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Mavropalias G, Boppart M, Usher KM, Grounds MD, Nosaka K, Blazevich AJ. Exercise builds the scaffold of life: muscle extracellular matrix biomarker responses to physical activity, inactivity, and aging. Biol Rev Camb Philos Soc 2023; 98:481-519. [PMID: 36412213 DOI: 10.1111/brv.12916] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022]
Abstract
Skeletal muscle extracellular matrix (ECM) is critical for muscle force production and the regulation of important physiological processes during growth, regeneration, and remodelling. ECM remodelling is a tightly orchestrated process, sensitive to multi-directional tensile and compressive stresses and damaging stimuli, and its assessment can convey important information on rehabilitation effectiveness, injury, and disease. Despite its profound importance, ECM biomarkers are underused in studies examining the effects of exercise, disuse, or aging on muscle function, growth, and structure. This review examines patterns of short- and long-term changes in the synthesis and concentrations of ECM markers in biofluids and tissues, which may be useful for describing the time course of ECM remodelling following physical activity and disuse. Forces imposed on the ECM during physical activity critically affect cell signalling while disuse causes non-optimal adaptations, including connective tissue proliferation. The goal of this review is to inform researchers, and rehabilitation, medical, and exercise practitioners better about the role of ECM biomarkers in research and clinical environments to accelerate the development of targeted physical activity treatments, improve ECM status assessment, and enhance function in aging, injury, and disease.
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Affiliation(s)
- Georgios Mavropalias
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, and Centre for Healthy Aging, Health Futures Institute, Murdoch University, Murdoch, WA, 6150, Australia
- Discipline of Exercise Science, Murdoch University, Murdoch, WA, 6150, Australia
| | - Marni Boppart
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 1206 South Fourth St, Urbana, IL, 61801, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana- Champaign, 405 N. Mathews Avenue, Urbana, IL, 61801, USA
| | - Kayley M Usher
- School of Biomedical Sciences, University of Western Australia (M504), 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Miranda D Grounds
- School of Human Sciences, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Kazunori Nosaka
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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Shafie N, Kordi N, Gadruni K, SalehFard Z, Jung F, Heidari N. Cardiac rehabilitation in coronary artery bypass grafting patients: Effect of eight weeks of moderate-intensity continuous training versus high-intensity interval training. Clin Hemorheol Microcirc 2023; 83:305-314. [PMID: 36683497 DOI: 10.3233/ch-221605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Physical training in patients with heart failure can affect hemodynamic, cardiac and angiogenesis parameters. OBJECTIVE The aim of the present study was to investigate the effects of traditional moderate-intensity rehabilitation training and interval training on some angiogenesis factors in coronary artery bypass graft (CABG) patients. METHODS Thirty CABG patients (mean age±SD, 55±3 years) were randomly assigned to one of three groups: high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT) or the control group. After the initial assessments, eligible patients in the experimental groups (HIIT and MICT) performed exercise training for 8 weeks, while the control group did not. Angiogenesis and angiostatic indices, including pro-adrenomedullin (pro-ADM), basic fibroblast growth factor (bFGF), and endostatin, were then measured. RESULTS The results showed no significant difference between pro-ADM in the HIIT and MICT groups (P = 0.99), but a significant difference was found between MICT and the control group and between HIIT and the control group (P = 0.001). There is also no significant difference between the bFGF levels in the HIIT and MICT training groups (P = 1.00), but the changes in this factor between the training groups and the control group were significant (P = 0.001). There was a significant difference between the levels of endostatin in all three groups. CONCLUSIONS Two methods of cardiac rehabilitation (HIIT and MICT) may be useful for the recovery of patients with coronary artery bypass grafting. This improvement manifested itself in changes in angiogenesis and angiostatic indices in this study. However, more extensive studies are needed to investigate the effects of these two types of rehabilitation programs on other indicators of angiogenesis and angiostatic.
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Affiliation(s)
- Neda Shafie
- Department of Sport Physiology, Faculty of Sport Sciences, The University of Mazandaran, Babolsar, Iran
| | - Negin Kordi
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, Iran
| | - Keivan Gadruni
- Faculty of Physical Education, University of Tabriz, Tabriz, Iran; Kurdistan Education Office, Ministry of Education, Kurdistan, Iran; Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ziba SalehFard
- Department of Sport Physiology, School of Physical Education and Sport Sciences, Alzahra University, Tehran, Iran
| | - Friedrich Jung
- Faculty of Health Sciences Brandenburg, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Naser Heidari
- Faculty of Sport Science, Shahid Rajaei Teacher Training University, Tehran, Iran
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Acute Exhaustive Exercise under Normoxic and Normobaric Hypoxic Conditions Differentially Regulates Angiogenic Biomarkers in Humans. ACTA ACUST UNITED AC 2021; 57:medicina57070727. [PMID: 34357009 PMCID: PMC8307406 DOI: 10.3390/medicina57070727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/16/2021] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Angiogenesis describes the outgrowth of new capillaries from already existing ones. Different biomarkers regulate this process. Physical exercise and hypoxia are key stimuli for the activation of different angiogenic molecules, such as the vascular endothelial growth factor (VEGF). matrix metalloproteases (MMPs)-2 and -9 or the extracellular matrix cleavage fragment endostatin. The present study aimed to investigate influences of short-term, intensive cycling exercise under both normoxic and normobaric hypoxic conditions on the mentioned parameters. Materials and Methods: Twelve male subjects (age: 23.3 ± 2.0 years) participated in the study. All subjects conducted four intensive cycling tests until individual exhaustion in a randomized order under the following conditions: normoxia, 2000 m, 3000 m and 4000 m above sea level. Blood samples were taken before (pre) and 10 min, 30 min, 60 min and 240 min post exercise and were analyzed by ELISA. Results: VEGF showed a significantly reduced concentration compared to the pre-value solely under 4000 m at 10 min post exercise. MMP-2 showed significantly reduced concentrations at 240 min post exercise under 4000 m. MMP-9 increased at 240 min post exercise under both 2000 m and 4000 m conditions. Endostatin was significantly increased at 10 min post exercise independently of the applied stimulus. Conclusions: The presented data show that intensive short-term exercise bouts facilitate the bioavailability of angiogenic, ECM (extracellular matrix)-related biomarkers. This finding is interesting for both health- and performance-related research as it demonstrates the positive effects of intensive short exercise interventions.
