Uniaxial cyclic stretch-stimulated glucose transport is mediated by a ca-dependent mechanism in cultured skeletal muscle cells

The Effects of Stretching Exercise on Levels of Blood Glucose: A Systematic Review with Meta-Analysis

BACKGROUND

Physical activity plays an important role in the management of blood glucose levels. However, compelling evidence exists only for aerobic and resistance training. In this review, we aimed to identify the potential effects of stretching exercises on blood glucose levels.

METHODS

A systematic literature search was performed using the following databases: Scopus, NLM PubMed, and Web of Science. Studies regarding the effects of stretching exercise in humans on blood glucose or any related variable were included. Further inclusion criteria were: (1) original articles (published from database inception to October 2022), (2) applying stretching as a unique exercise modality, (3) having either longitudinal or acute interventions, (4) including healthy and pathological populations, and (5) having within each study a pre- and post-intervention measure. Quality assessment of the studies was conducted using the Downs and Black checklist.

RESULTS

A total of 13 articles were included. The quality assessment revealed an overall moderate quality of the included records. Ten articles included patients with type 2 diabetes (T2D), whereas the remaining three included at-risk populations. A total of 731 people with a mean age of 56.7 ± 6.1 years old were analysed. Fasting blood glucose, 2 h post-oral glucose uptake, post-stretching intervention blood glucose levels, and HbA1c were identified as variables related to blood glucose within the studies. After the stretching interventions, a significant reduction was observed in either blood glucose (ES = - 0.79; p = 0.0174) or HbA1c (ES = - 1.11; p =  < 0.0001). Meta-analytic results highlighted greater effects in T2D patients (ES = - 1.15; p = 0.02) and for studies applying stretching as an exercise intervention (ES = - 1.27; p = 0.006) rather than considering stretching as a control exercise modality.

CONCLUSION

The results of this systematic review highlight the potential of stretching exercises to reduce blood glucose levels. In particular, if stretching is applied as a specific form of exercise intervention in patients with T2D greater effects are observed. However, further studies with more solid research designs are required, therefore, caution is needed before prescribing stretching as an exercise intervention for glycaemic management.

Molecular and Biomechanical Adaptations to Mechanical Stretch in Cultured Myotubes

Myotubes are mature muscle cells that form the basic structural element of skeletal muscle. When stretching skeletal muscles, myotubes are subjected to passive tension as well. This lead to alterations in myotube cytophysiology, which could be related with muscular biomechanics. During the past decades, much progresses have been made in exploring biomechanical properties of myotubes in vitro. In this review, we integrated the studies focusing on cultured myotubes being mechanically stretched, and classified these studies into several categories: amino acid and glucose uptake, protein turnover, myotube hypertrophy and atrophy, maturation, alignment, secretion of cytokines, cytoskeleton adaption, myotube damage, ion channel activation, and oxidative stress in myotubes. These biomechanical adaptions do not occur independently, but interconnect with each other as part of the systematic mechanoresponse of myotubes. The purpose of this review is to broaden our comprehensions of stretch-induced muscular alterations in cellular and molecular scales, and to point out future challenges and directions in investigating myotube biomechanical manifestations.

L1CAM-ILK-YAP Mechanotransduction Drives Proliferative Activity of Epithelial Cells in Middle Ear Cholesteatoma

Middle-ear cholesteatoma (cholesteatoma) is a chronic otitis media with an enhanced proliferation of epithelial cells. Negative pressure in the middle ear is thought to be important for the etiology of cholesteatoma. However, the mechanism of cholesteatoma formation remains unclear. Integrin-linked protein kinase (ILK), an important modulator of actin cytoskeletal dynamics, interacts with extracellular matrix and results in the up-regulation of mechanotransduction effector Yes-associated protein (YAP). The L1 cell adhesion molecule (L1CAM) has recently been reported as an activator of the mechanotransduction effectors related to cell proliferation and migration. In this study, we demonstrated a stretch assay for middle-ear cultured cells and performed immunohistochemistry using antibodies against Ilk, Yap, and L1cam. The tympanic membrane was also analyzed within a new middle-ear negative-pressure animal model and human cholesteatoma tissues, using immunohistochemistry with antibodies against ILK, YAP, Ki-67, and L1CAM. The expression of cytoplasmic ILK and nuclear shift of YAP increased in the thickened epithelium of the tympanic membrane under a negative-pressure load and the cholesteatoma. The expression of L1CAM was detected in the stromal cells, which enhanced epithelial cell proliferation depending on ILK signaling events. In conclusion, we demonstrated the possibility that the stromal L1CAM and epithelial ILK-YAP signaling played an important role in epithelial growth under mechanotransduction in cholesteatoma formation.

