Xu Xin, Talifu Zuliyaer, Zhang Chun-Jia, Gao Feng, Ke Han, Pan Yun-Zhu, Gong Han, Du Hua-Yong, Yu Yan, Jing Ying-Li, Du Liang-Jie, Li Jian-Jun, Yang De-Gang
School of Rehabilitation, Capital Medical University, Beijing, China.
Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China.
Front Nutr. 2023 Mar 3;10:1099143. doi: 10.3389/fnut.2023.1099143. eCollection 2023.
Spinal cord injury leads to loss of innervation of skeletal muscle, decreased motor function, and significantly reduced load on skeletal muscle, resulting in atrophy. Factors such as braking, hormone level fluctuation, inflammation, and oxidative stress damage accelerate skeletal muscle atrophy. The atrophy process can result in skeletal muscle cell apoptosis, protein degradation, fat deposition, and other pathophysiological changes. Skeletal muscle atrophy not only hinders the recovery of motor function but is also closely related to many systemic dysfunctions, affecting the prognosis of patients with spinal cord injury. Extensive research on the mechanism of skeletal muscle atrophy and intervention at the molecular level has shown that inflammation and oxidative stress injury are the main mechanisms of skeletal muscle atrophy after spinal cord injury and that multiple pathways are involved. These may become targets of future clinical intervention. However, most of the experimental studies are still at the basic research stage and still have some limitations in clinical application, and most of the clinical treatments are focused on rehabilitation training, so how to develop more efficient interventions in clinical treatment still needs to be further explored. Therefore, this review focuses mainly on the mechanisms of skeletal muscle atrophy after spinal cord injury and summarizes the cytokines and signaling pathways associated with skeletal muscle atrophy in recent studies, hoping to provide new therapeutic ideas for future clinical work.
脊髓损伤会导致骨骼肌失去神经支配、运动功能下降以及骨骼肌负荷显著降低,从而导致萎缩。制动、激素水平波动、炎症和氧化应激损伤等因素会加速骨骼肌萎缩。萎缩过程会导致骨骼肌细胞凋亡、蛋白质降解、脂肪沉积以及其他病理生理变化。骨骼肌萎缩不仅会阻碍运动功能的恢复,还与许多全身性功能障碍密切相关,影响脊髓损伤患者的预后。对骨骼肌萎缩机制及分子水平干预的广泛研究表明,炎症和氧化应激损伤是脊髓损伤后骨骼肌萎缩的主要机制,且涉及多个途径。这些可能成为未来临床干预的靶点。然而,大多数实验研究仍处于基础研究阶段,在临床应用中仍存在一些局限性,且大多数临床治疗都集中在康复训练上,因此如何在临床治疗中开发更有效的干预措施仍需进一步探索。因此,本综述主要聚焦于脊髓损伤后骨骼肌萎缩的机制,并总结近期研究中与骨骼肌萎缩相关的细胞因子和信号通路,希望为未来的临床工作提供新的治疗思路。