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Parganlija D, Gehlert S, Herrera F, Rittweger J, Bloch W, Zange J. Enhanced Blood Supply Through Lower Body Negative Pressure During Slow-Paced, High Load Leg Press Exercise Alters the Response of Muscle AMPK and Circulating Angiogenic Factors. Front Physiol 2020; 11:781. [PMID: 32848814 PMCID: PMC7406804 DOI: 10.3389/fphys.2020.00781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022] Open
Abstract
Lower body negative pressure (LBNP) is an established method of simulating the gravitational effects of orthostasis on the cardiovascular system during space flight or at supine body position on Earth. We hypothesized that LBNP added onto leg press exercise would promote leg muscle perfusion, stimulate oxygen consumption, and modify acute molecular responses. Eighteen subjects performed fifteen slow-paced concentric (4 s) and eccentric contractions (4 s) without or with 40 mmHg LBNP. Force corresponding to 6% of the one-repetition maximum (1-RM) at knee flexion gradually increased to 60% 1-RM within the first half of the range of motion, thereafter remaining constant. AMPK and P-AMPK protein expression was determined in biopsies of vastus lateralis. Venous blood samples were used to measure angiogenic factors. Physiological responses to LBNP included an elevated EMG amplitude, higher heart rate and doubling of the cardiac output compared to control (p < 0.001). Muscle total hemoglobin was increased by around 20 μmol/l vs. control (p < 0.001), accompanied by decreasing tissue oxygen saturation and elevated oxygen uptake (p < 0.05). MMP-2 levels were reduced, and the ratio of P-AMPK to AMPK elevated after exercise with LBNP (p < 0.05). MMP-9 similarly increased in both groups, whereas endostatin was only elevated in the control group (p < 0.05). Our results indicate facilitated peripheral blood supply and higher oxygen exploitation leading to activation of the energy sensor AMPK and differential regulation of angiogenic factors involved in muscle tissue remodeling and capillary growth. Simulating orthostasis with LBNP might promote beneficial structural adaptations of skeletal muscles during resistance exercise and contribute to future exercise countermeasures achieving increased muscle strength and endurance during space flight.
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Affiliation(s)
- Dajana Parganlija
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.,Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Sebastian Gehlert
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany.,Department for Biosciences of Sports, Institute of Sport Science, University of Hildesheim, Hildesheim, Germany
| | - Frankyn Herrera
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany.,Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Jochen Zange
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
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Plasma matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs and aging and lifelong exercise adaptations in ventricular and arterial stiffness. Exp Gerontol 2019; 123:36-44. [PMID: 31095969 DOI: 10.1016/j.exger.2019.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 04/18/2019] [Accepted: 05/08/2019] [Indexed: 01/19/2023]
Abstract
The age-associated increase in cardiac and central arterial stiffness is attenuated with lifelong (>25 years) endurance exercise in a dose-dependent manner. Remodelling of the extracellular matrix of cardiovascular structures may underpin these lifelong exercise adaptations in structural stiffness. The primary aim was to examine whether matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) levels are associated with aging and lifelong exercise-related changes in cardiac and central arterial stiffness. Plasma MMPs and TIMPs, left ventricular (LV) (LV stiffness constant) and central arterial stiffness (pulse wave velocity) were examined in healthy adults stratified into five groups based on age and lifelong weekly exercise frequency: (1) young sedentary adults (28-50 years), and older adults (>60 years) who had performed either: (a) sedentary (0-1 sessions/week), (b) casual (2-3 sessions/week), (c) committed (4-5 sessions/week) or (d) athletic (≥6 sessions/week) frequency of exercise. MMP-1 was significantly lower in young compared to older sedentary (p = 0.049). Except for TIMP-2 (p = 0.018 versus committed) and the ratio of MMP-2/TIMP-4 (p = 0.047 versus committed), MMP and TIMP expression was not significantly different in lifelong exercise groups (≥casual) compared to the older sedentary group. MMP-1, -3 had a weak positive relationship with central PWV (r = 0.17-0.25, p ≤ 0.050) but there were no significant relationships between MMPs or TIMPs and LV stiffness constant (p ≥ 0.148). In conclusion, there was not a clear or consistent difference in plasma MMPs and TIMPs with lifelong exercise dose despite exhibiting lower cardiovascular stiffness at the highest exercise levels.
