markers. Furthermore, these effects occurred sooner and were more pronounced in the rodent lumbar vertebrae than tibia. These results suggest that severe burn injury results in perturbations in bone remodeling secondary to increased bone resorption and diminished bone formation, impacting both bone mineral density and weight bearing capacity. Furthermore, these processes had a skeletal site effect more pronounced in the lumbar vertebrae. With a better understanding of the mechanisms of burn-injury bone loss, targeted therapies can be implemented to improve long-term clinical outcomes.
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7
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Exercise Altered the Skeletal Muscle MicroRNAs and Gene Expression Profiles in Burn Rats With Hindlimb Unloading. J Burn Care Res 2018; 38:11-19. [PMID: 27753701 DOI: 10.1097/bcr.0000000000000444] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study investigated microRNA and target gene profiles under different conditions of burn, bed rest, and exercise training. Male Sprague-Dawley rats (n = 48) were assigned to sham ambulatory, sham hindlimb unloading, burn ambulatory, or burn plus hindlimb unloading groups. Rats received a 40% TBSA scald burn or sham treatments and were ambulatory or hindlimb unloaded. Rats were further assigned to exercise or no exercise. Plantaris tissues were harvested on day 14 and pooled to analyze for microRNA and gene expression profiles. Compared with the sham ambulatory-no exercise group, 73, 79, and 80 microRNAs were altered 2-fold in the burn ambulatory, sham hindlimb unloading, and burn hindlimb unloading groups, all with no exercise, respectively. More than 70% of microRNAs were upregulated in response to burn and hindlimb unloading, whereas 60% microRNA of the profile decreased in hindlimb unloaded burn rats with exercise training. MiR-182 was the most affected in rat muscle. Gene ontology biological process and pathway analysis showed that the oxidative stress pathway was most stimulated in the hindlimb unloaded burn rats; while in response to exercise training, all genes in related pathways such as hypermetabolic, inflammation, and blood coagulation were alleviated. MicroRNAs and transcript gene profiles were altered in burn and hindlimb unloading groups, with additive effects on hindlimb unloaded burn rats. The altered genes' signal pathways were associated with muscle mass loss and function impairment. Muscle improvement with exercise training was observed in gene levels with microRNA alterations as well.
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8
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Wang C, Wang H, Wu D, Hu J, Wu W, Zhang Y, Peng X. A novel perspective for burn-induced myopathy: Membrane repair defect. Sci Rep 2016; 6:31409. [PMID: 27545095 PMCID: PMC4992861 DOI: 10.1038/srep31409] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 07/21/2016] [Indexed: 12/25/2022] Open
Abstract
Myopathy is a common complication of severe burn patients. One potential cause of this myopathy could be failure of the plasma membrane to undergo repair following injuries generated from toxin or exercise. The aim of this study is to assess systemic effect on muscle membrane repair deficiency in burn injury. Skeletal muscle fibers isolated from burn-injured mice were damaged with a UV laser and dye influx imaged confocally to evaluate membrane repair capacity. Membrane repair failure was also tested in burn-injured mice subjected to myotoxin or treadmill exercise. We further used C2C12 myotubules and animal models to investigate the role of MG53 in development of burn-induced membrane repair defect. We demonstrated that skeletal muscle myofibers in burn-injured mice showed significantly more dye uptake after laser damage than controls, indicating a membrane repair deficiency. Myotoxin or treadmill exercise also resulted in a higher-grade repair defect in burn-injured mice. Furthermore, we observed that burn injury induced a significant decrease in MG53 levels and its dimerization in skeletal muscles. Our findings highlight a new mechanism that implicates membrane repair failure as an underlying cause of burn-induced myopathy. And, the disorders in MG53 expression and MG53 dimerization are involved in this cellular pathology.
