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Kabir A, Mukilarasi B, Manohar A, Gadani M, Sinha AK, Sharma P, Verma A, Selvaraj V, Sudhakar S. Protein bioactive complexes promote osteogenesis under microgravity environment. Int J Biol Macromol 2025; 303:140483. [PMID: 39904451 DOI: 10.1016/j.ijbiomac.2025.140483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 01/25/2025] [Accepted: 01/28/2025] [Indexed: 02/06/2025]
Abstract
The space microgravity environment and cosmic radiation pose a significant threat to musculoskeletal health, particularly bone mass. However, the critical mechanism underlying space-induced bone loss and its relation to cellular oxidative stress remains unclear. Currently used bone-loss-reversing drugs face limitations like poor efficacy and metabolic defects. Herein, we revealed that simulated microgravity (SMG) induces reactive oxygen species (ROS), negatively impacting osteoblasts, causing cytoskeletal damage, and downregulating osteogenic genes. To combat this, we designed protein-zein nanocages loaded with a chimeric non-enzymatic cocktail (ZNAC) containing ascorbic acid, resveratrol, luteolin, coenzyme Q, and glutathione. These nanocages (~200 nm) demonstrated excellent stability, biocompatibility, and antioxidant properties compared to free drugs. We investigated the effects of ZNAC under SMG using two experimental models: MC3T3 pre-osteoblast/MG63 osteoblasts and regenerating zebrafish scales that represent compositional and physiological/pathophysiological analogy with mammalian system. ZNAC effectively reduced SMG-induced ROS, preserved cytoskeletal integrity, and enhanced alkaline phosphatase (ALP) activity along with the expression of osteogenic genes such as RUNX2 and Col1A1. In zebrafish scales, it increased osteogenic gene expression, calcification, and the calcium/phosphorus ratio, indicating enhanced scale regeneration. These findings suggest that ZNAC is a promising candidate for bone regeneration, offering potential solutions for maintaining astronaut health during extended space missions.
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Affiliation(s)
- Anisha Kabir
- Department of Applied Mechanics and Biomedical Engineering, Indian Institute of Technology Madras, Chennai, Tamil Nadu 600036, India.
| | - B Mukilarasi
- Department of Applied Mechanics and Biomedical Engineering, Indian Institute of Technology Madras, Chennai, Tamil Nadu 600036, India.
| | - Anagha Manohar
- Department of Applied Mechanics and Biomedical Engineering, Indian Institute of Technology Madras, Chennai, Tamil Nadu 600036, India.
| | - Maulesh Gadani
- Space Applications Centre, Indian Space Research Organisation, Ahmedabad, Gujarat 380015, India.
| | - Anurag Kumar Sinha
- Human Space Flight Centre, Antariksh Bhavan, New BEL Road, Bengaluru 560 094, India.
| | - Payal Sharma
- Space Applications Centre, Indian Space Research Organisation, Ahmedabad, Gujarat 380015, India.
| | - Anurag Verma
- Space Applications Centre, Indian Space Research Organisation, Ahmedabad, Gujarat 380015, India.
| | - Vimalraj Selvaraj
- Department of Applied Mechanics and Biomedical Engineering, Indian Institute of Technology Madras, Chennai, Tamil Nadu 600036, India.
| | - Swathi Sudhakar
- Department of Applied Mechanics and Biomedical Engineering, Indian Institute of Technology Madras, Chennai, Tamil Nadu 600036, India.
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Liu Y, Cao X, Zhou Q, Deng C, Yang Y, Huang D, Luo H, Zhang S, Li Y, Xu J, Chen H. Mechanisms and Countermeasures for Muscle Atrophy in Microgravity. Cells 2024; 13:2120. [PMID: 39768210 PMCID: PMC11727360 DOI: 10.3390/cells13242120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Revised: 12/09/2024] [Accepted: 12/18/2024] [Indexed: 01/12/2025] Open
Abstract
Previous studies have revealed that muscle atrophy emerges as a significant challenge faced by astronauts during prolonged missions in space. A loss in muscle mass results in a weakening of skeletal muscle strength and function, which will not only contribute to a decline in overall physical performance but also elevate the risk of various age-related diseases. Skeletal muscle atrophy in the microgravity environment is thought to be associated with changes in energy metabolism, protein metabolism, calcium ion homeostasis, myostatin levels, and apoptosis. Modulating some pathways could be a promising approach to mitigating muscle atrophy in the microgravity environment. This review serves as a comprehensive summary of research on the impact of microgravity on skeletal muscle, with the aim of providing insights into its pathogenesis and the development of effective treatments.