The Effect of Static Stretching Duration on Muscle Blood Volume and Oxygenation

Matsuo, H, Kubota, M, Shimada, S, Kitade, I, Matsumura, M, Nonoyama, T, Koie, Y, Naruse, H, Takahashi, A, Oki, H, Kokubo, Y, and Matsumine, A. The effect of static stretching duration on muscle blood volume and oxygenation. J Strength Cond Res XX(X): 000-000, 2020-Muscle blood volume increases due to stretching; however, the minimum duration of stretching to sustainably increase the muscle blood volume after stretching has not yet been elucidated. This study examined whether the duration of static stretching influenced the muscle blood volume and oxygenation. Ten healthy male subjects participated in this controlled laboratory study. Static stretching of the gastrocnemius muscle was performed for 5 durations (20 seconds, and 1, 2, 5, and 10 minutes). Changes in both the total-Hb (ΔtHb), as an index of blood volume, and tissue oxygenation index (ΔTOI) from baseline were determined using near-infrared spectroscopy. Both the ΔtHb and ΔTOI decreased during stretching and increased after stretching. The minimum value of ΔtHb during stretching did not differ in each of the 5 durations, but minimum ΔTOI progressively decreased with longer durations of stretching. The peak value of ΔtHb after stretching increased with longer durations of stretching. The value of ΔtHb at 5 minutes after the end of stretching increased with more than 2 minutes of stretching compared with 20 seconds of stretching, although the value of ΔtHb did not significantly differ between the 2, 5, and 10 minutes' durations. These findings suggest that a longer duration of stretching elicits a decrease in muscle oxygenation during stretching, and an increase in both the muscle blood volume and oxygenation after stretching. The results indicated that the minimum duration of stretching to sustain an increase in the muscle blood volume after stretching is 2 minutes.

Muscle-derived SDF-1α/CXCL12 modulates endothelial cell proliferation but not exercise training-induced angiogenesis

Chemokines are critical mediators of angiogenesis in several physiological and pathological conditions; however, a potential role for muscle-derived chemokines in exercise-stimulated angiogenesis in skeletal muscle remains poorly understood. Here, we postulated that the chemokine stromal cell-derived factor-1 (SDF-1α/C-X-C motif chemokine ligand 12: CXCL12), shown to promote neovascularization in several organs, contributes to angiogenesis in skeletal muscle. We found that CXCL12 is abundantly expressed in capillary-rich oxidative soleus and exercise-trained plantaris muscles. CXCL12 mRNA and protein were also abundantly expressed in muscle-specific peroxisome proliferator-activated receptor γ coactivator 1α transgenic mice, which have a high proportion of oxidative muscle fibers and capillaries when compared with wild-type littermates. We then generated CXCL12 muscle-specific knockout mice but observed normal baseline capillary density and normal angiogenesis in these mice when they were exercise trained. To get further insight into a potential CXCL12 role in a myofiber-endothelial cell crosstalk, we first mechanically stretched C2C12 myotubes, a model known to induce stretch-related chemokine release, and observed increased CXCL12 mRNA and protein. Human umbilical vein endothelial cells (HUVECs) exposed to conditioned medium from cyclically stretched C2C12 myotubes displayed increased proliferation, which was dependent on CXCL12-mediated signaling through the CXCR4 receptor. However, HUVEC migration and tube formation were unaltered under these conditions. Collectively, our findings indicate that increased muscle contractile activity enhances CXCL12 production and release from muscle, potentially contributing to endothelial cell proliferation. However, redundant signals from other angiogenic factors are likely sufficient to sustain normal endothelial cell migration and tube formation activity, thereby preserving baseline capillary density and exercise training-mediated angiogenesis in muscles lacking CXCL12.

