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Schütze K, Schopp M, Fairchild TJ, Needham M. Old muscle, new tricks: a clinician perspective on sarcopenia and where to next. Curr Opin Neurol 2023; 36:441-449. [PMID: 37501556 PMCID: PMC10487352 DOI: 10.1097/wco.0000000000001185] [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] [Indexed: 07/29/2023]
Abstract
PURPOSE OF REVIEW This review offers a contemporary clinical approach to the recognition, prevention and management of sarcopenia, and discusses recent clinically relevant advances in the aetiopathogenesis of muscle ageing that may lead to future therapeutic targets. RECENT FINDINGS The key recent directions for sarcopenia are in the diagnosis, understanding molecular mechanisms and management. Regarding the recognition of the condition, it has become increasingly clear that different definitions hamper progress in understanding. Therefore, the Global Leadership in Sarcopenia has been established in 2022 to develop a universally accepted definition. Moreover, substantial work is occurring to understand the various roles and contribution of inflammation, oxidative stress, mitochondrial dysfunction and metabolic dysregulation on skeletal muscle function and ageing. Finally, the role of resistance-based exercise regimes has been continually emphasised. However, the role of protein supplementation and hormone replacement therapy (HRT) are still under debate, and current clinical trials are underway. SUMMARY With the global ageing of our population, there is increasing emphasis on maintaining good health. Maintenance of skeletal muscle strength and function are key to preventing frailty, morbidity and death.
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Affiliation(s)
- Katie Schütze
- School of Medicine, The University of Notre Dame Australia, Fremantle
| | - Madeline Schopp
- School of Medicine, The University of Notre Dame Australia, Fremantle
| | - Timothy J. Fairchild
- Centre for Molecular Medicine & Innovative Therapeutics
- School of Allied Health, Murdoch University
| | - Merrilee Needham
- School of Medicine, The University of Notre Dame Australia, Fremantle
- Centre for Molecular Medicine & Innovative Therapeutics
- Perron Institute of Neurological and Translational Sciences, Nedlands
- Department of Neurology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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Cheng KYK, Bao Z, Long Y, Liu C, Huang T, Cui C, Chow SKH, Wong RMY, Cheung WH. Sarcopenia and Ageing. Subcell Biochem 2023; 103:95-120. [PMID: 37120466 DOI: 10.1007/978-3-031-26576-1_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Musculoskeletal ageing is a major health challenge as muscles and bones constitute around 55-60% of body weight. Ageing muscles will result in sarcopenia that is characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes. In recent years, a few consensus panels provide new definitions for sarcopenia. It was officially recognized as a disease in 2016 with an ICD-10-CM disease code, M62.84, in the International Classification of Diseases (ICD). With the new definitions, there are many studies emerging to investigate the pathogenesis of sarcopenia, exploring new interventions to treat sarcopenia and evaluating the efficacy of combination treatments for sarcopenia. The scope of this chapter is to summarize and appraise the evidence in terms of (1) clinical signs, symptoms, screening, and diagnosis, (2) pathogenesis of sarcopenia with emphasis on mitochondrial dysfunction, intramuscular fat infiltration and neuromuscular junction deterioration, and (3) current treatments with regard to physical exercises and nutritional supplement.