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Affiliation(s)
- Yizhou Liu
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
| | - Xiaojian Cao
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
| | - Qiuzhi Zhou
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
- Stem Cell Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chunchu Deng
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
| | - Yujie Yang
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
| | - Danxia Huang
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
| | - Hongmei Luo
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
| | - Song Zhang
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
| | - Yajie Li
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
- Stem Cell Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jia Xu
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
- Stem Cell Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hong Chen
- Department of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (Y.L.); (X.C.); (Q.Z.); (C.D.); (Y.Y.); (D.H.); (H.L.); (S.Z.); (Y.L.); (J.X.)
- Stem Cell Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Zhang G, Hu F, Huang T, Ma X, Cheng Y, Liu X, Jiang W, Dong B, Fu C. The recent development, application, and future prospects of muscle atrophy animal models. MEDCOMM – FUTURE MEDICINE 2024; 3. [DOI: 10.1002/mef2.70008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Accepted: 12/01/2024] [Indexed: 01/06/2025]
Abstract
AbstractMuscle atrophy, characterized by the loss of muscle mass and function, is a hallmark of sarcopenia and cachexia, frequently associated with aging, malignant tumors, chronic heart failure, and malnutrition. Moreover, it poses significant challenges to human health, leading to increased frailty, reduced quality of life, and heightened mortality risks. Despite extensive research on sarcopenia and cachexia, consensus in their assessment remains elusive, with inconsistent conclusions regarding their molecular mechanisms. Muscle atrophy models are crucial tools for advancing research in this field. Currently, animal models of muscle atrophy used for clinical and basic scientific studies are induced through various methods, including aging, genetic editing, nutritional modification, exercise, chronic wasting diseases, and drug administration. Muscle atrophy models also include in vitro and small organism models. Despite their value, each of these models has certain limitations. This review focuses on the limitations and diverse applications of muscle atrophy models to understand sarcopenia and cachexia, and encourage their rational use in future research, therefore deepening the understanding of underlying pathophysiological mechanisms, and ultimately advancing the exploration of therapeutic strategies for sarcopenia and cachexia.
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Affiliation(s)
- Gongchang Zhang
- Geriatric Health Care and Medical Research Center West China Hospital, Sichuan University Chengdu Sichuan Province China
- National Clinical Research Center for Geriatrics West China Hospital, Sichuan University Chengdu Sichuan Province China
| | - Fengjuan Hu
- Geriatric Health Care and Medical Research Center West China Hospital, Sichuan University Chengdu Sichuan Province China
- National Clinical Research Center for Geriatrics West China Hospital, Sichuan University Chengdu Sichuan Province China
| | - Tingting Huang
- National Clinical Research Center for Geriatrics West China Hospital, Sichuan University Chengdu Sichuan Province China
| | - Xiaoqing Ma
- Longkou People Hospital Longkou Shandong Province China
| | - Ying Cheng
- Geriatric Health Care and Medical Research Center West China Hospital, Sichuan University Chengdu Sichuan Province China
- National Clinical Research Center for Geriatrics West China Hospital, Sichuan University Chengdu Sichuan Province China
| | - Xiaolei Liu
- Geriatric Health Care and Medical Research Center West China Hospital, Sichuan University Chengdu Sichuan Province China
- National Clinical Research Center for Geriatrics West China Hospital, Sichuan University Chengdu Sichuan Province China
| | - Wenzhou Jiang
- Longkou People Hospital Longkou Shandong Province China
| | - Birong Dong
- Geriatric Health Care and Medical Research Center West China Hospital, Sichuan University Chengdu Sichuan Province China
- National Clinical Research Center for Geriatrics West China Hospital, Sichuan University Chengdu Sichuan Province China
| | - Chenying Fu
- Geriatric Health Care and Medical Research Center West China Hospital, Sichuan University Chengdu Sichuan Province China
- National Clinical Research Center for Geriatrics West China Hospital, Sichuan University Chengdu Sichuan Province China
- Department of Laboratory of Aging and Geriatric Medicine National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University Chengdu Sichuan Province China
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Reed CH, Tystahl AC, Eo H, Buhr TJ, Bauer EE, Lee JH, Clark PJ, Valentine RJ. The Influence of Stress and Binge-Patterned Alcohol Drinking on Mouse Skeletal Muscle Protein Synthesis and Degradation Pathways. Biomolecules 2024; 14:527. [PMID: 38785934 PMCID: PMC11118922 DOI: 10.3390/biom14050527] [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: 02/12/2024] [Revised: 03/30/2024] [Accepted: 04/09/2024] [Indexed: 05/25/2024] Open
