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Amorese AJ, Minchew EC, Tarpey MD, Readyoff AT, Williamson NC, Schmidt CA, McMillin SL, Goldberg EJ, Terwilliger ZS, Spangenburg QA, Witczak CA, Brault JJ, Abel ED, McClung JM, Fisher-Wellman KH, Spangenburg EE. Hypoxia Resistance Is an Inherent Phenotype of the Mouse Flexor Digitorum Brevis Skeletal Muscle. Function (Oxf) 2023; 4:zqad012. [PMID: 37168496 PMCID: PMC10165545 DOI: 10.1093/function/zqad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 05/13/2023] Open
Abstract
The various functions of skeletal muscle (movement, respiration, thermogenesis, etc.) require the presence of oxygen (O2). Inadequate O2 bioavailability (ie, hypoxia) is detrimental to muscle function and, in chronic cases, can result in muscle wasting. Current therapeutic interventions have proven largely ineffective to rescue skeletal muscle from hypoxic damage. However, our lab has identified a mammalian skeletal muscle that maintains proper physiological function in an environment depleted of O2. Using mouse models of in vivo hindlimb ischemia and ex vivo anoxia exposure, we observed the preservation of force production in the flexor digitorum brevis (FDB), while in contrast the extensor digitorum longus (EDL) and soleus muscles suffered loss of force output. Unlike other muscles, we found that the FDB phenotype is not dependent on mitochondria, which partially explains the hypoxia resistance. Muscle proteomes were interrogated using a discovery-based approach, which identified significantly greater expression of the transmembrane glucose transporter GLUT1 in the FDB as compared to the EDL and soleus. Through loss-and-gain-of-function approaches, we determined that GLUT1 is necessary for the FDB to survive hypoxia, but overexpression of GLUT1 was insufficient to rescue other skeletal muscles from hypoxic damage. Collectively, the data demonstrate that the FDB is uniquely resistant to hypoxic insults. Defining the mechanisms that explain the phenotype may provide insight towards developing approaches for preventing hypoxia-induced tissue damage.
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Affiliation(s)
| | | | - Michael D Tarpey
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Andrew T Readyoff
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC 27834, USA
| | - Nicholas C Williamson
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Cameron A Schmidt
- Department of Biology, East Carolina University, Greenville, NC 27834, USA
| | - Shawna L McMillin
- Department of Kinesiology, East Carolina University, Greenville, NC 27858, USA
| | - Emma J Goldberg
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Zoe S Terwilliger
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Quincy A Spangenburg
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Carol A Witczak
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Indiana Center for Musculoskeletal Health, Indianapolis, IN 46202, USA
- Indiana Center for Diabetes and Metabolic Diseases, Indianapolis, IN 46202, USA
| | - Jeffrey J Brault
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Indiana Center for Musculoskeletal Health, Indianapolis, IN 46202, USA
| | - E Dale Abel
- David Geffen School of Medicine, Department of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Joseph M McClung
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
- Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, NC 27834, USA
| | - Kelsey H Fisher-Wellman
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
- Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
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2
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Terwilliger ZS, Ryan TE, Goldberg EJ, Schmidt CA, Yamaguchi DJ, Karnekar R, Brophy P, Green TD, Zeczycki TN, Mac Gabhann F, Annex BH, McClung JM. Racial differences in the limb skeletal muscle transcriptional programs of patients with critical limb ischemia. Vasc Med 2021; 26:247-258. [PMID: 33685287 DOI: 10.1177/1358863x20983918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Critical limb ischemia (CLI) is the most severe manifestation of peripheral artery disease (PAD) and is characterized by high rates of morbidity and mortality. As with most severe cardiovascular disease manifestations, Black individuals disproportionately present with CLI. Accordingly, there remains a clear need to better understand the reasons for this discrepancy and to facilitate personalized therapeutic options specific for this population. Gastrocnemius muscle was obtained from White and Black healthy adult volunteers and patients with CLI for whole transcriptome shotgun sequencing (WTSS) and enrichment analysis was performed to identify alterations in specific Reactome pathways. When compared to their race-matched healthy controls, both White and Black patients with CLI demonstrated similar reductions in nuclear and mitochondrial encoded genes and mitochondrial oxygen consumption across multiple substrates, indicating a common bioenergetic paradigm associated with amputation outcomes regardless of race. Direct comparisons between tissues of White and Black patients with CLI revealed hemostasis, extracellular matrix organization, platelet regulation, and vascular wall interactions to be uniquely altered in limb muscles of Black individuals. Among traditional vascular growth factor signaling targets, WTSS revealed only Tie1 to be significantly altered from White levels in Black limb muscle tissues. Quantitative reverse transcription polymerase chain reaction validation of select identified targets verified WTSS directional changes and supports reductions in MMP9 and increases in NUDT4P1 and GRIK2 as unique to limb muscles of Black patients with CLI. This represents a critical first step in better understanding the transcriptional program similarities and differences between Black and White patients in the setting of amputations related to CLI and provides a promising start for therapeutic development in this population.
