title: Synergistic stimulation of myogenesis by glucocorticoid and IGF-I signaling.
abstract: Muscle wasting is associated with poor prognosis in chronic obstructive pulmonary disease (COPD). Exercise stimulates muscle recovery, but its efficacy is variable, depending on the clinical condition and medical treatment. Systemic glucocorticoids, commonly administered in high doses during acute disease exacerbations or as maintenance treatment in end-stage disease, are known to contribute to muscle wasting. As muscle mass recovery involves insulin-like growth factor (IGF)-I signaling, which can be stimulated by anabolic steroids, the impact of glucocorticoids and the effect of simultaneous IGF-I stimulation by anabolic steroids on muscle recovery and growth were investigated. The effects of, and interactions between, glucocorticoid and IGF-I signaling on skeletal muscle growth were assessed in differentiating C2C12 myocytes. As proof of principle, we performed a post hoc analysis stratifying patients by glucocorticoid use of a clinical trial investigating the efficacy of anabolic steroid supplementation on muscle recovery in muscle-wasted patients with COPD. Glucocorticoids strongly impaired protein synthesis signaling, myotube formation, and muscle-specific protein expression. In contrast, in the presence of glucocorticoids, IGF-I synergistically stimulated myotube fusion and myofibrillar protein expression, which corresponded with restored protein synthesis signaling by IGF-I and increased transcriptional activation of muscle-specific genes by glucocorticoids. In COPD patients on maintenance glucocorticoid treatment, the clinical trial also revealed an enhanced effect of anabolic steroids on muscle mass and respiratory muscle strength. In conclusion, synergistic effects of anabolic steroids and glucocorticoids on muscle recovery may be caused by relief of the glucocorticoid-imposed blockade on protein synthesis signaling, allowing effective translation of glucocorticoid-induced accumulation of muscle-specific gene transcripts.
authors.affiliation: Department of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: N A
authors.initials: NA
authors.lastname: Pansters
authors.forename: R C
authors.initials: RC
authors.lastname: Langen
authors.forename: E F
authors.initials: EF
authors.lastname: Wouters
authors.forename: A M
authors.initials: AM
authors.lastname: Schols
mesh_terms: D000368:Aged; D045930:Anabolic Agents / Q000494:pharmacology; D000818:Animals; D002460:Cell Line; D003907:Dexamethasone / Q000008:administration & dosage; D004357:Drug Synergism; D005786:Gene Expression Regulation / Q000187:drug effects; D005938:Glucocorticoids / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000008:administration & dosage / Q000502:physiology*; D008297:Male; D051379:Mice; D008875:Middle Aged; D008954:Models, Biological; D024510:Muscle Development / Q000187:drug effects* / Q000235:genetics / Q000502:physiology*; D018485:Muscle Fibers, Skeletal / Q000187:drug effects / Q000378:metabolism; D009124:Muscle Proteins / Q000235:genetics / Q000378:metabolism; D009277:Nandrolone / Q000031:analogs & derivatives / Q000494:pharmacology; D000077603:Nandrolone Decanoate; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D015398:Signal Transduction / Q000187:drug effects / Q000502:physiology
chemical_list: D045930:Anabolic Agents; D005938:Glucocorticoids; C583557:IGF1 protein, human; D009124:Muscle Proteins; C519530:insulin-like growth factor-1, mouse; D007334:Insulin-Like Growth Factor I; D009277:Nandrolone; D003907:Dexamethasone; D000077603:Nandrolone Decanoate