A novel polyurethane-based biodegradable elastomer as a promising material for skeletal muscle tissue engineering

A key challenge in skeletal muscle tissue engineering is the choice of a proper scaffolding material as it should demonstrate elastic behavior to withstand and support the dynamic loading of the tissue microenvironment while being biodegradable and biocompatible. In this study, we tested the applicability of a novel biodegradable polyurethane (PU) elastomer chain extended with fibrinogen (Fib) to fulfill these requirements. Biodegradable polyurethane-fibrinogen (PU-Fib) elastomers were synthesized by step-wise condensation polymerization. Firstly, PU prepolymer was synthesized and then Fib was integrated into PU prepolymer during the second step of polymerization. The chemical, thermal, viscoelastic, mechanical and biodegradation properties of PU-Fib were characterized. FTIR-ATR spectrum showed amide bands specific to PU and Fib, DSC thermograms showed the suitable integration between the components. Dynamic mechanical analysis revealed Tg and Tα* transitions at 64.5 °C and 38.4 °C, respectively. PU and Fib had shown chemically compatible interactions and when compared to PCL, PU-Fib possessed viscoelastic properties more suitable to the native tissue. PU-Fib films were produced and seeded with C2C12 mouse myoblasts. Uniaxial cyclic stretch was applied to the cell seeded films for 21 d to mimic the native dynamic tissue microenvironment. Cell proliferation, viability and the expression of muscle-specific markers (immunofluorescent staining for myogenin and myosin heavy chain) were assessed. Myoblasts proliferated well on PU-Fib films; aligned parallel along their long edge, and express myogenic markers under biomimetic dynamic culture. It was possible to culture myoblasts with high viability on PU-Fib elastomeric films mimicking native muscle microenvironment.

In vitro experimental models for examining the skeletal muscle cell biology of exercise: the possibilities, challenges and future developments

Exercise provides a cornerstone in the prevention and treatment of several chronic diseases. The use of in vivo exercise models alone cannot fully establish the skeletal muscle-specific mechanisms involved in such health-promoting effects. As such, models that replicate exercise-like effects in vitro provide useful tools to allow investigations that are not otherwise possible in vivo. In this review, we provide an overview of experimental models currently used to induce exercise-like effects in skeletal muscle in vitro. In particular, the appropriateness of electrical pulse stimulation and several pharmacological compounds to resemble exercise, as well as important technical considerations, are addressed. Each model covered herein provides a useful tool to investigate different aspects of exercise with a level of abstraction not possible in vivo. That said, none of these models are perfect under all circumstances, and the choice of model (and terminology) used should be informed by the specific research question whilst accounting for the several inherent limitations of each model. Further work is required to develop and optimise the current experimental models used, such as combination with complementary techniques during treatment, and thereby improve their overall utility and impact within muscle biology research.

Passive stretch regulates skeletal muscle glucose uptake independent of nitric oxide synthase

