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Pulsed glucocorticoids enhance dystrophic muscle performance through epigenetic-metabolic reprogramming
Mattia Quattrocelli, … , Joseph Bass, Elizabeth M. McNally
Mattia Quattrocelli, … , Joseph Bass, Elizabeth M. McNally
Published December 19, 2019
Citation Information: JCI Insight. 2019;4(24):e132402. https://doi.org/10.1172/jci.insight.132402.
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Research Article Metabolism Muscle biology

Pulsed glucocorticoids enhance dystrophic muscle performance through epigenetic-metabolic reprogramming

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Abstract

In humans, chronic glucocorticoid use is associated with side effects like muscle wasting, obesity, and metabolic syndrome. Intermittent steroid dosing has been proposed in Duchenne Muscular Dystrophy patients to mitigate the side effects seen with daily steroid intake. We evaluated biomarkers from Duchenne Muscular Dystrophy patients, finding that, compared with chronic daily steroid use, weekend steroid use was associated with reduced serum insulin, free fatty acids, and branched chain amino acids, as well as reduction in fat mass despite having similar BMIs. We reasoned that intermittent prednisone administration in dystrophic mice would alter muscle epigenomic signatures, and we identified the coordinated action of the glucocorticoid receptor, KLF15 and MEF2C as mediators of a gene expression program driving metabolic reprogramming and enhanced nutrient utilization. Muscle lacking Klf15 failed to respond to intermittent steroids. Furthermore, coadministration of the histone acetyltransferase inhibitor anacardic acid with steroids in mdx mice eliminated steroid-specific epigenetic marks and abrogated the steroid response. Together, these findings indicate that intermittent, repeated exposure to glucocorticoids promotes performance in dystrophic muscle through an epigenetic program that enhances nutrient utilization.

Authors

Mattia Quattrocelli, Aaron S. Zelikovich, Zhen Jiang, Clara Bien Peek, Alexis R. Demonbreun, Nancy L. Kuntz, Grant D. Barish, Saptarsi M. Haldar, Joseph Bass, Elizabeth M. McNally

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Figure 8

Pulsatile prednisone enhanced muscle metabolism and function in a distinct genetic model of muscular dystrophy, Dysf-null mice, a genetic model of Limb Girdle Muscular Dystrophy type 2B.

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Pulsatile prednisone enhanced muscle metabolism and function in a distin...
Mice lacking dysferlin (Dysf) serve as a model of Limb Girdle Muscular Dystrophy type 2B, and loss of dysferlin induces muscular dystrophy by impairing muscle repair. (A) Weekly prednisone exposure mitigated loss of grip strength over time seen in this model, and treatment increased muscle force at study endpoint (Tibialis anterior). (B and C) Weekly prednisone–treated mice had improved respiratory and cardiac muscle function over time, as compared with vehicle-treated controls. (D) ATP levels were increased in both muscle and heart tissues at endpoint. Curves, mean ± SEM; histograms depict single values and mean ± SEM; n = 10 mice/group. *P < 0.05 vs vehicle, Welch’s t-test (two-tailed); #P < 0.05 vs vehicle, 2-way ANOVA.

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