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Affiliation(s)
- Zoe S Terwilliger
- Diabetes and Obesity Institute, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Department of Physiology, East Carolina University, Brody Medical Center, Greenville, NC, USA
| | - Terence E Ryan
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Emma J Goldberg
- Diabetes and Obesity Institute, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Department of Physiology, East Carolina University, Brody Medical Center, Greenville, NC, USA
| | - Cameron A Schmidt
- Diabetes and Obesity Institute, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Department of Physiology, East Carolina University, Brody Medical Center, Greenville, NC, USA
| | - Dean J Yamaguchi
- Department of Cardiovascular Sciences, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Division of Surgery, East Carolina University, Brody Medical Center, Greenville, NC, USA
| | - Reema Karnekar
- Diabetes and Obesity Institute, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Department of Physiology, East Carolina University, Brody Medical Center, Greenville, NC, USA
| | - Patricia Brophy
- Diabetes and Obesity Institute, East Carolina University, Brody Medical Center, Greenville, NC, USA
| | - Thomas D Green
- Diabetes and Obesity Institute, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Department of Physiology, East Carolina University, Brody Medical Center, Greenville, NC, USA
| | - Tonya N Zeczycki
- Diabetes and Obesity Institute, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Department of Biochemistry, East Carolina University, Brody Medical Center, Greenville, NC, USA
| | - Feilim Mac Gabhann
- Department of Biomedical Engineering and Institute for Computational Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Brian H Annex
- Department of Medicine, Medical College of Georgia, Augusta, GA, USA.,Vascular Biology Center, Medical College of Georgia, Augusta, GA, USA
| | - Joseph M McClung
- Diabetes and Obesity Institute, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Department of Physiology, East Carolina University, Brody Medical Center, Greenville, NC, USA.,Department of Cardiovascular Sciences, East Carolina University, Brody Medical Center, Greenville, NC, USA
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3
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Ryan TE, Schmidt CA, Tarpey MD, Amorese AJ, Yamaguchi DJ, Goldberg EJ, Iñigo MM, Karnekar R, O'Rourke A, Ervasti JM, Brophy P, Green TD, Neufer PD, Fisher-Wellman K, Spangenburg EE, McClung JM. PFKFB3-mediated glycolysis rescues myopathic outcomes in the ischemic limb. JCI Insight 2020; 5:139628. [PMID: 32841216 PMCID: PMC7526546 DOI: 10.1172/jci.insight.139628] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022] Open
Abstract
Compromised muscle mitochondrial metabolism is a hallmark of peripheral arterial disease, especially in patients with the most severe clinical manifestation - critical limb ischemia (CLI). We asked whether inflexibility in metabolism is critical for the development of myopathy in ischemic limb muscles. Using Polg mtDNA mutator (D257A) mice, we reveal remarkable protection from hind limb ischemia (HLI) due to a unique and beneficial adaptive enhancement of glycolytic metabolism and elevated ischemic muscle PFKFB3. Similar to the relationship between mitochondria from CLI and claudicating patient muscles, BALB/c muscle mitochondria are uniquely dysfunctional after HLI onset as compared with the C57BL/6 (BL6) parental strain. AAV-mediated overexpression of PFKFB3 in BALB/c limb muscles improved muscle contractile function and limb blood flow following HLI. Enrichment analysis of RNA sequencing data on muscle from CLI patients revealed a unique deficit in the glucose metabolism Reactome. Muscles from these patients express lower PFKFB3 protein, and their muscle progenitor cells possess decreased glycolytic flux capacity in vitro. Here, we show supplementary glycolytic flux as sufficient to protect against ischemic myopathy in instances where reduced blood flow-related mitochondrial function is compromised preclinically. Additionally, our data reveal reduced glycolytic flux as a common characteristic of the failing CLI patient limb skeletal muscle.
