Abstract

Introduction: In humans without peripheral artery disease (PAD) and animal models, exposure to cigarette smoke is associated with reduced mitochondrial respiratory function. Many people with PAD smoke cigarettes, but the association of smoking with mitochondrial function in lower extremity skeletal muscle of people with PAD is unknown. Methods: From the Chicago, IL area, 31 people with PAD (ankle brachial index (ABI) < 0.90) were enrolled and consented to gastrocnemius muscle biopsy. Mitochondrial oxidative capacity in gastrocnemius muscle was measured with respirometry. Western blots were performed to quantify mitochondrial membrane abundance via voltage-dependent anion channel (VDAC), mitochondrial biogenesis via peroxisome proliferator-activated receptor-γ coactivator (PGC-1α) , and electron transport chain complexes I-V. Results: Among 31 people with PAD (mean 72.1 years, mean ABI 0.64), 14 (45.2%) smoked cigarettes currently. Participants who currently smoked had higher abundance of PGC-1α (0.75 vs. 0.45 arbitrary units (AU), P<0.01), VDAC (0.62 vs. 0.37 AU, P=0.022), electron transport chain complex I (0.46 vs. 0.21 AU, P=0.031), and complex III (0.76 vs. 0.42 AU, P=0.031), compared to those who did not currently smoke. After normalizing to VDAC, participants who currently smoked had lower mitochondrial oxidative capacity per unit of mitochondrial membrane compared to those who did not currently smoke (complex I+II-mediated oxidative phosphorylation (156.3 vs. 287.0 AU, P=0.017), complex I+II-mediated electron transport chain capacity (184.8 vs. 343.1 AU, P=0.019), complex I-mediated fatty acid oxidative phosphorylation (45.9 vs. 82.1 AU, P=0.034)). After statistical adjustment for age, sex, race, ABI, and body mass index (BMI), most associations were attenuated but remained statistically significant for the higher abundance of VDAC (0.65 vs. 0.35 AU, P=0.037) and complex I (0.50 vs. 0.18 AU, P=0.038) in participants who currently smoked compared to those who did not currently smoke. Conclusions: Results suggest that among people with PAD, current cigarette smoking may stimulate a compensatory increase in mitochondrial biogenesis that may counteract effects of reduced oxidative capacity per unit mitochondrial membrane.

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