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Affiliation(s)
- Chao Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Hongyu Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Dan Wu
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jianhong Hu
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Wei Wu
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Yong Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Xi Peng
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
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9
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Abstract
Muscle loss accompanies severe burn; in this hyper-catabolic state, muscle undergoes atrophy through protein degradation and disuse. Muscle volume is related to the relative rates of cellular degradation and myogenesis. We hypothesize that muscle atrophy after injury is in part because of insufficient myogenesis associated with the hyper-inflammatory response. The aim of this study was to investigate the role of skeletal myogenesis and muscle cell homeostasis in response to severe burn. Twenty-eight male C57BL6 mice received 25% TBSA scald. Gluteus muscle from these animals was analyzed at days 1, 3, 7, and 14 after injury. Six additional animals without burn served as controls. We showed muscle wet weight and protein content decreased at days 3 and 7 after burn, with elevated tumor necrosis factor (TNF) mRNA expression (P < 0.05). Increased cell death was observed through TUNEL staining, and cleaved caspase-3 levels reached a peak in muscle lysate at day 3 (P < 0.05). The cell proliferation marker proliferating cell nuclear antigen (PCNA) significantly increased after burn, associated with increased gene and protein expression of myogenesis markers Pax7 and myogenin. Desmin mRNA expression and the ratio of desmin to PCNA protein expression, however, significantly decreased at day 7 (P < 0.05). In vitro, the ratio of desmin to PCNA protein expression significantly decreased in C2C12 murine myoblasts after TNF-α stimulation for 24 h. We showed that severe burn induces both increased cell death and proliferation. Myogenesis, however, does not counterbalance increased cell death after burn. Data suggest insufficient myogenesis might be associated with pro-inflammatory mediator TNF activity.
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Saeman MR, DeSpain K, Liu MM, Carlson BA, Song J, Baer LA, Wade CE, Wolf SE. Effects of exercise on soleus in severe burn and muscle disuse atrophy. J Surg Res 2015; 198:19-26. [PMID: 26104324 DOI: 10.1016/j.jss.2015.05.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 05/11/2015] [Accepted: 05/21/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Muscle loss is a sequela of severe burn and critical illness with bed rest contributing significantly to atrophy. We hypothesize that exercise will mitigate muscle loss after burn with bed rest. MATERIALS AND METHODS Male rats were assigned to sham ambulatory (S/A), burn ambulatory (B/A), sham hindlimb unloading (S/H), or burn hindlimb unloading (B/H). Rats received a 40% scald burn or sham and were ambulatory or placed in hindlimb unloading, a model of bed rest. Half from each group performed twice daily resistance climbing. Hindlimb isometric forces were measured on day 14. RESULTS Soleus mass and muscle function were not affected by burn alone. Mass was significantly lower in hindlimb unloading (79 versus 139 mg, P < 0.001) and no exercise (103 versus 115 mg, P < 0.01). Exercise significantly increased soleus mass in B/H (86 versus 77 mg, P < 0.01). Hindlimb unloading significantly decreased muscle force in the twitch (12 versus 31 g, P < 0.001), tetanic (55 versus 148 g, P < 0.001), and specific tetanic measurements (12 versus 22 N/cm(2), P < 0.001). Effects of exercise on force depended on other factors. In B/H, exercise significantly increased twitch (14 versus 8 g, P < 0.05) and specific tetanic force (14 versus 7 N/cm(2), P < 0.01). Fatigue index was lower in ambulatory (55%) and exercise (52%) versus hindlimb (69%, P = 0.03) and no exercise (73%, P = 0.002). CONCLUSIONS Hindlimb unloading is a significant factor in muscle atrophy. Exercise increased the soleus muscle mass, twitch, and specific force in this model. However, the fatigue index decreased with exercise in all groups. This suggests exercise contributes to functional muscle change in this model of disuse and critical illness.
