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Kourek C, Kanellopoulos M, Raidou V, Antonopoulos M, Karatzanos E, Patsaki I, Dimopoulos S. Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery: A systematic review. World J Cardiol 2024; 16:27-39. [PMID: 38313389 PMCID: PMC10835467 DOI: 10.4330/wjc.v16.i1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/14/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit (ICU) are major factors resulting in the development of ICU-acquired muscle weakness (ICUAW). ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery, and may be a risk factor for prolonged duration of mechanical ventilation, associated with a higher risk of readmission and higher mortality. Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay. Neuromuscular electrical stimulation (NMES) is an alternative modality of exercise in patients with muscle weakness. A major advantage of NMES is that it can be applied even in sedated patients in the ICU, a fact that might enhance early mobilization in these patients. AIM To evaluate safety, feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery. METHODS We performed a search on Pubmed, Physiotherapy Evidence Database (PEDro), Embase and CINAHL databases, selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials (RCTs) that included implementation of NMES in patients before after cardiac surgery. RCTs were assessed for methodological rigor and risk of bias via the PEDro. The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function. RESULTS Ten studies were included in our systematic review, resulting in 703 participants. Almost half of them performed NMES and the other half were included in the control group, treated with usual care. Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery. Functional capacity was assessed in 8 studies via 6MWT or other indices, and improved only in 1 study before and in 1 after cardiac surgery. Nine studies explored the effects of NMES on muscle strength and function and, most of them, found increase of muscle strength and improvement in muscle function after NMES. NMES was safe in all studies without any significant complication. CONCLUSION NMES is safe, feasible and has beneficial effects on muscle strength and function in patients after cardiac surgery, but has no significant effect on functional capacity.
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Affiliation(s)
- Christos Kourek
- Medical School of Athens, National and Kapodistrian University of Athens, Athens 15772, Greece
| | - Marios Kanellopoulos
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, Evangelismos Hospital, Athens 10676, Greece
| | - Vasiliki Raidou
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, Evangelismos Hospital, Athens 10676, Greece
| | | | - Eleftherios Karatzanos
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, Evangelismos Hospital, Athens 10676, Greece
| | - Irini Patsaki
- Department of Physiotherapy, University of West Attica, Athens 12243, Greece
| | - Stavros Dimopoulos
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, Evangelismos Hospital, Athens 10676, Greece
- Intensive Care Unit, Onassis Cardiac Surgery Center, Kallithea 17674, Greece.
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Miyachi R, Morita Y, Yamazaki T. Division of loading time in reloading the disused atrophic soleus muscle induces proximal muscle injury. J Phys Ther Sci 2023; 35:193-198. [PMID: 36866019 PMCID: PMC9974327 DOI: 10.1589/jpts.35.193] [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] [Received: 10/20/2022] [Accepted: 12/01/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] This study aimed to compare the effects of loading time division in reloading atrophied muscles in different muscle long-axis regions. [Materials and Methods] We divided 8-week-old male Wistar rats into control (CON), 14-day hindlimb suspension (HS), 7-day hindlimb suspension followed by 60-min reloading for 7 consecutive days (WO), and 7-day hindlimb suspension followed by 60-min reloading on two separate occasions for 7 days (WT) groups. After the experimental period, muscle fibre cross-sectional area and necrotic fibre/central nuclei fibre ratio were measured in the soleus muscle's proximal, middle, and distal regions. [Results] The necrotic fibre/central nuclei fibre ratio was higher in the WT group than in the other groups in the proximal region. Proximal muscle fibre cross-sectional area was higher in the CON group than in the other groups. In the middle region, only HS group had muscle fibre cross-sectional area lower than the CON group. Similarly, muscle fibre cross-sectional area of the HS group was lower than the CON and WT groups in the distal region. [Conclusion] When reloading atrophied muscles, dividing the loading time can inhibit atrophy in the distal region but induce muscle injury in the proximal region.