Skeletal muscle contraction increases glucose uptake via an insulin-independent mechanism. Signaling pathways arising from mechanical strain are activated during muscle contractions, and mechanical strain in the form of passive stretching stimulates glucose uptake. However, the exact mechanisms regulating stretch-stimulated glucose uptake are not known. Since nitric oxide synthase (NOS) has been implicated in the regulation of glucose uptake during ex vivo and in situ muscle contractions and during exercise, and NO is increased with stretch, we examined whether the increase in muscle glucose uptake during stretching involves NOS. We passively stretched isolated extensor digitorum longus muscles (15 min at ~100-130 mN) from control mice and mice lacking either neuronal NOSµ (nNOSµ) or endothelial NOS (eNOS) isoforms, as well as used pharmacological inhibitors of NOS. Stretch significantly increased muscle glucose uptake appoximately twofold ( P < 0.05), and this was unaffected by the presence of the NOS inhibitors N^G-monomethyl-l-arginine (100 µM) or N^G-nitro-l-arginine methyl ester (100 µM). Similarly, stretch-stimulated glucose uptake was not attenuated by deletion of either eNOS or nNOSµ isoforms. Furthermore, stretching failed to increase skeletal muscle NOS enzymatic activity above resting levels. These data clearly demonstrate that stretch-stimulated skeletal muscle glucose uptake is not dependent on NOS. NEW & NOTEWORTHY Passive stretching is known to activate muscle glucose uptake through mechanisms that partially overlap with contraction. We report that genetic knockout of endothelial nitric oxide synthase (NOS) or neuronal NOS or pharmacological NOS inhibition does not affect stretch-stimulated glucose uptake. Passive stretch failed to increase NOS activity above resting levels. This information is important for the study of signaling pathways that regulate stretch-stimulated glucose uptake and indicate that NOS should be excluded as a potential signaling factor in this regard.

Adenosine monophosphate-activated protein kinase activation and suppression of inflammatory response by cell stretching in rabbit synovial fibroblasts

Joint mobilization is known to be beneficial in osteoarthritis (OA) patients. This study aimed to investigate the effect of stretching on adenosine monophosphate-activated protein kinase (AMPK) activity and its role in modulating inflammation in rabbit synovial fibroblasts. Uniaxial stretching of isolated rabbit synovial fibroblasts for ten min was performed. Stretching-induced AMPK activation, its underlying mechanism, and its anti-inflammatory effect were investigated using Western blot. Static stretching at 20 % of initial length resulted in AMPK activation characterized by expression of phosphorylated AMPK and phosphorylated acetyl-Co A carboxylase. AMP-activated protein kinase phosphorylation peaked 1 h after stretching and declined toward resting activity. Using cell viability assays, static stretching did not appear to cause cellular damage. Activation of AMPK involves Ca²⁺ influx via a mechanosensitive L-type Ca²⁺ channel, which subsequently raises intracellular Ca²⁺ and activates AMPK via Ca²⁺/calmodulin-dependent protein kinase kinase β (CaMKKβ). Interestingly, stretching suppressed TNFα-induced expression of COX-2, iNOS, and phosphorylated NF-κB. These effects were prevented by pretreatment with compound C, an AMPK inhibitor. These results suggest that mechanical stretching suppressed inflammatory responses in synovial fibroblasts via a L-type Ca²⁺-channel-CaMKKβ-AMPK-dependent pathway which may underlie joint mobilization's ability to alleviate OA symptoms.

The IsoStretcher: An isotropic cell stretch device to study mechanical biosensor pathways in living cells

Mechanosensation in many organs (e.g. lungs, heart, gut) is mediated by biosensors (like mechanosensitive ion channels), which convert mechanical stimuli into electrical and/or biochemical signals. To study those pathways, technical devices are needed that apply strain profiles to cells, and ideally allow simultaneous live-cell microscopy analysis. Strain profiles in organs can be complex and multiaxial, e.g. in hollow organs. Most devices in mechanobiology apply longitudinal uniaxial stretch to adhered cells using elastomeric membranes to study mechanical biosensors. Recent approaches in biomedical engineering have employed intelligent systems to apply biaxial or multiaxial stretch to cells. Here, we present an isotropic cell stretch system (IsoStretcher) that overcomes some previous limitations. Our system uses a rotational swivel mechanism that translates into a radial displacement of hooks attached to small circular silicone membranes. Isotropicity and focus stability are demonstrated with fluorescent beads, and transmission efficiency of elastomer membrane stretch to cellular area change in HeLa/HEK cells. Applying our system to lamin-A overexpressing fibrosarcoma cells, we found a markedly reduced stretch of cell area, indicative of a stiffer cytoskeleton. We also investigated stretch-activated Ca(2+) entry into atrial HL-1 myocytes. 10% isotropic stretch induced robust oscillating increases in intracellular Fluo-4 Ca(2+) fluorescence. Store-operated Ca(2+) entry was not detected in these cells. The Isostretcher provides a useful versatile tool for mechanobiology.

