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Extensive skeletal muscle cell mitochondriopathy distinguishes critical limb ischemia patients from claudicants
Terence E. Ryan, … , Espen E. Spangenburg, Joseph M. McClung
Terence E. Ryan, … , Espen E. Spangenburg, Joseph M. McClung
Published November 2, 2018
Citation Information: JCI Insight. 2018;3(21):e123235. https://doi.org/10.1172/jci.insight.123235.
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Research Article Metabolism

Extensive skeletal muscle cell mitochondriopathy distinguishes critical limb ischemia patients from claudicants

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Abstract

The most severe manifestation of peripheral arterial disease (PAD) is critical limb ischemia (CLI). CLI patients suffer high rates of amputation and mortality; accordingly, there remains a clear need both to better understand CLI and to develop more effective treatments. Gastrocnemius muscle was obtained from 32 older (51–84 years) non-PAD controls, 27 claudicating PAD patients (ankle-brachial index [ABI] 0.65 ± 0.21 SD), and 19 CLI patients (ABI 0.35 ± 0.30 SD) for whole transcriptome sequencing and comprehensive mitochondrial phenotyping. Comparable permeabilized myofiber mitochondrial function was paralleled by both similar mitochondrial content and related mRNA expression profiles in non-PAD control and claudicating patient tissues. Tissues from CLI patients, despite being histologically intact and harboring equivalent mitochondrial content, presented a unique bioenergetic signature. This signature was defined by deficits in permeabilized myofiber mitochondrial function and a unique pattern of both nuclear and mitochondrial encoded gene suppression. Moreover, isolated muscle progenitor cells retained both mitochondrial functional deficits and gene suppression observed in the tissue. These findings indicate that muscle tissues from claudicating patients and non-PAD controls were similar in both their bioenergetics profile and mitochondrial phenotypes. In contrast, CLI patient limb skeletal muscles harbor a unique skeletal muscle mitochondriopathy that represents a potentially novel therapeutic site for intervention.

Authors

Terence E. Ryan, Dean J. Yamaguchi, Cameron A. Schmidt, Tonya N. Zeczycki, Saame Raza Shaikh, Patricia Brophy, Thomas D. Green, Michael D. Tarpey, Reema Karnekar, Emma J. Goldberg, Genevieve C. Sparagna, Maria J. Torres, Brian H. Annex, P. Darrell Neufer, Espen E. Spangenburg, Joseph M. McClung

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Figure 5

Comprehensive mitochondrial phenotyping.

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Comprehensive mitochondrial phenotyping.
Skeletal muscle mitochondrial r...
Skeletal muscle mitochondrial respiratory function was measured in permeabilized myofiber samples (representative image in panel A). (A) CLI patients displayed decreased complex I3– (state 3), I+II–, II–, and IV–supported oxygen consumption compared with both IC and HA patients (N = 26 for HA, N = 7 for IC, N = 19 for CLI). Mitochondrial content was assessed by citrate synthase activity (B) (N = 17 for HA, N = 14 for IC, N = 16 for CLI), cardiolipin content (C) (N = 10/group), and mtDNA/nDNA ratio (D) (N = 6/group), indicating that mitochondrial content was not different between IC and CLI. (E) Biochemical enzyme assays of muscle lysates were performed to further dissect changes in the mitochondrial electron transport system. These assays indicate decreased specific activities (normalized for citrate synthase activity) in complexes I, III, and IV in CLI patients (N = 17 for HA, N = 14 for IC, N = 16 for CLI). *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001 using ANOVA with Tukey’s multiple comparison test. NS, not significant. Data are presented as the mean ± SEM (note: error bars in panel B are 95% CI).

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