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Affiliation(s)
- Ryo Miyachi
- Faculty of Health and Medical Sciences, Hokuriku
University: 1-1 Taiyogaoka, Kanazawa, Ishikawa 920-1180, Japan,Corresponding author. Ryo Miyachi (E-mail: )
| | - Yui Morita
- Department of Rehabilitation, Tokyo Medical and Dental
University Hospital, Japan
| | - Toshiaki Yamazaki
- Faculty of Health Sciences, Institute of Medical,
Pharmaceutical and Health Sciences, Kanazawa University, Japan
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3
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Impact of Rehabilitation Dose on Nutritional Status at Discharge from a Convalescent Rehabilitation Ward in Malnourished Patients with Hip Fracture. Healthcare (Basel) 2021; 9:healthcare9060722. [PMID: 34204642 PMCID: PMC8231257 DOI: 10.3390/healthcare9060722] [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] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/20/2022] Open
Abstract
The object of this study is to determine the impact of the rehabilitation dose on the nutritional status at discharge from a convalescent rehabilitation ward in malnourished patients with hip fracture. This retrospective case-control study involved malnourished patients with hip fracture aged 65 years or older who had been admitted to a convalescent rehabilitation ward and whose data were registered in the Japan Rehabilitation Nutrition Database. The primary outcome was nutritional status at discharge. Patients were classified according to whether nutritional status was improved or not at discharge, according to the Mini Nutritional Assessment-Short Form® (MNA-SF) score. The association between improved nutritional status and rehabilitation dose was assessed by a logistic regression analysis. Data were available for 145 patients (27 men, 118 women; mean age 85.1 ± 7.9 years). Daily rehabilitation dose was 109.5 (median 94.6–116.2) min and the MNA-SF score at admission was 5 (median 4–6). Nutritional status was improved in 97 patients and not improved in 48. Logistic regression analysis showed the following factors to be independently associated with nutritional status at discharge: Functional Independence Measure score (OR 1.042, 95% CI 1.016–1.068), energy intake (OR 1.002 CI 1.000–1.004), daily rehabilitation dose (OR 1.023, 95% CI 1.002–1.045), and length of hospital stay (OR 1.026, 95% CI 1.003–1.049). The daily rehabilitation dose in malnourished patients with hip fracture may positively impact nutritional status at discharge.
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4
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Li J, Yang T, Sha Z, Tang H, Hua X, Wang L, Wang Z, Gao Z, Sluijter JPG, Rowe GC, Das S, Yang L, Xiao J. Angiotensin II-induced muscle atrophy via PPARγ suppression is mediated by miR-29b. MOLECULAR THERAPY-NUCLEIC ACIDS 2020; 23:743-756. [PMID: 33614226 PMCID: PMC7868689 DOI: 10.1016/j.omtn.2020.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 12/19/2020] [Indexed: 12/20/2022]
Abstract
The activation of the renin-angiotensin system (RAS) induced by increased angiotensin II (AngII) levels has been implicated in muscle atrophy, which is involved in the pathogenesis of congestive heart failure. Although peroxisome proliferator-activated receptor gamma (PPARγ) activation can suppress RAS, the exact role of PPARγ in AngII-induced muscle atrophy is unclear. Here we identified PPARγ as a negative regulator of miR-29b, a microRNA that is able to promote multiple types of muscle atrophy. Suppression of miR-29b could prevent AngII-induced muscle atrophy both in vitro and in vivo. IGF1, PI3K(p85α), and Yin Yang 1 (YY1) were identified as target genes of miR-29b, and overexpression of these targets could rescue AngII-induced muscle atrophy. Importantly, inhibition of PPARγ was sufficient to induce muscle atrophy, while PPARγ overexpression could attenuate that. These data indicate that the PPARγ/miR-29b axis mediates AngII-induced muscle atrophy, and increasing PPARγ or inhibiting miR-29b represents a promising approach to counteract AngII-induced muscle atrophy.
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Affiliation(s)
- Jin Li
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Tingting Yang
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Zhao Sha
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Haifei Tang
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Xuejiao Hua
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Lijun Wang
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Zitong Wang
- Department of Pathophysiology, Basic Medical Science, Harbin Medical University, Harbin 150081, China
| | - Ziyu Gao
- Department of Pathophysiology, Basic Medical Science, Harbin Medical University, Harbin 150081, China
| | - Joost P G Sluijter
- Department of Cardiology, Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht 3508GA, the Netherlands.,UMC Utrecht Regenerative Medicine Center, University Medical Center, Utrecht University, Utrecht 3508GA, the Netherlands
| | - Glenn C Rowe
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Saumya Das
- Cardiovascular Division of the Massachusetts General Hospital and Harvard Medical School, Boston, MA 02215, USA
| | - Liming Yang
- Department of Pathophysiology, Harbin Medical University-Daqing, Daqing, 163319, China
| | - Junjie Xiao
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai 200444, China
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Wang W, Xu C, Ma X, Zhang X, Xie P. Intensive Care Unit-Acquired Weakness: A Review of Recent Progress With a Look Toward the Future. Front Med (Lausanne) 2020; 7:559789. [PMID: 33330523 PMCID: PMC7719824 DOI: 10.3389/fmed.2020.559789] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/11/2020] [Indexed: 12/16/2022] Open
Abstract
Intensive care unit-acquired weakness (ICU-AW), a common neuromuscular complication associated with patients in the ICU, is a type of skeletal muscle dysfunction that commonly occurs following sepsis, mobility restriction, hyperglycemia, and the use of glucocorticoids or neuromuscular blocking agents. ICU-AW can lead to delayed withdrawal of mechanical ventilation and extended hospitalization. Patients often have poor prognosis, limited mobility, and severely affected quality of life. Currently, its pathogenesis is uncertain, with unavailability of specific drugs or targeted therapies. ICU-AW has gained attention in recent years. This manuscript reviews the current research status of the epidemiology, pathogenesis, diagnosis, and treatment methods for ICU-AW and speculates the novel perspectives for future research.