Abstract
Adverse experiences (e.g., acute stress) and alcohol misuse can both impair skeletal muscle homeostasis, resulting in reduced protein synthesis and greater protein breakdown. Exposure to acute stress is a significant risk factor for engaging in alcohol misuse. However, little is known about how these factors together might further affect skeletal muscle health. To that end, this study investigated the effects of acute stress exposure followed by a period of binge-patterned alcohol drinking on signaling factors along mouse skeletal muscle protein synthesis (MPS) and degradation (MPD) pathways. Young adult male C57BL/6J mice participated in the Drinking in the Dark paradigm, where they received 2-4 h of access to 20% ethanol (alcohol group) or water (control group) for four days to establish baseline drinking levels. Three days later, half of the mice in each group were either exposed to a single episode of uncontrollable tail shocks (acute stress) or remained undisturbed in their home cages (no stress). Three days after stress exposure, mice received 4 h of access to 20% ethanol (alcohol) to model binge-patterned alcohol drinking or water for ten consecutive days. Immediately following the final episode of alcohol access, mouse gastrocnemius muscle was extracted to measure changes in relative protein levels along the Akt-mTOR MPS, as well as the ubiquitin-proteasome pathway (UPP) and autophagy MPD pathways via Western blotting. A single exposure to acute stress impaired Akt singling and reduced rates of MPS, independent of alcohol access. This observation was concurrent with a potent increase in heat shock protein seventy expression in the muscle of stressed mice. Alcohol drinking did not exacerbate stress-induced alterations in the MPS and MPD signaling pathways. Instead, changes in the MPS and MPD signaling factors due to alcohol access were primarily observed in non-stressed mice. Taken together, these data suggest that exposure to a stressor of sufficient intensity may cause prolonged disruptions to signaling factors that impact skeletal muscle health and function beyond what could be further induced by periods of alcohol misuse.
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Affiliation(s)
- Carter H Reed
- Department of Biology, Grand View University, Des Moines, IA 50316, USA;
| | - Anna C. Tystahl
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (A.C.T.)
| | - Hyeyoon Eo
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (A.C.T.)
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011, USA
| | - Trevor J. Buhr
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011, USA
| | - Ella E. Bauer
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011, USA
| | - Ji Heun Lee
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (A.C.T.)
| | - Peter J. Clark
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA 50011, USA
| | - Rudy J. Valentine
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
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Laskin GR, Cabrera AR, Greene NP, Tomko RJ, Vied C, Gordon BS. The mechanosensitive gene arrestin domain containing 2 regulates myotube diameter with direct implications for disuse atrophy with aging. Am J Physiol Cell Physiol 2024; 326:C768-C783. [PMID: 38314723 PMCID: PMC11193484 DOI: 10.1152/ajpcell.00444.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/08/2024] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
Arrestin domain containing 2 and 3 (Arrdc2/3) are genes whose mRNA contents are decreased in young skeletal muscle following mechanical overload. Arrdc3 is linked to the regulation of signaling pathways in nonmuscle cells that could influence skeletal muscle size. Despite a similar amino acid sequence, Arrdc2 function remains undefined. The purpose of this study was to further explore the relationship of Arrdc2/Arrdc3 expression with changes in mechanical load in young and aged muscle and define the effect of Arrdc2/3 expression on C2C12 myotube diameter. In young and aged mice, mechanical load was decreased using hindlimb suspension whereas mechanical load was increased by reloading previously unloaded muscle or inducing high-force contractions. Arrdc2 and Arrdc3 mRNAs were overexpressed in C2C12 myotubes using adenoviruses. Myotube diameter was determined 48-h posttransfection, and RNA sequencing was performed on those samples. Arrdc2 and Arrdc3 mRNA content was higher in the unloaded muscle within 1 day of disuse and remained higher up through 10 days. The induction of Arrdc2 mRNA was more pronounced in aged muscle than young muscle in response to unloading. Reloading previously unloaded muscle of young and aged mice restored Arrdc2 and Arrdc3 levels to ambulatory levels. Increasing mechanical load beyond normal ambulatory levels lowered Arrdc2 mRNA, but not Arrdc3 mRNA, in young and aged muscle. Arrdc2 overexpression only was sufficient to lower myotube diameter in C2C12 cells in part by altering the transcriptome favoring muscle atrophy. These data are consistent with Arrdc2 contributing to disuse atrophy, particularly in aged muscle.NEW & NOTEWORTHY We establish Arrdc2 as a novel mechanosensitive gene highly induced in response to mechanical unloading, particularly in aged muscle. Arrdc2 induction in C2C12 myotubes is sufficient to produce thinner myotubes and a transcriptional landscape consistent with muscle atrophy and disuse.
