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Atakan MM, Türkel İ, Özerkliğ B, Koşar ŞN, Taylor DF, Yan X, Bishop DJ. Small peptides: could they have a big role in metabolism and the response to exercise? J Physiol 2024; 602:545-568. [PMID: 38196325 DOI: 10.1113/jp283214] [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: 10/19/2023] [Accepted: 12/14/2023] [Indexed: 01/11/2024] Open
Abstract
Exercise is a powerful non-pharmacological intervention for the treatment and prevention of numerous chronic diseases. Contracting skeletal muscles provoke widespread perturbations in numerous cells, tissues and organs, which stimulate multiple integrated adaptations that ultimately contribute to the many health benefits associated with regular exercise. Despite much research, the molecular mechanisms driving such changes are not completely resolved. Technological advancements beginning in the early 1960s have opened new avenues to explore the mechanisms responsible for the many beneficial adaptations to exercise. This has led to increased research into the role of small peptides (<100 amino acids) and mitochondrially derived peptides in metabolism and disease, including those coded within small open reading frames (sORFs; coding sequences that encode small peptides). Recently, it has been hypothesized that sORF-encoded mitochondrially derived peptides and other small peptides play significant roles as exercise-sensitive peptides in exercise-induced physiological adaptation. In this review, we highlight the discovery of mitochondrially derived peptides and newly discovered small peptides involved in metabolism, with a specific emphasis on their functions in exercise-induced adaptations and the prevention of metabolic diseases. In light of the few studies available, we also present data on how both single exercise sessions and exercise training affect expression of sORF-encoded mitochondrially derived peptides. Finally, we outline numerous research questions that await investigation regarding the roles of mitochondrially derived peptides in metabolism and prevention of various diseases, in addition to their roles in exercise-induced physiological adaptations, for future studies.
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Affiliation(s)
- Muhammed M Atakan
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
| | - İbrahim Türkel
- Department of Exercise and Sport Sciences, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
| | - Berkay Özerkliğ
- Department of Exercise and Sport Sciences, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
| | - Şükran N Koşar
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
| | - Dale F Taylor
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
| | - Xu Yan
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
- Sarcopenia Research Program, Australia Institute for Musculoskeletal Sciences (AIMSS), Melbourne, Victoria, Australia
| | - David J Bishop
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, Victoria, Australia
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2
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Garcia-Retortillo S, Romero-Gómez C, Ivanov PC. Network of muscle fibers activation facilitates inter-muscular coordination, adapts to fatigue and reflects muscle function. Commun Biol 2023; 6:891. [PMID: 37648791 PMCID: PMC10468525 DOI: 10.1038/s42003-023-05204-3] [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: 03/08/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
Fundamental movement patterns require continuous skeletal muscle coordination, where muscle fibers with different timing of activation synchronize their dynamics across muscles with distinct functions. It is unknown how muscle fibers integrate as a network to generate and fine tune movements. We investigate how distinct muscle fiber types synchronize across arm and chest muscles, and respond to fatigue during maximal push-up exercise. We uncover that a complex inter-muscular network of muscle fiber cross-frequency interactions underlies push-up movements. The network exhibits hierarchical organization (sub-networks/modules) with specific links strength stratification profile, reflecting distinct functions of muscles involved in push-up movements. We find network reorganization with fatigue where network modules follow distinct phase-space trajectories reflecting their functional role and adaptation to fatigue. Consistent with earlier observations for squat movements under same protocol, our findings point to general principles of inter-muscular coordination for fundamental movements, and open a new area of research, Network Physiology of Exercise.
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Affiliation(s)
- Sergi Garcia-Retortillo
- Keck Laboratory for Network Physiology, Department of Physics, Boston University, Boston, MA, 02215, USA
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, 27190, USA
- Complex Systems in Sport, INEFC University of Barcelona, 08038, Barcelona, Spain
| | - Carlos Romero-Gómez
- Complex Systems in Sport, INEFC University of Barcelona, 08038, Barcelona, Spain
| | - Plamen Ch Ivanov
- Keck Laboratory for Network Physiology, Department of Physics, Boston University, Boston, MA, 02215, USA.