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Affiliation(s)
- Melody R Saeman
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Kevin DeSpain
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ming-Mei Liu
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Brett A Carlson
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Juquan Song
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Lisa A Baer
- Department of Surgery, University of Texas Health Science Center at Houston, Houston, Texas
| | - Charles E Wade
- Department of Surgery, University of Texas Health Science Center at Houston, Houston, Texas
| | - Steven E Wolf
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
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11
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Cisterna BA, Cardozo C, Sáez JC. Neuronal involvement in muscular atrophy. Front Cell Neurosci 2014; 8:405. [PMID: 25540609 PMCID: PMC4261799 DOI: 10.3389/fncel.2014.00405] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 11/10/2014] [Indexed: 12/18/2022] Open
Abstract
The innervation of skeletal myofibers exerts a crucial influence on the maintenance of muscle tone and normal operation. Consequently, denervated myofibers manifest atrophy, which is preceded by an increase in sarcolemma permeability. Recently, de novo expression of hemichannels (HCs) formed by connexins (Cxs) and other none selective channels, including P2X7 receptors (P2X7Rs), and transient receptor potential, sub-family V, member 2 (TRPV2) channels was demonstrated in denervated fast skeletal muscles. The denervation-induced atrophy was drastically reduced in denervated muscles deficient in Cxs 43 and 45. Nonetheless, the transduction mechanism by which the nerve represses the expression of the above mentioned non-selective channels remains unknown. The paracrine action of extracellular signaling molecules including ATP, neurotrophic factors (i.e., brain-derived neurotrophic factor (BDNF)), agrin/LDL receptor-related protein 4 (Lrp4)/muscle-specific receptor kinase (MuSK) and acetylcholine (Ach) are among the possible signals for repression for connexin expression. This review discusses the possible role of relevant factors in maintaining the normal functioning of fast skeletal muscles and suppression of connexin hemichannel expression.
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Affiliation(s)
- Bruno A. Cisterna
- Departamento de Fisiología, Pontificia Universidad Católica de ChileSantiago, Chile
| | - Christopher Cardozo
- Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical CenterBronx, NY, USA
- Departments of Medicine and Rehabilitation Medicine, Icahn School of Medicine at Mount SinaiNew York, NY, USA
| | - Juan C. Sáez
- Departamento de Fisiología, Pontificia Universidad Católica de ChileSantiago, Chile
- Instituto Milenio, Centro Interdisciplinario de Neurociencias de Valparaíso, Universidad de ValparaísoValparaíso, Chile
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Garg K, Corona BT, Walters TJ. Losartan administration reduces fibrosis but hinders functional recovery after volumetric muscle loss injury. J Appl Physiol (1985) 2014; 117:1120-31. [PMID: 25257876 DOI: 10.1152/japplphysiol.00689.2014] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Losartan is a Food and Drug Administration approved antihypertensive medication that is recently emerging as an antifibrotic therapy. Previously, losartan has been successfully used to reduce fibrosis and improve both muscle regeneration and function in several models of recoverable skeletal muscle injuries, such as contusion and laceration. In this study, the efficacy of losartan treatment in reducing fibrosis and improving regeneration was determined in a Lewis rat model of volumetric muscle loss (VML) injury. VML has been defined as the traumatic or surgical loss of skeletal muscle with resultant functional impairment. It is among the top 10 causes for wounded service members to be medically retired from the military. This study shows that, after several weeks of recovery, VML injury results in little to no muscle regeneration, but is marked by persistent inflammation, chronic upregulation of profibrotic markers and extracellular matrix (i.e., collagen type I), and fat deposition at the defect site, which manifest irrecoverable deficits in force production. Losartan administration at 10 mg·kg(-1)·day(-1) was able to modulate the gene expression of fibrotic markers and was also effective at reducing fibrosis (i.e., the deposition of collagen type I) in the injured muscle. However, there were no improvements in muscle regeneration, and deleterious effects on muscle function were observed instead. We propose that, in the absence of regeneration, reduction in fibrosis worsens the ability of the VML injured muscle to transmit forces, which ultimately results in decreased muscle function.