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Affiliation(s)
- Grant R Laskin
- Department of of Health, Nutrition, and Food Sciences, Florida State University, Tallahassee, Florida, United States
| | - Ana Regina Cabrera
- Department of Health, Human Performance and Recreation, Cachexia Research Laboratory, Exercise Science Research Center, University of Arkansas, Fayetteville, Arkansas, United States
| | - Nicholas P Greene
- Department of Health, Human Performance and Recreation, Cachexia Research Laboratory, Exercise Science Research Center, University of Arkansas, Fayetteville, Arkansas, United States
| | - Robert J Tomko
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, Florida, United States
| | - Cynthia Vied
- Translational Science Laboratory, Florida State University College of Medicine, Tallahassee, Florida, United States
| | - Bradley S Gordon
- Department of of Health, Nutrition, and Food Sciences, Florida State University, Tallahassee, Florida, United States
- Institute of Sports Sciences and Medicine, Florida State University, Tallahassee, Florida, United States
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Zhang J, Gao Y, Yan J. Roles of Myokines and Muscle-Derived Extracellular Vesicles in Musculoskeletal Deterioration under Disuse Conditions. Metabolites 2024; 14:88. [PMID: 38392980 PMCID: PMC10891558 DOI: 10.3390/metabo14020088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 02/25/2024] Open
Abstract
Prolonged inactivity and disuse conditions, such as those experienced during spaceflight and prolonged bedrest, are frequently accompanied by detrimental effects on the motor system, including skeletal muscle atrophy and bone loss, which greatly increase the risk of osteoporosis and fractures. Moreover, the decrease in glucose and lipid utilization in skeletal muscles, a consequence of muscle atrophy, also contributes to the development of metabolic syndrome. Clarifying the mechanisms involved in disuse-induced musculoskeletal deterioration is important, providing therapeutic targets and a scientific foundation for the treatment of musculoskeletal disorders under disuse conditions. Skeletal muscle, as a powerful endocrine organ, participates in the regulation of physiological and biochemical functions of local or distal tissues and organs, including itself, in endocrine, autocrine, or paracrine manners. As a motor organ adjacent to muscle, bone tissue exhibits a relative lag in degenerative changes compared to skeletal muscle under disuse conditions. Based on this phenomenon, roles and mechanisms involved in the communication between skeletal muscle and bone, especially from muscle to bone, under disuse conditions have attracted widespread attention. In this review, we summarize the roles and regulatory mechanisms of muscle-derived myokines and extracellular vesicles (EVs) in the occurrence of muscle atrophy and bone loss under disuse conditions, as well as discuss future perspectives based on existing research.
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Affiliation(s)
- Jie Zhang
- Institute of Special Medicine, Shanxi Medical University, Jinzhong 030619, China;
| | - Yunfang Gao
- Shaanxi Key Laboratory for Animal Conservation, College of Life Sciences, Northwest University, Xi’an 710069, China
| | - Jiangwei Yan
- Institute of Special Medicine, Shanxi Medical University, Jinzhong 030619, China;
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Zeineddine Y, Friedman MA, Buettmann EG, Abraham LB, Hoppock GA, Donahue HJ. Genetic diversity modulates the physical and transcriptomic response of skeletal muscle to simulated microgravity in male mice. NPJ Microgravity 2023; 9:86. [PMID: 38040743 PMCID: PMC10692100 DOI: 10.1038/s41526-023-00334-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/09/2023] [Indexed: 12/03/2023] Open
Abstract
Developments in long-term space exploration necessitate advancements in countermeasures against microgravity-induced skeletal muscle loss. Astronaut data shows considerable variation in muscle loss in response to microgravity. Previous experiments suggest that genetic background influences the skeletal muscle response to unloading, but no in-depth analysis of genetic expression has been performed. Here, we placed eight, male, inbred founder strains of the diversity outbred mice (129S1/SvImJ, A/J, C57BL/6J, CAST/EiJ, NOD/ShiLtJ, NZO/HILtJ, PWK/PhJ, and WSB/EiJ) in simulated microgravity (SM) via hindlimb unloading for three weeks. Body weight, muscle morphology, muscle strength, protein synthesis marker expression, and RNA expression were collected. A/J and CAST/EiJ mice were most susceptible to SM-induced muscle loss, whereas NOD/ShiLtJ mice were the most protected. In response to SM, A/J and CAST/EiJ mice experienced reductions in body weight, muscle mass, muscle volume, and muscle cross-sectional area. A/J mice had the highest number of differentially expressed genes (68) and associated gene ontologies (328). Downregulation of immunological gene ontologies and genes encoding anabolic immune factors suggest that immune dysregulation contributes to the response of A/J mice to SM. Several muscle properties showed significant interactions between SM and mouse strain and a high degree of heritability. These data imply that genetic background plays a role in the degree of muscle loss in SM and that more individualized programs should be developed for astronauts to protect their skeletal muscles against microgravity on long-term missions.
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Affiliation(s)
- Yasmina Zeineddine
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael A Friedman
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Evan G Buettmann
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Lovell B Abraham
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Gabriel A Hoppock
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Henry J Donahue
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
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