External physical and biochemical stimulation to enhance skeletal muscle bioengineering

PURPOSE OF REVIEW

Cell based muscle tissue engineering carries the potential to revert the functional loss of muscle tissue caused by disease and trauma. Although muscle tissue can be bioengineered using various precursor cells, major limitations still remain.

RECENT FINDINGS

In the last decades several cellular pathways playing a crucial role in muscle tissue regeneration have been described. These pathways can be influenced by external stimuli and they not only orchestrate the regenerative process after physiologic wear and muscle trauma, but also play an important part in aging and maintaining the stem cell niche, which is required to maintain long-term muscle function.

SUMMARY

In this review article we will highlight possible new avenues using external physical and biochemical stimulation in order to optimize muscle bioengineering.

Acute mechanical overload increases IGF-I and MMP-9 mRNA in 3D tissue-engineered skeletal muscle

Skeletal muscle (SkM) is a tissue that responds to mechanical load following both physiological (exercise) or pathophysiological (bed rest) conditions. The heterogeneity of human samples and the experimental and ethical limitations of animal studies provide a rationale for the study of SkM plasticity in vitro. Many current in vitro approaches of mechanical loading of SkM disregard the three-dimensional (3D) structure in vivo. Tissue engineered 3D SkM, that displays highly aligned and differentiated myotubes, was used to investigate mechano-regulated gene transcription of genes implicated in hypertrophy/atrophy. Static loading (STL) and ramp loading (RPL) at 10 % strain for 60 min were used as mechano-stimulation with constructs sampled immediately for RNA extraction. STL increased IGF-I mRNA compared to both RPL and CON (control, p = 0.003 and 0.011 respectively) whilst MMP-9 mRNA increased in STL and RPL compared to CON (both p < 0.05). IGFBP-2 mRNA was differentially regulated in RPL and STL compared to CON (p = 0.057), whilst a reduction in IGFBP-5 mRNA was found for STL and RPL compared to CON (both p < 0.05). There was no effect in the expression of putative atrophic genes, myostatin, MuRF-1 and MAFBx (all p > 0.05). These data demonstrate a transcriptional signature associated with SkM hypertrophy within a tissue-engineered model that more greatly recapitulates the in vivo SkM structure compared previously published studies.

Biophysical cues enhance myogenesis of human adipose derived stem/stromal cells

Adipose-derived stem/stromal cell (ASC)-based tissue engineered muscle grafts could provide an effective alternative therapy to autografts - which are limited by their availability - for the regeneration of damaged muscle. However, the current myogenic potential of ASCs is limited by their low differentiation efficiency into myoblasts. The aim of this study was to enhance the myogenic response of human ASCs to biochemical cues by providing biophysical stimuli (11% cyclic uniaxial strain, 0.5 Hz, 1h/day) to mimic the cues present in the native muscle microenvironment. ASCs elongated and fused upon induction with myogenic induction medium alone. Yet, their myogenic characteristics were significantly enhanced with the addition of biophysical stimulation; the nuclei per cell increased approximately 4.5-fold by day 21 in dynamic compared to static conditions (23.3 ± 7.3 vs. 5.2 ± 1.6, respectively), they aligned at almost 45° to the direction of strain, and exhibited significantly higher expression of myogenic proteins (desmin, myoD and myosin heavy chain). These results demonstrate that mimicking the biophysical cues inherent to the native muscle microenvironment in monolayer ASC cultures significantly improves their differentiation along the myogenic lineage.

Twenty minutes of passive stretching lowers glucose levels in an at-risk population: an experimental study

QUESTION

Can passive static stretching lower blood glucose in an at-risk population?

DESIGN

Randomised, within-participant experimental study.

PARTICIPANTS

22 adults (17 males) either at increased risk of Type 2 diabetes or with Type 2 diabetes.

