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Stevanovic S, Dalmao-Fernandez A, Mohamed D, Nyman TA, Kostovski E, Iversen PO, Savikj M, Nikolic N, Rustan AC, Thoresen GH, Kase ET. Time-dependent reduction in oxidative capacity among cultured myotubes from spinal cord injured individuals. Acta Physiol (Oxf) 2024:e14156. [PMID: 38711362 DOI: 10.1111/apha.14156] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 03/27/2024] [Accepted: 04/22/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Skeletal muscle adapts in reaction to contractile activity to efficiently utilize energy substrates, primarily glucose and free fatty acids (FA). Inactivity leads to atrophy and a change in energy utilization in individuals with spinal cord injury (SCI). The present study aimed to characterize possible inactivity-related differences in the energy metabolism between skeletal muscle cells cultured from satellite cells isolated 1- and 12-months post-SCI. METHODS To characterize inactivity-related disturbances in spinal cord injury, we studied skeletal muscle cells isolated from SCI subjects. Cell cultures were established from biopsy samples from musculus vastus lateralis from subjects with SCI 1 and 12 months after the injury. The myoblasts were proliferated and differentiated into myotubes before fatty acid and glucose metabolism were assessed and gene and protein expressions were measured. RESULTS The results showed that glucose uptake was increased, while oleic acid oxidation was reduced at 12 months compared to 1 month. mRNA expressions of PPARGC1α, the master regulator of mitochondrial biogenesis, and MYH2, a determinant of muscle fiber type, were significantly reduced at 12 months. Proteomic analysis showed reduced expression of several mitochondrial proteins. CONCLUSION In conclusion, skeletal muscle cells isolated from immobilized subjects 12 months compared to 1 month after SCI showed reduced fatty acid metabolism and reduced expression of mitochondrial proteins, indicating an increased loss of oxidative capacity with time after injury.
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Affiliation(s)
- Stanislava Stevanovic
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Andrea Dalmao-Fernandez
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Derya Mohamed
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Tuula A Nyman
- Department of Immunology, Institute of Clinical Medicine, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Emil Kostovski
- Vestre Viken Hospital Trust, Drammen, Norway
- Manifestsenteret, Røyken, Norway
| | - Per Ole Iversen
- Department of Nutrition, IMB, University of Oslo, Oslo, Norway
- Department of Hematology, Oslo University Hospital, Oslo, Norway
| | - Mladen Savikj
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Natasa Nikolic
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Arild C Rustan
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - G Hege Thoresen
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
- Department of Pharmacology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eili T Kase
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, University of Oslo, Oslo, Norway
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Wouda MF, Slettahjell HB, Lundgaard E, Bastani NE, Raastad T, Blomhoff R, Kostovski E. Acute changes in antioxidants and oxidative stress to vigorous arm exercise: an intervention trial in persons with spinal cord injury and healthy controls. Spinal Cord Ser Cases 2023; 9:32. [PMID: 37443310 DOI: 10.1038/s41394-023-00590-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
STUDY DESIGN Intervention trial. BACKGROUND Literature remains unclear on possible health benefits and risks assosciated with high intensity exercise for persons with SCI. Elevated oxidative stress levels might influence their ability to exercise at high intensity. We investigated several biomarkers of oxidative stress and antioxidant defense at rest, during and after vigorous exercise among persons with chronic SCI. SETTING Sunnaas Rehabilitation Hospital, Norway. METHODS Six participants (five males) with chronic SCI (AIS A, injury level thoracic 2-8, >1 year postinjury) and six matched able-bodied controls performed two maximal arm-cranking tests, with one-three days in between. During the second exercise test, participants performed three bouts with four minutes arm cranking at high intensity (85-95% of peak heart rate (HRpeak)), before they reached maximal effort. Blood and urine biomarkers for oxidative stress and antioxidant levels were collected at six time points at the day of the second exercise test; baseline, at high intensity exercise, at maximal effort, at five, 30 and 60 min post-exercise, and 24 h post exercise. RESULTS Participants with SCI had significant lower levels of creatinine (∆16 µmol/L, p = 0.03), α-carotene (∆0.14 nmol/L, p < 0.001) and β-carotene (∆0.51 nmol/L, p = 0.001) at baseline compared to controls. Urine and blood biomarkers of oxidative stress and antioxidant levels showed similar response to vigorous exercise in the SCI and control group. CONCLUSIONS SCI participants showed similar changes in redox status during high intensity exercise compared to matched able-bodied. SCI participants had lower levels of exogen antioxidants both before, during and after vigorous exercise.
