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Sonkodi B. Commentary: Effects of combined treatment with transcranial and peripheral electromagnetic stimulation on performance and pain recovery from delayed onset muscle soreness induced by eccentric exercise in young athletes. A randomized clinical trial. Front Physiol 2024; 15:1380261. [PMID: 38798879 PMCID: PMC11116897 DOI: 10.3389/fphys.2024.1380261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Balázs Sonkodi
- Department of Health Sciences and Sport Medicine, Hungarian University of Sports Science, Budapest, Hungary
- Department of Sports Medicine, Semmelweis University, Budapest, Hungary
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Oppitz LR, Arantes ACM, Garanhani RR, Costa CA, Araujo CMD, Tanaka OM, Andreis PKDS, Schappo C, Ignácio SA, Johann ACBR, Rached RN, Camargo ES. Efficiency of mixed and rigid occlusal stabilization splints: Randomized clinical trial. Braz Oral Res 2024; 38:e017. [PMID: 38477803 DOI: 10.1590/1807-3107bor-2024.vol38.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/13/2023] [Indexed: 03/14/2024] Open
Abstract
Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.
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Affiliation(s)
- Layza Rossatto Oppitz
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Ana Carolina Mastriani Arantes
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | | | - Carlos Alberto Costa
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | | | - Orlando Motohiro Tanaka
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Patricia Kern di Scala Andreis
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Undergraduate Program in Dentistry, Curitiba, PR, Brazil
| | - Claudia Schappo
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Sérgio Aparecido Ignácio
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Aline Cristina Batista Rodrigues Johann
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Rodrigo Nunes Rached
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Elisa Souza Camargo
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
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3
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Keriven H, Sánchez Sierra A, González de-la-Flor Á, García-Arrabé M, Bravo-Aguilar M, de la Plaza San Frutos M, Garcia-Perez-de-Sevilla G, Tornero-Aguilera JF, Clemente-Suarez VJ, Domínguez-Balmaseda D. Effects of combined treatment with transcranial and peripheral electromagnetic stimulation on performance and pain recovery from delayed onset muscle soreness induced by eccentric exercise in young athletes. A randomized clinical trial. Front Physiol 2023; 14:1267315. [PMID: 37900951 PMCID: PMC10603222 DOI: 10.3389/fphys.2023.1267315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Background: There is a common interest in finding a common consensus in the approach of athletes suffering from DOMS with the aim of accelerating recovery and thereby enhancing performance. The objective of this study was to observe the effects of a paired-associative transcranial and peripheral electromagnetic stimulation on young athletes suffering from DOMS, induced by 1 h of eccentric and plyometric exercises. Methods: Forty-eight young athletes participated in this randomized control trial: 13 were assigned to the peripheral group (P); 12 were in the control group (Cont); 11 were assigned to the transcranial group (T) and 12 were included in the paired-associative group (Comb). The Visual Analogue Scale (VAS) of pain perception and the mechanical Pressure Pain Threshold (PPT) were the tools used to analyze the symptoms of DOMS. On the other hand, the Half Squat (HS) test evaluated with an accelerometer, and the 30 m sprint velocity (30-mSP) test were used to observe the evolution of the sports performance of the lower limbs. All evaluations were performed before and after the eccentric exercise session that caused DOMS, as well as at 24-48, and 72 h afterward. Results: The AS group improved the symptoms of the induced DOMS, since significant positive differences were observed in the VAS and PPT compared to the other groups (p < 0.001). In addition, the AS group showed a significant improvement in the HS and the 30-mSP tests (p < 0.001). Based on the results a treatment with both peripheral and transcranial electromagnetic stimulation improves recovery and performance in athletes at 72 h, although these data would need to be verified in future research with a larger sample size. Conclusion: Paired-associative electromagnetic stimulation improved DOMS symptomatology, velocity, and sports performance in the lower limbs.