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Affiliation(s)
- Wenkang Wang
- Department of Critical Care Medicine of the Third Affiliated Hospital (The First People's Hospital of Zunyi), Zunyi Medical University, Zunyi, China
| | - Chuanjie Xu
- Department of Critical Care Medicine of the Third Affiliated Hospital (The First People's Hospital of Zunyi), Zunyi Medical University, Zunyi, China
| | - Xinglong Ma
- Department of Critical Care Medicine of the Third Affiliated Hospital (The First People's Hospital of Zunyi), Zunyi Medical University, Zunyi, China
| | - Xiaoming Zhang
- Department of Molecular and Cellular Biology, Baylor College of Medicine Houston, Houston, TX, United States
| | - Peng Xie
- Department of Critical Care Medicine of the Third Affiliated Hospital (The First People's Hospital of Zunyi), Zunyi Medical University, Zunyi, China
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Jukic I, Calleja-González J, Cos F, Cuzzolin F, Olmo J, Terrados N, Njaradi N, Sassi R, Requena B, Milanovic L, Krakan I, Chatzichristos K, Alcaraz PE. Strategies and Solutions for Team Sports Athletes in Isolation due to COVID-19. Sports (Basel) 2020; 8:E56. [PMID: 32344657 PMCID: PMC7240607 DOI: 10.3390/sports8040056] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/17/2020] [Accepted: 04/22/2020] [Indexed: 11/16/2022] Open
Abstract
In December of 2019, there was an outbreak of a severe acute respiratory syndrome caused by the Coronavirus 2 (SARS-CoV-2 or COVID-19) in China. The virus rapidly spread into the whole World causing an unprecedented pandemic and forcing governments to impose a global quarantine, entering an extreme unknown situation. The organizational consequences of quarantine/isolation are: absence of organized training and competition, lack of communication among athletes and coaches, inability to move freely, lack of adequate sunlight exposure, inappropriate training conditions. Based on the current scientific, we strongly recommend encouraging the athlete to reset their mindset to understand quarantine as an opportunity for development, organizing appropriate guidance, educating and encourage athletes to apply appropriate preventive behavior and hygiene measures to promote immunity and ensuring good living isolation conditions. The athlete's living space should be equipped with cardio and resistance training equipment (portable bicycle or rowing ergometer). Some forms of body mass resistance circuit-based training could promote aerobic adaptation. Sports skills training should be organized based on the athlete's needs. Personalized conditioning training should be carried out with emphasis on neuromuscular performance. Athletes should also be educated about nutrition (Vitamin D and proteins) and hydration. Strategies should be developed to control body composition. Mental fatigue should be anticipated and mental controlled. Adequate methods of recovery should be provided. Daily monitoring should be established. This is an ideal situation in which to rethink personal life, understanding the situation, that can be promoted in these difficult times that affect practically the whole world.
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Affiliation(s)
- Igor Jukic
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrenning Ltd., 10000 Zagreb, Croatia
| | - Julio Calleja-González
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Faculty of Education and Sport, University of Basque Country, 01007 Vitoria-Gasteiz, Spain
- Strength and Conditioning Society, 00118 Rome, Italy; (F.C.); (P.E.A.)
| | - Francesc Cos
- Strength and Conditioning Society, 00118 Rome, Italy; (F.C.); (P.E.A.)
- National Institute of Physical Education (INEFC), University of Barcelona, 08038 Barcelona, Spain
| | | | - Jesús Olmo
- Football Science Institute, 18016 Granada, Spain; (J.O.); (B.R.)
| | - Nicolas Terrados
- Unidad Regional de Medicina Deportiva, Avilés and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33401 Oviedo, Spain;
| | - Nenad Njaradi
- Football Club Deportivo Alavés, 01007 Vitoria-Gasteiz, Spain;
| | | | - Bernardo Requena
- Football Science Institute, 18016 Granada, Spain; (J.O.); (B.R.)
| | - Luka Milanovic
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrenning Ltd., 10000 Zagreb, Croatia
| | - Ivan Krakan
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrenning Ltd., 10000 Zagreb, Croatia
| | | | - Pedro E. Alcaraz
- Strength and Conditioning Society, 00118 Rome, Italy; (F.C.); (P.E.A.)