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Pingel J, Suhr F. Are mechanically sensitive regulators involved in the function and (patho)physiology of cerebral palsy-related contractures? J Muscle Res Cell Motil 2017; 38:317-330. [PMID: 29190010 DOI: 10.1007/s10974-017-9489-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/21/2017] [Indexed: 12/17/2022]
Abstract
Skeletal muscle tissue is mechanosensitive, as it is able to sense mechanical impacts and to translate these into biochemical signals making the tissue adapt. Among its mechanosensitive nature, skeletal muscle tissue is the largest metabolic organ of the human body. Disturbances in skeletal muscle mechanosensing and metabolism cause and contribute to many diseases, i.e. muscular dystrophies/myopathies, cardiovascular diseases, COPD or diabetes mellitus type 2. A less commonly focused muscle-related disorder is clinically known as muscle contractures that derive from cerebral palsy (CP) conditions in young and adults. Muscle contractures are characterized by gradually increasing passive muscle stiffness resulting in complete fixation of joints. Different mechanisms have been identified in CP-related contractures, i.e. altered calcium handling, altered metabolism or altered titin regulation. The muscle-related extracellular matrix (ECM), specifically collagens, plays a role in CP-related contractures. Herein, we focus on mechanically sensitive complexes, known as costameres (Cstms), and discuss their potential role in CP-related contractures. We extend our discussion to the ECM due to the limited knowledge of its role in CP-related contractures. The aims of this review are (1) to summarize CP-related contracture mechanisms, (2) to raise novel hypotheses on the genesis of contractures with a focus on Cstms, and (3) to stimulate novel approaches to study CP-related contractures.
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Affiliation(s)
- Jessica Pingel
- Motor Control Lab, Department of Neuroscience and Pharmacology, University of Copenhagen, Blegdamsvej 3b, 2200, Copenhagen N, Denmark.
| | - Frank Suhr
- Exercise Physiology Research Group, Department of Movement Sciences, Biomedical Sciences Group, KU Leuven, Tervuursevest 101, box 1500, 3001, Leuven, Belgium.
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Abstract
BACKGROUND Matrix metalloproteinases (MMPs), particularly gelatinase A (MMP-2) and gelatinase B (MMP-9), as well as their tissue inhibitors (TIMP-1 and TIMP-2), are involved in the development of skeletal muscle tissue, in the repair process after muscle injury and in the adaptive modifications induced by physical exercise in skeletal muscle. This paper aims at reviewing results from human studies that investigated the role of gelatinases and their inhibitors in skeletal muscle response to acute physical exercise or training. METHODS Electronic databases PubMed/MEDLINE, Scopus and Web of Science were searched for papers published between January 2000 and February 2017. The papers were eligible when reporting human studies in which MMP-2 and/or MMP-9 and/or the inhibitors TIMP-1/TIMP-2 were evaluated, in blood or muscular tissue, before and after acute physical exercise or before and after a period of structured physical training. We included studies on healthy subjects and patients with chronic metabolic diseases (obesity, diabetes mellitus, metabolic syndrome-MS) or asymptomatic coronary artery disease. We excluded studies on patients with neurological, rheumatologic or neoplastic diseases. RESULTS Studies conducted on muscle biopsies showed an early stimulation of MMP-9 gene transcription as a result of acute exercise, whereas MMP-2 and TIMP transcription resulted from regular repetition of exercise over time. Studies on serum or plasma level of gelatinases and their inhibitors showed an early release of MMP-9 after acute exercise of sufficient intensity, while data on MMP-2 and TIMP were more contrasting. Most of the studies dealing with the effect of training indicated a trend toward reduction in blood gelatinase levels, once again more clear for MMP-9. This result was related to an anti-inflammatory effect of regular exercise and was more evident when training consisted of aerobic activities. This study has limitations: as the initial selection was done through titles and abstracts, incomplete retrieval cannot be excluded, as well as we cannot exclude bias due to selective reporting within studies. CONCLUSION A better knowledge of the molecular events activated by different types of acute exercise and regular training could be of great relevance in order to maximize the benefits of physical activity in healthy subjects and patients.