- Harvard Medical School and Division of Sleep Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. Georgi Bonchev Str. Block 21, Sofia, 1113, Bulgaria.
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3
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Vertyshev AY, Akberdin IR, Kolpakov FA. Numerous Trigger-like Interactions of Kinases/Protein Phosphatases in Human Skeletal Muscles Can Underlie Transient Processes in Activation of Signaling Pathways during Exercise. Int J Mol Sci 2023; 24:11223. [PMID: 37446402 DOI: 10.3390/ijms241311223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
Optimizing physical training regimens to increase muscle aerobic capacity requires an understanding of the internal processes that occur during exercise that initiate subsequent adaptation. During exercise, muscle cells undergo a series of metabolic events that trigger downstream signaling pathways and induce the expression of many genes in working muscle fibers. There are a number of studies that show the dependence of changes in the activity of AMP-activated protein kinase (AMPK), one of the mediators of cellular signaling pathways, on the duration and intensity of single exercises. The activity of various AMPK isoforms can change in different directions, increasing for some isoforms and decreasing for others, depending on the intensity and duration of the load. This review summarizes research data on changes in the activity of AMPK, Ca2+/calmodulin-dependent protein kinase II (CaMKII), and other components of the signaling pathways in skeletal muscles during exercise. Based on these data, we hypothesize that the observed changes in AMPK activity may be largely related to metabolic and signaling transients rather than exercise intensity per se. Probably, the main events associated with these transients occur at the beginning of the exercise in a time window of about 1-10 min. We hypothesize that these transients may be partly due to putative trigger-like kinase/protein phosphatase interactions regulated by feedback loops. In addition, numerous dynamically changing factors, such as [Ca2+], metabolite concentration, and reactive oxygen and nitrogen species (RONS), can shift the switching thresholds and change the states of these triggers, thereby affecting the activity of kinases (in particular, AMPK and CaMKII) and phosphatases. The review considers the putative molecular mechanisms underlying trigger-like interactions. The proposed hypothesis allows for a reinterpretation of the experimental data available in the literature as well as the generation of ideas to optimize future training regimens.
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Affiliation(s)
| | - Ilya R Akberdin
- Department of Computational Biology, Scientific Center for Information Technologies and Artificial Intelligence, Sirius University of Science and Technology, 354340 Sochi, Russia
- Biosoft.Ru, Ltd., 630058 Novosibirsk, Russia
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Fedor A Kolpakov
- Department of Computational Biology, Scientific Center for Information Technologies and Artificial Intelligence, Sirius University of Science and Technology, 354340 Sochi, Russia
- Biosoft.Ru, Ltd., 630058 Novosibirsk, Russia
- Federal Research Center for Information and Computational Technologies, 630090 Novosibirsk, Russia
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4
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Herskind J, Kristensen AM, Ørtenblad N, de Paoli F, Vissing K, Overgaard K. Prolonged loss of force and power following fatiguing contractions in rat soleus muscles. Is low-frequency fatigue an issue during dynamic contractions? Am J Physiol Cell Physiol 2022; 323:C1642-C1651. [DOI: 10.1152/ajpcell.00241.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Low-frequency fatigue (LFF) is defined by a relatively larger deficit in isometric force elicited by low-frequency electrical stimulation compared with high-frequency stimulation. However, the effects of LFF on power during dynamic contractions elicited at low and high frequencies have not been thoroughly characterized. In the current study, rat soleus muscles underwent fatiguing either concentric, eccentric, or isometric contractions. Before and 1 h after the fatiguing contractions, a series of brief isometric and dynamic contractions elicited at 20 and 80 Hz stimulation to establish force-velocity relationships. Maximal force (Fmax), velocity (Vmax), and power (Pmax) were assessed for each frequency. Sarcoplasmic reticulum (SR) Ca2+ release and reuptake rates were assessed pre- and postfatigue. Prolonged fatigue was observed as a loss of Fmax and Pmax in muscles fatigued by concentric or eccentric, but not by isometric contractions. When quantified as a decrease in the ratio between 20 Hz and 80 Hz contractile output, LFF was more pronounced for isometric force than for power (−21% vs. −16% for concentrically fatigued muscles, P = 0.003; 29 vs. 13% for eccentrically fatigued muscles, P < 0.001). No changes in SR Ca2+ release or reuptake rates were observed. We conclude that LFF is less pronounced when expressed in terms of power deficits than when expressed in terms of force deficits, and that LFF, therefore, likely affects performance to a lesser degree during fast concentric contractions than during static or slow contractions.
