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Weitzner AS, Bhoopalam M, Khong J, Biswas A, Karwoski A, Haile M, Waldron N, Mawalkar R, Srikumar A, Broderick S, Ha J, Broderick KP. Rectus Abdominis Muscle Atrophy and Asymmetry After Pulmonary Lobectomy. J Surg Res 2024; 299:137-144. [PMID: 38754252 DOI: 10.1016/j.jss.2024.04.011] [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: 11/06/2023] [Revised: 03/19/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Pulmonary lobectomy can result in intercostal nerve injury, leading to denervation of the rectus abdominis (RA) resulting in asymmetric muscle atrophy or an abdominal bulge. While there is a high rate of intercostal nerve injury during thoracic surgery, there are no studies that evaluate the magnitude and predisposing factors for RA atrophy in a large cohort. METHODS A retrospective chart review was conducted of 357 patients who underwent open, thoracoscopic or robotic pulmonary lobectomy at a single academic center. RA volumes were measured on computed tomography scans preoperatively and postoperatively on both the operated and nonoperated sides from the level of the xiphoid process to the thoracolumbar junction. RA volume change and association of surgical/demographic characteristics was assessed. RESULTS Median RA volume decreased bilaterally after operation, decreasing significantly more on the operated side (-19.5%) versus the nonoperated side (-6.6%) (P < 0.0001). 80.4% of the analyzed cohort experienced a 10% or greater decrease from preoperative RA volume on the operated side. Overweight individuals (body mass index 25.5-29.9) experienced a 1.7-fold greater volume loss on the operated side compared to normal weight individuals (body mass index 18.5-24.9) (P = 0.00016). In all right-sided lobectomies, lower lobe resection had the highest postoperative volume loss (Median (interquartile range): -28 (-35, -15)) (P = 0.082). CONCLUSIONS This study of postlobectomy RA asymmetry includes the largest cohort to date; previous literature only includes case reports. Lobectomy operations result in asymmetric RA atrophy and predisposing factors include demographics and surgical approach. Clinical and quality of life outcomes of RA atrophy, along with mitigation strategies, must be assessed.
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Affiliation(s)
| | | | - Jeffrey Khong
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Arushi Biswas
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Meron Haile
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | | | | | - Stephen Broderick
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jinny Ha
- Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kristen P Broderick
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
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2
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Kaefer SL, Zhang L, Morrison RA, Brookes S, Awonusi O, Shay E, Hoilett OS, Anderson JL, Goergen CJ, Voytik-Harbin S, Halum S. Early Changes in Porcine Larynges Following Injection of Motor-Endplate Expressing Muscle Cells for the Treatment of Unilateral Vocal Fold Paralysis. Laryngoscope 2024; 134:272-282. [PMID: 37436167 DOI: 10.1002/lary.30868] [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: 03/06/2023] [Revised: 06/05/2023] [Accepted: 06/21/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES No curative injectable therapy exists for unilateral vocal fold paralysis. Herein, we explore the early implications of muscle-derived motor-endplate expressing cells (MEEs) for injectable vocal fold medialization after recurrent laryngeal nerve (RLN) injury. METHODS Yucatan minipigs underwent right RLN transection (without repair) and muscle biopsies. Autologous muscle progenitor cells were isolated, cultured, differentiated, and induced to form MEEs. Three weeks after the injury, MEEs or saline were injected into the paralyzed right vocal fold. Outcomes including evoked laryngeal electromyography (LEMG), laryngeal adductor pressure, and acoustic vocalization data were analyzed up to 7 weeks post-injury. Harvested porcine larynges were examined for volume, gene expression, and histology. RESULTS MEE injections were tolerated well, with all pigs demonstrating continued weight gain. Blinded analysis of videolaryngoscopy post-injection revealed infraglottic fullness, and no inflammatory changes. Four weeks after injection, LEMG revealed on average higher right distal RLN activity retention in MEE pigs. MEE-injected pigs on average had vocalization durations, frequencies, and intensities higher than saline pigs. Post-mortem, the MEE-injected larynges revealed statistically greater volume on quantitative 3D ultrasound, and statistically increased expression of neurotrophic factors (BDNF, NGF, NTF3, NTF4, NTN1) on quantitative PCR. CONCLUSIONS Minimally invasive MEE injection appears to establish an early molecular and microenvironmental framework to encourage innate RLN regeneration. Longer follow-up is needed to determine if early findings will translate into functional contraction. LEVEL OF EVIDENCE NA Laryngoscope, 134:272-282, 2024.
