Bamman Marcas M, Ferrando Arny A, Evans Richard P, Stec Michael J, Kelly Neil A, Gruenwald Johannes M, Corrick Katie L, Trump Jesse R, Singh Jasvinder A
Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama; Univeristy of Alabama at Birmingham Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Comprehensive Arthritis, Musculoskeletal, and Autoimmunity Center, University of Alabama at Birmingham, Birmingham, Alabama; Geriatric Research, Education, and Clinical Center, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama;
Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, Arkansas;
Am J Physiol Endocrinol Metab. 2015 Apr 15;308(8):E670-9. doi: 10.1152/ajpendo.00576.2014. Epub 2015 Feb 10.
While elective total hip arthroplasty (THA) for end-stage osteoarthritis (OA) improves pain, mobility function, and quality of life in most cases, a large proportion of patients suffer persistent muscle atrophy, pain, and mobility impairment. Extensive skeletal muscle damage is unavoidable in these surgical procedures, and it stands to reason that poor recovery and long-term mobility impairment among some individuals after THA is linked to failed muscle regeneration and regrowth following surgery and that local muscle inflammation susceptibility (MuIS) is a major contributing factor. Here we present results of two integrated studies. In study 1, we compared muscle inflammation and protein metabolism signaling in elective THA (n=15) vs. hip fracture/trauma (HFX; n=11) vs. nonsurgical controls (CON; n=19). In study 2, we compared two subgroups of THA patients dichotomized into MuIS⁺ (n=7) or MuIS⁻ (n=7) based on muscle expression of TNF-like weak inducer of apoptosis (TWEAK) receptor (Fn14). As expected, HFX demonstrated overt systemic and local muscle inflammation and hypermetabolism. By contrast, no systemic inflammation was detected in elective THA patients; however, local muscle inflammation in the perioperative limb was profound in MuIS⁺ and was accompanied by suppressed muscle protein synthesis compared with MuIS⁻. Muscle from the contralateral limb of MuIS⁺ was unaffected, providing evidence of a true inflammation susceptibility localized to the muscle surrounding the hip with end-stage OA. We suggest MuIS status assessed at the time of surgery may be a useful prognostic index for muscle recovery potential and could therefore provide the basis for a personalized approach to postsurgery rehabilitation.
虽然终末期骨关节炎（OA）的择期全髋关节置换术（THA）在大多数情况下可改善疼痛、活动功能和生活质量，但很大一部分患者仍存在持续性肌肉萎缩、疼痛和活动障碍。在这些手术过程中，广泛的骨骼肌损伤不可避免，因此可以推断，THA术后一些患者恢复不佳和长期活动障碍与术后肌肉再生和生长失败有关，而局部肌肉炎症易感性（MuIS）是一个主要促成因素。在此，我们展示两项综合研究的结果。在研究1中，我们比较了择期THA组（n = 15）、髋部骨折/创伤组（HFX；n = 11）和非手术对照组（CON；n = 19）的肌肉炎症和蛋白质代谢信号。在研究2中，我们比较了根据肿瘤坏死因子样凋亡弱诱导剂（TWEAK）受体（Fn14）的肌肉表达分为MuIS⁺（n = 7）或MuIS⁻（n = 7）的两个THA患者亚组。正如预期的那样，HFX表现出明显的全身和局部肌肉炎症以及代谢亢进。相比之下，在择期THA患者中未检测到全身炎症；然而，与MuIS⁻相比，MuIS⁺患者围手术期肢体的局部肌肉炎症严重，并伴有肌肉蛋白合成受抑制。MuIS⁺患者对侧肢体的肌肉未受影响，这为终末期OA患者髋部周围肌肉存在真正的炎症易感性提供了证据。我们认为，手术时评估的MuIS状态可能是肌肉恢复潜力的一个有用的预后指标，因此可为术后康复的个性化方法提供依据。