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Affiliation(s)
- Matthijs F Wouda
- Sunnaas Rehabilitation Hospital, Research department, Nesoddtangen, Norway.
| | - Hanne Bjørg Slettahjell
- Sunnaas Rehabilitation Hospital, Research department, Nesoddtangen, Norway
- University of Oslo, Department of Nutrition, Institute of Basic Medical Sciences, Oslo, Norway
| | - Eivind Lundgaard
- Sunnaas Rehabilitation Hospital, Research department, Nesoddtangen, Norway
| | - Nasser E Bastani
- University of Oslo, Department of Nutrition, Institute of Basic Medical Sciences, Oslo, Norway
| | - Truls Raastad
- Norwegian School of Sport Sciences, Department of Physical Performance, Oslo, Norway
| | - Rune Blomhoff
- University of Oslo, Department of Nutrition, Institute of Basic Medical Sciences, Oslo, Norway
- Oslo University Hospital, Department of Clinical Service, Division of Cancer Medicine, Oslo, Norway
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Jakimovska VM, Biering-Sørensen F, Lidal IB, Kostovski E. Community dwelling life- and health issues among persons living with chronic spinal cord injury in North Macedonia. Spinal Cord 2021; 60:245-250. [PMID: 34408273 DOI: 10.1038/s41393-021-00688-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES The purpose was to reveal late health consequences and life issues after a traumatic spinal cord injury (tSCI) in North Macedonia (NM). SETTING Community dwelling adults with tSCI in NM. METHODS Persons that sustained tSCI in 1999-2005 were selected, physical examined and a questionnaire was administered. Descriptive statistics were conducted. RESULTS From 203 eligible persons, 40 agreed to participate. Mean (range) age at time of injury was 36 (27-75) years and time since injury ranged 9-20 years. Around seventy percent reported current health problems, of which pain and spasm (>60%) were most prevalent, followed by urinary tract infections and pressure injuries. About 30% had never been to a medical specialist and ≈70% had only once been to physiotherapy after discharge from the primary inpatient period. Only one participant had a fully adjusted home for a person with a disability. Those with most severe tSCI (American Spinal Injury Association Impairment Scale (AIS) A, B, and C) seldom left their homes. About 50% were retired and/or unemployed, 50% were working. CONCLUSION This is the first study describing community-dwelling persons with a tSCI in NM. Our study revealed that persons with tSCI reported health issues mostly related to pain, spasms, urinary tract infections and pressure injuries. They lacked follow-ups, experienced physical barriers and poor inclusion in the society, and lacked financial support. Therefore, they were often socially isolated and fully dependent on their families. NM is in need of structured rehabilitation programs and better adaption for persons with reduced mobility.
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Affiliation(s)
| | - Fin Biering-Sørensen
- Department for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Emil Kostovski
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway. .,Manifestsenteret, Røyken, Norway.
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Savikj M, Ruby MA, Kostovski E, Iversen PO, Zierath JR, Krook A, Widegren U. Retained differentiation capacity of human skeletal muscle satellite cells from spinal cord-injured individuals. Physiol Rep 2019; 6:e13739. [PMID: 29906337 PMCID: PMC6003643 DOI: 10.14814/phy2.13739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/23/2018] [Revised: 05/16/2018] [Accepted: 05/18/2018] [Indexed: 02/07/2023] Open
Abstract
Despite the well‐known role of satellite cells in skeletal muscle plasticity, the effect of spinal cord injury on their function in humans remains unknown. We determined whether spinal cord injury affects the intrinsic ability of satellite cells to differentiate and produce metabolically healthy myotubes. We obtained vastus lateralis biopsies from eight spinal cord‐injured and six able‐bodied individuals. Satellite cells were isolated, grown and differentiated in vitro. Gene expression was measured by quantitative PCR. Abundance of differentiation markers and regulatory proteins was determined by Western blotting. Protein synthesis and fatty acid oxidation were measured by radioactive tracer‐based assays. Activated satellite cells (myoblasts) and differentiated myotubes derived from skeletal muscle of able‐bodied and spinal cord‐injured individuals expressed similar (P > 0.05) mRNA levels of myogenic regulatory factors. Myogenic differentiation factor 1 expression was higher in myoblasts from spinal cord‐injured individuals. Desmin and myogenin protein content was increased upon differentiation in both groups, while myotubes from spinal cord‐injured individuals contained more type I and II myosin heavy chain. Phosphorylated and total protein levels of Akt‐mechanistic target of rapamycin and forkhead box protein O signalling axes and protein synthesis rate in myotubes were similar (P > 0.05) between groups. Additionally, fatty acid oxidation of myotubes from spinal cord‐injured individuals was unchanged (P > 0.05) compared to able‐bodied controls. Our results indicate that the intrinsic differentiation capacity of satellite cells and metabolic characteristics of myotubes are preserved following spinal cord injury. This may inform potential interventions targeting satellite cell activation to alleviate skeletal muscle atrophy.