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Affiliation(s)
- Hugo Keriven
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Alberto Sánchez Sierra
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Faculty of Phisioterapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
- Toledo Physiotherapy Research Group (GIFTO), Madrid, Spain
| | - Ángel González de-la-Flor
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - María García-Arrabé
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - María Bravo-Aguilar
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Marta de la Plaza San Frutos
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Guillermo Garcia-Perez-de-Sevilla
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Jose Francisco Tornero-Aguilera
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Vicente Javier Clemente-Suarez
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Diego Domínguez-Balmaseda
- Department of Physiotherapy, Faculty of Sports Sciences, Therapeutic Exercise and Fucntional Rehabiltiation Research Group, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Masmicrobiota Group, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, Spain
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Badiola-Mateos M, Osaki T, Kamm RD, Samitier J. In vitro modelling of human proprioceptive sensory neurons in the neuromuscular system. Sci Rep 2022; 12:21318. [PMID: 36494423 PMCID: PMC9734133 DOI: 10.1038/s41598-022-23565-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 11/02/2022] [Indexed: 12/13/2022] Open
Abstract
Proprioceptive sensory neurons (pSN) are an essential and undervalued part of the neuromuscular circuit. A protocol to differentiate healthy and amyotrophic lateral sclerosis (ALS) human neural stem cells (hNSC) into pSN, and their comparison with the motor neuron (MN) differentiation process from the same hNSC sources, facilitated the development of in vitro co-culture platforms. The obtained pSN spheroids cultured interact with human skeletal myocytes showing the formation of annulospiral wrapping-like structures between TrkC + neurons and a multinucleated muscle fibre, presenting synaptic bouton-like structures in the contact point. The comparative analysis of the genetic profile performed in healthy and sporadic ALS hNSC differentiated to pSN suggested that basal levels of ETV1, critical for motor feedback from pSN, were much lower for ALS samples and that the differences between healthy and ALS samples, suggest the involvement of pSN in ALS pathology development and progression.
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Affiliation(s)
- Maider Badiola-Mateos
- grid.424736.00000 0004 0536 2369Institute for Bioengineering of Catalonia (IBEC)—Barcelona Institute of Science and Technology, 08028 Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Electronic and Biomedical Engineering, Universitat de Barcelona, 08028 Barcelona, Spain ,grid.116068.80000 0001 2341 2786Department of Biological Engineering, Massachusetts Institute of Technology (MIT), 500 Technology Square, MIT Building, Cambridge, MA 02139 USA ,grid.263145.70000 0004 1762 600XPresent Address: The BioRobotics Institute, Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Tatsuya Osaki
- grid.116068.80000 0001 2341 2786Department of Biological Engineering, Massachusetts Institute of Technology (MIT), 500 Technology Square, MIT Building, Cambridge, MA 02139 USA ,grid.26999.3d0000 0001 2151 536XPresent Address: Institute of Industrial Science, The University of Tokyo, 4-6-1, Komaba, Meguro-Ku, Tokyo, 153-8505 Japan
| | - Roger Dale Kamm
- grid.116068.80000 0001 2341 2786Department of Biological Engineering, Massachusetts Institute of Technology (MIT), 500 Technology Square, MIT Building, Cambridge, MA 02139 USA ,grid.116068.80000 0001 2341 2786Department of Mechanical Engineering, Massachusetts Institute of Technology, 500 Technology Square, MIT Building, Cambridge, MA 02139 USA
| | - Josep Samitier
- grid.424736.00000 0004 0536 2369Institute for Bioengineering of Catalonia (IBEC)—Barcelona Institute of Science and Technology, 08028 Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Electronic and Biomedical Engineering, Universitat de Barcelona, 08028 Barcelona, Spain ,grid.512890.7Centro de Investigación Biomédica en Red (CIBER-BBN), 28029 Madrid, Spain
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Lynch E, Peek E, Reilly M, FitzGibbons C, Robertson S, Suzuki M. Current Progress in the Creation, Characterization, and Application of Human Stem Cell-derived in Vitro Neuromuscular Junction Models. Stem Cell Rev Rep 2022; 18:768-780. [PMID: 34212303 PMCID: PMC8720113 DOI: 10.1007/s12015-021-10201-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 02/03/2023]
Abstract
Human pluripotent stem cells (PSCs) such as embryonic stem cells (ESCs) or induced pluripotent stem cells (iPSCs) are of great value for studying developmental processes, disease modeling, and drug testing. One area in which the use of human PSCs has become of great interest in recent years is for in vitro models of the neuromuscular junction (NMJ). The NMJ is a synapse at which a motor neuron releases acetylcholine to bind to skeletal muscle and stimulate contraction. Degeneration of the NMJ and subsequent loss of muscle function is a common feature of many neuromuscular diseases such as myasthenia gravis, spinal muscular atrophy, and amyotrophic lateral sclerosis. In order to develop new therapies for patients with neuromuscular diseases, it is essential to understand mechanisms taking place at the NMJ. However, we have limited ability to study the NMJ in living human patients, and animal models are limited by physiological relevance. Therefore, an in vitro model of the NMJ consisting of human cells is of great value. The use of stem cells for in vitro NMJ models is still in progress and requires further optimization in order to yield reliable, reproducible results. The objective of this review is (1) to outline the current progress towards fully PSC-derived in vitro co-culture models of the human NMJ and (2) to discuss future directions and challenges that must be overcome in order to create reproducible fully PSC-derived models that can be used for developmental studies, disease modeling, and drug testing.
