Rôles de rank/rankl/opg dans le muscle squelettique : intérêt thérapeutique potentiel pour la dystrophie musculaire de Duchenne

Une synchronicité existe entre l’apparition de l’atrophie musculaire et osseuse (ostéoporose) mais, très peu de groupes de recherche se sont intéressés à la possibilité qu’une voie de signalisation commune puisse contrôler simultanément ces tissus dans un contexte pathologique. Le but de cette thèse est de caractériser les rôles du sentier signalétique principal du remodelage osseux soit la voie RANK/RANKL/OPG, sur le muscle squelettique sain ou pathologique. Premièrement, nous avons démontré que RANK est exprimé dans le muscle squelettique et que son absence dans ce tissu induit un effet inotropique sur le muscle rapide extensor digitorum longus (EDL), limitant ainsi la perte de force maximale spécifique, tout en augmentant l'atrophie musculaire, la fatigabilité et la proportion de fibres rapides. Ensuite, nous avons montré qu’un blocage pharmacologique de la voie RANKL/RANK par l’OPG atténue la perte de la force musculaire de manière dose-dépendante et préserve l'intégrité musculaire, en particulier des muscles rapides EDL de souris dystrophiques. Cette étude nous a également permis de démontrer que l’OPG-Fc a un effet intéressant mais plus limité sur la préservation de la force du muscle lent soleus (Sol). Par contre, nous avons découvert que l’OPG-Fc potentialise les effets positifs d'une faible dose de formotérol, un membre de la famille des β2-agonistes, et leur combinaison restaure complètement la fonction du Sol des souris dystrophiques. Finalement, nous avons débuté une étude mécanistique sur l’effet protecteur de l’OPG-Fc sur le muscle squelettique dystrophique. Structurellement, l'OPG-Fc pleine longueur contient quatre domaines TNFR (RANKL), deux domaines de la mort cellulaire par apoptose (TRAIL) et un domaine lié à l'héparine. Nos résultats indiquent que les injections d'anti-RANKL, d’anti-TRAIL et d’OPG-Fc tronquée (possédant seulement les domaines TNFR) ou la suppression génétique de RANK dans le muscle sont nettement moins efficaces sur la préservation de la force des muscles dystrophiques que celles d’OPG-Fc pleine longueur. Étonnamment, l'absence de Ca2+ extracellulaire réduit considérablement les effets de l’OPG-Fc pleine longueur sur la force des muscles dystrophiques dans un modèle de contractilité in vitro. Nos analyses en microscopie confocale ont démontré que l’OPG-Fc pleine longueur pourrait se lier à un récepteur présentement non identifié localisé sur les myotubes et que cette liaison entraîne possiblement une activation d’une kinase liée aux intégrines (ILK) et la surexpression d’une pompe calcique ATPase du réticulum sarcoplasmique appelée SERCA-2a, un déterminant clé de la performance musculaire. Les myotubes traités à l'héparinase, une enzyme connue pour cliver les domaines de l'héparine ou encore l’inhibition de l’ILK réduit significativement la surexpression de SERCA-2a induite par l’OPG-Fc. Cette thèse apporte globalement, une meilleure compréhension des fonctions de RANK/RANKL/OPG dans le muscle squelettique dénervé ou dystrophique et s’inscrit dans la liste des travaux pré-cliniques qui pourrait éventuellement contribuer à l’élaboration de nouveaux traitements pour les maladies musculaires et osseuses.Although there is an obvious dynamic cross-talk between muscle and bone, a common signalling pathway that efficiently and synchronously controls these tissues has barely been investigated in all forms of muscle diseases. The aim of this thesis is to characterize the roles of RANK/RANKL/OPG, key regulators of bone remodeling, on skeletal muscle atrophy, phenotype and dysfunction. Firstly, we show that RANK is expressed in skeletal muscle and that muscle RANK deletion has inotropic effects in denervated fast-twitch extensor digitorum longus (EDL) muscles, preventing on one side the loss of maximum specific force while promoting muscle atrophy and fatigability, and increasing the proportion of fast-twitch fibers. We next demonstrate that a pharmacological treatment of dystrophic mdx mice with recombinant full-length OPG-Fc mitigates the loss of muscle force in a dose-dependent manner and preserves muscle integrity, particularly in EDL muscles. We also found that the full-length OPG-Fc has limited effects on slow-twitch soleus (Sol) muscles. However OPG-Fc potentiates the positive effects of a low dose of formoterol, a member of β2-agonists, and completely restores the function of the Sol dystrophic muscles. Finally, we investigated the mechanism by which the full-length OPGFc protects the dystrophic muscles. Structurally, the OPG protein contains four TNFR domains (RANKL), two death domains ( TRAIL) and a heparin-binding region. Our results indicate that anti-RANKL or anti-TRAIL or truncated OPG treatments (only TNFR domains) or RANK deletion are much less effective in preserving the strength of dystrophic muscles than full-length OPG-Fc. Surprisingly, the absence of extracellular Ca2+ significantly reduces the effects of full-length OPG-Fc on the force production of dystrophic muscles when incubated in a physiological bath in vitro. Confocal microscopy images showed that the full-length OPG-Fc binds directly to myotubes through a receptor that is currently unidentified activating possibly integrin-linked kinase (ILK) which upregulates sarco/endoplasmic calcium ATPase pump (SERCA-2a) expression in C2C12 myotubes. Heparinase, which cleaves heparin and heparin sulphate proteoglycan, or an inhibitor of ILK activity abrogates OPG-induced SERCA-2a expression, suggesting that OPG through ILK upregulates SERCA-2a expression, a key determinant of muscle performance. Overall, this thesis shed some light on RANK/RANKL/OPG functions in skeletal muscle which will potentially contribute to the development of new treatments for several forms of muscle and bone diseases