- Research Center for High Performance Sport, UCAM, 30107 Murcia, Spain
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Yoshihara T, Tsuzuki T, Chang SW, Kakigi R, Sugiura T, Naito H. Exercise preconditioning attenuates hind limb unloading-induced gastrocnemius muscle atrophy possibly via the HDAC4/Gadd45 axis in old rats. Exp Gerontol 2019; 122:34-41. [PMID: 31009659 DOI: 10.1016/j.exger.2019.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 04/01/2019] [Accepted: 04/18/2019] [Indexed: 11/25/2022]
Abstract
The mechanisms involved in unloading-induced skeletal muscle loss may be age-specific, and the evidence for exercise preconditioning-induced protection against disuse muscle atrophy in aged rats is limited. Therefore, in this study, we investigated age-related differences in the activation of the HDAC4/Gadd45α pathway following hindlimb unloading (HU). We also assessed the protective effect of preconditioning exercise on this pathway in young and old rat gastrocnemius muscle. Three-month-old (young, n = 18) and 24-month-old (old, n = 18) male Wistar rats were assigned to the following groups: control group (n = 6), seven days of HU group (n = 6), and a bout of exercise preconditioning prior to HU (Ex+HU) group (n = 6). Rats of both ages in the Ex + HU group ran continuously on a motor-driven treadmill (0° slope, 20 m/min, 15 min) prior to HU. The gastrocnemius muscles were removed after 7 days of HU and analyzed for protein content and mRNA expression. Gastrocnemius muscle weight was significantly higher in the Ex+HU group than in the HU group of old rats, but not in young rats. Levels of HDAC4 protein and mRNA were significantly increased in the old HU group. However, the increase was significantly suppressed in the old Ex+HU group. Moreover, the protective effect of exercise preconditioning had a positive effect on Gadd45α mRNA and protein levels only in the old Ex+HU group. No exercise preconditioning-related protection was observed in the young rats. Our data indicated that a single bout of preconditioning exercise prior to HU may exert a protective effect in disuse muscle atrophy in old rats and that these effects may be partially mediated by the HDAC4/Gadd45α axis.
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Affiliation(s)
- Toshinori Yoshihara
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hirakagakuendai, Inzai, Chiba 270-1695, Japan.
| | - Takamasa Tsuzuki
- Faculty of Pharmacy, Meijo University, 150 Yagotoyama, Tempaku-ku, Nagoya, Aichi 468-8503, Japan.
| | - Shuo-Wen Chang
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hirakagakuendai, Inzai, Chiba 270-1695, Japan.
| | - Ryo Kakigi
- Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Takao Sugiura
- Faculty of Education, Yamaguchi University, 1677-1 Yoshida, Yamaguchi 753-8513, Japan.
| | - Hisashi Naito
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hirakagakuendai, Inzai, Chiba 270-1695, Japan.
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Tieland M, Trouwborst I, Clark BC. Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle 2018; 9:3-19. [PMID: 29151281 PMCID: PMC5803609 DOI: 10.1002/jcsm.12238] [Citation(s) in RCA: 422] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/20/2017] [Accepted: 08/05/2017] [Indexed: 02/06/2023] Open
Abstract
The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co-morbidity, and premature death. An important cause of physical limitations is the age-related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation-contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing.
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Affiliation(s)
- Michael Tieland
- Faculty of Sports and NutritionAmsterdam University of Applied SciencesDr. Meurerlaan 81067 SMAmsterdamthe Netherlands
| | - Inez Trouwborst
- Faculty of Sports and NutritionAmsterdam University of Applied SciencesDr. Meurerlaan 81067 SMAmsterdamthe Netherlands
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI)Ohio University250 Irvine HallAthensOH 45701USA
- Department of Biomedical SciencesOhio UniversityAthensOH 45701USA
- Department of Geriatric MedicineOhio UniversityAthensOH 45701USA
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Huang L, Guo B, Xu F, Zhao J. Effects of quadriceps functional exercise with isometric contraction in the treatment of knee osteoarthritis. Int J Rheum Dis 2017; 21:952-959. [PMID: 28544687 DOI: 10.1111/1756-185x.13082] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE This study aims to investigate the effects of a quadriceps isometric contraction exercise method in the treatment of knee osteoarthritis (OA). METHODS A total of 250 patients with a confirmed diagnosis of knee OA were enrolled. The patients were randomly divided into an exercise treatment test group (128 patients) and a traditional treatment control group (122 patients). Quadriceps isometric contraction exercise was used in the test group, and local physiotherapy and oral nonsteroidal anti-inflammatory drugs were used in the control group. Knee joint function was evaluated with a visual analog scale (VAS) score and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire before treatment, and 1 and 3 months after treatment. RESULTS VAS scoring and the WOMAC questionnaire showed significant relief in pain 1 month after treatment in the test group (P < 0.05), but minimal relief in the control group; at 1 month, there was also minimal joint function improvement in the test group (P > 0.05), but significant improvement in the control group (P < 0.05). However, 3 months after treatment, pain relief and knee joint function were more improved in the test group than in the control group, with a significant difference (P < 0.05). CONCLUSION Through our short-term observation, joint pain was effectively relieved and knee joint function was improved with systematic quadriceps isometric contraction exercise.