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Affiliation(s)
- Eileen Lynch
- Department of Comparative Biosciences, University of Wisconsin-Madison, Wisconsin, USA
| | - Emma Peek
- Department of Comparative Biosciences, University of Wisconsin-Madison, Wisconsin, USA
| | - Megan Reilly
- Department of Comparative Biosciences, University of Wisconsin-Madison, Wisconsin, USA
| | - Claire FitzGibbons
- Department of Comparative Biosciences, University of Wisconsin-Madison, Wisconsin, USA
| | - Samantha Robertson
- Department of Comparative Biosciences, University of Wisconsin-Madison, Wisconsin, USA
| | - Masatoshi Suzuki
- Department of Comparative Biosciences, University of Wisconsin-Madison, Wisconsin, USA,Stem Cell and Regenerative Medicine Center, University of Wisconsin-Madison, Wisconsin, USA
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Barrett P, Quick TJ, Mudera V, Player DJ. Neuregulin 1 Drives Morphological and Phenotypical Changes in C2C12 Myotubes: Towards De Novo Formation of Intrafusal Fibres In Vitro. Front Cell Dev Biol 2022; 9:760260. [PMID: 35087826 PMCID: PMC8787273 DOI: 10.3389/fcell.2021.760260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Muscle spindles are sensory organs that detect and mediate both static and dynamic muscle stretch and monitor muscle position, through a specialised cell population, termed intrafusal fibres. It is these fibres that provide a key contribution to proprioception and muscle spindle dysfunction is associated with multiple neuromuscular diseases, aging and nerve injuries. To date, there are few publications focussed on de novo generation and characterisation of intrafusal muscle fibres in vitro. To this end, current models of skeletal muscle focus on extrafusal fibres and lack an appreciation for the afferent functions of the muscle spindle. The goal of this study was to produce and define intrafusal bag and chain myotubes from differentiated C2C12 myoblasts, utilising the addition of the developmentally associated protein, Neuregulin 1 (Nrg-1). Intrafusal bag myotubes have a fusiform shape and were assigned using statistical morphological parameters. The model was further validated using immunofluorescent microscopy and western blot analysis, directed against an extensive list of putative intrafusal specific markers, as identified in vivo. The addition of Nrg-1 treatment resulted in a 5-fold increase in intrafusal bag myotubes (as assessed by morphology) and increased protein and gene expression of the intrafusal specific transcription factor, Egr3. Surprisingly, Nrg-1 treated myotubes had significantly reduced gene and protein expression of many intrafusal specific markers and showed no specificity towards intrafusal bag morphology. Another novel finding highlights a proliferative effect for Nrg-1 during the serum starvation-initiated differentiation phase, leading to increased nuclei counts, paired with less myotube area per myonuclei. Therefore, despite no clear collective evidence for specific intrafusal development, Nrg-1 treated myotubes share two inherent characteristics of intrafusal fibres, which contain increased satellite cell numbers and smaller myonuclear domains compared with their extrafusal neighbours. This research represents a minimalistic, monocellular C2C12 model for progression towards de novo intrafusal skeletal muscle generation, with the most extensive characterisation to date. Integration of intrafusal myotubes, characteristic of native, in vivo intrafusal skeletal muscle into future biomimetic tissue engineered models could provide platforms for developmental or disease state studies, pre-clinical screening, or clinical applications.
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Affiliation(s)
- Philip Barrett
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Tom J Quick
- Peripheral Nerve Injury Research Unit, Royal National Orthopaedic Hospital, London, United Kingdom.,UCL Centre for Nerve Engineering, University College London, London, United Kingdom
| | - Vivek Mudera
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Darren J Player
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
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Moyle LA, Davoudi S, Gilbert PM. Innovation in culture systems to study muscle complexity. Exp Cell Res 2021; 411:112966. [PMID: 34906582 DOI: 10.1016/j.yexcr.2021.112966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/31/2021] [Accepted: 12/04/2021] [Indexed: 11/19/2022]
Abstract
Endogenous skeletal muscle development, regeneration, and pathology are extremely complex processes, influenced by local and systemic factors. Unpinning how these mechanisms function is crucial for fundamental biology and to develop therapeutic interventions for genetic disorders, but also conditions like sarcopenia and volumetric muscle loss. Ex vivo skeletal muscle models range from two- and three-dimensional primary cultures of satellite stem cell-derived myoblasts grown alone or in co-culture, to single muscle myofibers, myobundles, and whole tissues. Together, these systems provide the opportunity to gain mechanistic insights of stem cell behavior, cell-cell interactions, and mature muscle function in simplified systems, without confounding variables. Here, we highlight recent advances (published in the last 5 years) using in vitro primary cells and ex vivo skeletal muscle models, and summarize the new insights, tools, datasets, and screening methods they have provided. Finally, we highlight the opportunity for exponential advance of skeletal muscle knowledge, with spatiotemporal resolution, that is offered by guiding the study of muscle biology and physiology with in silico modelling and implementing high-content cell biology systems and ex vivo physiology platforms.
