Various animal models have been employed to investigate the metabolic changes produced by muscle disuse. The most widely used of these is likely hindlimb suspension, but an atrophic response is seen in response to extended bed rest, denervation, or hindlimb immobilization (either bilateral or unilateral). Each model has specific strengths which encourage its use as well as weaknesses which limit data interpretation
[45]. Although other murine models of immobilization have been reported
[46],
[47], the current series of experiments were performed using a newly developed unilateral hindlimb immobilization model which is easy to implement and requires no specialized equipment, permits comparison of the immobilized to control muscle in the same mouse, maintains neural innervation to the musculature, does not alter food consumption, permits recovery-type studies to be performed, and produces a relatively low level of animal stress. As we are aware of no investigation which reports the temporal progression of changes in both muscle protein synthesis and degradation during both a period of immobilization and recovery in the same animal model, our initial studies focused on the metabolic characterization of this new murine model.
The immobilized hindlimb demonstrated progressive atrophy of the gastrocnemius during the 7 day experimental protocol. It is noteworthy that this localized muscle atrophy did not decrease whole-body lean mass, as assessed by
1H-NMR, and this consistent with the unaltered food consumption in casted mice. Disuse atrophy results from an imbalance between rates of protein synthesis and degradation. The consensus from the available literature indicates a reduction in muscle protein synthesis, which commences as early as 6 h after immobilization
[11] and remains decreased for several days to weeks
[5],
[48]. Several previous studies of muscle disuse have revealed a close association between reduced protein synthesis and impaired mTORC1 activity, as evidenced by the coordinate decrease in phosphorylated S6K1 (or S6) and 4E-BP1
[6],
[19]–
[21], and our current data are consistent with the these previous reports. Additionally, we also detected an immobilization-induced decrease in S473-phosphorylated Akt, similar to that previously reported
[18], suggesting either a direct or indirect inhibition of mTORC2 activity. Moreover, immobilization impaired the ability of leucine to acutely stimulate muscle protein synthesis and 4E-BP1 phosphorylation. Such data are consistent with the anabolic resistance seen in human muscle after 14 days of immobilization
[14]. Despite the recognized importance of mTOR signaling in regulating protein balance, our data indicate that the immobilization-induced decrement in muscle mass and protein synthesis was comparable in WT and mTOR
+/− mice. These data are consistent with the previous work of Bodine et al
[18] where in vivo administration of the mTOR inhibitor rapamycin did not alter muscle weight in mature rodents, suggesting that maintenance of muscle weight under basal control conditions is not mTOR-dependent.
The atrophic response to muscle disuse is also partially mediated by increased protein degradation. Although the relative importance of the various proteolytic pathways is still a area of controversy and may appear to be dependent upon the etiology of the atrophic insult
[46], however, a diverse array of catabolic conditions activate the ubiquitin proteasome pathway
[22],
[33]. Muscle disuse increases the mRNA content for the muscle-specific ubiquitin E3 ligases atrogin-1 and MuRF1
[6],
[8],
[21],
[47],
[49],
[50], whereas knock down of these atrogenes ameliorates the loss of muscle mass induced by denervation or hindlimb suspension
[10],
[51]. Collectively, atrogin-1 and MuRF1 mRNA expression is routinely used as a surrogate marker for muscle proteolysis. However, while the immobilization-induced up-regulation of atrogenes is commonly detected, the duration of the increase is variable and often transient
[8],
[47],
[50],
[52]. In the current study, we found both atrogin-1 and MuRF1 mRNA had returned to levels seen in the control muscle by day 7 of immobilization. However, proteasome activity was still elevated in the immobilized muscle at this specific time point. The discordant association of proteasome activity and atrogene expression may suggest atrogin-1 and/or MuRF1 do not catalyze the rate controlling step in protein degradation. In this regard, cleavage of sarcomeric proteins by calpain may be necessary to provide substrate for the ubiquitin proteasome system
[53]. Therefore, it is possible that proteasome activity can be increased without a concomitant elevation in either atrogin-1 or MuRF1. Alternatively, there may be a discordant regulation of atrogene mRNA and protein expression, which was not assessed in the current study because of the relatively limited mass of available muscle. The lysosomal-autophagy pathway also contributes to protein degradation in selected models of muscle atrophy
[54]. However, while autophagy-related genes are up-regulated in response to differing atrophic stimuli
[54],
[55], other studies have reported that such an increase is not evident in immobilized muscle
[46]. Finally, the current study did not investigate changes in muscle apoptosis which has been shown to be increased in immobilized muscle
[13],
[39]. Hence, the relative contribution of autophagy and apoptosis to immobilization-induced in this particular model of disuse remains to be elucidated. Similar to protein synthesis, all measured indices of protein degradation in the immobilized muscle did not differ between WT and mTOR
+/− mice during the immobilization phase.
