Abstract

Total knee arthroplasty (TKA) is the most common and cost-effective treatment for older adults with long-standing osteoarthritis. During TKA, muscle cells suffer from prolonged oxygen deficiency, which leads to altered cell metabolism that reduces the energy demand and maintains cell homeostasis before blood flow is restored. This study focused on the role of the lncRNA muscleblind-like 1 antisense RNA 1 (MBNL1-AS1) in protecting sevoflurane-pretreated mice against ischemia-reperfusion (I/R) injury after TKA, as well as the elucidation of the potential associated mechanism. Identification of differentially expressed lncRNAs was performed using the microarray dataset GSE21164, which was extracted from the GEO database. Target genes of the lncRNA were determined using Multi-Experiment Matrix (MEM), a dual-luciferase reporter gene assay, and KEGG enrichment analyses. The results showed that MBNL1-AS1 was overexpressed in skeletal muscle cells in mice, while KCNMA1, which was enriched in the cGMP-PKG signaling pathway, was negatively regulated by MBNL1-AS1. Furthermore, I/R mice displayed serious inflammatory reactions. Down-regulation of MBNL1-AS1 increased the expression of KCNMA1, PKGII, VASP, VEGF, Bcl-2, Cyclin D1, Cyclin D3, and Cdc 42 but decreased the expression of Bax, cleaved caspase-3, and cleaved PARP. Furthermore, upon MBNL1-AS1 upregulation, the rate of cell apoptosis increased while the rate of cell proliferation decreased. Our data suggested that down-regulated lncRNA MBNL1-AS1 might promote the proliferation and inhibit the apoptosis of skeletal muscle cells by upregulating KCNMA1 expression via activation of the cGMP-PKG signaling pathway, thus protecting sevoflurane-pretreated mice against I/R injury after TKA.

Highlights

  • Total knee arthroplasty (TKA) is one of the most common orthopedic operations in elderly patients with end-stage osteoarthritis (OA), a degenerative disease greatly affecting the quality of life of older adults[1]

  • Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis based on the WebGestalt database indicated that KCNMA1 was involved in the cGMP-PKG signaling pathway

  • While the protein levels of KCNMA1, PKGII, VASP, p-PKGII, p-VASP, VEGF, Bcl-2, Cyclin D1, Cyclin D3, Cdc 42, cleaved caspase-3, and cleaved PARP were all elevated in the si-MBNL1-AS1#1 and si-MBNL1-AS1#2 groups, the protein levels of Bax, cleaved caspase-3, and cleaved PARP (p < 0.05) were decreased in these groups. These results indicated that the KCNMA1 and cGMP-PKG pathways might be negatively regulated by MBNL1-AS1, while the overexpression of KCNMA1 could increase the expression of cGMP-PKG pathway-related proteins suppressed by the overexpression of MBNL1-AS1

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Summary

Introduction

Total knee arthroplasty (TKA) is one of the most common orthopedic operations in elderly patients with end-stage osteoarthritis (OA), a degenerative disease greatly affecting the quality of life of older adults[1]. TKA has been widely used in China due to its excellent midterm prognosis[2]. During orthopedic procedures such as TKA, tourniquets are generally applied to control blood loss and to maintain a relatively clear surgical field[3]. When tourniquets are used, skeletal muscles can suffer from ischemia, while subsequent reperfusion into ischemic muscles can cause severe complications[4]. Ischemia-reperfusion (I/R) injury caused by the application of tourniquets can lead to oxidative muscle injury and muscle atrophy, which can hinder full functional recovery after TKA surgery.

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