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Affiliation(s)
- Koyal Garg
- US Army Institute of Surgical Research, Extremity Trauma and Regenerative Medicine, Fort Sam Houston, Texas
| | - Benjamin T Corona
- US Army Institute of Surgical Research, Extremity Trauma and Regenerative Medicine, Fort Sam Houston, Texas
| | - Thomas J Walters
- US Army Institute of Surgical Research, Extremity Trauma and Regenerative Medicine, Fort Sam Houston, Texas
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13
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Pidcoke HF, Baer LA, Wu X, Wolf SE, Aden JK, Wade CE. Insulin effects on glucose tolerance, hypermetabolic response, and circadian-metabolic protein expression in a rat burn and disuse model. Am J Physiol Regul Integr Comp Physiol 2014; 307:R1-R10. [PMID: 24760998 DOI: 10.1152/ajpregu.00312.2013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Insulin controls hyperglycemia after severe burns, and its use opposes the hypermetabolic response. The underlying molecular mechanisms are poorly understood, and previous research in this area has been limited because of the inadequacy of animal models to mimic the physiological effects seen in humans with burns. Using a recently published rat model that combines both burn and disuse components, we compare the effects of insulin treatment vs. vehicle on glucose tolerance, hypermetabolic response, muscle loss, and circadian-metabolic protein expression after burns. Male Sprague-Dawley rats were assigned to three groups: cage controls (n = 6); vehicle-treated burn and hindlimb unloading (VBH; n = 11), and insulin-treated burn and hindlimb unloading (IBH; n = 9). With the exception of cage controls, rats underwent a 40% total body surface area burn with hindlimb unloading, then IBH rats received 12 days of subcutaneous insulin injections (5 units·kg(-1)·day(-1)), and VBH rats received an equivalent dose of vehicle. Glucose tolerance testing was performed on day 14, after which blood and tissues were collected for analysis. Body mass loss was attenuated by insulin treatment (VBH = 265 ± 17 g vs. IBH = 283 ± 14 g, P = 0.016), and glucose clearance capacity was increased. Soleus and gastrocnemius muscle loss was decreased in the IBH group. Insulin receptor substrate-1, AKT, FOXO-1, caspase-3, and PER1 phosphorylation was altered by injury and disuse, with levels restored by insulin treatment in almost all cases. Insulin treatment after burn and during disuse attenuated the hypermetabolic response, increased glucose clearance, and normalized circadian-metabolic protein expression patterns. Therapies aimed at targeting downstream effectors may provide the beneficial effects of insulin without hypoglycemic risk.
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Affiliation(s)
| | - Lisa A Baer
- University of Texas Health Science Center at Houston, Houston, Texas; and
| | - Xiaowu Wu
- U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas
| | - Steven E Wolf
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - James K Aden
- U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas
| | - Charles E Wade
- University of Texas Health Science Center at Houston, Houston, Texas; and
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Animal models in burn research. Cell Mol Life Sci 2014; 71:3241-55. [PMID: 24714880 DOI: 10.1007/s00018-014-1612-5] [Citation(s) in RCA: 264] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 03/14/2014] [Accepted: 03/17/2014] [Indexed: 01/08/2023]
Abstract
Burn injury is a severe form of trauma affecting more than 2 million people in North America each year. Burn trauma is not a single pathophysiological event but a devastating injury that causes structural and functional deficits in numerous organ systems. Due to its complexity and the involvement of multiple organs, in vitro experiments cannot capture this complexity nor address the pathophysiology. In the past two decades, a number of burn animal models have been developed to replicate the various aspects of burn injury, to elucidate the pathophysiology, and to explore potential treatment interventions. Understanding the advantages and limitations of these animal models is essential for the design and development of treatments that are clinically relevant to humans. This review aims to highlight the common animal models of burn injury in order to provide investigators with a better understanding of the benefits and limitations of these models for translational applications. While many animal models of burn exist, we limit our discussion to the skin healing of mouse, rat, and pig. Additionally, we briefly explain hypermetabolic characteristics of burn injury and the animal model utilized to study this phenomena. Finally, we discuss the economic costs associated with each of these models in order to guide decisions of choosing the appropriate animal model for burn research.
