University of Leicester
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Impact of transcutaneous neuromuscular electrical stimulation or resistance exercise on skeletal muscle mRNA expression in COPD

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journal contribution
posted on 2019-06-28, 14:34 authored by L. E. Latimer, D. Constantin, N. J. Greening, L. Calvert, M. K. Menon, M. C. Steiner, P. L. Greenhaff
Background: Voluntary resistance exercise (RE) training increases muscle mass and strength in patients with chronic obstructive pulmonary disease (COPD). Nonvolitional transcutaneous neuromuscular electrical stimulation (NMES) may be an alternative strategy for reducing ambulatory muscle weakness in patients unable to perform RE training, but little comparative data are available. This study, therefore, investigated changes in muscle mRNA abundance of a number of gene targets in response to a single bout of NMES compared with RE. Methods: Twenty-six patients with stable COPD (15 male; FEV1, 43±18% predicted; age, 64±8 years; fat free mass index, 16.6±1.8 kg/m2,) undertook 30 minutes of quadriceps NMES (50 Hz, current at the limit of tolerance) or 5×30 maximal voluntary isokinetic knee extensions. Vastus lateralis muscle biopsies were obtained at rest immediately before and 24 hours after intervention. Expression of 384 targeted mRNA transcripts was assessed by real time TaqMan PCR. Significant change in expression from baseline was determined using the ΔΔCT method with a false discovery rate (FDR) of <5%. Results: NMES and RE altered mRNA abundance of 18 and 68 genes, respectively (FDR <5%), of which 14 genes were common to both interventions and of the same magnitude of fold change. Biological functions of upregulated genes included inflammation, hypertrophy, muscle protein turnover, and muscle growth, whilst downregulated genes included mitochondrial and cell signaling functions. Conclusions: Compared with NMES, RE had a broader impact on mRNA abundance and, therefore, appears to be the superior intervention for maximizing transcriptional responses in the quadriceps of patients with COPD. However, if voluntary RE is not feasible in a clinical setting, NMES by modifying expression of genes known to impact upon muscle mass and strength may have a positive influence on muscle function.


This work was supported by the Medical Research Council [grant number MR/P021220/1]. This research was also supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Leicestershire Nothamptonshire and Rutland (CLAHRC LNR), UK, and by CLAHRC East Midlands, and by the NIHR Leicester Biomedical Research Centre - Respiratory, at the University Hospitals of Leicester NHS Trust, UK. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. This work was partly funded by Remedi: Enabling Research in Rehabilitation (a UK registered charity; 1063359). Study funders did not participate in study design, data interpretation, or manuscript presentation. LL was supported by the NIHR Leicester Biomedical Research Centre - Respiratory. DC was supported by the Medical Research Council/Arthritis Research UK (MRC/ ARUK) Centre for Musculoskeletal Ageing Research.



International Journal of COPD, 2019, 2019:14, pp. 1355-1364

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/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Infection, Immunity and Inflammation


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International Journal of COPD


Dove Medical Press



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The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.



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