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Affiliation(s)
- Lanfeng Huang
- Department of Orthopaedics, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Bin Guo
- Department of Orthopaedics, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Feixiang Xu
- Department of Orthopaedics, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Jinsong Zhao
- Department of Ophthalmology, the Second Hospital of Jilin University, Changchun, Jilin, China
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Rudrappa SS, Wilkinson DJ, Greenhaff PL, Smith K, Idris I, Atherton PJ. Human Skeletal Muscle Disuse Atrophy: Effects on Muscle Protein Synthesis, Breakdown, and Insulin Resistance-A Qualitative Review. Front Physiol 2016; 7:361. [PMID: 27610086 PMCID: PMC4997013 DOI: 10.3389/fphys.2016.00361] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/08/2016] [Indexed: 12/25/2022] Open
Abstract
The ever increasing burden of an aging population and pandemic of metabolic syndrome worldwide demands further understanding of the modifiable risk factors in reducing disability and morbidity associated with these conditions. Disuse skeletal muscle atrophy (sometimes referred to as “simple” atrophy) and insulin resistance are “non-pathological” events resulting from sedentary behavior and periods of enforced immobilization e.g., due to fractures or elective orthopedic surgery. Yet, the processes and drivers regulating disuse atrophy and insulin resistance and the associated molecular events remain unclear—especially in humans. The aim of this review is to present current knowledge of relationships between muscle protein turnover, insulin resistance and muscle atrophy during disuse, principally in humans. Immobilization lowers fasted state muscle protein synthesis (MPS) and induces fed-state “anabolic resistance.” While a lack of dynamic measurements of muscle protein breakdown (MPB) precludes defining a definitive role for MPB in disuse atrophy, some proteolytic “marker” studies (e.g., MPB genes) suggest a potential early elevation. Immobilization also induces muscle insulin resistance (IR). Moreover, the trajectory of muscle atrophy appears to be accelerated in persistent IR states (e.g., Type II diabetes), suggesting IR may contribute to muscle disuse atrophy under these conditions. Nonetheless, the role of differences in insulin sensitivity across distinct muscle groups and its effects on rates of atrophy remains unclear. Multifaceted time-course studies into the collective role of insulin resistance and muscle protein turnover in the setting of disuse muscle atrophy, in humans, are needed to facilitate the development of appropriate countermeasures and efficacious rehabilitation protocols.
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Affiliation(s)
- Supreeth S Rudrappa
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Royal Derby Hospital, University of Nottingham Derby, UK
| | - Daniel J Wilkinson
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Royal Derby Hospital, University of Nottingham Derby, UK
| | - Paul L Greenhaff
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Royal Derby Hospital, University of Nottingham Derby, UK
| | - Kenneth Smith
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Royal Derby Hospital, University of Nottingham Derby, UK
| | - Iskandar Idris
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Royal Derby Hospital, University of Nottingham Derby, UK
| | - Philip J Atherton
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Royal Derby Hospital, University of Nottingham Derby, UK
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11
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Reihmane D, Gram M, Vigelsø A, Wulff Helge J, Dela F. Exercise promotes IL-6 release from legs in older men with minor response to unilateral immobilization. Eur J Sport Sci 2015; 16:1039-46. [PMID: 27686402 DOI: 10.1080/17461391.2015.1111939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Physical inactivity is a major contributor to low-grade systemic inflammation. Most of the studies characterizing interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) release from exercising legs have been done in young, healthy men, but studies on inactivity in older people are lacking. The impact of 14 days of one-leg immobilization (IM) on IL-6 and TNF-α release during exercise in comparison to the contralateral control (CON) leg was investigated. Fifteen healthy men (age 68.1 ± 1.1 year (mean ± SEM); BMI 27.0 ± 0.4 kg·m(2); VO2max 33.3 ± 1.6 ml·kg(‒1)·min(‒1)) performed 45 min of two-leg dynamic knee extensor exercise at 19.5 ± 0.9 W. Arterial and femoral venous blood samples from the CON and the IM legs were collected every 15 min during exercise, and thigh blood flow was measured with ultrasound Doppler. Arterial plasma IL-6 concentration increased with exercise (rest vs. 45 min, main effect p < .05). IL-6 release increased with exercise (rest vs. 30 min, main effect p < .05). Furthermore, IL-6 release was borderline (main effect, p = .085, effect size 0.28) higher in the IM leg compared to the CON leg (288 (95% CI: 213-373) vs. 220 (95% CI: 152-299) pg·min(‒1), respectively). There was no release of TNF-α in either leg and arterial concentrations remained unchanged during exercise (p > .05). In conclusion, exercise induces more pronounced IL-6 secretion in healthy older men. Two weeks of unilateral immobilization on the other hand had only a minor influence on IL-6 release. Neither immobilization nor exercise had an effect on TNF-α release across the working legs in older men.