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Affiliation(s)
- Rosalia Lo Presti
- Dipartimento di Scienze Psicologiche, Pedagogiche e della Formazione
| | - Eugenia Hopps
- Dipartimento Biomedico di Medicina Interna e Specialistica Università degli Studi di Palermo, Palermo, Italy
| | - Gregorio Caimi
- Dipartimento Biomedico di Medicina Interna e Specialistica Università degli Studi di Palermo, Palermo, Italy
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8
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Greiwe L, Vinck M, Suhr F. The muscle contraction mode determines lymphangiogenesis differentially in rat skeletal and cardiac muscles by modifying local lymphatic extracellular matrix microenvironments. Acta Physiol (Oxf) 2016; 217:61-79. [PMID: 26601802 DOI: 10.1111/apha.12633] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/14/2015] [Accepted: 11/16/2015] [Indexed: 12/13/2022]
Abstract
AIM Lymphatic vessels are of special importance for tissue homeostasis, and increases of their density may foster tissue regeneration. Exercise could be a relevant tool to increase lymphatic vessel density (LVD); however, a significant lack of knowledge remains to understand lymphangiogenesis in skeletal muscles upon training. Interestingly, training-induced lymphangiogenesis has never been studied in the heart. We studied lymphangiogenesis and LVD upon chronic concentric and chronic eccentric muscle contractions in both rat skeletal (Mm. Edl and Sol) and cardiac muscles. METHODS/RESULTS We found that LVD decreased in both skeletal muscles specifically upon eccentric training, while this contraction increased LVD in cardiac tissue. These observations were supported by opposing local remodelling of lymphatic vessel-specific extracellular matrix components in skeletal and cardiac muscles and protein levels of lymphatic markers (Lyve-1, Pdpn, Vegf-C/D). Confocal microscopy further revealed transformations of lymphatic vessels into vessels expressing both blood (Cav-1) and lymphatic (Vegfr-3) markers upon eccentric training specifically in skeletal muscles. In addition and phenotype supportive, we found increased inflammation (NF-κB/p65, Il-1β, Ifn-γ, Tnf-α and MPO(+) cells) in eccentrically stressed skeletal, but decreased levels in cardiac muscles. CONCLUSION Our data provide novel mechanistic insights into lymphangiogenic processes in skeletal and cardiac muscles upon chronic muscle contraction modes and demonstrate that both tissues adapt in opposing manners specifically to eccentric training. These data are highly relevant for clinical applications, because eccentric training serves as a sufficient strategy to increase LVD and to decrease inflammation in cardiac tissue, for example in order to reduce tissue abortion in transplantation settings.
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Affiliation(s)
- L. Greiwe
- Department of Molecular and Cellular Sport Medicine; Institute of Cardiovascular Research and Sport Medicine; German Sport University Cologne; Cologne Germany
| | - M. Vinck
- Department of Molecular and Cellular Sport Medicine; Institute of Cardiovascular Research and Sport Medicine; German Sport University Cologne; Cologne Germany
| | - F. Suhr
- Department of Molecular and Cellular Sport Medicine; Institute of Cardiovascular Research and Sport Medicine; German Sport University Cologne; Cologne Germany
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Abstract
During the last decade, epigenetics became one of the fastest growing research fields in numerous clinical and basic science disciplines. Evidence suggests that chromatin modifications (e.g., histone modifications and DNA methylation) as well as the expression of micro-RNA molecules play a crucial role in the pathogenesis of several cardiovascular diseases. On the one hand, they are involved in the development of general risk factors like chronic inflammation, but on the other hand, epigenetic modifications are conducive to smooth muscle cell, cardiomyocyte, and endothelial progenitor cell proliferation/differentiation as well as to extracellular matrix processing and endothelial function (e.g., endothelial nitric oxide synthase regulation). Therefore, epigenetic medical drugs have gained increased attention and provided the first promising results in the context of cardiovascular malignancies. Beside other lifestyle factors, physical activity and sports essentially contribute to cardiovascular health and regeneration. In this review we focus on recent research proposing physical activity as a potent epigenetic regulator that has the potential to counteract pathophysiological alterations in almost all the aforementioned cardiovascular cells and tissues. As with epigenetic medical drugs, more knowledge about the molecular mechanisms and dose-response relationships of exercise is needed to optimize the outcome of preventive and rehabilitative exercise programs and recommendations.
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Affiliation(s)
- P Zimmer
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
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Nascimento DDC, Durigan RDCM, Tibana RA, Durigan JLQ, Navalta JW, Prestes J. The response of matrix metalloproteinase-9 and -2 to exercise. Sports Med 2015; 45:269-78. [PMID: 25252612 DOI: 10.1007/s40279-014-0265-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Matrix metalloproteinases (MMPs) are a major group of enzymes that play essential roles in normal functioning of diverse tissues during growth, development, and aging. However, among the MMPs little is known regarding the role of exercise in MMP-9 and MMP-2 function in humans. OBJECTIVE The aim of this study was to provide a systematic comprehensive review of the literature examining the effect of different exercise interventions on MMP-9 and MMP-2 in human investigations. DATA SOURCES A comprehensive systematic database search was performed, including PubMed/MEDLINE, Scopus, ScienceDirect, and Web of Science. STUDY SELECTION Both the acute and chronic effects of exercise were included for evaluation in this systematic review. Inclusion criteria included the use of any type of planned, structured, and repetitive movement and its effects on the MMP-2 and MMP-9 response (obtained from plasma samples), participants (humans only) of any age with or without diseases, sedentary participants and those involved in light, moderate, and vigorous activity, randomized controlled trials (RCTs) and clinical trials (CTs), full text article citations with no restrictions in terms of language, and scored at least 5/11 on the Physiotherapy Evidence Database (PEDro) quality scale. STUDY APPRAISAL AND SYNTHESIS METHODS The PEDro scale was used to appraise study quality of RCTs and CTs. Two reviewers independently reviewed the full texts of all potentially relevant articles for eligibility and disagreements were discussed and resolved. RESULTS Seven studies met the previously determined quality indicators and were reviewed; three were RCTs and four were CTs. In general, the quality of the studies ranged from 5 to 9 out of a maximum of 11 on the PEDro quality criteria scale. Results revealed that chronic aerobic training induces a decrease in MMP-9 and MMP-2 levels, possibly indicating a cardioprotective effect, while resistance exercise training displayed conflicting results. CONCLUSION Alterations in MMP-9 and MMP-2 plasma concentrations may be valuable biomarkers to reflect the influence of exercise on the inflammatory state. Nevertheless, the limited evidence available regarding the effects of exercise on the MMP-9 and MMP-2 response in human participants suggests that further studies are needed to fully define the connection between the role of exercise on the MMP-9 and MMP-2 response.