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Affiliation(s)
- Keith Yu-Kin Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhengyuan Bao
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
- Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yufeng Long
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Chaoran Liu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Tao Huang
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Can Cui
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Ronald Man Yeung Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
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Alizadeh Pahlavani H, Laher I, Knechtle B, Zouhal H. Exercise and mitochondrial mechanisms in patients with sarcopenia. Front Physiol 2022; 13:1040381. [PMID: 36561214 PMCID: PMC9767441 DOI: 10.3389/fphys.2022.1040381] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Sarcopenia is a severe loss of muscle mass and functional decline during aging that can lead to reduced quality of life, limited patient independence, and increased risk of falls. The causes of sarcopenia include inactivity, oxidant production, reduction of antioxidant defense, disruption of mitochondrial activity, disruption of mitophagy, and change in mitochondrial biogenesis. There is evidence that mitochondrial dysfunction is an important cause of sarcopenia. Oxidative stress and reduction of antioxidant defenses in mitochondria form a vicious cycle that leads to the intensification of mitochondrial separation, suppression of mitochondrial fusion/fission, inhibition of electron transport chain, reduction of ATP production, an increase of mitochondrial DNA damage, and mitochondrial biogenesis disorder. On the other hand, exercise adds to the healthy mitochondrial network by increasing markers of mitochondrial fusion and fission, and transforms defective mitochondria into efficient mitochondria. Sarcopenia also leads to a decrease in mitochondrial dynamics, mitophagy markers, and mitochondrial network efficiency by increasing the level of ROS and apoptosis. In contrast, exercise increases mitochondrial biogenesis by activating genes affected by PGC1-ɑ (such as CaMK, AMPK, MAPKs) and altering cellular calcium, ATP-AMP ratio, and cellular stress. Activation of PGC1-ɑ also regulates transcription factors (such as TFAM, MEFs, and NRFs) and leads to the formation of new mitochondrial networks. Hence, moderate-intensity exercise can be used as a non-invasive treatment for sarcopenia by activating pathways that regulate the mitochondrial network in skeletal muscle.
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Affiliation(s)
- Hamed Alizadeh Pahlavani
- Department of Physical Education, Farhangian University, Tehran, Iran,*Correspondence: Beat Knechtle, ; Hamed Alizadeh Pahlavani, ; Hassane Zouhal,
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland,Medbase St Gallen Am Vadianplatz, St. Gallen, Switzerland,*Correspondence: Beat Knechtle, ; Hamed Alizadeh Pahlavani, ; Hassane Zouhal,
| | - Hassane Zouhal
- Movement Sport, Health and Sciences Laboratory (M2S) UFR-STAPS, University of Rennes 2-ENS Cachan, Charles Tillon, France,Institut International des Sciences Du Sport (2IS), Irodouer, France,*Correspondence: Beat Knechtle, ; Hamed Alizadeh Pahlavani, ; Hassane Zouhal,
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Analysis of the Effects of Ninjin’yoeito on Physical Frailty in Mice. Int J Mol Sci 2022; 23:ijms231911183. [PMID: 36232484 PMCID: PMC9569708 DOI: 10.3390/ijms231911183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/08/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Physical frailty is an aging-related clinical syndrome involving decreases in body weight, mobility, activity, and walking speed that occurs in individuals with sarcopenia and is accelerated by increased oxidative stress. Ninjin’yoeito, a traditional Japanese Kampo medicine, is used for treating conditions, including anemia and physical weakness. Here, we investigated whether ninjin’yoeito could improve physical frailty by controlling oxidative stress in the senescence-accelerated mouse prone 8 (SAMP8) model. First, SAMP8 mice were divided into two groups, ninjin’yoeito treated and untreated, with the former consuming a diet containing 3% ninjin’yoeito from 3 months of age. At 7 months of age, body weight, motor function, locomotor activity, and mean walking speed were measured. Subsequently, mice were euthanized and measured for muscle weight, 8-hydroxy-2′-deoxyguanosine levels in muscle and brain, and cleaved caspase-3 expression in brain. The results showed reductions in weight, locomotor function, locomotion, and average walking speed in the untreated group, which were significantly improved by ninjin’yoeito. Furthermore, 8-hydroxy-2′-deoxyguanosine levels were reduced in muscle and brain from ninjin’yoeito-treated mice, compared with the levels in untreated mice; cleaved caspase-3 expression was similarly reduced in brain from the treated mice, indicating reduced apoptosis. Our findings suggest that ninjin’yoeito inhibits sarcopenia-based physical frailty through its antioxidant effects.