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Affiliation(s)
- Dace Reihmane
- a Institute of Clinical and Experimental Medicine , University of Latvia , Riga , Latvia
| | - Martin Gram
- b Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Andreas Vigelsø
- b Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Jørn Wulff Helge
- b Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Flemming Dela
- b Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark
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Perkin O, McGuigan P, Thompson D, Stokes K. A reduced activity model: a relevant tool for the study of ageing muscle. Biogerontology 2015; 17:435-47. [PMID: 26506931 PMCID: PMC4889637 DOI: 10.1007/s10522-015-9613-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 10/05/2015] [Indexed: 12/24/2022]
Abstract
Skeletal muscle mass is in a constant state of turnover, and atrophy is the result of a shift in the balance of muscle protein synthesis and breakdown resulting in net muscle protein loss. Total disuse of skeletal muscle quickly leads to muscle atrophy and loss of strength, and this has been repeatedly demonstrated in studies employing bed rest and lower limb immobilisation methodologies in young healthy participants. Fewer studies have focused on older participants (>65 years of age), but those that have provide evidence that advancing age brings increased vulnerability to rapid and marked loss of muscle size and strength during period of total muscle unloading. Increased systemic inflammation and reduced protein synthetic responses to protein feeding and muscle contraction might influence the severity of muscle protein loss during periods of total unloading compared with younger individuals. Less extreme reductions in muscle loading (e.g., 2 weeks of reducing daily ambulation to <1500 steps/day) have also been shown to result in decreases in muscle mass. This step-reduction model may be more relevant than total bed rest or limb immobilisation for examining real-world scenarios that present a physiological challenge to the maintenance of skeletal muscle mass in older individuals.
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Affiliation(s)
- Oliver Perkin
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Polly McGuigan
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Keith Stokes
- Department for Health, University of Bath, Bath, BA2 7AY, UK.
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Evaluation of Nutritional Biochemical Parameters in Haemodialysis Patients over a Ten-year Period. W INDIAN MED J 2015; 64:213-7. [PMID: 26426172 DOI: 10.7727/wimj.2014.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 06/06/2014] [Indexed: 11/18/2022]
Abstract
AIM Protein-energy malnutrition as well as systemic inflammation and metabolic disorders are common in patients with chronic kidney failure, who require renal replacement therapy (haemodialysis). Such malnutrition is a factor that significantly contributes to their morbidity and mortality. This study evaluated the nutritional status of haemodialysis patients by assessing biochemical and anthropometric parameters in order to determine whether these patients suffered disorders reflecting nutritional deterioration directly related to time on haemodialysis. SUBJECTS AND METHOD This research comprised 90 patients of both genders with chronic kidney failure, who regularly received haemodialysis at our unit over a period of ten years. The patients' blood was tested quarterly for plasma albumin, total cholesterol and total proteins, and tested monthly for transferrin. The patients' weight, height and body mass index (BMI) were monitored. Body mass index was calculated using the formula: weight (kg)/height (m2 ) and classified in one of the following categories defined in the World Health Organization (WHO) Global Database on Body Mass Index: (i) underweight [BMI < 18.50], (ii) normal [BMI 18.50 - 24.99], (iii) overweight [BMI 25 - 29.99], (iv) obese [BMI > 30]. RESULTS In the ten-year period of the study, the patients experienced a substantial decline in their biochemical parameters. Nevertheless, their BMI did not show any significant changes despite the patients' state of malnutrition. CONCLUSIONS The prevalence of malnutrition in haemodialysis patients was evident. Nevertheless, the BMI of the subjects did not correspond to the biochemical parameters measured. Consequently, the results showed that the nutritional deterioration of these patients was mainly reflected in their biochemical parameters rather than in their anthropometric measurements.