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Affiliation(s)
- Mladen Savikj
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Science Department, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Maxwell A Ruby
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom
| | - Emil Kostovski
- Science Department, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Per O Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Department of Haematology, Oslo University Hospital, Oslo, Norway
| | - Juleen R Zierath
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Anna Krook
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Widegren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Savikj M, Kostovski E, Lundell LS, Iversen PO, Massart J, Widegren U. Altered oxidative stress and antioxidant defence in skeletal muscle during the first year following spinal cord injury. Physiol Rep 2019; 7:e14218. [PMID: 31456346 PMCID: PMC6712236 DOI: 10.14814/phy2.14218] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 12/21/2022] Open
Abstract
Oxidative stress promotes protein degradation and apoptosis in skeletal muscle undergoing atrophy. We aimed to determine whether spinal cord injury leads to changes in oxidative stress, antioxidant capacity, and apoptotic signaling in human skeletal muscle during the first year after spinal cord injury. Vastus lateralis biopsies were obtained from seven individuals 1, 3, and 12 months after spinal cord injury and from seven able-bodied controls. Protein content of enzymes involved in reactive oxygen species production and detoxification, and apoptotic signaling were analyzed by western blot. Protein carbonylation and 4-hydroxynonenal protein adducts were measured as markers of oxidative damage. Glutathione content was determined fluorometrically. Protein content of NADPH oxidase 2, xanthine oxidase, and pro-caspase-3 was increased at 1 and 3 months after spinal cord injury compared to able-bodied controls. Furthermore, total and reduced glutathione content was increased at 1 and 3 months after spinal cord injury. Conversely, mitochondrial complexes and superoxide dismutase 2 protein content were decreased 12 months after spinal cord injury compared to able-bodied controls. In conclusion, we provide indirect evidence of increased reactive oxygen species production and increased apoptotic signaling at 1 and 3 months after spinal cord injury. Concomitant increases in glutathione antioxidant defences may reflect adaptations poised to maintain redox homeostasis in skeletal muscle following spinal cord injury.
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Affiliation(s)
| | - Emil Kostovski
- Faculty of MedicineUniversity of OsloOsloNorway
- Department of ResearchSunnaas Rehabilitation HospitalNesoddenNorway
| | - Leonidas S. Lundell
- Department of Physiology and Pharmacology, Section for Integrative PhysiologyKarolinska InstitutetStockholmSweden
| | - Per O. Iversen
- Department of Nutrition, Institute of Basic Medical SciencesUniversity of OsloOsloNorway
- Department of HaematologyOslo University HospitalOsloNorway
| | - Julie Massart
- Department of Molecular Medicine and Surgery, Section for Integrative PhysiologyKarolinska InstitutetStockholmSweden
| | - Ulrika Widegren
- Department of Molecular Medicine and Surgery, Section for Integrative PhysiologyKarolinska InstitutetStockholmSweden
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Jørgensen V, Slettahjell HB, Skavberg Roaldsen K, Kostovski E. Carboxy terminal collagen crosslinks as a prognostic risk factor for fall-related fractures in individuals with established spinal cord injury. Spinal Cord 2019; 57:985-991. [PMID: 31308468 PMCID: PMC6892418 DOI: 10.1038/s41393-019-0322-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/29/2019] [Accepted: 06/15/2019] [Indexed: 11/09/2022]
Abstract
Study design Prospective cohort study. Objective To study associations between specific bone turnover markers and fall-related fractures in individuals with spinal cord injury (SCI). Setting Rehabilitation Hospital. Methods Carboxy terminal collagen crosslinks (CTX), type-1 procollagen N-terminal (P1NP), albumin-corrected calcium (Ca2+), parathyroid hormone (PTH) and vitamin D were examined in a cohort of 106 participants with SCI at least 1 year post injury. The participants were followed for 1 year monitoring fall-related fractures. Results In total, 29 out of 106 reported having experienced a fall-related fracture post-injury at baseline, and 5 out of 100 had experienced a fall-related bone fracture during the 1 year follow-up. Our main findings were that high levels of serum CTX increased the odds of being in the fracture group, and that 25-hydroxy vitamin D (25 OHD) levels, Ca2+, PTH or P1NP were not associated with being in the fracture group. Conclusions We here present an association between high-CTX plasma levels at baseline and fall-related fractures reported during a 1-year follow-up among individuals with established SCI. We recommend studies with larger SCI populations before further clinical implications can be drawn.