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Affiliation(s)
- Samuel L Kaefer
- School of Medicine, Indiana University, Indianapolis, Indiana, U.S.A
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
| | - Lujuan Zhang
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, U.S.A
| | - Rachel A Morrison
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
| | - Sarah Brookes
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
| | - Oluwaseyi Awonusi
- School of Medicine, Indiana University, Indianapolis, Indiana, U.S.A
| | - Elizabeth Shay
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, U.S.A
| | - Orlando S Hoilett
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, U.S.A
| | - Jennifer L Anderson
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
| | - Sherry Voytik-Harbin
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
- Department of Basic Medical Sciences, Purdue University, West Lafayette, Indiana, U.S.A
| | - Stacey Halum
- School of Medicine, Indiana University, Indianapolis, Indiana, U.S.A
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, U.S.A
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana, U.S.A
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Gupta R, Johnston TR, Chen VY, Gonzales LP, Steward O. Human Motor Endplate Survival after Chronic Peripheral Nerve Injury. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.12.23296760. [PMID: 37873401 PMCID: PMC10592993 DOI: 10.1101/2023.10.12.23296760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objective Degeneration of motor endplates (MEPs) in denervated muscle is thought to be a key factor limiting functional regeneration after peripheral nerve injury (PNI) in humans. However, there is currently no paradigm to determine MEP status in denervated human muscle to estimate likelihood of reinnervation success. Here, we present a quantitative analysis of MEP status in biopsies of denervated muscles taken during nerve repair surgery and ensuing functional recovery. Methods This is a retrospective single-surgeon cohort study of patients (n=22) with upper extremity PNI confirmed with electromyography (EMG), treated with nerve transfers. Muscle biopsies were obtained intra-operatively from 10 patients for MEP morphometric analysis. Age at time of surgery ranged from 22-77 years and time from injury to surgery ranged from 2.5-163 months. Shoulder range of motion (ROM) and Medical Research Council (MRC) scores were recorded pre-op and at final follow-up. Results Surviving MEPs were observed in biopsies of denervated muscles from all patients, even those greater than six months from injury. Average postoperative ROM improvement (assessed between 6-9 months post-surgery) was: forward flexion 84.3 ± 51.8°, abduction 62.5 ± 47.9°, and external rotation 25.3 ± 28.0°. Interpretation While it is believed that MEP degeneration 6 months post-injury prevents reinnervation, this data details MEP persistence beyond this timepoint along with significant functional recovery after nerve surgery. Accordingly, persistence of MEPs in denervated muscles may predict the extent of functional recovery from nerve repair surgery.
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Affiliation(s)
- Ranjan Gupta
- University of California, Irvine, Department of Orthopaedics
| | | | - Vivian Y. Chen
- University of California, Irvine, Department of Orthopaedics
| | | | - Oswald Steward
- University of California, Irvine, Reeve-Irvine Research Center
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4
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Sharma B, Roy A, Sengupta T, Vishwakarma LC, Singh A, Netam R, Nag TC, Akhtar N, Mallick HN. Acute sleep deprivation induces synaptic remodeling at the soleus muscle neuromuscular junction in rats. Sleep 2023; 46:zsac229. [PMID: 36130235 DOI: 10.1093/sleep/zsac229] [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: 02/28/2022] [Revised: 08/03/2022] [Indexed: 07/26/2023] Open
Abstract
Sleep is important for cognitive and physical performance. Sleep deprivation not only affects neural functions but also results in muscular fatigue. A good night's sleep reverses these functional derangements caused by sleep deprivation. The role of sleep in brain function has been extensively studied. However, its role in neuromuscular junction (NMJ) or skeletal muscle morphology is sparsely addressed although skeletal muscle atonia and suspended thermoregulation during rapid eye movement sleep possibly provide a conducive environment for the muscle to rest and repair; somewhat similar to slow-wave sleep for synaptic downscaling. In the present study, we have investigated the effect of 24 h sleep deprivation on the NMJ morphology and neurochemistry using electron microscopy and immunohistochemistry in the rat soleus muscle. Acute sleep deprivation altered synaptic ultra-structure viz. mitochondria, synaptic vesicle, synaptic proteins, basal lamina, and junctional folds needed for neuromuscular transmission. Further acute sleep deprivation showed the depletion of the neurotransmitter acetylcholine and the overactivity of its degrading enzyme acetylcholine esterase at the NMJ. The impact of sleep deprivation on synaptic homeostasis in the brain has been extensively reported recently. The present evidence from our studies shows new information on the role of sleep on the NMJ homeostasis and its functioning.