A short-term statin treatment changes the contractile properties of fast-twitch skeletal muscles

Background : Cumulative evidence indicates that statins induce myotoxicity. However, the lack of understanding of how statins affect skeletal muscles at the structural, functional, and physiological levels hampers proper healthcare management. The purpose of the present study was to investigate the early after-effects of lovastatin on the slow-twitch soleus (Sol) and fast-twitch extensor digitorum longus (EDL) muscles. Methods : Adult C57BL/6 mice were orally administrated with placebo or lovastatin [50 mg/kg/d] for 28 days. At the end of the treatment, the isometric ex vivo contractile properties of the Sol and EDL muscles were measured. Subtetanic and tetanic contractions were assessed and contraction kinetics were recorded. The muscles were then frozen for immunohistochemical analyses. Data were analyzed by two-way ANOVA followed by an a posteriori Tukey’s test. Results : The short-term lovastatin treatment did not induce muscle mass loss, muscle fiber atrophy, or creatine kinase (CK) release. It had no functional impact on slow-twitch Sol muscles. However, subtetanic stimulations at 10 Hz provoked greater force production in fast-twitch EDL muscles. The treatment also decreased the maximal rate of force development (dP/dT) of twitch contractions and prolonged the half relaxation time (1/2RT) of tetanic contractions of EDL muscles. Conclusions : An early short-term statin treatment induced subtle but significant changes in some parameters of the contractile profile of EDL muscles, providing new insights into the selective initiation of statin-induced myopathy in fast-twitch muscles

Physiological role of receptor activator nuclear factor-kB (RANK) in denervation-induced muscle atrophy and dysfunction

The bone remodeling and homeostasis are mainly controlled by the receptor-activator of nuclear factor kB (RANK), its ligand RANKL, and the soluble decoy receptor osteoprotegerin (OPG) pathway. While there is a strong association between osteoporosis and skeletal muscle dysfunction, the functional relevance of a particular biological pathway that synchronously regulates bone and skeletal muscle physiopathology remains elusive. Our recent article published in the American Journal of Physiology (Cell Physiology) showed that RANK is also expressed in fully differentiated C2C12 myotubes and skeletal muscles. We used the Cre-Lox approach to inactivate muscle RANK (RANKmko) and showed that RANK deletion preserves the force of denervated fast-twitch EDL muscles. However, RANK deletion had no positive impact on slow-twitch Sol muscles. In addition, denervating RANKmko EDL muscles induced an increase in the total calcium concentration ([CaT]), which was associated with a surprising decrease in SERCA activity. Interestingly, the levels of STIM-1, which mediates Ca2+ influx following the depletion of SR Ca2+ stores, were markedly higher in denervated RANKmko EDL muscles. We speculated that extracellular Ca2+ influx mediated by STIM-1 may be important for the increase in [CaT] and the gain of force in denervated RANKmko EDL muscles. Overall, these findings showed for the first time that the RANKL/RANK interaction plays a role in denervation-induced muscle atrophy and dysfunction

Impact of inflammation and anti-inflammatory modalities on skeletal muscle healing : from fundamental research to the clinic.