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Affiliation(s)
- Jon Herskind
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | | | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Frank de Paoli
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Kristian Vissing
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | - Kristian Overgaard
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
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5
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Hostrup M, Cairns SP, Bangsbo J. Muscle Ionic Shifts During Exercise: Implications for Fatigue and Exercise Performance. Compr Physiol 2021; 11:1895-1959. [PMID: 34190344 DOI: 10.1002/cphy.c190024] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise causes major shifts in multiple ions (e.g., K+ , Na+ , H+ , lactate- , Ca2+ , and Cl- ) during muscle activity that contributes to development of muscle fatigue. Sarcolemmal processes can be impaired by the trans-sarcolemmal rundown of ion gradients for K+ , Na+ , and Ca2+ during fatiguing exercise, while changes in gradients for Cl- and Cl- conductance may exert either protective or detrimental effects on fatigue. Myocellular H+ accumulation may also contribute to fatigue development by lowering glycolytic rate and has been shown to act synergistically with inorganic phosphate (Pi) to compromise cross-bridge function. In addition, sarcoplasmic reticulum Ca2+ release function is severely affected by fatiguing exercise. Skeletal muscle has a multitude of ion transport systems that counter exercise-related ionic shifts of which the Na+ /K+ -ATPase is of major importance. Metabolic perturbations occurring during exercise can exacerbate trans-sarcolemmal ionic shifts, in particular for K+ and Cl- , respectively via metabolic regulation of the ATP-sensitive K+ channel (KATP ) and the chloride channel isoform 1 (ClC-1). Ion transport systems are highly adaptable to exercise training resulting in an enhanced ability to counter ionic disturbances to delay fatigue and improve exercise performance. In this article, we discuss (i) the ionic shifts occurring during exercise, (ii) the role of ion transport systems in skeletal muscle for ionic regulation, (iii) how ionic disturbances affect sarcolemmal processes and muscle fatigue, (iv) how metabolic perturbations exacerbate ionic shifts during exercise, and (v) how pharmacological manipulation and exercise training regulate ion transport systems to influence exercise performance in humans. © 2021 American Physiological Society. Compr Physiol 11:1895-1959, 2021.
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Affiliation(s)
- Morten Hostrup
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Simeon Peter Cairns
- SPRINZ, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand.,Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Jens Bangsbo
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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6
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Gejl KD, Hvid LG, Andersson EP, Jensen R, Holmberg HC, Ørtenblad N. Contractile Properties of MHC I and II Fibers From Highly Trained Arm and Leg Muscles of Cross-Country Skiers. Front Physiol 2021; 12:682943. [PMID: 34220547 PMCID: PMC8242206 DOI: 10.3389/fphys.2021.682943] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Little is known about potential differences in contractile properties of muscle fibers of the same type in arms and legs. Accordingly, the present study was designed to compare the force-generating capacity and Ca2+ sensitivity of fibers from arm and leg muscles of highly trained cross-country skiers. Method Single muscle fibers of m. vastus lateralis and m. triceps brachii of eight highly trained cross-country skiers were analyzed with respect to maximal Ca2+-activated force, specific force and Ca2+ sensitivity. Result The maximal Ca2+-activated force was greater for myosin heavy chain (MHC) II than MHC I fibers in both the arm (+62%, P < 0.001) and leg muscle (+77%, P < 0.001), with no differences between limbs for each MHC isoform. In addition, the specific force of MHC II fibers was higher than that of MHC I fibers in both arms (+41%, P = 0.002) and legs (+95%, P < 0.001). The specific force of MHC II fibers was the same in both limbs, whereas MHC I fibers from the m. triceps brachii were, on average, 39% stronger than fibers of the same type from the m. vastus lateralis (P = 0.003). pCa50 was not different between MHC I and II fibers in neither arms nor legs, but the MHC I fibers of m. triceps brachii demonstrated higher Ca2+ sensitivity than fibers of the same type from m. vastus lateralis (P = 0.007). Conclusion Comparison of muscles in limbs equally well trained revealed that MHC I fibers in the arm muscle exhibited a higher specific force-generating capacity and greater Ca2+ sensitivity than the same type of fiber in the leg, with no such difference in the case of MHC II fibers. These distinct differences in the properties of fibers of the same type in equally well-trained muscles open new perspectives in muscle physiology.