In many chronic catabolic states, elevated blood borne proinflammatory cytokines induce muscle wasting by decreasing protein synthesis and/or increasing protein degradation
[53],
[56]. Furthermore, myocytes contribute to the innate immune response by synthesizing and secreting a host of proinflammatory cytokines
[57], and the local activation of nuclear factor-kappa B is sufficient to produced muscle atrophy
[58]–
[60]. In this regard, the consistent elevation in CD45 mRNA throughout immobilization suggests a marked infiltration of inflammatory leukocytes. Moreover, the sustained increase in TNFα mRNA and the more transient increase in IL-6, is indicative of a localized muscle inflammation. While we were unable to resolve the temporal progression of infiltrating leukocytes versus cytokine synthesis in our current study, previous work has reported that an in increase in TNFα, IL-1 and IL-6 precede the immobilization-induced increase in CD45
[47]. Based on the sustained increase in TNFα in the immobilized muscle, coupled with the changes in both protein synthesis and proteolysis, we cannot exclude this cytokine as a potential mediator of the atrophic response. The role of mTOR in regulating the innate immune response in leukocytes is poorly defined and may vary depending on whether pro- or anti-inflammatory cytokine production is being examined
[61]. In the current study, there was no difference in the immobilization-induced increase in TNFα or IL-6 between WT and mTOR
+/− mice. However, mTOR haploinsufficient mice did exhibit an exaggerated increase in CD45 mRNA on day 7 of immobilization, but the cause and physiological importance of this difference remains unclear.
Although TNFα or an unidentified cytokine may directly mediate the atrophic response during the unloading phase, these immunomodulators may also function in an indirect manner by reducing the local concentration of an anabolic mediator. One such potent mitogen is IGF-I which functions both as a traditional endocrine hormone, but also by an autocrine/paracrine mechanism
[42],
[62]. In this regard, exogenously delivered IGF-I ameliorates wasting produced by excess glucocorticoids
[63], denervation
[64], and sepsis
[65], and the local over-expression of a muscle-restricted IGF-I isoform can prevent decrement in muscle loss seen with aging
[66] and neuromuscular disease
[67]. In contrast, others have reported that the localized over-expression of IGF-I in muscle does not prevent the casting-induced decrease in muscle mass and force generation
[16],
[68]. Our data and others
[16] show a marked reduction in muscle IGF-I mRNA in immobilized muscle. However, the temporal progression of the immobilization-induced change in IGF-I was not consistent with the accompanying alterations in protein synthesis or atrogene expression. While these data suggest the decreased muscle IGF-I is an unlikely mediator of disuse atrophy, our data should be interpreted cautiously as we assayed all muscle IGF-I transcripts. We did not quantify various splice variants or muscle-specific isoforms of IGF-I which may be differentially regulated and which may have differing bioactivities
[69], but whose physiological functions remain controversial
[70].
It is important to distinguish between mechanisms responsible for disuse atrophy and those which promote muscle repair upon reloading as they likely differ
[71]. Therefore, using the same murine model we also examined the role of mTOR in the recovery of muscle mass. In WT mice protein synthesis is selectively elevated in the previously immobilized muscle within 24 h of reloading and the increase persists for at least 6 days. By day 10 of recovery, both protein synthesis and muscle weight had returned to control values in WT mice. However, despite the normalization of muscle protein synthesis by 10 days of recovery, the previously immobilized muscle still exhibited leucine resistance. Characterization of metabolic changes in both the atrophy and recovery phase is important, as the temporal progression of muscle regrowth appears to be inversely proportional to the duration of immobilization
[3],
[7],
[27],
[28],
[45],
[72]. Moreover, the ability of mice to fully recover muscle mass is in contrast to the more prolonged time for muscle repair and regeneration needed in rats
[13],
[27],
[73].
