School of Kinesiology and Health Science, Muscle Health Research Centre, 344 Norman Bethune College, York University, Toronto, ON, Canada.
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
J Cachexia Sarcopenia Muscle. 2019 Jun;10(3):643-661. doi: 10.1002/jcsm.12405. Epub 2019 Apr 2.
Muscle wasting and weakness in Duchenne muscular dystrophy (DMD) causes severe locomotor limitations and early death due in part to respiratory muscle failure. Given that current clinical practice focuses on treating secondary complications in this genetic disease, there is a clear need to identify additional contributions in the aetiology of this myopathy for knowledge-guided therapy development. Here, we address the unresolved question of whether the complex impairments observed in DMD are linked to elevated mitochondrial H O emission in conjunction with impaired oxidative phosphorylation. This study performed a systematic evaluation of the nature and degree of mitochondrial-derived H O emission and mitochondrial oxidative dysfunction in a mouse model of DMD by designing in vitro bioenergetic assessments that attempt to mimic in vivo conditions known to be critical for the regulation of mitochondrial bioenergetics.
Mitochondrial bioenergetics were compared with functional and histopathological indices of myopathy early in DMD (4 weeks) in D2.B10-DMD /2J mice (D2.mdx)-a model that demonstrates severe muscle weakness. Adenosine diphosphate's (ADP's) central effect of attenuating H O emission while stimulating respiration was compared under two models of mitochondrial-cytoplasmic phosphate exchange (creatine independent and dependent) in muscles that stained positive for membrane damage (diaphragm, quadriceps, and white gastrocnemius).
Pathway-specific analyses revealed that Complex I-supported maximal H O emission was elevated concurrent with a reduced ability of ADP to attenuate emission during respiration in all three muscles (mH O : +17 to +197% in D2.mdx vs. wild type). This was associated with an impaired ability of ADP to stimulate respiration at sub-maximal and maximal kinetics (-17 to -72% in D2.mdx vs. wild type), as well as a loss of creatine-dependent mitochondrial phosphate shuttling in diaphragm and quadriceps. These changes largely occurred independent of mitochondrial density or abundance of respiratory chain complexes, except for quadriceps. This muscle was also the only one exhibiting decreased calcium retention capacity, which indicates increased sensitivity to calcium-induced permeability transition pore opening. Increased H O emission was accompanied by a compensatory increase in total glutathione, while oxidative stress markers were unchanged. Mitochondrial bioenergetic dysfunctions were associated with induction of mitochondrial-linked caspase 9, necrosis, and markers of atrophy in some muscles as well as reduced hindlimb torque and reduced respiratory muscle function.
These results provide evidence that Complex I dysfunction and loss of central respiratory control by ADP and creatine cause elevated oxidant generation during impaired oxidative phosphorylation. These dysfunctions may contribute to early stage disease pathophysiology and support the growing notion that mitochondria are a potential therapeutic target in this disease.
杜氏肌营养不良症(DMD)中的肌肉消耗和无力导致严重的运动受限,并导致早期死亡,部分原因是呼吸肌衰竭。鉴于目前的临床实践侧重于治疗这种遗传性疾病的继发性并发症,因此显然需要确定这种肌病发病机制中的其他因素,以进行知识指导的治疗开发。在这里,我们解决了一个悬而未决的问题,即 DMD 中观察到的复杂损伤是否与线粒体 H O 排放增加以及氧化磷酸化受损有关。本研究通过设计体外生物能量评估来模拟对线粒体生物能量调节至关重要的体内条件,对 DMD 小鼠模型中的线粒体衍生的 H O 排放和线粒体氧化功能障碍的性质和程度进行了系统评估。
在 D2.B10-DMD / 2J 小鼠(D2.mdx)中,比较了线粒体生物能量与肌病的功能和组织病理学指标,该模型表现出严重的肌肉无力。在对膜损伤呈阳性的肌肉中(膈,四头肌和白色腓肠肌),比较了两种线粒体-细胞质磷酸盐交换模型(肌酸非依赖性和依赖性)下,二磷酸腺苷(ADP)对 H O 排放的中央抑制作用与刺激呼吸的作用。
途径特异性分析表明,在所有三种肌肉中,支持复合物 I 的最大 H O 排放均升高,同时 ADP 在呼吸过程中减弱排放的能力降低(D2.mdx 与野生型相比为 +17 至 +197%)。这与 ADP 以亚最大和最大动力学刺激呼吸的能力受损有关(D2.mdx 与野生型相比为-17 至-72%),以及膈和四头肌中肌酸依赖性线粒体磷酸盐穿梭的丧失。这些变化主要与线粒体密度或呼吸链复合物的丰度无关,除了四头肌。该肌肉也是唯一表现出钙保留能力降低的肌肉,这表明其对钙诱导的通透性转换孔打开的敏感性增加。增加的 H O 排放伴随着总谷胱甘肽的代偿性增加,而氧化应激标志物保持不变。线粒体生物能量功能障碍与一些肌肉中诱导的线粒体相关半胱天冬酶 9、坏死和萎缩标志物以及后肢扭矩和呼吸肌功能降低有关。
这些结果提供了证据,表明复合物 I 功能障碍和 ADP 和肌酸对中央呼吸控制的丧失导致氧化磷酸化受损期间氧化应激的产生增加。这些功能障碍可能导致疾病早期的病理生理学,并支持线粒体是该疾病的潜在治疗靶标的观点。