Anti-inflammatory modalities are commonly used for the treatment of various musculoskeletal injuries. Although inflammation was originally believed to interfere with skeletal muscle regeneration, several recent studies have highlighted the beneficial effects of inflammatory cells on muscle healing. This discrepancy is attributable to an evolving understanding of the complex inflammatory process. To better appreciate the paradoxical roles of inflammation, clinicians must have a better comprehension of the fundamental mechanisms regulating the inflammatory response. In this perspective article, cellular, animal, and human studies were analyzed to summarize recent knowledge regarding the impact of inflammation on muscle regeneration in acute or chronic conditions. The effect of anti-inflammatory drugs on the treatment of various muscle injuries was also considered. Overall, this work aims to summarize the current state of the literature on the inflammatory process associated with muscle healing in order to give clinicians the necessary tools to have a more efficient and evidence-based approach to the treatment of muscle injuries and disorders

Galectin-3 and N-acetylglucosamine promote myogenesis and improve skeletal muscle function in the mdx model of Duchenne muscular dystrophy

The muscle membrane, sarcolemma, must be firmly attached to the basal lamina. The failure of proper attachment results in muscle injury, which is the underlying cause of Duchenne muscular dystrophy (DMD), where mutations in the dystrophin gene disrupts the firm adhesion. In DMD patients, even moderate contraction causes damage, leading to progressive muscle degeneration. The damaged muscles are repaired through myogenesis. Consequently, myogenesis is highly active in DMD patients, and the repeated activation of myogenesis leads to the exhaustion of the myogenic stem cells. Therefore, approaches to reducing the risk of the exhaustion are to develop a treatment that strengthens the interaction between the sarcolemma and the basal lamina, and increases the efficiency of myogenesis. Galectin-3 is an oligosaccharide-binding protein and known to be involved in cell–cell interactions and cell–matrix interactions. Galectin-3 is expressed in myoblasts and skeletal muscle while its function in muscle remains elusive. In this study, we found evidence that galectin-3 and the monosaccharide N-acetylglucosamine, which increases the ligands (oligosaccharides) of galectin-3, promotes myogenesis in vitro. Moreover, in the mdx mouse model of DMD, treatment with N-acetylglucosamine increased the muscle force production. Our results demonstrate that treatment with N-acetylglucosamine can mitigate the burden of DMD

Nucleoside triphosphate diphosphohydrolase-1 ectonucleotidase is required for normal vas deferens contraction and male fertility through maintaining P2X1 receptor function

In this work, we report that Entpd1(-/-) mice, deficient for the ectonucleotidase nucleoside triphosphate diphosphohydrolase-1 (NTPDase1), produce smaller litters (27% reduction) compared with wild-type C57BL6 animals. This deficit is linked to reduced in vivo oocyte fertilization by Entpd1(-/-) males (61 ± 11% versus 88 ± 7% for Entpd1(+/+)). Normal epididymal sperm count, spermatozoa morphology, capacitation, and motility and reduced ejaculated sperm number (2.4 ± 0.5 versus 3.7 ± 0.4 million for Entpd1(+/+)) pointed to vas deferens dysfunction. NTPDase1 was localized by immunofluorescence in the tunica muscularis of the vas deferens. Its absence resulted in a major ATP hydrolysis deficiency, as observed in situ by histochemistry and in primary smooth muscle cell cultures. In vitro, Entpd1(-/-) vas deferens displayed an exacerbated contraction to ATP, a diminished response to its non-hydrolysable analog αβMeATP, and a reduced contraction to electrical field stimulation, suggesting altered P2X1 receptor function with a propensity to desensitize. This functional alteration was accompanied by a 3-fold decrease in P2X1 protein expression in Entpd1(-/-) vas deferens with no variation in mRNA levels. Accordingly, exogenous nucleotidase activity was required to fully preserve P2X1 receptor activation by ATP in vitro. Our study demonstrates that NTPDase1 is required to maintain normal P2X1 receptor functionality in the vas deferens and that its absence leads to impaired peristalsis, reduced spermatozoa concentration in the semen, and, eventually, reduced fertility. This suggests that alteration of NTPDase1 activity affects ejaculation efficacy and male fertility. This work may contribute to unveil a cause of infertility and open new therapeutic potentials