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Affiliation(s)
- Louise A Moyle
- Institute of Biomedical Engineering, Toronto, ON, M5S 3G9, Canada; Donnelly Centre for Cellular and Biomolecular Research, Toronto, ON, M5S 3E1, Canada
| | - Sadegh Davoudi
- Institute of Biomedical Engineering, Toronto, ON, M5S 3G9, Canada; Donnelly Centre for Cellular and Biomolecular Research, Toronto, ON, M5S 3E1, Canada
| | - Penney M Gilbert
- Institute of Biomedical Engineering, Toronto, ON, M5S 3G9, Canada; Donnelly Centre for Cellular and Biomolecular Research, Toronto, ON, M5S 3E1, Canada; Department of Cell and Systems Biology, University of Toronto, Toronto, ON, M5S 1A8, Canada.
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8
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Khodabukus A. Tissue-Engineered Skeletal Muscle Models to Study Muscle Function, Plasticity, and Disease. Front Physiol 2021; 12:619710. [PMID: 33716768 PMCID: PMC7952620 DOI: 10.3389/fphys.2021.619710] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/25/2021] [Indexed: 12/20/2022] Open
Abstract
Skeletal muscle possesses remarkable plasticity that permits functional adaptations to a wide range of signals such as motor input, exercise, and disease. Small animal models have been pivotal in elucidating the molecular mechanisms regulating skeletal muscle adaptation and plasticity. However, these small animal models fail to accurately model human muscle disease resulting in poor clinical success of therapies. Here, we review the potential of in vitro three-dimensional tissue-engineered skeletal muscle models to study muscle function, plasticity, and disease. First, we discuss the generation and function of in vitro skeletal muscle models. We then discuss the genetic, neural, and hormonal factors regulating skeletal muscle fiber-type in vivo and the ability of current in vitro models to study muscle fiber-type regulation. We also evaluate the potential of these systems to be utilized in a patient-specific manner to accurately model and gain novel insights into diseases such as Duchenne muscular dystrophy (DMD) and volumetric muscle loss. We conclude with a discussion on future developments required for tissue-engineered skeletal muscle models to become more mature, biomimetic, and widely utilized for studying muscle physiology, disease, and clinical use.
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Affiliation(s)
- Alastair Khodabukus
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
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9
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Abstract
The muscle spindle is an important sense organ for motor control and proprioception. Specialized intrafusal fibers are innervated by both stretch sensitive afferents and γ motor neurons that control the length of the spindle and tune the sensitivity of the muscle spindle afferents to both dynamic movement and static length. γ motor neurons share many similarities with other skeletal motor neurons, making it challenging to identify and specifically record or stimulate them. This short review will discuss recent advances in genetic and molecular biology techniques, electrophysiological recording, optical imaging, computer modelling, and stem cell culture techniques that have the potential to help answer important questions about fusimotor function in motor control and disease.
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10
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Barrett P, Quick TJ, Mudera V, Player DJ. Generating intrafusal skeletal muscle fibres in vitro: Current state of the art and future challenges. J Tissue Eng 2020; 11:2041731420985205. [PMID: 34956586 PMCID: PMC8693220 DOI: 10.1177/2041731420985205] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/12/2020] [Indexed: 01/18/2023] Open
Abstract
Intrafusal fibres are a specialised cell population in skeletal muscle, found within the muscle spindle. These fibres have a mechano-sensory capacity, forming part of the monosynaptic stretch-reflex arc, a key component responsible for proprioceptive function. Impairment of proprioception and associated dysfunction of the muscle spindle is linked with many neuromuscular diseases. Research to-date has largely been undertaken in vivo or using ex vivo preparations. These studies have provided a foundation for our understanding of muscle spindle physiology, however, the cellular and molecular mechanisms which underpin physiological changes are yet to be fully elucidated. Therefrom, the use of in vitro models has been proposed, whereby intrafusal fibres can be generated de novo. Although there has been progress, it is predominantly a developing and evolving area of research. This narrative review presents the current state of art in this area and proposes the direction of future work, with the aim of providing novel pre-clinical and clinical applications.