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Affiliation(s)
- Vivien Jørgensen
- Department of Research, Sunnaas Rehabilitation Hospital, University of Oslo, Oslo, Norway
| | | | - Kirsti Skavberg Roaldsen
- Department of Research, Sunnaas Rehabilitation Hospital, University of Oslo, Oslo, Norway.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Emil Kostovski
- Department of Research, Sunnaas Rehabilitation Hospital, University of Oslo, Oslo, Norway
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7
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Kostovski E, Miloshevska Jakimovska V, Lidal IB, Biering-Sørensen F. Cross-sectional and prospective data-collection in North Macedonia-methodological considerations. Spinal Cord Ser Cases 2019; 5:58. [PMID: 31632716 PMCID: PMC6786405 DOI: 10.1038/s41394-019-0204-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/01/2019] [Indexed: 11/09/2022] Open
Abstract
Study design Cross-sectional and prospective cohort-study. Objectives To describe methodological issues, experienced challenges related to data collection in North Macedonia and to discuss possible improvements of epidemiological data collection in future studies. Setting Clinic for Traumatology, Orthopedics, Anesthesia, Reanimation, Intensive Care Unit and Emergency Center, Mother Teresa Skopje University Hospital, Skopje and community settings, North Macedonia. Method A description of methodological challenges experienced in collecting data from 78 persons with acute and chronic traumatic spinal cord injury (SCI) examined and interviewed in 2015-2017 using a semiquantitative questionnaire and standard assessments tools. Results This study identified three major challenges with data collection in this setting: (1) research logistics and procedures, such as recruitment, infrastructure, and compensation, (2) ethical issues and the initial lack of mutual trust and understanding between researchers and participants, and (3) scientific quality and interpretation, including representativeness. Conclusions Methodological issues influenced by settings, are important to consider when interpreting study results. Healthcare systems vary between (and sometimes in) countries, language and culture may introduce barriers to understanding, and epidemiological research also rely on infrastructure and surroundings. For this study, making time for and listening to the participants without being intruding was of special importance in building trust and a good relationship with the participants during recruiting participants and collecting data. We here provide suggestions regarding how to facilitate future epidemiological data collections in North Macedonia.
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Affiliation(s)
| | | | | | - Fin Biering-Sørensen
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Jakimovska VM, Kostovski E, Biering-Sørensen F, Lidal IB. Fractures and musculoskeletal ailments in persons 20+ years after a traumatic spinal cord injury in Norway. Spinal Cord Ser Cases 2018; 4:76. [PMID: 30131875 PMCID: PMC6092425 DOI: 10.1038/s41394-018-0102-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/08/2018] [Accepted: 06/17/2018] [Indexed: 01/12/2023] Open
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVES To gain insights into fracture rate and musculoskeletal ailments among Norwegians with a spinal cord injury (SCI) acquired more than 20 years ago. SETTINGS Sunnaas Hospital, Nesoddtangen, Norway. METHODS 165 persons with SCI were interviewed in 2004-2005 by questionnaires and clinical examination. Descriptive statistics and a logistic regression analysis were performed to identify variables associated with bone fractures and musculoskeletal ailments. RESULTS Around half of the participants experienced a fracture after injury and excessive use of alcohol increased the odds (OR 0.09; CI 0.01-0.74) of suffering a post-injury fracture (p = 0.03). Sixty percent experienced shoulder ailments after the SCI and the use of orthosis to the knee and hip increased the odds (OR 4.4; CI 1.4-13) of experiencing shoulder ailment (p = 0.01). CONCLUSION Around half of the 165 participants reported to have suffered a fracture and over 100 to experience musculoskeletal ailment 20 years after injury. We suggest that prevention strategies and symptom management must be embedded in follow-up visits after SCI.
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Affiliation(s)
| | - Emil Kostovski
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Fin Biering-Sørensen
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Lundell LS, Savikj M, Kostovski E, Iversen PO, Zierath JR, Krook A, Chibalin AV, Widegren U. Protein translation, proteolysis and autophagy in human skeletal muscle atrophy after spinal cord injury. Acta Physiol (Oxf) 2018; 223:e13051. [PMID: 29423932 DOI: 10.1111/apha.13051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 10/16/2017] [Revised: 01/17/2018] [Accepted: 01/21/2018] [Indexed: 12/14/2022]
Abstract
AIM Spinal cord injury-induced loss of skeletal muscle mass does not progress linearly. In humans, peak muscle loss occurs during the first 6 weeks postinjury, and gradually continues thereafter. The aim of this study was to delineate the regulatory events underlying skeletal muscle atrophy during the first year following spinal cord injury. METHODS Key translational, autophagic and proteolytic proteins were analysed by immunoblotting of human vastus lateralis muscle obtained 1, 3 and 12 months following spinal cord injury. Age-matched able-bodied control subjects were also studied. RESULTS Several downstream targets of Akt signalling decreased after spinal cord injury in skeletal muscle, without changes in resting Akt Ser473 and Akt Thr308 phosphorylation or total Akt protein. Abundance of mTOR protein and mTOR Ser2448 phosphorylation, as well as FOXO1 Ser256 phosphorylation and FOXO3 protein, decreased in response to spinal cord injury, coincident with attenuated protein abundance of E3 ubiquitin ligases, MuRF1 and MAFbx. S6 protein and Ser235/236 phosphorylation, as well as 4E-BP1 Thr37/46 phosphorylation, increased transiently after spinal cord injury, indicating higher levels of protein translation early after injury. Protein abundance of LC3-I and LC3-II decreased 3 months postinjury as compared with 1 month postinjury, but not compared to able-bodied control subjects, indicating lower levels of autophagy. Proteins regulating proteasomal degradation were stably increased in response to spinal cord injury. CONCLUSION Together, these data provide indirect evidence suggesting that protein translation and autophagy transiently increase, while whole proteolysis remains stably higher in skeletal muscle within the first year after spinal cord injury.