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Affiliation(s)
- Terence E Ryan
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | - Cameron A Schmidt
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | - Michael D Tarpey
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | - Adam J Amorese
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | - Dean J Yamaguchi
- Department of Cardiovascular Science, and.,Division of Surgery, East Carolina University, Brody School of Medicine, Greenville, North Carolina, USA
| | - Emma J Goldberg
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | - Melissa Mr Iñigo
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | - Reema Karnekar
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | - Allison O'Rourke
- Department of Biochemistry, Molecular Biology and Biophysics, College of Biological Sciences, University of Minnesota, Saint Paul, Minnesota, USA
| | - James M Ervasti
- Department of Biochemistry, Molecular Biology and Biophysics, College of Biological Sciences, University of Minnesota, Saint Paul, Minnesota, USA
| | | | - Thomas D Green
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | - P Darrell Neufer
- East Carolina Diabetes and Obesity Institute.,Department of Physiology
| | | | | | - Joseph M McClung
- East Carolina Diabetes and Obesity Institute.,Department of Physiology.,Department of Cardiovascular Science, and
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4
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Schmidt CA, Goldberg EJ, Green TD, Karnekar RR, Brault JJ, Miller SG, Amorese AJ, Yamaguchi DJ, Spangenburg EE, McClung JM. Effects of fasting on isolated murine skeletal muscle contractile function during acute hypoxia. PLoS One 2020; 15:e0225922. [PMID: 32324778 PMCID: PMC7179920 DOI: 10.1371/journal.pone.0225922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/03/2020] [Indexed: 11/19/2022] Open
Abstract
Stored muscle carbohydrate supply and energetic efficiency constrain muscle functional capacity during exercise and are influenced by common physiological variables (e.g. age, diet, and physical activity level). Whether these constraints affect overall functional capacity or the timing of muscle energetic failure during acute hypoxia is not known. We interrogated skeletal muscle contractile properties in two anatomically distinct rodent hindlimb muscles that have well characterized differences in energetic efficiency (locomotory- extensor digitorum longus (EDL) and postural- soleus muscles) following a 24 hour fasting period that resulted in substantially reduced muscle carbohydrate supply. 180 mins of acute hypoxia resulted in complete energetic failure in all muscles tested, indicated by: loss of force production, substantial reductions in total adenosine nucleotide pool intermediates, and increased adenosine nucleotide degradation product-inosine monophosphate (IMP). These changes occurred in the absence of apparent myofiber structural damage assessed histologically by both transverse section and whole mount. Fasting and the associated reduction of the available intracellular carbohydrate pool (~50% decrease in skeletal muscle) did not significantly alter the timing to muscle functional impairment or affect the overall force/work capacities of either muscle type. Fasting resulted in greater passive tension development in both muscle types, which may have implications for the design of pre-clinical studies involving optimal timing of reperfusion or administration of precision therapeutics.
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Affiliation(s)
- Cameron A. Schmidt
- Dept. of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States of America
| | - Emma J. Goldberg
- Dept. of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States of America
| | - Tom D. Green
- Dept. of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States of America
| | - Reema R. Karnekar
- Dept. of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States of America
| | - Jeffrey J. Brault
- Dept. of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- Dept. of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Spencer G. Miller
- Dept. of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Adam J. Amorese
- Dept. of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States of America
| | - Dean J. Yamaguchi
- Department of Cardiovascular Sciences, East Carolina University, Greenville, North Carolina, United States of America
- Division of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Espen E. Spangenburg
- Dept. of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States of America
| | - Joseph M. McClung
- Dept. of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, United States of America
- Department of Cardiovascular Sciences, East Carolina University, Greenville, North Carolina, United States of America
- * E-mail:
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5
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Goldberg EJ, Schmidt CA, Green TD, Karnekar R, Yamaguchi DJ, Spangenberg EE, McClung JM. Temporal Association Between Ischemic Muscle Perfusion Recovery and the Restoration of Muscle Contractile Function After Hindlimb Ischemia. Front Physiol 2019; 10:804. [PMID: 31316393 PMCID: PMC6611152 DOI: 10.3389/fphys.2019.00804] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/06/2019] [Indexed: 12/15/2022] Open
Abstract
