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Pharmacologic or genetic interference with atrogene signaling protects against glucocorticoid-induced musculoskeletal and cardiac disease
Amy Y. Sato, Meloney Cregor, Kevin McAndrews, Charles A. Schurman, Eric Schaible, Jennifer Shutter, Punit Vyas, Bhawana Adhikari, Monte S. Willis, Marjan Boerma, Tamara Alliston, Teresita Bellido
Amy Y. Sato, Meloney Cregor, Kevin McAndrews, Charles A. Schurman, Eric Schaible, Jennifer Shutter, Punit Vyas, Bhawana Adhikari, Monte S. Willis, Marjan Boerma, Tamara Alliston, Teresita Bellido
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Research Article Bone biology

Pharmacologic or genetic interference with atrogene signaling protects against glucocorticoid-induced musculoskeletal and cardiac disease

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Abstract

Despite their beneficial actions as immunosuppressants, glucocorticoids (GC) have devastating effects on the musculoskeletal and cardiac systems, as long-term treated patients exhibit high incidence of falls, bone fractures, and cardiovascular events. Herein, we show that GC upregulate simultaneously in bone, skeletal muscle, and the heart the expression of E3 ubiquitin ligases (atrogenes), known to stimulate the proteasomal degradation of proteins. Activation of vitamin D receptor (VDR) signaling with the VDR ligands calcitriol or eldecalcitol prevented GC-induced atrogene upregulation in vivo and ex vivo in bone/muscle organ cultures and preserved tissue structure/mass and function of the 3 tissues in vivo. Direct pharmacologic inhibition of the proteasome with carfilzomib also conferred musculoskeletal protection. Genetic loss of the atrogene MuRF1-mediated protein ubiquitination in ΔRING mice afforded temporary or sustained protection from GC excess in bone or skeletal and heart muscle. We concluded that the atrogene pathway downstream of MuRF1 underlies GC action in bone, muscle, and the heart, and it can be pharmacologically or genetically targeted to confer protection against the damaging actions of GC simultaneously in the 3 tissues.

Authors

Amy Y. Sato, Meloney Cregor, Kevin McAndrews, Charles A. Schurman, Eric Schaible, Jennifer Shutter, Punit Vyas, Bhawana Adhikari, Monte S. Willis, Marjan Boerma, Tamara Alliston, Teresita Bellido

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Figure 6

Loss of MuRF1-mediated ubiquitination prevents GC dysfunction in skeletal and cardiac muscle, but only temporarily in bone, in vivo.

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Loss of MuRF1-mediated ubiquitination prevents GC dysfunction in skeleta...
(A and B) MuRF1 expression was quantified by qPCR in OB-6 cells not infected (controls [C]) or infected with GFP-labeled lentivirus containing scramble shRNA (SCR) or shRNA directed to silence MuRF1. (A) *P < 0.05 vs. non-infected cells by 1-way ANOVA, Dunnett’s method post hoc test. (B) Mineralization was visualized by Alizarin Red S staining followed by optical density quantification (absorption 405 nm), read in duplicate. Representative images for GFP visualization are shown. Scale bars: 200 μm. n = 4–6, *P < 0.05 vs. vehicle-treated, by Student’s t test. (C–I) WT littermates and mice lacking MuRF1-mediated ubiquitination due to deletion of the RING region (ΔRING) were implanted with slow-release pellets delivering 2.1 mg/kg/d (GC) prednisolone or placebo. (C and D) BMD and (E) sera TRAP 5b and P1NP, (F) mouse body weights, and (H) wet weight of isolated muscles. n = 10–12. *P < 0.05 vs. corresponding placebos, #P < 0.05 vs. corresponding WTs, by 2-way ANOVA, Tukey’s post hoc test. (G) Skeletal muscle function, as assessed by plantarflexion torque in vivo testing, measured after 2 and 4 weeks of the indicated treatments. n = 10–12. *P < 0.05 vs. corresponding placebo treated. Main group effects are indicated by red symbols: red *P < 0.05 all corresponding placebos vs. all corresponding GC by 2-way repeated-measures ANOVA, Tukey’s post hoc test. (I) Left ventricle (LV) systolic volume and ejection fraction, as assessed by ultrasound echocardiography. n = 11–12. *P < 0.05 vs. corresponding placebos, #P < 0.05 vs. corresponding WT, by 2-way ANOVA, Tukey’s post hoc test.

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