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Affiliation(s)
- Dahan da Cunha Nascimento
- Graduation Program on Physical Education, Catholic University of Brasilia, Q.S. 07, Lote 01, EPTC-Bloco G, Brasilia, DF, 71966-700, Brazil,
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11
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Stelzer I, Kröpfl JM, Fuchs R, Pekovits K, Mangge H, Raggam RB, Gruber HJ, Prüller F, Hofmann P, Truschnig-Wilders M, Obermayer-Pietsch B, Haushofer AC, Kessler HH, Mächler P. Ultra-endurance exercise induces stress and inflammation and affects circulating hematopoietic progenitor cell function. Scand J Med Sci Sports 2014; 25:e442-50. [PMID: 25438993 DOI: 10.1111/sms.12347] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2014] [Indexed: 01/18/2023]
Abstract
Although amateur sports have become increasingly competitive within recent decades, there are as yet few studies on the possible health risks for athletes. This study aims to determine the impact of ultra-endurance exercise-induced stress on the number and function of circulating hematopoietic progenitor cells (CPCs) and hematological, inflammatory, clinical, metabolic, and stress parameters in moderately trained amateur athletes. Following ultra-endurance exercise, there were significant increases in leukocytes, platelets, interleukin-6, fibrinogen, tissue enzymes, blood lactate, serum cortisol, and matrix metalloproteinase-9. Ultra-endurance exercise did not influence the number of CPCs but resulted in a highly significant decline of CPC functionality after the competition. Furthermore, Epstein-Barr virus was seen to be reactivated in one of seven athletes. The link between exercise-induced stress and decline of CPC functionality is supported by a negative correlation between cortisol and CPC function. We conclude that ultra-endurance exercise induces metabolic stress and an inflammatory response that affects not only mature hematopoietic cells but also the function of the immature hematopoietic stem and progenitor cell fraction, which make up the immune system and provide for regeneration.
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Affiliation(s)
- I Stelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - J M Kröpfl
- Institute of Human Movement Sciences and Sport, Exercise Physiology Lab, ETH Zurich, Zurich, Switzerland.,Institute of Biophysics, Medical University of Graz, Graz, Austria
| | - R Fuchs
- Institute of Pathophysiology and Immunology, Medical University of Graz, Graz, Austria
| | - K Pekovits
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - H Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,BioTechMed-Graz, Graz, Austria
| | - R B Raggam
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - H-J Gruber
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - F Prüller
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - P Hofmann
- Institute of Sports Science, Karl-Franzens-University of Graz, Graz, Austria
| | - M Truschnig-Wilders
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - B Obermayer-Pietsch
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - A C Haushofer
- Institute of Medical and Chemical Laboratory Diagnostics Wels-Grieskirchen, Wels-Grieskirchen, Austria
| | - H H Kessler
- Research Unit Molecular Diagnostics, IHMEM, Medical University of Graz, Graz, Austria
| | - P Mächler
- Center for Cardiac Rehabilitation, SKA-PVA St. Radegund, Graz, Austria
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12
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Lauten A, Gerhard-Garcia A, Suhr F, Fischer JH, Figulla HR, Bloch W. Impact of ischemia-reperfusion on extracellular matrix processing and structure of the basement membrane of the heart. PLoS One 2014; 9:e92833. [PMID: 24681713 PMCID: PMC3969375 DOI: 10.1371/journal.pone.0092833] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 02/26/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Acute ischemic injury is a strong inductor of cardiac remodelling, resulting in structural changes of the extracellular matrix (ECM) and basement membrane (BM). In a large animal model of ischemia-reperfusion (I/R) we investigated the post-ischemic liberation of the collagen-IV-fragments Tumstatin (TUM; 28 kDa-fragment of collagen-IV-alpha-3), Arresten (ARR; 26 kDa-fragment of collagen-IV-alpha-1) and Endorepellin (LG3, 85 kDa-fragment of perlecan) which are biologically active in angiogenesis and vascularization in the post-ischemic myocardium. METHODS AND RESULTS In this blinded study, 30 pigs were randomized to 60 min of global I/R at either 4°C or 32°C or served as control. Three transmyocardial tissue samples were collected prior to ischemia and within 30 min and 150 min of reperfusion. Tissue content of TUM, ARR and LG3 was analyzed by western blotting and immunostaining. Within 150 min of mild hypothermic I/R a significantly increased tissue content of ARR (0.17±0.14 vs. 0.56±0.56; p = 0.001) and LG3 (1.13±0.34 vs. 2.51±1.71, p<0.001) was observed. In contrast, deep hypothermic I/R was not associated with a significant release of cleavage products. Cleavage of TUM remained unchanged irrespective of temperature. Increased matrix processing following mild hypothermia I/R is further supported by a >11fold elevation of creatine kinase (2075±2595 U/l vs. 23248±6551 U/l; p<0.001) in the coronary sinus plasma samples. Immunostaining demonstrated no changes for ARR and LG3 presentation irrespective of temperature. In contrast, TUM significantly decreased in the BM surrounding cardiomyocytes and capillaries after mild and deep hypothermic I/R, thus representing structural alterations of the BM in these groups. CONCLUSION The study demonstrates an early temperature-dependent processing of Col-IV as major component of the BM of cardiomyocytes and vascular endothelium. These observations support the protective effects of deep hypothermia during I/R. Furthermore, the results suggest an increased structural remodelling of the myocardial basement membrane with potential functional impairment during mild hypothermic I/R which may contribute to the progression to post-ischemic heart failure.
