Eguchi Takahiro, Kabetani Keiko, Ito Naoki
Brain-Skeletal Muscle Connection in Aging Project Team, Geroscience Research Center, National Center for Geriatrics and Gerontology, Japan.
J Cachexia Sarcopenia Muscle. 2025 Oct;16(5):e70055. doi: 10.1002/jcsm.70055.
Sarcopenia has become an urgent socioeconomic problem in rapidly aging societies. The pathogenesis of age-associated sarcopenia is not fully understood and no effective therapeutic strategies have been developed to date. Recent studies have suggested the importance of the functional linkage between the brain and skeletal muscles in the pathogenesis of sarcopenia. However, the functional connections between the brain and skeletal muscles, particularly between the hypothalamus and skeletal muscles, remain unclear. In this study, we focused on the importance of nicotinamide adenine dinucleotide (NAD) metabolism in the lateral hypothalamus (LH) and explored the importance of the NAD-mediated functional connection between the LH and skeletal muscle and its involvement in the pathogenesis of sarcopenia.
To explore the role of NAD in the LH, we knocked down nicotinamide phosphoribosyltransferase (Nampt), a rate-limiting enzyme in the NAD salvage pathway that is required for the maintenance of NAD, by stereotaxic injection of a lentivirus encoding short hairpin RNA for Nampt into the LH.
Loss-of-function of Nampt in the LH caused decreased muscle mass (mg/cm) [tibialis anterior: 24.8 ± 0.36 vs. 22.9 ± 0.29, p < 0.001; gastrocnemius: 65.7 ± 1.60 vs. 60.9 ± 0.65, p < 0.05] and strength (mN) [382.0 ± 10.4 vs. 345.7 ± 5.47 at 100 Hz stimulation, p < 0.01], accompanied by disruption of the p70S6K-S6 protein synthesis axis in skeletal muscle. Skeletal muscle of LH-specific Nampt-knockdown mice exhibited decreased levels of pyruvate and lactate, the end products of glycolysis and decreased levels of glucose metabolism-related genes, such as β2 adrenergic receptor (β2-AR), peroxisome proliferator-activated receptor delta (PPARδ), PPARγ and pyruvate dehydrogenase kinase 4 (PDK4). We identified lactate as a mediator linking decreased glycolysis and protein synthesis. Lactate induces increases in intracellular Ca levels, which induce the activation of the p70S6K-S6 protein synthesis axis.
Our results indicate that Nampt in the LH maintains skeletal muscle function by regulating lactate-mediated Ca signalling in skeletal muscle. Our study highlights the essential role of Nampt in the LH in the regulation of skeletal muscles and lactate as a mediator that links glycolysis and protein synthesis. As NAD levels in the LH decrease with age, our study provides new insights into the pathogenesis of sarcopenia.
在快速老龄化的社会中,肌肉减少症已成为一个紧迫的社会经济问题。与年龄相关的肌肉减少症的发病机制尚未完全明确,迄今为止尚未开发出有效的治疗策略。最近的研究表明,大脑与骨骼肌之间的功能联系在肌肉减少症的发病机制中具有重要意义。然而,大脑与骨骼肌之间的功能连接,尤其是下丘脑与骨骼肌之间的功能连接仍不清楚。在本研究中,我们聚焦于下丘脑外侧区(LH)中烟酰胺腺嘌呤二核苷酸(NAD)代谢的重要性,并探讨了NAD介导的LH与骨骼肌之间的功能连接及其在肌肉减少症发病机制中的作用。
为了探究NAD在LH中的作用,我们通过立体定向注射编码针对烟酰胺磷酸核糖转移酶(Nampt)的短发夹RNA的慢病毒至LH,敲低Nampt,Nampt是NAD补救途径中的限速酶,对维持NAD水平至关重要。
LH中Nampt功能丧失导致肌肉质量(mg/cm)下降[胫前肌:24.8±0.36 vs. 22.9±0.29,p<0.001;腓肠肌:65.7±1.60 vs. 60.9±0.65,p<0.05]和力量(mN)下降[在100Hz刺激下为382.0±10.4 vs. 345.7±5.47,p<0.01],同时伴有骨骼肌中p70S6K-S6蛋白合成轴的破坏。LH特异性Nampt敲低小鼠的骨骼肌表现出糖酵解终产物丙酮酸和乳酸水平降低,以及葡萄糖代谢相关基因水平降低,如β2肾上腺素能受体(β2-AR)、过氧化物酶体增殖物激活受体δ(PPARδ)、PPARγ和丙酮酸脱氢酶激酶4(PDK4)。我们确定乳酸是连接糖酵解降低和蛋白质合成的介质。乳酸诱导细胞内Ca水平升高,从而诱导p70S6K-S6蛋白合成轴的激活。
我们的结果表明,LH中的Nampt通过调节骨骼肌中乳酸介导的Ca信号来维持骨骼肌功能。我们的研究突出了Nampt在LH中对骨骼肌调节的重要作用,以及乳酸作为连接糖酵解和蛋白质合成的介质的作用。随着LH中NAD水平随年龄下降,我们的研究为肌肉减少症的发病机制提供了新的见解。