INTERVENTION

The participants reported to the laboratory 2hr after eating a meal, and drank 355ml of fruit juice (∼43g carbohydrate). Thirty minutes later, they underwent either a 40min passive static stretching regimen or a mock passive stretching regimen. Stretching consisted of six lower body and four upper body static passive stretches. For the mock stretches, the same positions were adopted, but no tension was applied to the musculature.

OUTCOME MEASURES

Blood glucose levels for both the stretching and mock stretching were analysed from a finger prick sample using a hand-held glucometer. Values were obtained at baseline (0min), during the regimen (20min), and after the regimen (40min) on both study days.

RESULTS

Compared to mock stretch, stretching resulted in a significantly greater drop in blood glucose at 20min (mean difference 28mg/dL, 95% CI 13 to 43; or 1.57mmol/L, 95% CI 0.72 to 2.39). This effect was also statistically significant at 40min (mean difference 24mg/dL, 95% CI 9 to 39; or 1.35mmol/L, 95% CI 0.50 to 2.17).

CONCLUSION

These results suggest that passive static stretching of the skeletal muscles may be an alternative to exercise to help lower blood glucose levels.

Skeletal muscle-derived cell cultures as potent models in regenerative medicine research

Cell cultures have been used extensively by many scientists in recent decades to study various cell and tissue mechanisms. The use of cell cultures has many advantages over use of in vivo experimental models, but there are also limitations. As skeletal muscle-derived cell cultures become more commonly utilized in studies of muscle regeneration processes the question of their relevance in experimentation is highlighted with regard to in vivo experimental models. This article reviews studies that have been performed simultaneously in in vivo and in vitro experiments on skeletal muscle and assesses the correlation of results. Although they seem to correlate, no such studies on humans have been performed so far.

Cyclic stretch reduces myofibrillar protein synthesis despite increases in FAK and anabolic signalling in L6 cells

Muscle protein synthesis is increased after exercise, but evidence is now accruing that during muscular activity it is suppressed. In life, muscles are subjected to shortening forces due to contraction, but may also be subject to stretching forces during lengthening. It would be biologically inefficient if contraction and stretch have different effects on muscle protein turnover, but little is known about the metabolic effects of stretch. To investigate this, we assessed myofibrillar and sarcoplasmic protein synthesis (MPS, SPS, respectively) by incorporation of [1-13C]proline (using gas chromatography-mass spectrometry) and anabolic signalling (by phospho-immunoblotting and kinase assays) in cultured L6 skeletal muscle cells during 30 min of cyclic stretch and over 30 min intervals for up to 120 min afterwards. SPS was unaffected, whereas MPS was suppressed by 40 +/- 0.03% during stretch, before returning to basal rates by 90-20 min afterwards. Paradoxically, stretch stimulated anabolic signalling with peak values after 2-30 min: e.g. focal adhesion kinase (FAK Tyr576/577; +28 +/- 6%), protein kinase B activity (Akt; +113 +/- 31%), p70S6K1 (ribosomal S6 kinase Thr389; 25 +/- 5%), 4E binding protein 1 (4EBP1 Thr37/46; 14 +/- 3%), eukaryotic elongation factor 2 (eEF2 Thr56; -47 +/- 4%), extracellular regulated protein kinase 1/2 (ERK1/2 Tyr202/204; +65% +/- 9%), eukaryotic initiation factor 2alpha (eIF2alpha Ser51; -20 +/- 5%, P < 0.05) and eukaryotic initiation factor 4E (eIF4E Ser209; +33 +/- 10%, P < 0.05). After stretch, except for Akt activity, stimulatory phosphorylations were sustained: e.g. FAK (+26 +/- 11%) for > or =30 min, eEF2 for > or =60 min (peak -45 +/- 4%), 4EBP1 for > or =90 min (+33 +/- 5%), and p70S6K1 remained elevated throughout (peak +64 +/- 7%). Adenosine monophosphate-activated protein kinase (AMPK) phosphorylation was unchanged throughout. We report for the first time that acute cyclic stretch specifically suppresses MPS, despite increases in activity/phosphorylation of elements thought to increase anabolism.