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Affiliation(s)
- Philip Barrett
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Tom J Quick
- Peripheral Nerve Injury Research Unit, Royal National Orthopaedic Hospital, Stanmore, UK
- UCL Centre for Nerve Engineering, University College London, London, UK
| | - Vivek Mudera
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Darren J Player
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
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11
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The intensity of awake bruxism episodes is increased in individuals with high trait anxiety. Clin Oral Investig 2020; 25:3197-3206. [PMID: 33098032 DOI: 10.1007/s00784-020-03650-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/16/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Trait anxiety is associated with an increased occurrence of awake bruxism episodes, a behavior characterized by clenching of the teeth contributing to temporomandibular disorders in some individuals. Here we measured the activity of the masseter and the intensity and duration of spontaneous wake-time tooth clenching episodes in healthy individuals with different levels of trait anxiety (TA). MATERIALS AND METHODS Two hundred fifty-five individuals completed a web survey. Using their TA scores, we allocated them in low (< 20th percentile of the TA score distribution), intermediate (between 20th and 80th ), and high (> 80th) TA groups. We analyzed the electromyographic (EMG) activity of the right masseter during a 15-min silent reading task in forty-three individuals with low (n = 12), intermediate (n = 17), and high TA (n = 14). We tested between-group differences in EMG activity of the masseter, as well as postural activity-the muscular activity that maintains mandibular posture, and amplitude and duration of spontaneous tooth clenching episodes. RESULTS The activity of the masseter (mean ± SEM %maximum voluntary contraction/MVC) was greater in the high TA (10.23 ± 0.16%MVC) than the intermediate (8.49 ± 0.16%MVC) and low (7.97 ± 0.22%MVC) TA groups (all p < 0.001). Postural activity did not differ between groups (all p > 0.05). The EMG amplitude of tooth clenching episodes was greater in the high TA (19.97 ± 0.21 %MVC) than the intermediate (16.40 ± 0.24%MVC) and low (15.48 ± 0.38 %MVC) TA groups (all p < 0.05). The cumulative duration of clenching episodes was not different between groups (p = 0.390). CONCLUSIONS Increased TA is associated with both increased masseter muscle activity and intensity of wake-time tooth clenching episodes. CLINICAL RELEVANCE TA may contribute significantly to masticatory muscle overload.
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Colón A, Badu-Mensah A, Guo X, Goswami A, Hickman JJ. Differentiation of Intrafusal Fibers from Human Induced Pluripotent Stem Cells. ACS Chem Neurosci 2020; 11:1085-1092. [PMID: 32159941 DOI: 10.1021/acschemneuro.0c00055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Human-based "body-on-a-chip" technology provides powerful platforms in developing models for drug evaluation and disease evaluations in phenotypic models. Induced pluripotent stem cells (iPSCs) are ideal cell sources for generating different cell types for these in vitro functional systems and recapitulation of the neuromuscular reflex arc would allow for the study of patient specific neuromuscular diseases. Regarding relevant afferent (intrafusal fibers, sensory neurons) and efferent (extrafusal fibers, motoneurons) cells, in vitro differentiation of intrafusal fiber from human iPSCs has not been established. This work demonstrates a protocol for inducing an enrichment of intrafusal bag fibers from iPSCs using morphological analysis and immunocytochemistry. Phosphorylation of the ErbB2 receptors and S46 staining indicated a 3-fold increase of total intrafusal fibers further confirming the efficiency of the protocol. Integration of induced intrafusal fibers would enable more accurate reflex arc models and application of this protocol on patient iPSCs would allow for patient-specific disease modeling.
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Affiliation(s)
- Alisha Colón
- Hybrid Systems Lab, NanoScience Technology Center, University of Central Florida, 12424 Research Parkway, Suite 400, Orlando, Florida 32826, United States
| | - Agnes Badu-Mensah
- Hybrid Systems Lab, NanoScience Technology Center, University of Central Florida, 12424 Research Parkway, Suite 400, Orlando, Florida 32826, United States
| | - Xiufang Guo
- Hybrid Systems Lab, NanoScience Technology Center, University of Central Florida, 12424 Research Parkway, Suite 400, Orlando, Florida 32826, United States
| | - Arindom Goswami
- Hybrid Systems Lab, NanoScience Technology Center, University of Central Florida, 12424 Research Parkway, Suite 400, Orlando, Florida 32826, United States
| | - James J. Hickman
- Hybrid Systems Lab, NanoScience Technology Center, University of Central Florida, 12424 Research Parkway, Suite 400, Orlando, Florida 32826, United States
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13
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Have We Looked in the Wrong Direction for More Than 100 Years? Delayed Onset Muscle Soreness Is, in Fact, Neural Microdamage Rather Than Muscle Damage. Antioxidants (Basel) 2020; 9:antiox9030212. [PMID: 32150878 PMCID: PMC7139782 DOI: 10.3390/antiox9030212] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/23/2020] [Accepted: 03/03/2020] [Indexed: 12/29/2022] Open
Abstract
According to our hypothesis, delayed onset muscle soreness (DOMS) is an acute compression axonopathy of the nerve endings in the muscle spindle. It is caused by the superposition of compression when repetitive eccentric contractions are executed under cognitive demand. The acute compression axonopathy could coincide with microinjury of the surrounding tissues and is enhanced by immune-mediated inflammation. DOMS is masked by sympathetic nervous system activity at initiation, but once it subsides, a safety mode comes into play to prevent further injury. DOMS becomes manifest when the microinjured non-nociceptive sensory fibers of the muscle spindle stop inhibiting the effects of the microinjured, hyperexcited nociceptive sensory fibers, therefore providing the ‘open gate’ in the dorsal horn to hyperalgesia. Reactive oxygen species and nitric oxide play a cross-talking role in the parallel, interlinked degeneration–regeneration mechanisms of these injured tissues. We propose that the mitochondrial electron transport chain generated free radical involvement in the acute compression axonopathy. ‘Closed gate exercises’ could be of nonpharmacological therapeutic importance, because they reduce neuropathic pain in addition to having an anti-inflammatory effect. Finally, DOMS could have an important ontogenetical role by not just enhancing ability to escape danger to survive in the wild, but also triggering muscle growth.