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Affiliation(s)
- Binney Sharma
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Avishek Roy
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Trina Sengupta
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
- Department of Physiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - Anuraag Singh
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Ritesh Netam
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Tapas Chandra Nag
- Department of Physiology, Faculty of Medicine & Health Sciences, SGT University, Gurugram, Haryana, India
| | - Nasreen Akhtar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Hruda Nanda Mallick
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
- Department of Physiology, Faculty of Medicine & Health Sciences, SGT University, Gurugram, Haryana, India
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5
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Megerle K. Kommentar zu "Combined Reconstruction of the Ulnar Nerve after its wide Resection by Nerve Grafting at the Site of the Resection and distal Transfer of the Anterior Interosseus Nerve to the deep Branch of the Ulnar Nerve". HANDCHIR MIKROCHIR P 2023; 55:85-86. [PMID: 36796376 DOI: 10.1055/a-1984-8485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Affiliation(s)
- Kai Megerle
- Zentrum für Handchirurgie, Mikrochirurgie und Plastische Chirurgie, Schön Klinik München Harlaching, München, Germany
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6
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Chen VY, Gonzales LP, Johnston TR, Steward O, Gupta R. Preoperative Muscle Biopsy to Assess Motor End Plate Integrity as a Predictor for Successful Nerve Transfer: A Case Report. JBJS Case Connect 2023; 13:01709767-202303000-00042. [PMID: 36795913 DOI: 10.2106/jbjs.cc.22.00569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
CASE A 60-year-old right-hand-dominant man was referred for persistent right deltoid weakness, lateral shoulder numbness, and severe functional deficit 3 months after undergoing proximal humerus open reduction and internal fixation with plate and fibular strut allograft. Deltoid muscle biopsy demonstrated motor end plate (MEP) degeneration. After partial radial-to-axillary nerve transfer, repeat deltoid muscle biopsy revealed successful regeneration of MEPs with reinnervation of deltoid confirmed with postnerve transfer electromyography. CONCLUSION Selective nerve transfer can successfully rescue a denervated target muscle from further degeneration by restoration of healthy MEPs.
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Affiliation(s)
- Vivian Y Chen
- Department of Orthopaedic Surgery, University of California, Irvine, California
| | - Luigi P Gonzales
- Department of Orthopaedic Surgery, University of California, Irvine, California
| | - Tyler R Johnston
- Department of Orthopaedic Surgery, University of California, Irvine, California
| | - Oswald Steward
- Reeve-Irvine Research Center, University of California, Irvine, California
| | - Ranjan Gupta
- Department of Orthopaedic Surgery, University of California, Irvine, California
- Reeve-Irvine Research Center, University of California, Irvine, California
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BDNF Spinal Overexpression after Spinal Cord Injury Partially Protects Soleus Neuromuscular Junction from Disintegration, Increasing VAChT and AChE Transcripts in Soleus but Not Tibialis Anterior Motoneurons. Biomedicines 2022; 10:biomedicines10112851. [DOI: 10.3390/biomedicines10112851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/20/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
After spinal cord transection (SCT) the interaction between motoneurons (MNs) and muscle is impaired, due to reorganization of the spinal network after a loss of supraspinal inputs. Rats subjected to SCT, treated with intraspinal injection of a AAV-BDNF (brain-derived neurotrophic factor) construct, partially regained the ability to walk. The central effects of this treatment have been identified, but its impact at the neuromuscular junction (NMJ) has not been characterized. Here, we compared the ability of NMJ pre- and postsynaptic machinery in the ankle extensor (Sol) and flexor (TA) muscles to respond to intraspinal AAV-BDNF after SCT. The gene expression of cholinergic molecules (VAChT, ChAT, AChE, nAChR, mAChR) was investigated in tracer-identified, microdissected MN perikarya, and in muscle fibers with the use of qPCR. In the NMJs, a distribution of VAChT, nAChR and Schwann cells was studied by immunofluorescence, and of synaptic vesicles and membrane active zones by electron microscopy. We showed partial protection of the Sol NMJs from disintegration, and upregulation of the VAChT and AChE transcripts in the Sol, but not the TA MNs after spinal enrichment with BDNF. We propose that the observed discrepancy in response to BDNF treatment is an effect of difference in the TrkB expression setting BDNF responsiveness, and of BDNF demands in Sol and TA muscles.