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Affiliation(s)
- Alexander Lauten
- Department of Internal Medicine I (Cardiology, Angiology, Pneumology), Friedrich- Schiller University, Jena, Germany
- Institute of Cardiovascular Research and Sports Medicine, German Sports University, Cologne, Germany
- * E-mail:
| | - Alexandra Gerhard-Garcia
- Institute of Cardiovascular Research and Sports Medicine, German Sports University, Cologne, Germany
| | - Frank Suhr
- Institute of Cardiovascular Research and Sports Medicine, German Sports University, Cologne, Germany
| | - Juergen H. Fischer
- Institute for Experimental Medicine, University of Cologne, Cologne, Germany
| | - Hans R. Figulla
- Department of Internal Medicine I (Cardiology, Angiology, Pneumology), Friedrich- Schiller University, Jena, Germany
| | - Wilhelm Bloch
- Institute of Cardiovascular Research and Sports Medicine, German Sports University, Cologne, Germany
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13
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Vasiliadis AV, Zafeiridis A, Dipla K, Galanis N, Chatzidimitriou D, Kyparos A, Nikolaidis MG, Vrabas IS. Circulating angiogenic biomolecules at rest and in response to upper-limb exercise in individuals with spinal cord injury. J Spinal Cord Med 2014; 37:226-32. [PMID: 24090471 PMCID: PMC4066432 DOI: 10.1179/2045772313y.0000000141] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE Individuals with spinal cord injury (SCI) show structural and functional vascular maladaptations and muscle loss in their lower limbs. Angiogenic biomolecules play important roles in physiological and pathological angiogenesis, and are implicated in the maintenance of muscle mass. This study examined the responses of angiogenic molecules during upper-limb aerobic exercise in patients with SCI and in able-bodied (AB) individuals. METHODS Eight SCI patients with thoracic lesions (T6-T12, ASIA A) and eight AB individuals performed an arm-cranking exercise for 30 minutes at 60% of their VO2max. Plasma concentrations of vascular endothelial growth factor (VEGF-A165), VEGF receptor 1 (sVEGFr-1), VEGF receptor 2 (sVEGFr-2), metalloproteinase 2 (MMP-2), and endostatin were measured at rest, after exercise, and at 1.5 and 3.0 hours during recovery. RESULTS The two-way analysis of variance showed non-significant main effects of "group" and significant main effects of "time/exercise" for all angiogenic biomolecules examined (P < 0.01-0.001). The arm-cranking exercise significantly increased plasma concentrations of VEGF, sVEGFr-1, sVEGFr-2, MMP-2, and endostatin in both groups (P < 0.001-0.01). The magnitude of the increase was similar in both patients with SCI and AB individuals, as shown by the non-significant group × time interaction for all angiogenic parameters. CONCLUSIONS Upper-limb exercise (arm-cranking for 30 minutes at 60% of VO2max) is a sufficient stimulus to trigger a coordinated circulating angiogenic response in patients with SCI. The response of angiogenic molecules to upper-limb aerobic exercise in SCI appears relatively similar to that observed in AB individuals.
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Affiliation(s)
- Angelo V. Vasiliadis
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Andreas Zafeiridis
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece,Correspondence to: Andreas Zafeiridis, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Ag. Ioannis, 62110 Serres, Greece.
