Abstract
BackgroundLoss of muscle mass and strength are important sequelae of chronic disease, but the response of individuals is remarkably variable, suggesting important genetic and epigenetic modulators of muscle homeostasis. Such factors are likely to modify the activity of pathways that regulate wasting, but to date, few such factors have been identified.MethodsThe effect of miR‐422a on SMAD4 expression and transforming growth factor (TGF)‐β signalling were determined by western blotting and luciferase assay. miRNA expression was determined by qPCR in plasma and muscle biopsy samples from a cross‐sectional study of patients with chronic obstructive pulmonary disease (COPD) and a longitudinal study of patients undergoing aortic surgery, who were subsequently admitted to the intensive care unit (ICU).ResultsmiR‐422a was identified, by a screen, as a microRNA that was present in the plasma of patients with COPD and negatively associated with muscle strength as well as being readily detectable in the muscle of patients. In vitro, miR‐422a suppressed SMAD4 expression and inhibited TGF‐beta and bone morphogenetic protein‐dependent luciferase activity in muscle cells. In male patients with COPD and those undergoing aortic surgery and on the ICU, a model of ICU‐associated muscle weakness, quadriceps expression of miR‐422a was positively associated with muscle strength (maximal voluntary contraction r = 0.59, P < 0.001 and r = 0.51, P = 0.004, for COPD and aortic surgery, respectively). Furthermore, pre‐surgery levels of miR‐422a were inversely associated with the amount of muscle that would be lost in the first post‐operative week (r = −0.57, P < 0.001).ConclusionsThese data suggest that differences in miR‐422a expression contribute to the susceptibility to muscle wasting associated with chronic and acute disease and that at least part of this activity may be mediated by reduced TGF‐beta signalling in skeletal muscle.
Highlights
Loss of muscle mass and strength are common complications of a range of chronic diseases, including chronic obstructive pulmonary disease (COPD)[1] and heart failure.[2]
The variation in response may result from differences in the strength of the atrophic signal sent to the muscle for a given disease severity, the sensitivity of the individual to the atrophic signal or other factors affecting muscle homeostasis including relative rates of muscle regeneration, each of which will be affected by a mixture of environmental, genetic[10,11] and epigenetic factors
We have shown that expression of microRNAs from imprinted loci (C19MC miRNAs and miR-675) is associated with fat free mass index (FFMI), a marker of muscle bulk in patients with COPD12 with miRNAs from the C19MC positively associated with FFMI in men and miR-657 negatively associated with FFMI in all patients
Summary
Loss of muscle mass and strength are common complications of a range of chronic diseases, including chronic obstructive pulmonary disease (COPD)[1] and heart failure.[2]. We have shown that expression of microRNAs (miRNAs) from imprinted loci (C19MC miRNAs and miR-675) is associated with fat free mass index (FFMI), a marker of muscle bulk in patients with COPD12 with miRNAs from the C19MC positively associated with FFMI in men and miR-657 negatively associated with FFMI in all patients These epigenetic factors may contribute to the relative rate of regeneration, an observation supported by the reduced presence of centralized nuclei in the muscle of cachectic patients with COPD compared with those with a normal FFMI.[12,13] The relative importance of these factors will depend on the nature and strength of the atrophic signal. Such factors are likely to modify the activity of pathways that regulate wasting, but to date, few such factors have been identified
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