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8
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Volpe P, Bosutti A, Nori A, Filadi R, Gherardi G, Trautmann G, Furlan S, Massaria G, Sciancalepore M, Megighian A, Caccin P, Bernareggi A, Salanova M, Sacchetto R, Sandonà D, Pizzo P, Lorenzon P. Nerve-dependent distribution of subsynaptic type 1 inositol 1,4,5-trisphosphate receptor at the neuromuscular junction. J Gen Physiol 2022; 154:213498. [PMID: 36149386 PMCID: PMC9513380 DOI: 10.1085/jgp.202213128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 08/30/2022] [Accepted: 09/09/2022] [Indexed: 11/20/2022] Open
Abstract
Inositol 1,4,5-trisphosphate receptors (IP3Rs) are enriched at postsynaptic membrane compartments of the neuromuscular junction (NMJ), surrounding the subsynaptic nuclei and close to nicotinic acetylcholine receptors (nAChRs) of the motor endplate. At the endplate level, it has been proposed that nerve-dependent electrical activity might trigger IP3-associated, local Ca2+ signals not only involved in excitation-transcription (ET) coupling but also crucial to the development and stabilization of the NMJ itself. The present study was undertaken to examine whether denervation affects the subsynaptic IP3R distribution in skeletal muscles and which are the underlying mechanisms. Fluorescence microscopy, carried out on in vivo denervated muscles (following sciatectomy) and in vitro denervated skeletal muscle fibers from flexor digitorum brevis (FDB), indicates that denervation causes a reduction in the subsynaptic IP3R1-stained region, and such a decrease appears to be determined by the lack of muscle electrical activity, as judged by partial reversal upon field electrical stimulation of in vitro denervated skeletal muscle fibers.
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Affiliation(s)
- Pompeo Volpe
- Department of Biomedical Sciences and Interdepartmental Research Center of Myology (cirMYO), University of Padova, Padova, Italy
- Correspondence to Pompeo Volpe:
| | | | - Alessandra Nori
- Department of Biomedical Sciences and Interdepartmental Research Center of Myology (cirMYO), University of Padova, Padova, Italy
| | - Riccardo Filadi
- Department of Biomedical Sciences and Interdepartmental Research Center of Myology (cirMYO), University of Padova, Padova, Italy
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Gaia Gherardi
- Department of Biomedical Sciences and Interdepartmental Research Center of Myology (cirMYO), University of Padova, Padova, Italy
| | - Gabor Trautmann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Institute of Integrative Neuroanatomy, Berlin, Germany
| | - Sandra Furlan
- National Research Council, Neuroscience Institute, Padova, Italy
| | | | | | - Aram Megighian
- Department of Biomedical Sciences and Interdepartmental Research Center of Myology (cirMYO), University of Padova, Padova, Italy
| | - Paola Caccin
- Department of Biomedical Sciences and Interdepartmental Research Center of Myology (cirMYO), University of Padova, Padova, Italy
| | | | - Michele Salanova
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Institute of Integrative Neuroanatomy, Berlin, Germany
- Neuromuscular Signaling, Center of Space Medicine Berlin, Berlin, Germany
| | - Roberta Sacchetto
- Department of Comparative Biomedicine and Food Science, University of Padova, Padova, Italy
| | - Dorianna Sandonà
- Department of Biomedical Sciences and Interdepartmental Research Center of Myology (cirMYO), University of Padova, Padova, Italy
| | - Paola Pizzo
- Department of Biomedical Sciences and Interdepartmental Research Center of Myology (cirMYO), University of Padova, Padova, Italy
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Paola Lorenzon
- Department of Life Sciences, University of Trieste, Trieste, Italy
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Cahalan SD, Boehm I, Jones RA, Piercy RJ. Recognising the potential of large animals for modelling neuromuscular junction physiology and disease. J Anat 2022; 241:1120-1132. [PMID: 36056593 PMCID: PMC9558152 DOI: 10.1111/joa.13749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 12/28/2022] Open
Abstract
The aetiology and pathophysiology of many diseases of the motor unit remain poorly understood and the role of the neuromuscular junction (NMJ) in this group of disorders is particularly overlooked, especially in humans, when these diseases are comparatively rare. However, elucidating the development, function and degeneration of the NMJ is essential to uncover its contribution to neuromuscular disorders, and to explore potential therapeutic avenues to treat these devastating diseases. Until now, an understanding of the role of the NMJ in disease pathogenesis has been hindered by inherent differences between rodent and human NMJs: stark contrasts in body size and corresponding differences in associated axon length underpin some of the translational issues in animal models of neuromuscular disease. Comparative studies in large mammalian models, including examination of naturally occurring, highly prevalent animal diseases and evaluation of their treatment, might provide more relevant insights into the pathogenesis and therapy of equivalent human diseases. This review argues that large animal models offer great potential to enhance our understanding of the neuromuscular system in health and disease, and in particular, when dealing with diseases for which nerve length dependency might underly the pathogenesis.