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Affiliation(s)
- L. S. Lundell
- Department of Physiology and Pharmacology; Section for Integrative Physiology; Karolinska Institutet; Stockholm Sweden
| | - M. Savikj
- Department of Physiology and Pharmacology; Section for Integrative Physiology; Karolinska Institutet; Stockholm Sweden
- Faculty of Medicine; University of Oslo; Oslo Norway
- Department of Research; Sunnaas Rehabilitation Hospital; Nesoddtangen Norway
| | - E. Kostovski
- Faculty of Medicine; University of Oslo; Oslo Norway
- Department of Research; Sunnaas Rehabilitation Hospital; Nesoddtangen Norway
| | - P. O. Iversen
- Department of Nutrition; Institute of Basic Medical Sciences; University of Oslo; Oslo Norway
- Department of Hematology; Oslo University Hospital; Oslo Norway
| | - J. R. Zierath
- Department of Physiology and Pharmacology; Section for Integrative Physiology; Karolinska Institutet; Stockholm Sweden
- Department of Molecular Medicine and Surgery; Section for Integrative Physiology; Karolinska Institutet; Stockholm Sweden
| | - A. Krook
- Department of Physiology and Pharmacology; Section for Integrative Physiology; Karolinska Institutet; Stockholm Sweden
| | - A. V. Chibalin
- Department of Molecular Medicine and Surgery; Section for Integrative Physiology; Karolinska Institutet; Stockholm Sweden
| | - U. Widegren
- Department of Molecular Medicine and Surgery; Section for Integrative Physiology; Karolinska Institutet; Stockholm Sweden
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10
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Jakimovska VM, Kostovski E, Biering-Sørensen F, Lidal IB. Psychological distress and user experiences with health care provision in persons living with spinal cord injury for more than 20 years. Spinal Cord 2017; 55:864-869. [DOI: 10.1038/sc.2017.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 02/20/2017] [Accepted: 02/23/2017] [Indexed: 11/09/2022]
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Boon H, Sjögren RJO, Massart J, Egan B, Kostovski E, Iversen PO, Hjeltnes N, Chibalin AV, Widegren U, Zierath JR. MicroRNA-208b progressively declines after spinal cord injury in humans and is inversely related to myostatin expression. Physiol Rep 2015; 3:3/11/e12622. [PMID: 26603456 PMCID: PMC4673649 DOI: 10.14814/phy2.12622] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 08/25/2015] [Accepted: 10/20/2015] [Indexed: 11/24/2022] Open
Abstract
The effects of long-term physical inactivity on the expression of microRNAs involved in the regulation of skeletal muscle mass in humans are largely unknown. MicroRNAs are short, noncoding RNAs that fine-tune target expression through mRNA degradation or by inhibiting protein translation. Intronic to the slow, type I, muscle fiber type genes MYH7 and MYH7b, microRNA-208b and microRNA-499-5p are thought to fine-tune the expression of genes important for muscle growth, such as myostatin. Spinal cord injured humans are characterized by both skeletal muscle atrophy and transformation toward fast-twitch, type II fibers. We determined the expression of microRNA-208b, microRNA-499-5p, and myostatin in human skeletal muscle after complete cervical spinal cord injury. We also determined whether these microRNAs altered myostatin expression in rodent skeletal muscle. A progressive decline in skeletal muscle microRNA-208b and microRNA-499-5p expression occurred in humans during the first year after spinal cord injury and with long-standing spinal cord injury. Expression of myostatin was inversely correlated with microRNA-208b and microRNA-499-5p in human skeletal muscle after spinal cord injury. Overexpression of microRNA-208b in intact mouse skeletal muscle decreased myostatin expression, whereas microRNA-499-5p was without effect. In conclusion, we provide evidence for an inverse relationship between expression of microRNA-208b and its previously validated target myostatin in humans with severe skeletal muscle atrophy. Moreover, we provide direct evidence that microRNA-208b overexpression decreases myostatin gene expression in intact rodent muscle. Our results implicate that microRNA-208b modulates myostatin expression and this may play a role in the regulation of skeletal muscle mass following spinal cord injury.
