Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Mitochondrial Pathology and Neuromuscular Disorders Laboratory, Vall d'Hebron Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain.
Mol Genet Metab. 2018 Jan;123(1):21-27. doi: 10.1016/j.ymgme.2017.11.006. Epub 2017 Nov 21.
McArdle disease (glycogen storage disease type V) is an inborn error of skeletal muscle metabolism, which affects glycogen phosphorylase (myophosphorylase) activity leading to an inability to break down glycogen. Patients with McArdle disease are exercise intolerant, as muscle glycogen-derived glucose is unavailable during exercise. Metabolic adaptation to blocked muscle glycogenolysis occurs at rest in the McArdle mouse model, but only in highly glycolytic muscle. However, it is unknown what compensatory metabolic adaptations occur during exercise in McArdle disease.
In this study, 8-week old McArdle and wild-type mice were exercised on a treadmill until exhausted. Dissected muscles were compared with non-exercised, age-matched McArdle and wild-type mice for histology and activation and expression of proteins involved in glucose uptake and glycogenolysis.
Investigation of expression and activation of proteins involved in glycolytic flux revealed that in glycolytic, but not oxidative muscle from exercised McArdle mice, the glycolytic flux had changed compared to that in wild-type mice. Specifically, exercise triggered in glycolytic muscle a differentiated activation of insulin receptor, 5' adenosine monophosphate-activated protein kinase, Akt and hexokinase II expression, while inhibiting glycogen synthase, suggesting that the need and adapted ability to take up blood glucose and use it for metabolism or glycogen storage is different among the investigated muscles.
The main finding of the study is that McArdle mouse muscles appear to adapt to the energy crisis by increasing expression and activation of proteins involved in blood glucose metabolism in response to exercise in the same directional way across the investigated muscles.
McArdle 病(糖原贮积病 V 型)是一种骨骼肌代谢的先天性缺陷,影响糖原磷酸化酶(肌磷酸化酶)的活性,导致糖原无法分解。McArdle 病患者不耐受运动,因为运动期间肌肉糖原衍生的葡萄糖无法利用。在 McArdle 小鼠模型中,休息时肌肉糖原分解受阻会发生代谢适应,但仅在高度糖酵解的肌肉中发生。然而,在 McArdle 病患者运动期间发生何种代偿性代谢适应尚不清楚。
本研究中,8 周龄的 McArdle 病和野生型小鼠在跑步机上运动直至力竭。将运动后的和未运动的、年龄匹配的 McArdle 病和野生型小鼠的肌肉进行解剖,比较其组织学和葡萄糖摄取及糖原分解相关蛋白的激活和表达。
研究涉及糖酵解通量相关蛋白的表达和激活,结果显示,与野生型小鼠相比,运动后的 McArdle 病小鼠的糖酵解肌肉中的糖酵解通量发生了改变。具体而言,运动在糖酵解肌肉中触发了胰岛素受体、5' 腺苷单磷酸激活蛋白激酶、Akt 和己糖激酶 II 表达的不同激活,同时抑制了糖原合酶,表明在研究的肌肉中,对血糖的摄取和利用进行代谢或糖原储存的需求和适应能力是不同的。
本研究的主要发现是,McArdle 病小鼠肌肉似乎通过增加参与血糖代谢的蛋白的表达和激活来适应能量危机,这种适应方式在研究的肌肉中是一致的。