During incomplete skeletal muscle recovery from ischemia, such as that occurs with critical limb ischemia, the temporal relationship between recovery of muscle capillary perfusion and contractile function is poorly defined. We examined this relationship in BALB/cJ mice (N = 24) following unilateral hindlimb ischemia (HLI), which pre-clinically mimics the myopathy observed in critical limb ischemia patients. Specifically, we examined this relationship in two phenotypically distinct muscles (i.e., "oxidative" soleus - Sol and "glycolytic" extensor digitorum longus - EDL) 14- or 56-days after HLI. Although overall limb blood flow (LDPI) reached its' recovery peak (48% of control) by HLI d14, the capillary networks in both the Sol and EDL (whole mount confocal imaging) were disrupted and competent muscle capillary perfusion (perfused lectin+μm2/muscle μm2) remained reduced. Interestingly, both Sol and EDL muscles recovered their distinct capillary structures and perfusion (Con Sol; 0.056 ± 0.02 lectin+μm2/muscle μm2, and Con EDL; 0.039 ± 0.005 lectin+μm2/muscle μm2) by HLI d56 (Sol; 0.062 ± 0.011 lectin+μm2/muscle μm2 and EDL; 0.0035 ± 0.005 lectin+μm2/muscle μm2), despite no further improvement in limb blood flow (LDPI). Both muscles suffered severe myopathy, indicated by loss of dystrophin positive immunostaining and the absence of stimulation induced isometric force production at HLI d14. Dystrophin immunofluorescence returned at HLI d56, although neither myofiber CSA (μm2) nor isometric force production (58 and 28% sustained deficits, Sol and EDL, respectively) recovered completely in either muscle. In summary, we reveal that the temporal relationship between the restoration of muscle capillary perfusion and functional ischemic skeletal muscle regeneration favors competent muscle capillary perfusion recovery in BALB/c mice in a phenotypically non-distinct manner.
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Affiliation(s)
- Emma J Goldberg
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, United States.,East Carolina Diabetes and Obesity Institute, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Cameron A Schmidt
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, United States.,East Carolina Diabetes and Obesity Institute, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - T D Green
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, United States.,East Carolina Diabetes and Obesity Institute, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - R Karnekar
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, United States.,East Carolina Diabetes and Obesity Institute, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - D J Yamaguchi
- Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, United States.,Division of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - E E Spangenberg
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, United States.,East Carolina Diabetes and Obesity Institute, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Joseph M McClung
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, NC, United States.,East Carolina Diabetes and Obesity Institute, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, United States.,Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, United States
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6
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Ryan TE, Yamaguchi DJ, Schmidt CA, Zeczycki TN, Shaikh SR, Brophy P, Green TD, Tarpey MD, Karnekar R, Goldberg EJ, Sparagna GC, Torres MJ, Annex BH, Neufer PD, Spangenburg EE, McClung JM. Extensive skeletal muscle cell mitochondriopathy distinguishes critical limb ischemia patients from claudicants. JCI Insight 2018; 3:123235. [PMID: 30385731 DOI: 10.1172/jci.insight.123235] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 10/02/2018] [Indexed: 12/31/2022] Open
Abstract
The most severe manifestation of peripheral arterial disease (PAD) is critical limb ischemia (CLI). CLI patients suffer high rates of amputation and mortality; accordingly, there remains a clear need both to better understand CLI and to develop more effective treatments. Gastrocnemius muscle was obtained from 32 older (51-84 years) non-PAD controls, 27 claudicating PAD patients (ankle-brachial index [ABI] 0.65 ± 0.21 SD), and 19 CLI patients (ABI 0.35 ± 0.30 SD) for whole transcriptome sequencing and comprehensive mitochondrial phenotyping. Comparable permeabilized myofiber mitochondrial function was paralleled by both similar mitochondrial content and related mRNA expression profiles in non-PAD control and claudicating patient tissues. Tissues from CLI patients, despite being histologically intact and harboring equivalent mitochondrial content, presented a unique bioenergetic signature. This signature was defined by deficits in permeabilized myofiber mitochondrial function and a unique pattern of both nuclear and mitochondrial encoded gene suppression. Moreover, isolated muscle progenitor cells retained both mitochondrial functional deficits and gene suppression observed in the tissue. These findings indicate that muscle tissues from claudicating patients and non-PAD controls were similar in both their bioenergetics profile and mitochondrial phenotypes. In contrast, CLI patient limb skeletal muscles harbor a unique skeletal muscle mitochondriopathy that represents a potentially novel therapeutic site for intervention.