| | - Konstantina Dipla
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Nikiforos Galanis
- Department of Orthopedics, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Greece
| | - Dimitrios Chatzidimitriou
- 2nd Department of Microbiology and National Influenza Center for Northern Greece, Medical School, Aristotle University of Thessaloniki, Greece
| | - Antonios Kyparos
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Michalis G. Nikolaidis
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
| | - Ioannis S. Vrabas
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece
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14
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Beijer Å, Rosenberger A, Bölck B, Suhr F, Rittweger J, Bloch W. Whole-body vibrations do not elevate the angiogenic stimulus when applied during resistance exercise. PLoS One 2013; 8:e80143. [PMID: 24260349 PMCID: PMC3829849 DOI: 10.1371/journal.pone.0080143] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 09/29/2013] [Indexed: 01/12/2023] Open
Abstract
Knowledge about biological factors involved in exercise-induced angiogenesis is to date still scanty. The present study aimed to investigate the angiogenic stimulus of resistance exercise with and without superimposed whole-body vibrations. Responses to the exercise regimen before and after a 6-week training intervention were investigated in twenty-six healthy male subjects. Serum was collected at the initial and final exercise sessions and circulating levels of matrix metalloproteinases (MMP) -2 and -9, Vascular Endothelial Growth Factor (VEGF) and endostatin were determined via ELISA. Furthermore, we studied the proliferative effect of serum-treated human umbilical vein endothelial cells in vitro via BrdU-incorporation assay. It was found that circulating MMP-2, MMP-9, VEGF and endostatin levels were significantly elevated (P<0.001) from resting levels after both exercise interventions, with higher post-exercise VEGF concentrations in the resistance exercise (RE) group compared to the resistive vibration exercise (RVE) group. Moreover, RE provoked increased endothelial cell proliferation in vitro and higher post-exercise circulating endostatin concentrations after 6 weeks of training. These effects were elusive in the RVE group. The present findings suggest that resistance exercise leads to a transient rise in circulating angiogenic factors and superimposing vibrations to this exercise type might not further trigger a potential signaling of angiogenic stimulation in skeletal muscle.
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Affiliation(s)
- Åsa Beijer
- German Aerospace Center, Institute of Aerospace Medicine and Space Physiology, Cologne, Germany
- German Sport University Cologne, Department of Molecular and Cellular Sport Medicine, Cologne, Germany
- * E-mail:
| | - André Rosenberger
- German Aerospace Center, Institute of Aerospace Medicine and Space Physiology, Cologne, Germany
- German Sport University Cologne, Institute of Training Science and Sports Informatics, Cologne, Germany
| | - Birgit Bölck
- German Sport University Cologne, Department of Molecular and Cellular Sport Medicine, Cologne, Germany
| | - Frank Suhr
- German Sport University Cologne, Department of Molecular and Cellular Sport Medicine, Cologne, Germany
| | - Jörn Rittweger
- German Aerospace Center, Institute of Aerospace Medicine and Space Physiology, Cologne, Germany
- Institute for Biomedical Research into Human Movement and Health, Manchester Metropolitan University, Manchester, United Kingdom
| | - Wilhelm Bloch
- German Sport University Cologne, Department of Molecular and Cellular Sport Medicine, Cologne, Germany
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15
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Bellafiore M, Battaglia G, Bianco A, Farina F, Palma A, Paoli A. The involvement of MMP-2 and MMP-9 in heart exercise-related angiogenesis. J Transl Med 2013; 11:283. [PMID: 24195673 PMCID: PMC3827823 DOI: 10.1186/1479-5876-11-283] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the involvement of matrix metalloproteinases (MMPs) in cardiac vascular remodelling induced by exercise. Our aim was to evaluate and localize MMP-2 and MMP-9's activities in relation to capillary proliferation in mouse hearts trained for 15, 30 and 45 days. METHODS Sixty-three mice were randomly assigned to 7 groups: four control sedentary groups (C0, C15, C30 and C45) and three groups trained by an endurance protocol (T15, T30 and T45). MMP-2 and MMP-9 were examined with zymography and immunostaining analyses. Capillary proliferation was evaluated counting the number of CD31-positive cells. RESULTS Different activity patterns of the latent form of both MMPs were found. Pro-MMP-9 increased after 15 days of training; whereas pro-MMP-2 gradually decreased after 30 and 45 days of training below the control groups. The latter was inversely correlated with capillary growth. MMP-9 was mainly localized in myocardiocytes and less evident in capillaries. Conversely, MMP-2 was more intense in capillary endothelial cells and slightly in myocardiocytes. CONCLUSIONS A different spatiotemporal modulation of pro-MMP-2 and pro-MMP-9 activities has been detected in the myocardium during angiogenesis related to the aerobic training. These results can be useful to draw up training protocols for improving the performance of healthy and diseased human hearts.
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Affiliation(s)
- Marianna Bellafiore
- Department of Legal, Society and Sport Sciences, University of Palermo, Via E, Duse 2, 90146 Palermo, Italy.
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16
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Olenich SA, Gutierrez-Reed N, Audet GN, Olfert IM. Temporal response of positive and negative regulators in response to acute and chronic exercise training in mice. J Physiol 2013; 591:5157-69. [PMID: 23878369 PMCID: PMC3810816 DOI: 10.1113/jphysiol.2013.254979] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 07/19/2013] [Indexed: 12/18/2022] Open
Abstract
Angiogenesis is controlled by a balance between positive and negative angiogenic factors, but temporal protein expression of many key angiogenic regulators in response to exercise are still poorly defined. In C57BL/6 mice, we evaluated the temporal protein expression of several pro-angiogenic and anti-angiogenic factors in response to (1) a single acute bout of exercise and (2) chronic exercise training resulting from 3, 5, 7, 14 and 28 days of voluntary wheel running. Following acute exercise, protein levels of vascular endothelial growth factor-A (VEGF), endostatin and nucleolin were increased at 2-4 h (P < 0.05), whereas matrix metalloproteinase (MMP)-2 was elevated within a 12-24 h window (P < 0.05). Training increased muscle capillarity 11%, 15% and 22% starting with 7, 14 and 28 days of training, respectively (P < 0.01). Basal VEGF and MMP-2 were increased by 31% and 22%, respectively, compared to controls (P < 0.05) after 7 days (7d) training, but decreased to back to baseline after 14d training. After 28d training VEGF fell 49% below baseline control (P < 0.01). Basal muscle expression of thrombospondin 1 (TSP-1) was ∼900% greater in 14d- and 28d-trained mice compared to either 5d- and 7d-trained mice (P < 0.05), and tended to increase by ∼180-258% compared to basal control levels (P < 0.10). The acute responsiveness of VEGF to exercise in untrained mice (i.e. 161% increase, P < 0.001) was lost with capillary adaptation occurring after 7, 14 and 28d training. Taken together, these data support the notion that skeletal muscle angiogenesis is controlled by a balance between positive and negative mitogens, and reveals a complex, highly-coordinated, temporal scheme whereby these factors can differentially influence capillary growth in response to acute versus chronic exercise.