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14
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Coln EA, Colon A, Long CJ, Sriram NN, Esch M, Prot JM, Elbrecht DH, Wang Y, Jackson M, Shuler ML, Hickman JJ. Piezoelectric BioMEMS Cantilever for Measurement of Muscle Contraction and for Actuation of Mechanosensitive Cells. MRS COMMUNICATIONS 2019; 9:1186-1192. [PMID: 33777497 PMCID: PMC7995331 DOI: 10.1557/mrc.2019.129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 09/06/2019] [Indexed: 06/12/2023]
Abstract
A piezoelectric biomedical microelectromechanical system (bioMEMS) cantilever device was designed and fabricated to act as either a sensing element for muscle tissue contraction or as an actuator to apply mechanical force to cells. The sensing ability of the piezoelectric cantilevers was shown by monitoring the electrical signal generated from the piezoelectric aluminum nitride in response to the contraction of iPSC-derived cardiomyocytes cultured on the piezoelectric cantilevers. Actuation was demonstrated by applying electrical pulses to the piezoelectric cantilever and observing bending via an optical detection method. This piezoelectric cantilever device was designed to be incorporated into body-on-a-chip systems.
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Affiliation(s)
- Elizabeth A. Coln
- Hybrid Systems Laboratory, University of Central Florida, NanoScience Technology Center, 12424 Research Parkway, Suite 400, Orlando, FL 32826
- Department of Electrical & Computer Engineering, University of Central Florida, 4328 Scorpius St., Orlando, FL 32816
| | - Alisha Colon
- Hybrid Systems Laboratory, University of Central Florida, NanoScience Technology Center, 12424 Research Parkway, Suite 400, Orlando, FL 32826
| | | | | | - Mandy Esch
- Department of Biomedical Engineering, Cornell University, Weill Hall, Ithaca, NY 14853
| | - Jean-Matthieu Prot
- Department of Biomedical Engineering, Cornell University, Weill Hall, Ithaca, NY 14853
| | - Daniel H. Elbrecht
- Hybrid Systems Laboratory, University of Central Florida, NanoScience Technology Center, 12424 Research Parkway, Suite 400, Orlando, FL 32826
| | - Ying Wang
- Department of Biomedical Engineering, Cornell University, Weill Hall, Ithaca, NY 14853
| | - Max Jackson
- Hesperos, Inc., 3259 Progress Drive #158, Orlando, FL 32826
| | - Michael L. Shuler
- Hesperos, Inc., 3259 Progress Drive #158, Orlando, FL 32826
- Department of Biomedical Engineering, Cornell University, Weill Hall, Ithaca, NY 14853
| | - James J. Hickman
- Hybrid Systems Laboratory, University of Central Florida, NanoScience Technology Center, 12424 Research Parkway, Suite 400, Orlando, FL 32826
- Department of Electrical & Computer Engineering, University of Central Florida, 4328 Scorpius St., Orlando, FL 32816
- Hesperos, Inc., 3259 Progress Drive #158, Orlando, FL 32826
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15
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Wang J, Khodabukus A, Rao L, Vandusen K, Abutaleb N, Bursac N. Engineered skeletal muscles for disease modeling and drug discovery. Biomaterials 2019; 221:119416. [PMID: 31419653 DOI: 10.1016/j.biomaterials.2019.119416] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 08/01/2019] [Accepted: 08/05/2019] [Indexed: 01/04/2023]
Abstract
Skeletal muscle is the largest organ of human body with several important roles in everyday movement and metabolic homeostasis. The limited ability of small animal models of muscle disease to accurately predict drug efficacy and toxicity in humans has prompted the development in vitro models of human skeletal muscle that fatefully recapitulate cell and tissue level functions and drug responses. We first review methods for development of three-dimensional engineered muscle tissues and organ-on-a-chip microphysiological systems and discuss their potential utility in drug discovery research and development of new regenerative therapies. Furthermore, we describe strategies to increase the functional maturation of engineered muscle, and motivate the importance of incorporating multiple tissue types on the same chip to model organ cross-talk and generate more predictive drug development platforms. Finally, we review the ability of available in vitro systems to model diseases such as type II diabetes, Duchenne muscular dystrophy, Pompe disease, and dysferlinopathy.
