Huang Li, Li Ming, Deng Chunyan, Qiu Jiayi, Wang Kexin, Chang Mengyuan, Zhou Songlin, Gu Yun, Shen Yuntian, Wang Wei, Huang Ziwei, Sun Hualin
Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, Medical College of Nantong University, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Nantong University, Nantong 226001, China.
Department of Laboratory Medicine, Binhai County People's Hospital, Yancheng 224500, China.
Antioxidants (Basel). 2022 Dec 26;12(1):44. doi: 10.3390/antiox12010044.
The maintenance of muscle homeostasis is vital for life and health. Skeletal muscle atrophy not only seriously reduces people's quality of life and increases morbidity and mortality, but also causes a huge socioeconomic burden. To date, no effective treatment has been developed for skeletal muscle atrophy owing to an incomplete understanding of its molecular mechanisms. Exercise therapy is the most effective treatment for skeletal muscle atrophy. Unfortunately, it is not suitable for all patients, such as fractured patients and bedridden patients with nerve damage. Therefore, understanding the molecular mechanism of skeletal muscle atrophy is crucial for developing new therapies for skeletal muscle atrophy. In this review, PubMed was systematically screened for articles that appeared in the past 5 years about potential therapeutic strategies for skeletal muscle atrophy. Herein, we summarize the roles of inflammation, oxidative stress, ubiquitin-proteasome system, autophagic-lysosomal pathway, caspases, and calpains in skeletal muscle atrophy and systematically expound the potential drug targets and therapeutic progress against skeletal muscle atrophy. This review focuses on current treatments and strategies for skeletal muscle atrophy, including drug treatment (active substances of traditional Chinese medicine, chemical drugs, antioxidants, enzyme and enzyme inhibitors, hormone drugs, etc.), gene therapy, stem cell and exosome therapy (muscle-derived stem cells, non-myogenic stem cells, and exosomes), cytokine therapy, physical therapy (electroacupuncture, electrical stimulation, optogenetic technology, heat therapy, and low-level laser therapy), nutrition support (protein, essential amino acids, creatine, β-hydroxy-β-methylbutyrate, and vitamin D), and other therapies (biomaterial adjuvant therapy, intestinal microbial regulation, and oxygen supplementation). Considering many treatments have been developed for skeletal muscle atrophy, we propose a combination of proper treatments for individual needs, which may yield better treatment outcomes.
肌肉稳态的维持对生命和健康至关重要。骨骼肌萎缩不仅会严重降低人们的生活质量，增加发病率和死亡率，还会造成巨大的社会经济负担。迄今为止，由于对其分子机制的理解不完整，尚未开发出针对骨骼肌萎缩的有效治疗方法。运动疗法是治疗骨骼肌萎缩最有效的方法。不幸的是，它并不适用于所有患者，如骨折患者和神经损伤的卧床患者。因此，了解骨骼肌萎缩的分子机制对于开发新的骨骼肌萎缩治疗方法至关重要。在本综述中，我们系统地筛选了PubMed上过去5年发表的关于骨骼肌萎缩潜在治疗策略的文章。在此，我们总结了炎症、氧化应激、泛素-蛋白酶体系统、自噬-溶酶体途径、半胱天冬酶和钙蛋白酶在骨骼肌萎缩中的作用，并系统地阐述了针对骨骼肌萎缩的潜在药物靶点和治疗进展。本综述重点关注当前骨骼肌萎缩的治疗方法和策略，包括药物治疗（中药活性成分、化学药物、抗氧化剂、酶和酶抑制剂、激素药物等）、基因治疗、干细胞和外泌体治疗（肌肉来源干细胞、非肌源性干细胞和外泌体）、细胞因子治疗、物理治疗（电针、电刺激、光遗传学技术、热疗和低强度激光治疗）、营养支持（蛋白质、必需氨基酸、肌酸、β-羟基-β-甲基丁酸和维生素D）以及其他治疗方法（生物材料辅助治疗、肠道微生物调节和吸氧）。考虑到已经开发了多种治疗骨骼肌萎缩的方法，我们建议根据个体需求采用适当的治疗方法组合，这可能会产生更好的治疗效果。