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Wade CE, Baer LA, Wu X, Silliman DT, Walters TJ, Wolf SE. Severe burn and disuse in the rat independently adversely impact body composition and adipokines. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2013; 17:R225. [PMID: 24099533 PMCID: PMC4057079 DOI: 10.1186/cc13048] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 08/28/2013] [Indexed: 12/26/2022]
Abstract
Introduction Severe trauma is accompanied by a period of hypermetabolism and disuse. In this study, a rat model was used to determine the effects of burn and disuse independently and in combination on body composition, food intake and adipokines. Methods Male rats were assigned to four groups 1) sham ambulatory (SA), 2) sham hindlimb unloaded (SH), 3) 40% total body surface area full thickness scald burn ambulatory (BA) and 4) burn and hindlimb unloaded (BH). Animals designated to the SH and BH groups were placed in a tail traction system and their hindlimbs unloaded. Animals were followed for 14 days. Plasma, urine, fecal and tissue samples were analyzed. Results SA had a progressive increase in body mass (BM), SH and BA no change and BH a reduction. Compared to SA, BM was reduced by 10% in both SH and BA and by 17% when combined in BH. Compared to SA, all groups had reductions in lean and fat body mass with BH being greater. The decrease in lean mass was associated with the rate of urinary corticosterone excretion. The loss in fat mass was associated with decreases in plasma leptin and adiponectin and an increase in ghrelin. Following the acute response to injury, BH had a greater food intake per 100 g BM. Food intake was associated with the levels of leptin, adiponectin and ghrelin. Conclusions The effects of the combination of burn and disuse in this animal model were additive, therefore in assessing metabolic changes with severe trauma both injury and disuse should be considered. Furthermore, the observed changes in adipokines, corticosterone and ghrelin provide insights for interventions to attenuate the hypermetabolic state following injury, possibly reducing catabolism and muscle loss and subsequent adverse effects on recovery and function.
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Corona BT, Wu X, Ward CL, McDaniel JS, Rathbone CR, Walters TJ. The promotion of a functional fibrosis in skeletal muscle with volumetric muscle loss injury following the transplantation of muscle-ECM. Biomaterials 2013; 34:3324-35. [DOI: 10.1016/j.biomaterials.2013.01.061] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 01/11/2013] [Indexed: 10/27/2022]
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Wu X, Corona BT, Chen X, Walters TJ. A standardized rat model of volumetric muscle loss injury for the development of tissue engineering therapies. Biores Open Access 2013; 1:280-90. [PMID: 23515319 PMCID: PMC3559228 DOI: 10.1089/biores.2012.0271] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Soft tissue injuries involving volumetric muscle loss (VML) are defined as the traumatic or surgical loss of skeletal muscle with resultant functional impairment and represent a challenging clinical problem for both military and civilian medicine. In response, a variety of tissue engineering and regenerative medicine treatments are under preclinical development. A wide variety of animal models are being used, all with critical limitations. The objective of this study was to develop a model of VML that was reproducible and technically uncomplicated to provide a standardized platform for the development of tissue engineering and regenerative medicine solutions to VML repair. A rat model of VML involving excision of ∼20% of the muscle's mass from the superficial portion of the middle third of the tibialis anterior (TA) muscle was developed and was functionally characterized. The contralateral TA muscle served as the uninjured control. Additionally, uninjured age-matched control rats were also tested to determine the effect of VML on the contralateral limb. TA muscles were assessed at 2 and 4 months postinjury. VML muscles weighed 22.7% and 19.5% less than contralateral muscles at 2 and 4 months postinjury, respectively. These differences were accompanied by a reduction in peak isometric tetanic force (Po) of 28.4% and 32.5% at 2 and 4 months. Importantly, Po corrected for differences in body weight and muscle wet weights were similar between contralateral and age-matched control muscles, indicating that VML did not have a significant impact on the contralateral limb. Lastly, repair of the injury with a biological scaffold resulted in rapid vascularization and integration with the wound. The technical simplicity, reliability, and clinical relevance of the VML model developed in this study make it ideal as a standard model for the development of tissue engineering solutions for VML.