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Affiliation(s)
- Jason Wang
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | | | - Lingjun Rao
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Keith Vandusen
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Nadia Abutaleb
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Nenad Bursac
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.
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16
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Park D, Lee J, Chung JJ, Jung Y, Kim SH. Integrating Organs-on-Chips: Multiplexing, Scaling, Vascularization, and Innervation. Trends Biotechnol 2019; 38:99-112. [PMID: 31345572 DOI: 10.1016/j.tibtech.2019.06.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 06/18/2019] [Accepted: 06/21/2019] [Indexed: 12/29/2022]
Abstract
Organs-on-chips (OoCs) have attracted significant attention because they can be designed to mimic in vivo environments. Beyond constructing a single OoC, recent efforts have tried to integrate multiple OoCs to broaden potential applications such as disease modeling and drug discoveries. However, various challenges remain for integrating OoCs towards in vivo-like operation, such as incorporating various connections for integrating multiple OoCs. We review multiplexed OoCs and challenges they face: scaling, vascularization, and innervation. In our opinion, future OoCs will be constructed to have increased predictive power for in vivo phenomena and will ultimately become a mainstream tool for high quality biomedical and pharmaceutical research.
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Affiliation(s)
- DoYeun Park
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Jaeseo Lee
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Justin J Chung
- Biomaterials Research Center, Korea Institute of Science and Technology, 5, Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Youngmee Jung
- Biomaterials Research Center, Korea Institute of Science and Technology, 5, Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea
| | - Soo Hyun Kim
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea; Biomaterials Research Center, Korea Institute of Science and Technology, 5, Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea.
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17
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Badiola-Mateos M, Hervera A, Del Río JA, Samitier J. Challenges and Future Prospects on 3D in-vitro Modeling of the Neuromuscular Circuit. Front Bioeng Biotechnol 2018; 6:194. [PMID: 30622944 PMCID: PMC6297173 DOI: 10.3389/fbioe.2018.00194] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/27/2018] [Indexed: 12/18/2022] Open
Abstract
Movement of skeletal-muscle fibers is generated by the coordinated action of several cells taking part within the locomotion circuit (motoneurons, sensory-neurons, Schwann cells, astrocytes, microglia, and muscle-cells). Failures in any part of this circuit could impede or hinder coordinated muscle movement and cause a neuromuscular disease (NMD) or determine its severity. Studying fragments of the circuit cannot provide a comprehensive and complete view of the pathological process. We trace the historic developments of studies focused on in-vitro modeling of the spinal-locomotion circuit and how bioengineered innovative technologies show advantages for an accurate mimicking of physiological conditions of spinal-locomotion circuit. New developments on compartmentalized microfluidic culture systems (cμFCS), the use of human induced pluripotent stem cells (hiPSCs) and 3D cell-cultures are analyzed. We finally address limitations of current study models and three main challenges on neuromuscular studies: (i) mimic the whole spinal-locomotion circuit including all cell-types involved and the evaluation of independent and interdependent roles of each one; (ii) mimic the neurodegenerative response of mature neurons in-vitro as it occurs in-vivo; and (iii) develop, tune, implement, and combine cμFCS, hiPSC, and 3D-culture technologies to ultimately create patient-specific complete, translational, and reliable NMD in-vitro model. Overcoming these challenges would significantly facilitate understanding the events taking place in NMDs and accelerate the process of finding new therapies.