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Affiliation(s)
- Hanneke Boon
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
| | - Rasmus J O Sjögren
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
| | - Julie Massart
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
| | - Brendan Egan
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
| | - Emil Kostovski
- Section for Spinal Cord Injury, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Per O Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Department of Hematology, Oslo University Hospital, Oslo, Norway
| | - Nils Hjeltnes
- Section for Spinal Cord Injury, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Alexander V Chibalin
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Widegren
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
| | - Juleen R Zierath
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
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Iversen PO, Dahm A, Skretting G, Mowinckel MC, Stranda A, Østerud B, Sandset PM, Kostovski E. Reduced peak, but no diurnal variation, in thrombin generation upon melatonin supplementation in tetraplegia. A randomised, placebo-controlled study. Thromb Haemost 2015. [PMID: 26202881 DOI: 10.1160/th15-05-0396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/05/2022]
Abstract
Tetraplegic patients have increased risk of venous thrombosis despite anti-thrombotic prophylaxis. Moreover, they have blunted plasma variations in melatonin and altered diurnal variation of several haemostatic markers, compared with able-bodied. However, whether healthy individuals and tetraplegic patients, with or without melatonin, display abnormalities in thrombin generation during a 24-hour (h) cycle, is unknown. We therefore used the Calibrated Automated Thrombogram (CAT) assay to examine diurnal variations and the possible role of melatonin in thrombin generation. Six men with long-standing complete tetraplegia were included in a randomised placebo-controlled cross-over study with melatonin supplementation (2 mg, 4 consecutive nights), whereas six healthy, able-bodied men served as controls. Ten plasma samples were collected frequently during a 24-h awake/sleep cycle. No significant diurnal variation of any of the measured CAT indices was detected in the three study groups. Whereas endogenous thrombin potential (ETP) was independent (p > 0.05) of whether the tetraplegic men received melatonin or placebo, melatonin decreased (p = 0.005) peak values in tetraplegia compared with those given placebo. Able-bodied men had lower (p = 0.019) ETP and Lag-Time (p = 0.018) compared with tetraplegics receiving placebo. Neither the Time-to-Peak nor the Start-Tail was affected (p > 0.05) by melatonin in tetraplegia. In conclusion, indices of thrombin generation are not subjected to diurnal variation in healthy able-bodied or tetraplegia, but peak thrombin generation is reduced in tetraplegic men receiving oral melatonin.
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Affiliation(s)
- Per Ole Iversen
- Per Ole Iversen, Department of Nutrition, P. O. Box 1046 Blindern, 0317 Oslo, Norway, Tel.: +47 22 85 13 91, Fax: +47 22 85 13 41, E-mail: p.
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Kostovski E, Dahm AEA, Mowinckel MC, Stranda A, Skretting G, Østerud B, Sandset PM, Iversen PO. Circadian rhythms of hemostatic factors in tetraplegia: a double-blind, randomized, placebo-controlled cross-over study of melatonin. Spinal Cord 2015; 53:285-90. [PMID: 25644388 PMCID: PMC5399146 DOI: 10.1038/sc.2014.243] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/03/2014] [Accepted: 12/17/2014] [Indexed: 11/17/2022]
Abstract
Study design: This is a double-blind, randomized, placebo-controlled cross-over study of melatonin in complete tetraplegia. Objectives: Tetraplegic patients have an increased risk of venous thrombosis despite prophylaxis, blunted variations in melatonin and altered circadian variation of several hemostatic markers. To examine whether melatonin could modify the regulation of hemostasis, we measured plasma melatonin and several markers of hemostasis in tetraplegic subjects with or without melatonin supplement. Setting: The study was conducted in the Section for Spinal Cord Injury, Sunnaas Hospital, Nesoddtangen, Norway. Methods: Six subjects with long-standing complete tetraplegia were included in this cross-over study with 2 mg of melatonin or placebo given 4 days before sampling. We also included six able-bodied men without any intervention. Plasma samples were then collected frequently during a 24-h awake/sleep cycle. The plasma concentrations of melatonin and the various markers were analyzed using linear mixed models. Results: The 24-h profiles of prothrombin fragment 1+2 and von Willebrand factor, but not D-dimer, activated FVII, tissue factor pathway inhibitor and plasminogen activator inhibitor type 1, differed (P<0.05) between tetraplegic patients and able-bodied subjects. The absolute plasma concentration of activated FVII was higher (P<0.05) among the able-bodied compared with the tetraplegic groups. Supplementation of melatonin had no impact on these findings. Conclusions: We found differences in circadian variation of several hemostatic markers between able-bodied and tetraplegics. These differences were apparently unrelated to fluctuations in the melatonin concentrations, suggesting little or no role of melatonin in the regulation of hemostasis in tetraplegia. Sponsorship: Financial support was provided from the Throne Holst Foundation.