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Affiliation(s)
- Stephen D Cahalan
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
| | - Ines Boehm
- Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Edinburgh, UK.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh, UK.,Biozentrum University of Basel, Basel, Switzerland
| | - Ross A Jones
- Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Edinburgh, UK.,Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh, UK
| | - Richard J Piercy
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
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10
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Kostrominova TY. Skeletal Muscle Denervation: Past, Present and Future. Int J Mol Sci 2022; 23:ijms23147489. [PMID: 35886838 PMCID: PMC9316613 DOI: 10.3390/ijms23147489] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Tatiana Y Kostrominova
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Northwest, Gary, IN 46408, USA
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11
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Hildebrandt W, Keck J, Schmich S, Bonaterra GA, Wilhelm B, Schwarzbach H, Eva A, Bertoune M, Slater EP, Fendrich V, Kinscherf R. Inflammation and Wasting of Skeletal Muscles in Kras-p53-Mutant Mice with Intraepithelial Neoplasia and Pancreatic Cancer-When Does Cachexia Start? Cells 2022; 11:1607. [PMID: 35626644 PMCID: PMC9139525 DOI: 10.3390/cells11101607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/28/2022] [Accepted: 05/06/2022] [Indexed: 02/05/2023] Open
Abstract
Skeletal muscle wasting critically impairs the survival and quality of life in patients with pancreatic ductal adenocarcinoma (PDAC). To identify the local factors initiating muscle wasting, we studied inflammation, fiber cross-sectional area (CSA), composition, amino acid metabolism and capillarization, as well as the integrity of neuromuscular junctions (NMJ, pre-/postsynaptic co-staining) and mitochondria (electron microscopy) in the hindlimb muscle of LSL-KrasG12D/+; LSL-TrP53R172H/+; Pdx1-Cre mice with intraepithelial-neoplasia (PanIN) 1-3 and PDAC, compared to wild-type mice (WT). Significant decreases in fiber CSA occurred with PDAC but not with PanIN 1-3, compared to WT: These were found in the gastrocnemius (type 2x: −20.0%) and soleus (type 2a: −21.0%, type 1: −14.2%) muscle with accentuation in the male soleus (type 2a: −24.8%, type 1: −17.4%) and female gastrocnemius muscle (−29.6%). Significantly higher densities of endomysial CD68+ and cyclooxygenase-2+ (COX2+) cells were detected in mice with PDAC, compared to WT mice. Surprisingly, CD68+ and COX2+ cell densities were also higher in mice with PanIN 1-3 in both muscles. Significant positive correlations existed between muscular and hepatic CD68+ or COX2+ cell densities. Moreover, in the gastrocnemius muscle, suppressor-of-cytokine-3 (SOCS3) expressions was upregulated >2.7-fold with PanIN 1A-3 and PDAC. The intracellular pools of proteinogenic amino acids and glutathione significantly increased with PanIN 1A-3 compared to WT. Capillarization, NMJ, and mitochondrial ultrastructure remained unchanged with PanIN or PDAC. In conclusion, the onset of fiber atrophy coincides with the manifestation of PDAC and high-grade local (and hepatic) inflammatory infiltration without compromised microcirculation, innervation or mitochondria. Surprisingly, muscular and hepatic inflammation, SOCS3 upregulation and (proteolytic) increases in free amino acids and glutathione were already detectable in mice with precancerous PanINs. Studies of initial local triggers and defense mechanisms regarding cachexia are warranted for targeted anti-inflammatory prevention.