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Deshmukh AS, Murgia M, Nagaraj N, Treebak JT, Cox J, Mann M. Deep proteomics of mouse skeletal muscle enables quantitation of protein isoforms, metabolic pathways, and transcription factors. Mol Cell Proteomics 2015; 14:841-53. [PMID: 25616865 PMCID: PMC4390264 DOI: 10.1074/mcp.m114.044222] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Indexed: 11/07/2022] Open
Abstract
Skeletal muscle constitutes 40% of individual body mass and plays vital roles in locomotion and whole-body metabolism. Proteomics of skeletal muscle is challenging because of highly abundant contractile proteins that interfere with detection of regulatory proteins. Using a state-of-the art MS workflow and a strategy to map identifications from the C2C12 cell line model to tissues, we identified a total of 10,218 proteins, including skeletal muscle specific transcription factors like myod1 and myogenin and circadian clock proteins. We obtain absolute abundances for proteins expressed in a muscle cell line and skeletal muscle, which should serve as a valuable resource. Quantitation of protein isoforms of glucose uptake signaling pathways and in glucose and lipid metabolic pathways provides a detailed metabolic map of the cell line compared with tissue. This revealed unexpectedly complex regulation of AMP-activated protein kinase and insulin signaling in muscle tissue at the level of enzyme isoforms.
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Affiliation(s)
- Atul S Deshmukh
- From the ‡Department of Proteomics and Signal Transduction, Max-Planck-Institute of Biochemistry, Am Klopferspitz 18, D-82152 Martinsried, Germany
| | - Marta Murgia
- From the ‡Department of Proteomics and Signal Transduction, Max-Planck-Institute of Biochemistry, Am Klopferspitz 18, D-82152 Martinsried, Germany; §Department of Biomedical Sciences, University of Padova, Viale G. Colombo 3, 35121 Padua, Italy
| | - Nagarjuna Nagaraj
- From the ‡Department of Proteomics and Signal Transduction, Max-Planck-Institute of Biochemistry, Am Klopferspitz 18, D-82152 Martinsried, Germany
| | - Jonas T Treebak
- ¶The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Integrative Physiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jürgen Cox
- From the ‡Department of Proteomics and Signal Transduction, Max-Planck-Institute of Biochemistry, Am Klopferspitz 18, D-82152 Martinsried, Germany
| | - Matthias Mann
- From the ‡Department of Proteomics and Signal Transduction, Max-Planck-Institute of Biochemistry, Am Klopferspitz 18, D-82152 Martinsried, Germany; ‖The Novo Nordisk Foundation Center for Protein Research, Department for proteomics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Todd A, Carroll R, Gallagher M, Meade A. Nutritional status of haemodialysis patients: comparison of Australian cohorts of Aboriginal and European descent. Nephrology (Carlton) 2014; 18:790-7. [PMID: 24118237 DOI: 10.1111/nep.12165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2013] [Indexed: 11/26/2022]
Abstract
AIM It is not known whether nutritional status differs between Australian Aboriginal and non Aboriginal haemodialysis subjects. The aim of this study was to investigate the nutritional status of Australian Aboriginal and non-Aboriginal haemodialysis subjects at satellite dialysis centres. METHOD Seventy-six (25 Aboriginal, 51 non-Aboriginal) prevalent haemodialysis patients were enrolled in a 3-month cross-sectional study. Each month anthropometric and biochemical measurements were collected. Nutritional status (diet history, patient-generated subjective global assessment (PG-SGA), handgrip strength) was assessed by a dietitian. RESULTS PG-SGA detected mild to moderate malnutrition in 35% of Aboriginal patients and 25% of non-Aboriginal patients. The overall physical rating on the PG-SGA was significantly higher in Aboriginal patients, indicating the presence of a greater deficit in muscle mass in this population. Inter-dialytic weight gain was significantly greater in Aboriginal subjects (median [range] 3.0 [2.1-5.7] vs 2.5 [-0.3-5.0] kg, P<0.001). Glucose and HbA1c were significantly higher in Aboriginal subjects with diabetes than in non-Aboriginal patients with diabetes (median [range] 9.4 [4.9-23.4] vs 5.7 [3.1-12.9], P=0.002; 7.0 [5.2-11.0] vs 5.8 [4.6-9.0], P<0.000; respectively). These findings occurred in the setting of each cohort having adequate dialysis parameters (median Kt/V of >1.6 and median normalized protein catabolic rate 1.5). Difficulties were encountered in obtaining dietary information from Aboriginal subjects using the diet history method. CONCLUSION Subjects had acceptable parameters of dialysis adequacy; however, 35% had evidence of malnutrition. Further research should focus on establishing a knowledge base for the nutritional management for Aboriginal dialysis subjects, and the development of a validated individual dietary assessment method for use in this population group.