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Affiliation(s)
| | - A E A Dahm
- 1] Akershus University Hospital, Nordbyhagen, Norway [2] Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - M C Mowinckel
- 1] Institute of Clinical Medicine, University of Oslo, Oslo, Norway [2] Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - A Stranda
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - G Skretting
- 1] Institute of Clinical Medicine, University of Oslo, Oslo, Norway [2] Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - B Østerud
- Institute of Medical Biology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - P M Sandset
- 1] Institute of Clinical Medicine, University of Oslo, Oslo, Norway [2] Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway [3] Department of Hematology, Oslo University Hospital, Oslo, Norway
| | - P O Iversen
- 1] Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway [2] Department of Hematology, Oslo University Hospital, Oslo, Norway
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Kostovski E, Hjeltnes N, Eriksen EF, Kolset SO, Iversen PO. Differences in bone mineral density, markers of bone turnover and extracellular matrix and daily life muscular activity among patients with recent motor-incomplete versus motor-complete spinal cord injury. Calcif Tissue Int 2015; 96:145-54. [PMID: 25539858 DOI: 10.1007/s00223-014-9947-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/17/2014] [Indexed: 01/10/2023]
Abstract
Spinal cord injury (SCI) leads to severe bone loss, but the associated mechanisms are poorly described in incomplete SCI individuals. The purpose of the study is to compare alterations in bone mineral density (BMD) and serum biomarkers of bone turnover in recent motor-incomplete to -complete SCI men, as well as to describe their physical activity and spasticity. We studied 31 men with acute SCI. Whole-body DXA scans, serum biomarkers and self-reported activity and spasticity were examined 1 and/or 3 and 12 months after the injury. We observed a decrease in proximal femur BMD (p < 0.02) in both the groups. Serum phosphate and carboxy-terminal-collagen crosslinks were significantly lower in motor-incomplete versus complete SCI men, whereas albumin-corrected Ca(2+) (p = 0.02) were lower only 3 months after injury. When data from all 31 SCI participants were pooled, we observed increased serum matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of MMP-2 (TIMP-2) (p < 0.02) whereas TIMP-1 decreased (p = 0.03). BMD correlated positively with self-reported activity (r = 0.59, p = 0.04) and negatively with spasticity (r = 0.74, p = 0.02) 12 months after injury. As a summary, men with motor-incomplete SCI developed significant proximal femur bone loss 12 months after injury and exhibited increased bone resorption throughout the first year after the injury. Compared with complete SCI men, incomplete SCI men show attenuated bone resorption. Our pooled data show increased turnover of extracellular matrix after injury and that increased exercise before and after injury correlated with reduced bone loss.
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Affiliation(s)
- E Kostovski
- Department of Science, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway,
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Kostovski E, Boon H, Hjeltnes N, Lundell LS, Ahlsén M, Chibalin AV, Krook A, Iversen PO, Widegren U. Altered content of AMP-activated protein kinase isoforms in skeletal muscle from spinal cord injured subjects. Am J Physiol Endocrinol Metab 2013; 305:E1071-80. [PMID: 24022865 DOI: 10.1152/ajpendo.00132.2013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AMP-activated protein kinase (AMPK) is a pivotal regulator of energy homeostasis. Although downstream targets of AMPK are widely characterized, the physiological factors governing isoform expression of this protein kinase are largely unknown. Nerve/contractile activity has a major impact on the metabolic phenotype of skeletal muscle, therefore likely to influence AMPK isoform expression. Spinal cord injury represents an extreme form of physical inactivity, with concomitant changes in skeletal muscle metabolism. We assessed the influence of longstanding and recent spinal cord injury on protein abundance of AMPK isoforms in human skeletal muscle. We also determined muscle fiber type as a marker of glycolytic or oxidative metabolism. In subjects with longstanding complete injury, protein abundance of the AMPKγ3 subunit, as well as myosin heavy chain (MHC) IIa and IIx, were increased, whereas abundance of the AMPKγ1 subunit and MHC I were decreased. Similarly, abundance of AMPKγ3 and MHC IIa proteins were increased, whereas AMPKα2, -β1, and -γ1 subunits and MHC I abundance was decreased during the first year following injury, reflecting a more glycolytic phenotype of the skeletal muscle. However, in incomplete cervical lesions, partial recovery of muscle function attenuated the changes in the isoform profile of AMPK and MHC. Furthermore, exercise training (electrically stimulated leg cycling) partly normalized mRNA expression of AMPK isoforms. Thus, physical activity affects the relative expression of AMPK isoforms. In conclusion, skeletal muscle abundance of AMPK isoforms is related to physical activity and/or muscle fiber type. Thus, physical/neuromuscular activity is an important determinant of isoform abundance of AMPK and MCH. This further underscores the need for physical activity as part of a treatment regimen after spinal cord injury to maintain skeletal muscle metabolism.