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Affiliation(s)
- Wulf Hildebrandt
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
| | - Jan Keck
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
- Department of General, Visceral and Pedriatic Surgery, University Clinics, Georg-August University, Robert-Koch-Str. 40, 37075 Goettingen, Germany
| | - Simon Schmich
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
| | - Gabriel A. Bonaterra
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
| | - Beate Wilhelm
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
| | - Hans Schwarzbach
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
| | - Anna Eva
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
| | - Mirjam Bertoune
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
| | - Emily P. Slater
- Department of Visceral, Thoracic and Vascular Surgery, University Clinics of Giessen and Marburg, Baldinger Str., 35043 Marburg, Germany; (E.P.S.); (V.F.)
| | - Volker Fendrich
- Department of Visceral, Thoracic and Vascular Surgery, University Clinics of Giessen and Marburg, Baldinger Str., 35043 Marburg, Germany; (E.P.S.); (V.F.)
- Center for Endocrine Surgery, Schön Klinik Hamburg-Eilbek, Dehnhaide 120, 22081 Hamburg, Germany
| | - Ralf Kinscherf
- Institute of Anatomy and Cell Biology, Department of Medical Cell Biology, Philipps-University of Marburg, Robert-Koch-Str. 8, 35032 Marburg, Germany; (J.K.); (S.S.); (G.A.B.); (B.W.); (H.S.); (A.E.); (M.B.); (R.K.)
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12
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Huang X, Jiang J, Xu J. Denervation-Related Neuromuscular Junction Changes: From Degeneration to Regeneration. Front Mol Neurosci 2022; 14:810919. [PMID: 35282655 PMCID: PMC8908450 DOI: 10.3389/fnmol.2021.810919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/30/2021] [Indexed: 11/13/2022] Open
Abstract
Neuromuscular junctions (NMJs) are the key interface between terminal nerves and targeted muscle, which undergo degeneration during denervation periods. Denervation-related NMJs changes limits the recovery level of nerve repair strategies. Insights into mechanisms behind neuromuscular junction degeneration and regeneration, following denervation and reinnervation, are of clinical value. Developing some therapies to maintain or protect structures and functions of NMJs may contribute to a better prognosis. Here, we reviewed previous studies of NMJs focusing on the morphological, functional, and molecular changes after denervation, and if those changes can be reversed after reinnervation. Also, we reviewed about the present probable strategies that have been applied clinically or could still be studied in targeting the neuromuscular junction protection or regeneration improvement.
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Affiliation(s)
- Xinying Huang
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
- Shanghai Medical College, Fudan University, Shanghai, China
- Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
| | - Junjian Jiang
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- *Correspondence: Junjian Jiang,
| | - Jianguang Xu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
- Jianguang Xu,
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13
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Preliminary Observations on Skeletal Muscle Adaptation and Plasticity in Homer 2 -/- Mice. Metabolites 2021; 11:metabo11090642. [PMID: 34564458 PMCID: PMC8469648 DOI: 10.3390/metabo11090642] [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: 07/01/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 01/05/2023] Open
Abstract
Homer represents a diversified family of scaffold and transduction proteins made up of several isoforms. Here, we present preliminary observations on skeletal muscle adaptation and plasticity in a transgenic model of Homer 2-/- mouse using a multifaceted approach entailing morphometry, quantitative RT-PCR (Reverse Transcription PCR), confocal immunofluorescence, and electrophysiology. Morphometry shows that Soleus muscle (SOL), at variance with Extensor digitorum longus muscle (EDL) and Flexor digitorum brevis muscle (FDB), displays sizable reduction of fibre cross-sectional area compared to the WT counterparts. In SOL of Homer 2-/- mice, quantitative RT-PCR indicated the upregulation of Atrogin-1 and Muscle ring finger protein 1 (MuRF1) genes, and confocal immunofluorescence showed the decrease of neuromuscular junction (NMJ) Homer content. Electrophysiological measurements of isolated FDB fibres from Homer 2-/- mice detected the exclusive presence of the adult ε-nAChR isoform excluding denervation. As for NMJ morphology, data were not conclusive, and further work is needed to ascertain whether the null Homer 2 phenotype induces any endplate remodelling. Within the context of adaptation and plasticity, the present data show that Homer 2 is a co-regulator of the normotrophic status in a muscle specific fashion.