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Affiliation(s)
- Alwyn Todd
- Department of Nutrition and Dietetics, Mater Health Services, Brisbane, Queensland, Australia; Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia; Department of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
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Haraguchi FK, de Brito Magalhães CL, Neves LX, dos Santos RC, Pedrosa ML, Silva ME. Whey protein modifies gene expression related to protein metabolism affecting muscle weight in resistance-exercised rats. Nutrition 2014; 30:876-81. [DOI: 10.1016/j.nut.2013.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 11/06/2013] [Accepted: 12/05/2013] [Indexed: 11/30/2022]
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Abstract
Age-related muscle loss impacts on whole-body metabolism and leads to frailty and sarcopenia, which are risk factors for fractures and mortality. Although nutrients are integral to muscle metabolism the relationship between nutrition and muscle loss has only been extensively investigated for protein and amino acids. The objective of the present paper is to describe other aspects of nutrition and their association with skeletal muscle mass. Mechanisms for muscle loss relate to imbalance in protein turnover with a number of anabolic pathways of which the mechanistic TOR pathway and the IGF-1–Akt–FoxO pathways are the most characterised. In terms of catabolism the ubiquitin proteasome system, apoptosis, autophagy, inflammation, oxidation and insulin resistance are among the major mechanisms proposed. The limited research associating vitamin D, alcohol, dietary acid–base load, dietary fat and anti-oxidant nutrients with age-related muscle loss is described. Vitamin D may be protective for muscle loss; a more alkalinogenic diet and diets higher in the anti-oxidant nutrients vitamin C and vitamin E may also prevent muscle loss. Although present recommendations for prevention of sarcopenia focus on protein, and to some extent on vitamin D, other aspects of the diet including fruits and vegetables should be considered. Clearly, more research into other aspects of nutrition and their role in prevention of muscle loss is required.
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Nalbandian A, Nguyen C, Katheria V, Llewellyn KJ, Badadani M, Caiozzo V, Kimonis VE. Exercise training reverses skeletal muscle atrophy in an experimental model of VCP disease. PLoS One 2013; 8:e76187. [PMID: 24130765 PMCID: PMC3794032 DOI: 10.1371/journal.pone.0076187] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 08/21/2013] [Indexed: 12/12/2022] Open
Abstract
Background The therapeutic effects of exercise resistance and endurance training in the alleviation of muscle hypertrophy/atrophy should be considered in the management of patients with advanced neuromuscular diseases. Patients with progressive neuromuscular diseases often experience muscle weakness, which negatively impact independence and quality of life levels. Mutations in the valosin containing protein (VCP) gene lead to Inclusion body myopathy associated with Paget's disease of bone and frontotemporal dementia (IBMPFD) and more recently affect 2% of amyotrophic lateral sclerosis (ALS)-diagnosed cases. Methods/Principle Findings The present investigation was undertaken to examine the effects of uphill and downhill exercise training on muscle histopathology and the autophagy cascade in an experimental VCP mouse model carrying the R155H mutation. Progressive uphill exercise in VCPR155H/+ mice revealed significant improvement in muscle strength and performance by grip strength and Rotarod analyses when compared to the sedentary mice. In contrast, mice exercised to run downhill did not show any significant improvement. Histologically, the uphill exercised VCPR155H/+ mice displayed an improvement in muscle atrophy, and decreased expression levels of ubiquitin, P62/SQSTM1, LC3I/II, and TDP-43 autophagy markers, suggesting an alleviation of disease-induced myopathy phenotypes. There was also an improvement in the Paget-like phenotype. Conclusions Collectively, our data highlights that uphill exercise training in VCPR155H/+ mice did not have any detrimental value to the function of muscle, and may offer effective therapeutic options for patients with VCP-associated diseases.
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Affiliation(s)
- Angèle Nalbandian
- Department of Pediatrics, Division of Genetics and Metabolism, University of California Irvine, Irvine, California, United States of America
| | - Christopher Nguyen
- Department of Pediatrics, Division of Genetics and Metabolism, University of California Irvine, Irvine, California, United States of America
| | - Veeral Katheria
- Department of Pediatrics, Division of Genetics and Metabolism, University of California Irvine, Irvine, California, United States of America
| | - Katrina J. Llewellyn
- Department of Pediatrics, Division of Genetics and Metabolism, University of California Irvine, Irvine, California, United States of America
| | - Mallikarjun Badadani
- Department of Pediatrics, Division of Genetics and Metabolism, University of California Irvine, Irvine, California, United States of America
| | - Vincent Caiozzo
- Department of Physiology and Biophysics, University of California Irvine, Irvine, California, United States of America
- Department of Orthopedics, University of California Irvine, Irvine, California, United States of America
| | - Virginia E. Kimonis
- Department of Pediatrics, Division of Genetics and Metabolism, University of California Irvine, Irvine, California, United States of America
- * E-mail:
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