Mechanisms of the effect of oxidative phosphorylation deficiencies on the skeletal muscle bioenergetic system in patients with mitochondrial myopathies

Pi-based biochemical mechanism of endurance-training-induced improvement of running performance in humans

PURPOSE

Endurance training improves running performance in distances where oxidative phosphorylation (OXPHOS) is the main ATP source. Here, a dynamic computer model is used to assess possible biochemical mechanisms underlying this improvement.

METHODS

The dynamic computer model is based on the "Pi double-threshold" mechanism of muscle fatigue, according to which the additional ATP usage appears when (1) inorganic phosphate (Pi) exceeds a critical value (Picrit); (2) exercise is terminated because of fatigue, when Pi reaches a peak value (Pipeak); (3) the Pi increase and additional ATP usage increase mutually stimulate each other.

RESULTS

The endurance-training-induced increase in oxidative phosphorylation (OXPHOS) activity attenuates the reaching of Pipeak by Pi (and thus of V ˙ O2max by V ˙ O2) at increased power output. This in turn allows a greater work intensity, and thus higher speed, to be achieved before exercise is terminated because of fatigue at the end of the 1500 m run. Thus, identical total work is performed in a shorter time. Probably, endurance training also lowers Pipeak, which improves the homeostasis of "bioenergetic" muscle metabolites: ADP, PCr, Pi and H+ ions.

CONCLUSIONS

The present dynamic computer model generates clear predictions of metabolic changes that limit performance during 1500 m running. It contributes to our mechanistic understanding of training-induced improvement in running performance and stimulates further physiological experimental studies.

Training-Induced Increase in V·O2max and Critical Power, and Acceleration of V·O2 on-Kinetics Result from Attenuated Pi Increase Caused by Elevated OXPHOS Activity

Computer simulations using a dynamic model of the skeletal muscle bioenergetic system, involving the Pi-double-threshold mechanism of muscle fatigue, demonstrate that the training-induced increase in V·O2max, increase in critical power (CP) and acceleration of primary phase II of the V·O2 on kinetics (decrease in t0.63) is caused by elevated OXPHOS activity acting through a decrease in and slowing of the Pi (inorganic phosphate) rise during the rest-to-work transition. This change leads to attenuation of the reaching by Pi of Pipeak, peak Pi at which exercise is terminated because of fatigue. The delayed (in time and in relation to V·O2 increase) Pi rise for a given power output (PO) in trained muscle causes Pi to reach Pipeak (in very heavy exercise) after a longer time and at a higher V·O2; thus, exercise duration is lengthened, and V·O2max is elevated compared to untrained muscle. The diminished Pi increase during exercise with a given PO can cause Pi to stabilize at a steady state less than Pipeak, and exercise can continue potentially ad infinitum (heavy exercise), instead of rising unceasingly and ultimately reaching Pipeak and causing exercise termination (very heavy exercise). This outcome means that CP rises, as the given PO is now less than, and not greater than CP. Finally, the diminished Pi increase (and other metabolite changes) results in, at a given PO (moderate exercise), the steady state of fluxes (including V·O2) and metabolites being reached faster; thus, t0.63 is shortened. This effect of elevated OXPHOS activity is possibly somewhat diminished by the training-induced decrease in Pipeak.

V̇O2 (non-)linear increase in ramp-incremental exercise vs. V̇O2 slow component in constant-power exercise: Underlying mechanisms

A computer model of the skeletal muscle bioenergetic system involving the P_i double-threshold mechanism of muscle fatigue was used to study the V̇O₂ (non-)linear increase in time in ramp-incremental exercise as compared to the V̇O₂ slow component in constant-power exercise. The P_i double-threshold mechanism applies to both constant-power and ramp-incremental exercise. The additional ATP usage is initiated at a significantly higher ATP usage activity (power output), determining the moderate/heavy exercise border, in ramp-incremental, than in constant-power exercise. A significantly lowered additional ATP usage activity or elevated glycolysis stimulation at the highest power outputs in ramp-incremental exercise in relation to constant-power exercise can additionally explain the much smaller (or zero) V̇O₂ non-linearity in ramp-incremental exercise, than V̇O₂ slow component in constant-power exercise. The V̇O₂ (non-)linearity in ramp-incremental exercise and V̇O₂ slow component in constant-power exercise is a derivative of a balance between the additional ATP usage and ATP production by anaerobic glycolysis.

Skeletal Muscle Biochemical Origin of Exercise Intensity Domains and their Relation to Whole-Body V̇O2 Kinetics

This article presents the biochemical intra-skeletal-muscle basis of exercise intensity domains: moderate (M), heavy (H), very heavy (VH) and severe (S). Threshold origins are mediated by a "Pi double-threshold" mechanism of muscle fatigue, which assumes: (1) additional ATP usage, underlying muscle V̇O2 and metabolite slow components, is initiated when inorganic phosphate (Pi) exceeds a critical value (Picrit); (2) exercise is terminated because of fatigue, when Pi reaches a peak value (Pipeak); (3) the Pi increase and additional ATP usage increase mutually stimulate each other forming a positive feedback. M/H and H/VH borders are defined by Pi on-kinetics in relation to Picrit and Pipeak. The values of the ATP usage activity, proportional to power output (PO), for the M/H, H/VH and VH/S borders are lowest in untrained muscle and highest in well-trained muscle. The metabolic range between the M/H and H/VH border (or "H space") decreases with muscle training, while the difference between the H/VH and VH/S border (or "VH space") is only weakly dependent on training status. The absolute magnitude of the muscle V̇O2 slow-component, absent in M exercise, rises gradually with PO to a maximal value in H exercise, and then decreases with PO in VH and S exercise. Simulations of untrained, physically-active and well-trained muscle demonstrate that the muscle M/H border need not be identical to the whole-body M/H border determined from pulmonary V̇O2 on-kinetics and blood lactate, while suggesting that the biochemical origins of the H/VH border reside within skeletal muscle and correspond to whole-body critical power.

Effect of training on skeletal muscle bioenergetic system in patients with mitochondrial myopathies: A computational study

A computer model of the skeletal muscle bioenergetic system, involving the "P_i double-threshold" mechanism of muscle fatigue, was used to investigate the effect of muscle training on system kinetic properties in mitochondrial myopathies (MM) patients with inborn OXPHOS deficiencies. An increase in OXPHOS activity and decrease in peak P_i can account for the training-induced increase in V̇O_2max, acceleration of the primary phase II of the V̇O₂ on-kinetics, delay of muscle fatigue and prolongation of exercise at a given work intensity encountered in experimental studies. Depending on the mutation load and work intensity, training can bring the muscle from severe- to very-heavy- to moderate-exercise-like behavior, thus lessening the exertional fatigue and lengthening the physical activity of a given intensity. Training significantly increases critical power (CP) and slightly decreases the curvature constant (W') of the power-duration relationship. Generally, a mechanism underlying the training-induced changes in the skeletal muscle bioenergetic system in MM patients is proposed.