In contrast to WT mice, there was a significant delay in the reloading-induced accretion of muscle protein in previously immobilized muscle from mTOR+/− mice. The impaired response was caused by a reduced rate of muscle protein synthesis, with no apparent difference in the rate of degradation (e.g., proteasome activity). The decreased rate of protein synthesis in reloaded muscle from mTOR+/− mice was associated with a reduction in phosphorylation of 4E-BP1, but not S6. The reason for this divergent mTOR signaling response is not understood, but emphasizes the need to determine both the activation of specific signal transduction pathways as well as protein synthesis per se.
mTORC1 is a multiprotein complex with raptor functioning as a scaffold protein recruiting a variety of substrates
[17]. Raptor binds to the TOR signaling motif found in all known substrates of mTORC1, including 4E-BP1, S6K1 and PRAS40
[74]. In the previously immobilized muscle from mTOR
+/− mice which exhibited delay regrowth, the binding of 4E-BP1 to raptor was decreased. This observation is consistent with the endotoxin-induced decrease in muscle protein synthesis and mTORC1 activity previously reported
[75] and, conversely, the recruitment of 4E-BP1 to raptor for optimal stimulation of protein synthesis
[76]. However, this defect appeared to be relatively selective and was not a generalized phenomenon as the binding of raptor to either S6K1 or PRAS40 was not altered. However, Deptor is a negative-regulator of mTOR kinase activity in skeletal muscle
[12] and the interaction of Deptor with raptor was increased in the previously immobilized muscle from mTOR
+/− mice. Finally, in contrast to the inhibition of mTORC1 signaling, S473-phosphorylated Akt and T246- phosphorylated PRAS40 did not differ from values from the contralateral control muscle.
The protein metabolic changes in WT mice were temporally associated with an increase in IGF-I mRNA, and the impaired ability of mTOR
+/− mice to replete mass was associated with a failure of these animals to increase IGF-I in a compensatory manner. Although somewhat counterintuitive, the up-regulation of the local inflammatory response in muscle is also necessary for efficient muscle recovery from disuse
[77],
[78]. We did not see a reloading-induced increase in muscle CD45, TNFα or IL-6 in WT mice in the current study and this may be explained by a relatively transient cytokine response which we missed by only sampling tissue at day 3 and 10 of recovery. In contrast, mTOR
+/− mice showed a relatively small but sustained increase in CD45 throughout the duration of the 10-day recovery period which was associated with a transient early (day 3) increase in TNFα and IL-6. However, we speculate that the limited difference in the magnitude of the inflammatory response between mTOR
+/− and WT mice, is an unlikely mediator for the differences in protein balance and mass during the recovery period. In general, our data are consistent with previous reports concluding that recovery is associated with an increase in the phosphorylation-activation state of various elements of the IGF-I/AKT/mTOR pathway
[18],
[20],
[79] and that locally delivered IGF-I can enhance muscle regeneration during the recovery period
[16].
In summary, our data indicate that muscle loss is mediated by rapid and sustained changes in both protein synthesis and degradation which cannot be attributed to a localized change in IGF-I. While these disuse-induced changes are likely mediated through inhibition of the canonical mTOR signaling pathway, a reduction in the total amount of mTOR (as seen in the mTOR+/− mice) in muscle does not exacerbate the metabolic imbalance in the immobilized muscle. However, the ability of mTOR heterozygous mice to increase protein synthesis in response to the anabolic signals generated by reloading was greatly impaired. These data support the contention that the inability to fully activate mTOR in previously immobilized muscle limits muscle regrowth and suggests stimulation of this kinase might be expected to preferentially enhance regrowth, but with little salutary effect on the initial loss of muscle.