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Affiliation(s)
- Kasper Degn Gejl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars G Hvid
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | - Erik P Andersson
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.,School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsö, Norway
| | - Rasmus Jensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Hans-Christer Holmberg
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.,Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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7
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Lee HS, Kim JH. The dog as an exercise science animal model: a review of physiological and hematological effects of exercise conditions. Phys Act Nutr 2021; 24:1-6. [PMID: 33539688 PMCID: PMC7923746 DOI: 10.20463/pan.2020.0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/15/2020] [Indexed: 01/04/2023] Open
Abstract
[Purpose] Exercise is a fundamental way to maintain and improve health and physical fitness. Many human studies have demonstrated the beneficial effects of exercise on various biological parameters. However, studies investigating the effects of exercise in dogs are limited. This review summarized the current data from studies that examined the effects of different exercise conditions (treadmill vs. non-treadmill and acute vs. chronic) on physiological and hematological parameters in dogs. [Methods] Papers addressing the effects of exercise in dogs published from January 2000 to October 2020 were retrieved from the online databases of Scopus, Google Scholar, and PubMed and were selected and reviewed. [Results] The exercise conditions differentially affected physiological and hematological responses and adaptation in dogs. Therefore, the development and comprehensive evaluation of scientific exercise programs for dogs are necessary. [Conclusion] The dog would be a valuable exercise science animal model, and studies aiming at the optimal health, well-being, and quality of life of dogs need to be conducted.
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Affiliation(s)
- Hae Sung Lee
- Department of Physical Education, Hanyang University, Seoul, Republic of Korea.,Sports & Exercise Science Convergence Center, Hanyang University, Seoul, Republic of Korea
| | - Jong-Hee Kim
- Department of Physical Education, Hanyang University, Seoul, Republic of Korea.,Sports & Exercise Science Convergence Center, Hanyang University, Seoul, Republic of Korea
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Acute Beetroot Juice Supplementation Attenuates Morning-Associated Decrements in Supramaximal Exercise Performance in Trained Sprinters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020412. [PMID: 33430250 PMCID: PMC7825729 DOI: 10.3390/ijerph18020412] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/12/2022]
Abstract
Diurnal fluctuations in power output have been well established with power loss typically occurring in morning (AM) times. Beetroot juice (BRJ) is a source of dietary nitrate that possess ergogenic properties, but it is unknown if ingestion can mitigate performance decrements in the morning. The purpose of this study was to examine the effects of acute BRJ supplementation on diurnal fluctuations in anaerobic performance in trained sprinters. Male Division 1 National Collegiate Athletic Association (NCAA) sprinters (n = 10) participated. In a double-blinded crossover study design, participants completed three counterbalanced exercise trials under different conditions: Morning–placebo (8:00 HR, AM-PL), Morning–BRJ (8:00 HR, AM-BRJ), and Afternoon–no supplement (15:00 HR, PM). For each trial, participants completed 3 × 15 s Wingate anaerobic tests separated by 2 min of rest. Each trial was separated by a 72 h washout period. Mean power output (p = 0.043), anaerobic capacity (p = 0.023), and total work (p = 0.026) were significantly lower with the AM-PL condition compared to PM. However, BRJ supplementation prevented AM losses of mean power output (p = 0.994), anaerobic capacity (p = 0.941), and total work (p = 0.933) in the AM-BRJ compared to the PM condition. Rate of perceived exertion was not significantly different between any conditions (p = 0.516). Heart rate was significantly lower during the AM-BRJ condition compared to AM-PL (p = 0.030) and PM (p < 0.001). Findings suggest anaerobic capacity suffers during AM versus PM times in trained sprinters, but BRJ ingestion abolishes AM-associated decrements in performance.