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14
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Sorensen JR, Hoffman DB, Corona BT, Greising SM. Secondary denervation is a chronic pathophysiologic sequela of volumetric muscle loss. J Appl Physiol (1985) 2021; 130:1614-1625. [PMID: 33830817 DOI: 10.1152/japplphysiol.00049.2021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Volumetric muscle loss (VML) is the traumatic loss of muscle tissue that results in long-term functional impairments. Despite the loss of myofibers, there remains an unexplained significant decline in muscle function. VML injury likely extends beyond the defect area, causing negative secondary outcomes to the neuromuscular system, including the neuromuscular junctions (NMJs), yet the extent to which VML induces denervation is unclear. This study systematically examined NMJs surrounding the VML injury, hypothesizing that the sequela of VML includes denervation. The VML injury removed ∼20% of the tibialis anterior (TA) muscle in adult male inbred Lewis rats (n = 43), the noninjured leg served as an intra-animal control. Muscles were harvested up to 48 days post-VML. Synaptic terminals were identified immunohistochemically, and quantitative confocal microscopy evaluated 2,613 individual NMJ. Significant denervation was apparent by 21 and 48 days post-VML. Initially, denervation increased ∼10% within 3 days of injury; with time, denervation further increased to ∼22% and 32% by 21 and 48 days post-VML, respectively, suggesting significant secondary denervation. The appearance of terminal axon sprouting and polyinnervation were observed as early as 7 days post-VML, increasing in number and complexity throughout 48 days. There was no evidence of VML-induced NMJ size alteration, which may be beneficial for interventions aimed at restoring muscle function. This work recognizes VML-induced secondary denervation and poor remodeling of the NMJ as part of the sequela of VML injury; moreover, secondary denervation is a possible contributing factor to the chronic functional impairments and potentially an overlooked treatment target.NEW & NOTEWORTHY This work advances our understanding of the pathophysiologic complexity of volumetric muscle loss injury. Specifically, we identified secondary denervation in the muscle remaining after volumetric muscle loss injuries as a novel aspect of the injury sequela. Denervation increased chronically, in parallel with the appearance of irregular morphological characteristics and destabilization of the neuromuscular junction, which is expected to further confound chronic functional impairments.
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Affiliation(s)
- Jacob R Sorensen
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
| | - Daniel B Hoffman
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
| | - Benjamin T Corona
- School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Sarah M Greising
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
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15
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Adyaksa G, Suroto H. Apoptosis of proximal stump postganglionic brachial plexus injury, before and after six months post-trauma. Ann Med Surg (Lond) 2021; 63:102156. [PMID: 33664944 PMCID: PMC7907218 DOI: 10.1016/j.amsu.2021.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 12/15/2022] Open
Abstract
Background The success of the micro-surgery procedure for the treatment of postganglionic brachial plexus injury was influenced by several factors, including the surgical timing and also the viability of the proximal stump. This study evaluates the evidence of apoptosis in the brachial plexus proximal stump and its correlation with the surgical timing. Methods Proximal stump biopsy of postganglionic brachial plexus injury patients were obtained during nerve procedure surgery. The samples were grouped based on the surgical timing, before six months post-trauma (early group) and after six months post-trauma (late group). The apoptosis of motorneurons was evaluated by immunohistochemistry expression of Caspase-3, TNF-α, Caspase-8, and Caspase-9. Results Immunohistochemistry findings showed higher expression of Caspase-3 in the late group compared to the early group, as well as the expression of Caspase-8 and Caspase-9 (p < 0,05), and with a positive correlation between Caspase-8 and Caspase-9 to Caspase-3. Meanwhile, TNF-α expression was higher in the early group than the late group (p < 0,05) and with no correlation between TNF-α to Caspase-3. Conclusion Apoptosis of proximal stump motorneuron plexus brachialis on more than six months post-trauma is higher than on less than six months post-trauma. Study of apoptosis of the brachial plexus proximal stump of the postganglionic BPI. Compare between before 6 months post-trauma and after 6 months post-trauma. Evaluate the apoptosis, the extrinsic and intrinsic pro-apoptosis pathway. The apoptosis of more than 6 months post-trauma is higher than before 6 months.
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Affiliation(s)
- Gana Adyaksa
- Department of Orthopedics & Traumatology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Heri Suroto
- Department of Orthopedics & Traumatology, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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