Muscle RANK is a key regulator of calcium storage, SERCA activity, and function of fast-twitch skeletal muscles

Receptor-activator of nuclear factor kB (RANK), its ligand RANKL and the soluble decoy receptor osteoprotegerin (OPG)are the key regulators of osteoclast differentiation and bone remodeling. Here we show that RANK is also expressed in fully differentiated myotubes and skeletal muscle. Muscle RANK deletion (RANKmko) has inotropic effects in denervated, but not in sham, extensor digitorum longus (EDL) muscle preventing the loss of maximum specific force while promoting muscle atrophy, fatigability and increased proportion of fast-twitch fibers. In denervated EDL muscles, RANK deletion markedly increased stromal interaction molecule 1 (Stim1) content, a calcium sensor, and altered activity of the sarco(endo)plasmic reticulum Ca2+ ATPase (SERCA) modulating Ca2+ storage. Muscle RANK deletion had no significant effects on the sham or denervated slow-twitch soleus (Sol) muscles. These data identify a novel role for RANK as a key regulator of calcium storage and SERCA activity, ultimately affecting denervated skeletal muscle function

Deletion of the Ste20-like kinase SLK in skeletal muscle results in a progressive myopathy and muscle weakness

Background The Ste20-like kinase, SLK, plays an important role in cell proliferation and cytoskeletal remodeling. In fibroblasts, SLK has been shown to respond to FAK/Src signaling and regulate focal adhesion turnover through Paxillin phosphorylation. Full-length SLK has also been shown to be essential for embryonic development. In myoblasts, the overexpression of a dominant negative SLK is sufficient to block myoblast fusion. Methods In this study, we crossed the Myf5-Cre mouse model with our conditional SLK knockout model to delete SLK in skeletal muscle. A thorough analysis of skeletal muscle tissue was undertaken in order to identify defects in muscle development caused by the lack of SLK. Isometric force analysis was performed on adult knockout mice and compared to age-matched wild-type mice. Furthermore, cardiotoxin injections were performed followed by immunohistochemistry for myogenic markers to assess the efficiency muscle regeneration following SLK deletion. Results We show here that early deletion of SLK from the myogenic lineage does not markedly impair skeletal muscle development but delays the regenerative process. Interestingly, adult mice (~6 months) display an increase in the proportion of central nuclei and increased p38 activation. Furthermore, mice as young as 3 months old present with decreased force generation, suggesting that the loss of SLK impairs myofiber stability and function. Assessment of structural components revealed aberrant localization of focal adhesion proteins, such as FAK and paxillin. Our data show that the loss of SLK results in unstable myofibers resulting in a progressive myopathy. Additionally, the loss of SLK resulted in a delay in muscle regeneration following cardiotoxin injections. Conclusions Our results show that SLK is dispensable for muscle development and regeneration but is required for myofiber stability and optimal force generation

Pregnant and non-pregnant women and low back pain-related differences on postural control measures during different balance tasks

Introduction: Low back pain (LBP) is the most common musculoskeletal complaint in pregnancy, being responsible for many negative impacts. Objective: To evaluate the effect of LBP on static and dynamic balance in pregnant women and whether pregnancy mediates the results compared to non-pregnant women. Methods: 44 women (mean age 30 yrs) participated voluntarily in this study: 16 pregnant women with LBP starting in pregnancy, 14 pregnant women without LBP and 14 non-pregnant women as a group control. Participants were assessed for static postural balance using a force platform and dynamic mobility balance using the Timed Up and Go (TUG) test. Results: The pregnant women with LBP showed significant (P < 0.04, for mean, d= 1,2) poor postural balance in static tests (force platform), in the area of COP eyes open. In dynamic balance (TUG test), statistical difference was found between the groups (P 0.038) and the effect size were moderate to strong in the comparison between the three groups. The most sensitive differences were reported mainly between pregnant women with LBP versus non-pregnant control group in balance measures from force platform. Conclusion: The findings indicate that LBP associated to pregnant clinical status can decrease the balance capacity in women. These results have implication for balance evaluation and retraining in pregnant women with and without LBP from rehabilitation or prevention programs