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Affiliation(s)
- Maider Badiola-Mateos
- Institute for Bioengineering of Catalonia-Barcelona Institute of Science and Technology, Barcelona, Spain.,Department of Electronics and Biomedical Engineering, Faculty of Physics, Universitat de Barcelona, Barcelona, Spain
| | - Arnau Hervera
- Institute for Bioengineering of Catalonia-Barcelona Institute of Science and Technology, Barcelona, Spain.,Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Barcelona, Spain.,Institut de Neurociències de la Universitat de Barcelona, Barcelona, Spain
| | - José Antonio Del Río
- Institute for Bioengineering of Catalonia-Barcelona Institute of Science and Technology, Barcelona, Spain.,Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Barcelona, Spain.,Institut de Neurociències de la Universitat de Barcelona, Barcelona, Spain
| | - Josep Samitier
- Institute for Bioengineering of Catalonia-Barcelona Institute of Science and Technology, Barcelona, Spain.,Department of Electronics and Biomedical Engineering, Faculty of Physics, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain
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18
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Qiao Y, Cong M, Li J, Li H, Li Z. The effects of neuregulin-1β on intrafusal muscle fiber formation in neuromuscular coculture of dorsal root ganglion explants and skeletal muscle cells. Skelet Muscle 2018; 8:29. [PMID: 30219099 PMCID: PMC6139134 DOI: 10.1186/s13395-018-0175-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 09/03/2018] [Indexed: 01/24/2023] Open
Abstract
Background The formation of intrafusal muscle (IM) fibers and their contact with afferent proprioceptive axons is critical for construction, function, and maintenance of the stretch reflex. Many factors affect the formation of IM fibers. Finding new factors and mechanisms of IM fiber formation is essential for the reconstruction of stretch reflex arc after injury. Methods We established a coculture system of organotypic dorsal root ganglion (DRG) explants and dissociated skeletal muscle (SKM) cells. The formation of IM fibers was observed in this coculture system after neuregulin-1β (NRG-1β) incubation. Results We found that NRG-1β promoted outgrowth of neurites and migration of neurons from the organotypic DRG explants and that this correlated with an induction of growth-associated protein 43 (GAP-43) expression. NRG-1β also increased the amount of nuclear bag fibers and nuclear chain fibers by elevating the proportion of tyrosine kinase receptor C (TrkC) phenotypic DRG neurons. In addition, we found that the effects of NRG-1β could be blocked by inhibiting ERK1/2, PI3K/Akt, and JAK2/STAT3 signaling pathways. Conclusion These data imply that NRG-1β promoted neurite outgrowth and neuronal migration from the organotypic DRG explants and that this correlated with an induction of GAP-43 expression. The modulating effects of NRG-1β on TrkC DRG neuronal phenotype may link to promote IM fiber formation. The effects produced by NRG-1β in this neuromuscular coculture system provide new data for the therapeutic potential on IM fiber formation after muscle injury. Electronic supplementary material The online version of this article (10.1186/s13395-018-0175-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuan Qiao
- Department of Anatomy, Shandong University School of Basic Medical Sciences, 44 Wenhua Xi Road, Jinan, 250012, Shandong Province, China.,Department of Orthopaedics, Shandong University Qilu Hospital, Jinan, 250012, China
| | - Menglin Cong
- Department of Orthopaedics, Shandong University Qilu Hospital, Jinan, 250012, China
| | - Jianmin Li
- Department of Orthopaedics, Shandong University Qilu Hospital, Jinan, 250012, China
| | - Hao Li
- Department of Orthopaedics, Shandong University Qilu Hospital, Jinan, 250012, China
| | - Zhenzhong Li
- Department of Anatomy, Shandong University School of Basic Medical Sciences, 44 Wenhua Xi Road, Jinan, 250012, Shandong Province, China.
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19
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Khodabukus A, Prabhu N, Wang J, Bursac N. In Vitro Tissue-Engineered Skeletal Muscle Models for Studying Muscle Physiology and Disease. Adv Healthc Mater 2018; 7:e1701498. [PMID: 29696831 PMCID: PMC6105407 DOI: 10.1002/adhm.201701498] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 02/18/2018] [Indexed: 12/18/2022]
Abstract
Healthy skeletal muscle possesses the extraordinary ability to regenerate in response to small-scale injuries; however, this self-repair capacity becomes overwhelmed with aging, genetic myopathies, and large muscle loss. The failure of small animal models to accurately replicate human muscle disease, injury and to predict clinically-relevant drug responses has driven the development of high fidelity in vitro skeletal muscle models. Herein, the progress made and challenges ahead in engineering biomimetic human skeletal muscle tissues that can recapitulate muscle development, genetic diseases, regeneration, and drug response is discussed. Bioengineering approaches used to improve engineered muscle structure and function as well as the functionality of satellite cells to allow modeling muscle regeneration in vitro are also highlighted. Next, a historical overview on the generation of skeletal muscle cells and tissues from human pluripotent stem cells, and a discussion on the potential of these approaches to model and treat genetic diseases such as Duchenne muscular dystrophy, is provided. Finally, the need to integrate multiorgan microphysiological systems to generate improved drug discovery technologies with the potential to complement or supersede current preclinical animal models of muscle disease is described.
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Affiliation(s)
- Alastair Khodabukus
- Department of Biomedical Engineering Duke University 101 Science Drive, FCIEMAS 1427, Durham, NC 27708-90281, USA
| | - Neel Prabhu
- Department of Biomedical Engineering Duke University 101 Science Drive, FCIEMAS 1427, Durham, NC 27708-90281, USA
| | - Jason Wang
- Department of Biomedical Engineering Duke University 101 Science Drive, FCIEMAS 1427, Durham, NC 27708-90281, USA
| | - Nenad Bursac
- Department of Biomedical Engineering Duke University 101 Science Drive, FCIEMAS 1427, Durham, NC 27708-90281, USA
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