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Jessen S, Reitelseder S, Kalsen A, Kreiberg M, Onslev J, Gad A, Ørtenblad N, Backer V, Holm L, Bangsbo J, Hostrup M. β 2-Adrenergic agonist salbutamol augments hypertrophy in MHCIIa fibers and sprint mean power output but not muscle force during 11 weeks of resistance training in young men. J Appl Physiol (1985) 2020; 130:617-626. [PMID: 33357007 DOI: 10.1152/japplphysiol.00553.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In this study, we examined the effect of β2-agonist salbutamol at oral doses during a period of resistance training on sprint performance, quadriceps contractile function, skeletal muscle hypertrophy, fiber type composition, maximal activity of enzymes of importance for anaerobic energy turnover, and sarcoplasmic reticulum Ca2+ handling in young men. Twenty-six men (23 ± 2 yr; means ± SD) were randomized to daily intake of oral salbutamol (16 mg/day; RES+SAL) or placebo (RES) during 11 wk of full-body resistance training 3 times/wk. Mean power output during 10-s maximal cycling increased more (P = 0.027) in RES+SAL (+12%) than in RES (+7%), whereas peak power output increased similarly (RES+SAL: +8%; RES: +7%; P = 0.400). Quadriceps dynamic peak torque and maximal voluntary isometric torque increased by 13 and 14% (P ≤ 0.001) in RES+SAL and 13 and 13% (P ≤ 0.001) in RES, respectively. Myosin heavy-chain (MHC) isoform distribution transitioned from MHCI and MHCIIx toward MHCIIa in RES+SAL (P = 0.002), but not in RES (P = 0.323). MHCIIa cross-sectional-area increased more (P = 0.040) in RES+SAL (+35%) than RES (+21%). Sarcoplasmic reticulum Ca2+ release rate increased in both groups (RES+SAL: +9%, P = 0.048; RES: +13%, P = 0.008), whereas Ca2+-uptake rate increased only in RES (+12%, P = 0.022) but was not different from the nonsignificant change in RES+SAL (+2%, P = 0.484). Maximal activity of lactate dehydrogenase increased only in RES+SAL (+13%, P = 0.008). Muscle content of the dihydropyridine receptor, ryanodine receptor 1, and sarcoplasmic reticulum Ca2+-ATPase isoform 1 and 2 did not change with the intervention in either group (P ≥ 0.100). These observations indicate that the enhancement of sprint mean power output induced by salbutamol is at least partly attributed to greater hypertrophy of MHCIIa fibers and transition toward the MHCIIa isoform.NEW & NOTEWORTHY Here, we show that daily oral treatment with selective β2-agonist salbutamol induces muscle fiber isoform transition from myosin-heavy-chain (MHC)-I toward MHCIIa and augments hypertrophy of MHCIIa fibers during a period of resistance training. Compared with placebo, salbutamol enhanced sprint mean power output, whereas peak power output and measures of muscle strength increased similarly during the resistance training period despite augmented hypertrophy with salbutamol. Thus, salbutamol is a muscle anabolic drug that can enhance sprint ability adaptations to resistance training.
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Affiliation(s)
- Søren Jessen
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Søren Reitelseder
- Institute of Sports Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Anders Kalsen
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Michael Kreiberg
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Johan Onslev
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Anders Gad
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Vibeke Backer
- Centre for Physical Activity Research, Rigshospitalet and University of Copenhagen, Copenhagen Denmark.,Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Lars Holm
- Institute of Sports Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.,School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Jens Bangsbo
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Morten Hostrup
- Section of Integrative Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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