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Affiliation(s)
- Xiaowu Wu
- Extremity Trauma and Regenerative Medicine Research Program, United States Army Institute of Surgical Research , Fort Sam Houston, Texas. ; Department of Surgery, University of Texas Health Science Center , San Antonio, Texas
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Baer LA, Wu X, Tou JC, Johnson E, Wolf SE, Wade CE. Contributions of severe burn and disuse to bone structure and strength in rats. Bone 2013; 52:644-50. [PMID: 23142361 PMCID: PMC4578653 DOI: 10.1016/j.bone.2012.10.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 10/24/2012] [Accepted: 10/27/2012] [Indexed: 10/27/2022]
Abstract
Burn and disuse results in metabolic and bone changes associated with substantial and sustained bone loss. Such loss can lead to an increased fracture incidence and osteopenia. We studied the independent effects of burn and disuse on bone morphology, composition and strength, and microstructure of the bone alterations 14days after injury. Sprague-Dawley rats were randomized into four groups: Sham/Ambulatory (SA), Burn/Ambulatory (BA), Sham/Hindlimb Unloaded (SH) and Burn/Hindlimb Unloaded (BH). Burn groups received a 40% total body surface area full-thickness scald burn. Disuse by hindlimb unloading was initiated immediately following injury. Bone turnover was determined in plasma and urine. Femur biomechanical parameters were measured by three-point bending tests and bone microarchitecture was determined by micro-computed tomography (uCT). On day 14, a significant reduction in body mass was observed as a result of burn, disuse and a combination of both. In terms of bone health, disuse alone and in combination affected femur weight, length and bone mineral content. Bending failure energy, an index of femur strength, was significantly reduced in all groups and maximum bending stress was lower when burn and disuse were combined. Osteocalcin was reduced in BA compared to the other groups, indicating influence of burn. The reductions observed in femur weight, BMC, biomechanical parameters and indices of bone formation are primarily responses to the combination of burn and disuse. These results offer insight into bone degradation following severe injury and disuse.
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Affiliation(s)
- L A Baer
- US Army Institute of Surgical Research, 3611 Rawley E Chambers, Fort Sam Houston, TX 78234, USA.
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Mallinson JE, Murton AJ. Mechanisms responsible for disuse muscle atrophy: Potential role of protein provision and exercise as countermeasures. Nutrition 2013; 29:22-8. [DOI: 10.1016/j.nut.2012.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 02/16/2012] [Accepted: 04/02/2012] [Indexed: 01/08/2023]
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Wu X, Walters TJ, Rathbone CR. Skeletal muscle satellite cell activation following cutaneous burn in rats. Burns 2012; 39:736-44. [PMID: 23146573 DOI: 10.1016/j.burns.2012.10.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 10/10/2012] [Accepted: 10/15/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cutaneous burn distant from skeletal muscles induces atrophy; however, its effect on muscle stem cells resident in skeletal muscle (satellite cells) distal to burn is not known. METHODS Satellite cell activation was measured in predominantly fast-twitch [tibialis anterior, extensor digitorum longus (EDL), plantaris, and gastrocnemius] and slow-twitch (soleus) muscles of rats that received either 40% total body surface area full-thickness scald burn or sham burn to the trunk area by determining bromodeoxyuridine incorporation, MyoD, and Pax7 immunohistochemistry in vivo ≤48 h after burn. To determine the effects of circulating factors on satellite cell activation, satellite cell cultures were treated with serum from sham or burn rats. RESULTS In vivo activation of satellite cells was increased in fast muscles isolated from burn as compared to sham animals, whereas a significant response was not seen in slow muscles. Serum taken from animals in the burn group increased the activation of satellite cells isolated from both sham and burn animals in vitro, suggesting that circulating factors have the potential to increase satellite cell activation following burn. CONCLUSIONS Increases in satellite cell activation in muscles distal to burn are fiber-type-dependent, and circulating factors may play a role in the activation of satellite cells following burn. A better understanding of the impact of burn on satellite cell functionality will allow us to identify the cellular mechanisms of long-term muscle atrophy.
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Affiliation(s)
- Xiaowu Wu
- Extremity Trauma and Regenerative Medicine, US Army Institute of Surgical Research, Fort Sam Houston, TX 78234-6315, USA.
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