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Papadopoulou SK, Mantzorou M, Kondyli-Sarika F, Alexandropoulou I, Papathanasiou J, Voulgaridou G, Nikolaidis PT. The Key Role of Nutritional Elements on Sport Rehabilitation and the Effects of Nutrients Intake. Sports (Basel) 2022; 10:sports10060084. [PMID: 35736824 PMCID: PMC9227980 DOI: 10.3390/sports10060084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 01/25/2023] Open
Abstract
Adequate nutrition is of utmost importance for athletes, especially during rehabilitation after injury in order to achieve fast healing and return to sports. The aim of this narrative review is to define the proper nutritional elements for athletes to meet their needs and facilitate their fast return to sports after surgery or injury, as well as determine the effects of specific nutrients intake. Studies on antioxidants, which are substances that protect against free radicals, for the injured athlete are few and unclear, yet poly-phenols and especially flavonoids might improve healing and inflammation following an injury. Benefits of vitamin C or E on muscle damage are disputable in relevant studies, while optimal levels of vitamin D and calcium contribute to bone healing. Minerals are also essential for athletes. Other supplements suggested for muscle damage treatment and protein synthesis include leucine, creatine, and hydroxymethylbutyrate. Diets that include high-quality products, rich in micronutrients (like vitamins, minerals, etc.) bio-active compounds and other nutritional elements (like creatine) are suggested, while an individualized nutrition program prescribed by a trained dietitian is important. Further studies are needed to clarify the underlying mechanisms of these nutritional elements, especially regarding injury treatment.
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Affiliation(s)
- Sousana K. Papadopoulou
- Department Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (F.K.-S.); (I.A.); (G.V.)
| | - Maria Mantzorou
- Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece;
| | - Foivi Kondyli-Sarika
- Department Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (F.K.-S.); (I.A.); (G.V.)
| | - Ioanna Alexandropoulou
- Department Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (F.K.-S.); (I.A.); (G.V.)
| | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology& Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
- Department of Kinesitherapy, Faculty of Public Health, Medical University of Sofia, 1431 Sofia, Bulgaria
| | - Gavriela Voulgaridou
- Department Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (F.K.-S.); (I.A.); (G.V.)
| | - Pantelis T. Nikolaidis
- School of Health and Caring Sciences, University of West Attica, 12243 Athens, Greece
- Correspondence:
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An Overview of Physical Exercise and Antioxidant Supplementation Influences on Skeletal Muscle Oxidative Stress. Antioxidants (Basel) 2021; 10:antiox10101528. [PMID: 34679663 PMCID: PMC8532825 DOI: 10.3390/antiox10101528] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/21/2022] Open
Abstract
One of the essential injuries caused by moderate to high-intensity and short-duration physical activities is the overproduction of reactive oxygen species (ROS), damaging various body tissues such as skeletal muscle (SM). However, ROS is easily controlled by antioxidant defense systems during low to moderate intensity and long-term exercises. In stressful situations, antioxidant supplements are recommended to prevent ROS damage. We examined the response of SM to ROS generation during exercise using an antioxidant supplement treatment strategy in this study. The findings of this review research are paradoxical due to variances in antioxidant supplements dose and duration, intensity, length, frequency, types of exercise activities, and, in general, the lack of a regular exercise and nutrition strategy. As such, further research in this area is still being felt.
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SILVA DCGD, FERREIRA FG, SANTOS TCD, ALMEIDA JNMD, ALMEIDA EDS. Dietary total antioxidant capacity and its association with anthropometric, biochemical, and functional parameters in chronic kidney disease patients on hemodialysis. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e200239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To investigate the association of dietary total antioxidant capacity with anthropometric, functional, and biochemical parameters in chronic kidney disease patients on hemodialysis. Methods This is a cross-sectional study of hemodialysis patients in Western Bahia. A structured questionnaire, three 24-hour dietary recalls, anthropometric measurements and clinical and biochemical records were used for data collection. Dietary total antioxidant capacity was estimated using 24-hour dietary recalls data. A database of ferric reducing antioxidant power values for foods was used to evaluate the dietary total antioxidant capacity. Multiple linear regression was applied to assess the relationship between dietary total antioxidant capacity and anthropometric, functional, and biochemical parameters. Results A total of 97 patients were evaluated, of which 57.7% were men and 57.7% were aged between 36 and 59 years. After adjusting for gender, education level, and socioeconomic level, inverse associations were found between dietary total antioxidant capacity and body mass index (p=0.008). Handgrip strength (p=0.037) and serum albumin concentration (p=0.047) were positively associated with dietary total antioxidant capacity. Conclusion High dietary total antioxidant capacity is associated with low body mass index, high handgrip strength, and high serum albumin concentration in chronic kidney disease patients undergoing hemodialysis.
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