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Affiliation(s)
- Terence E Ryan
- Department of Physiology.,East Carolina Diabetes and Obesity Institute
| | | | - Cameron A Schmidt
- Department of Physiology.,East Carolina Diabetes and Obesity Institute
| | - Tonya N Zeczycki
- East Carolina Diabetes and Obesity Institute.,Department of Biochemistry and Molecular Biology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Saame Raza Shaikh
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Thomas D Green
- Department of Physiology.,East Carolina Diabetes and Obesity Institute
| | - Michael D Tarpey
- Department of Physiology.,East Carolina Diabetes and Obesity Institute
| | - Reema Karnekar
- Department of Physiology.,East Carolina Diabetes and Obesity Institute
| | - Emma J Goldberg
- Department of Physiology.,East Carolina Diabetes and Obesity Institute
| | | | | | - Brian H Annex
- Division of Cardiovascular Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - P Darrell Neufer
- Department of Physiology.,East Carolina Diabetes and Obesity Institute
| | | | - Joseph M McClung
- Department of Physiology.,East Carolina Diabetes and Obesity Institute.,Department of Cardiovascular Sciences
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7
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Schmidt CA, Amorese AJ, Ryan TE, Goldberg EJ, Tarpey MD, Green TD, Karnekar RR, Yamaguchi DJ, Spangenburg EE, McClung JM. Strain-Dependent Variation in Acute Ischemic Muscle Injury. Am J Pathol 2018; 188:1246-1262. [PMID: 29454751 DOI: 10.1016/j.ajpath.2018.01.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/15/2017] [Accepted: 01/11/2018] [Indexed: 12/19/2022]
Abstract
Limited efficacy of clinical interventions for peripheral arterial disease necessitates a better understanding of the environmental and genetic determinants of tissue pathology. Existing research has largely ignored the early skeletal muscle injury response during hind limb ischemia (HLI). We compared the hind limb muscle response, after 6 hours of ischemia, in two mouse strains that differ dramatically in their postischemic extended recovery: C57BL/6J and BALB/cJ. Perfusion, measured by laser Doppler and normalized to the control limb, differed only slightly between strains after HLI (<12% across all measures). Similar (<10%) effect sizes in lectin-perfused vessel area and no differences in tissue oxygen saturation measured by reflectance spectroscopy were also found. Muscles from both strains were functionally impaired after HLI, but greater muscle necrosis and loss of dystrophin-positive immunostaining were observed in BALB/cJ muscle compared with C57BL/6J. Muscle cell-specific dystrophin loss and reduced viability were also detected in additional models of ischemia that were independent of residual perfusion differences. Our results indicate that factors other than the completeness of ischemia alone (ie, background genetics) influence the magnitude of acute ischemic muscle injury. These findings may have implications for future development of therapeutic interventions for limb ischemia and for understanding the phasic etiology of chronic and acute ischemic muscle pathophysiology.
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Affiliation(s)
- Cameron A Schmidt
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina
| | - Adam J Amorese
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina
| | - Terence E Ryan
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina
| | - Emma J Goldberg
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina
| | - Michael D Tarpey
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina
| | - Thomas D Green
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina
| | - Reema R Karnekar
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina
| | - Dean J Yamaguchi
- Department of Cardiovascular Sciences, East Carolina University, Greenville, North Carolina; Division of Vascular Surgery, East Carolina University, Greenville, North Carolina
| | - Espen E Spangenburg
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina
| | - Joseph M McClung
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina; East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina; Department of Cardiovascular Sciences, East Carolina University, Greenville, North Carolina.
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8
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Goldberg EJ, Abraham E, Siegel I. The surgical treatment of chronic lateral humeral epicondylitis by common extensor release. Clin Orthop Relat Res 1988:208-12. [PMID: 3402125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This retrospective study reports on the surgical treatment of chronic lateral epicondylitis. Thirty-four elbows were followed for an average of four years after surgery. Only those patients with persistent or recurrent local pain and muscle weakness, nonresponsive to conservative measures for at least six months, were considered for surgery. A complete release of the common extensor tendon permitted about a 1-cm distal muscle slide to a new resting length. The results indicate 73% excellent, 18% good, and 9% failures. Complete pain relief was obtained in 25 of 34 (73%) elbows, and eight of 33 (24%) had minimal residual symptoms that did not impair activity. There was no loss of range of motion in any patient, and 33 of 34 (97%) elbows had improved extremity muscle strength. All but one patient (97%) returned to their regular jobs on the average of five weeks after surgery. The gross and histologic findings were consistent with a degenerative process. This relatively simple outpatient procedure using Bier block anesthesia is recommended for carefully selected patients.
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Affiliation(s)
- E J Goldberg
- University of Illinois, Department of Orthopaedics, Chicago, Illinois 60680
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