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Affiliation(s)
- Emil Kostovski
- Section for Spinal Cord Injury, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
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Boon H, Kostovski E, Pirkmajer S, Song M, Lubarski I, Iversen PO, Hjeltnes N, Widegren U, Chibalin AV. Influence of chronic and acute spinal cord injury on skeletal muscle Na+-K+-ATPase and phospholemman expression in humans. Am J Physiol Endocrinol Metab 2012; 302:E864-71. [PMID: 22275761 DOI: 10.1152/ajpendo.00625.2011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Na(+)-K(+)-ATPase is an integral membrane protein crucial for the maintenance of ion homeostasis and skeletal muscle contractibility. Skeletal muscle Na(+)-K(+)-ATPase content displays remarkable plasticity in response to long-term increase in physiological demand, such as exercise training. However, the adaptations in Na(+)-K(+)-ATPase function in response to a suddenly decreased and/or habitually low level of physical activity, especially after a spinal cord injury (SCI), are incompletely known. We tested the hypothesis that skeletal muscle content of Na(+)-K(+)-ATPase and the associated regulatory proteins from the FXYD family is altered in SCI patients in a manner dependent on the severity of the spinal cord lesion and postinjury level of physical activity. Three different groups were studied: 1) six subjects with chronic complete cervical SCI, 2) seven subjects with acute, complete cervical SCI, and 3) six subjects with acute, incomplete cervical SCI. The individuals in groups 2 and 3 were studied at months 1, 3, and 12 postinjury, whereas individuals with chronic SCI were compared with an able-bodied control group. Chronic complete SCI was associated with a marked decrease in [(3)H]ouabain binding site concentration in skeletal muscle as well as reduced protein content of the α(1)-, α(2)-, and β(1)-subunit of the Na(+)-K(+)-ATPase. In line with this finding, expression of the Na(+)-K(+)-ATPase α(1)- and α(2)-subunits progressively decreased during the first year after complete but not after incomplete SCI. The expression of the regulatory protein phospholemman (PLM or FXYD1) was attenuated after complete, but not incomplete, cervical SCI. In contrast, FXYD5 was substantially upregulated in patients with complete SCI. In conclusion, the severity of the spinal cord lesion and the level of postinjury physical activity in patients with SCI are important factors controlling the expression of Na(+)-K(+)-ATPase and its regulatory proteins PLM and FXYD5.
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Affiliation(s)
- Hanneke Boon
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
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Long YC, Kostovski E, Boon H, Hjeltnes N, Krook A, Widegren U. Differential expression of metabolic genes essential for glucose and lipid metabolism in skeletal muscle from spinal cord injured subjects. J Appl Physiol (1985) 2011; 110:1204-10. [PMID: 21393466 DOI: 10.1152/japplphysiol.00686.2010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Skeletal muscle plays an important role in the regulation of energy homeostasis; therefore, the ability of skeletal muscle to adapt and alter metabolic gene expression in response to changes in physiological demands is critical for energy balance. Individuals with cervical spinal cord lesions are characterized by tetraplegia, impaired thermoregulation, and altered skeletal muscle morphology. We characterized skeletal muscle metabolic gene expression patterns, as well as protein content, in these individuals to assess the impact of spinal cord injury on critical determinants of skeletal muscle metabolism. Our results demonstrate that mRNA levels and protein expression of skeletal muscle genes essential for glucose storage are reduced, whereas expression of glycolytic genes is reciprocally increased in individuals with spinal cord injury. Furthermore, expression of genes essential for lipid oxidation is coordinately reduced in spinal cord injured subjects, consistent with a marked reduction of mitochondrial proteins. Thus spinal cord injury resulted in a profound and tightly coordinated change in skeletal muscle metabolic gene expression program that is associated with the aberrant metabolic features of the tissue.
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Affiliation(s)
- Yun Chau Long
- Department of Molecular Medicine and Surgery, Section for Integrative Physiology, Karolinska Institutet, Stockholm, Sweden
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Abstract
BACKGROUND A spinal cord injury changes body composition and metabolism over time. The main purpose of this article is to provide an overview of what is known about these changes and the consequences of those in the chronic phase, long after the acute injury. MATERIAL AND METHODS The article is based on own research and clinical experience, as well as a non-systematic search in the PubMed database. RESULTS The following has been documented for people with spinal cord injury: reduced bone and muscle mass, altered composition of muscle fibre, marked increase of body fat, decreased sensitivity to insulin and leptin and an increased activity in inflammatory signalling pathways. Changes are also demonstrated in hemostatic mechanisms and immune system. INTERPRETATION Changes in metabolism and hormonal regulation in people with spinal cord injury, may increase the risk of osteoporosis, obesity, cardiovascular disease and type 2 diabetes. Changed body composition and inflammatory activity may contribute to the higher incidence of cardiovascular disease and diabetes/metabolic syndrome, although other important risk factors (such as obesity and high blood pressure) may be absent. It has not been documented that changes in haemostatic mechanisms and the immune system are associated with the increased incidence of thromboembolic complications, severe infections or certain types of cancer.
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Affiliation(s)
- Emil Kostovski
- Forskningsavdelingen, Sunnaas sykehus, 1450 Nesoddtangen, Norway.
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