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Affiliation(s)
- Sara A Olenich
- I. M. Olfert: West Virginia University School of Medicine, Center for Cardiovascular and Respiratory Sciences, Division of Exercise Physiology, One Medical Center Dr., Morgantown, WV 26506-9105, USA.
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17
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Circulating MMP-9 during exercise in humans. Eur J Appl Physiol 2012; 113:1249-55. [PMID: 23160657 DOI: 10.1007/s00421-012-2545-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 11/04/2012] [Indexed: 10/27/2022]
Abstract
Matrix metalloproteinase 9 (MMP-9) is a member of a family of zinc-dependent endopeptidases capable of degrading extracellular matrix (ECM) proteins. A single bout of exercise increases levels of activated MMP-9 in skeletal muscle and in the circulation. However, whether the exercise-induced activation of MMP-9 is associated with ECM remodeling and the cellular source behind MMP-9 in the circulation is not known. In the present study ten healthy male subjects performed a single cycle exercise bout and arterial and venous femoral blood was collected. To test if exercise induces basal lamina degradation and if circulating levels of MMP-9 is related to a release from the exercising muscle, arteriovenous differences of collagen IV and MMP-9 were measured by ELISA and zymography, respectively. Furthermore, markers of neutrophil degranulation elastase and neutrophil gelatinase-associated lipocalin (NGAL) were measured by ELISA. Plasma levels of collagen IV increased during the exercise bout and an increased arteriovenous difference of collagen IV was noted at 27 min of exercise. Plasma levels of MMP-9 were increased at both 27 and 57 min of exercise but no arteriovenous difference was noted. No changes over time were detected for elastase and NGAL. The observed release of collagen IV from the exercising muscle indicate basal lamina turnover following a single bout of exercise. No detectable release of MMP-9 was observed, suggesting that the increase in plasma MMP-9 could come from a source other than the skeletal muscle.
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18
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Bloch W, Suhr F, Zimmer P. Molekulare Mechanismen der Herz- und Gefäßanpassung durch Sport. Herz 2012; 37:508-15. [DOI: 10.1007/s00059-012-3637-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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19
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OLFERT IMARK, BIROT OLIVIER. Importance of Anti-angiogenic Factors in the Regulation of Skeletal Muscle Angiogenesis. Microcirculation 2011; 18:316-30. [DOI: 10.1111/j.1549-8719.2011.00092.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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20
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Lu PY, Taylor M, Jia HT, Ni JH. Muscle LIM protein promotes expression of the acetylcholine receptor gamma-subunit gene cooperatively with the myogenin-E12 complex. Cell Mol Life Sci 2004; 61:2386-92. [PMID: 15378207 PMCID: PMC11138884 DOI: 10.1007/s00018-004-4213-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Muscle LIM protein (MLP, also referred to as CRP3) is a muscle-specific LIM-only protein, which consists of two LIM motifs. MLP functions as a positive regulator during myogenesis. Here we report that MLP serves as a cofactor regulating the expression of the nicotinic acetylcholine receptor (AChR) gamma-subunit gene in skeletal muscle cells. We found that MLP promoted the expression of the AChR gamma-subunit gene in C2C12 myotubes, but not in C2C12 myoblasts or NIH3T3 fibroblasts. Furthermore, we showed that MLP interacted with myogenin in vivo and enhanced the binding ability of the myogenin-E12 heterodimer to the E boxes in the AChR gamma-subunit gene promoter. Together, these results suggest that MLP promotes the specific expression of the AChR gamma-subunit gene cooperatively with the myogenin-E12 complex during myogenesis.
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Affiliation(s)
- P. Y. Lu
- Department of Biochemistry and Molecular Biology, Peking University Health Science Center, 100083 Beijing, China
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, 02115 Boston, Massachusetts USA
| | - M. Taylor
- Department of Biochemistry and Molecular Biology, Peking University Health Science Center, 100083 Beijing, China
- Biology Department, Tougaloo College, 39174 Tougaloo, Mississippi USA
| | - H. T. Jia
- Department of Biochemistry and Molecular Biology, Peking University Health Science Center, 100083 Beijing, China
- Department of Biochemistry, Capital University of Medical Sciences, You An Men, 100054 Beijing, China
| | - J. H. Ni
- Department of Biochemistry and Molecular Biology, Peking University Health Science Center, 100083 Beijing, China
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