Mechanism of skeletal muscle atrophy after spinal cord injury: A narrative review

Frontiers in Nutrition, 2023 · DOI: 10.3389/fnut.2023.1099143 · Published: March 3, 2023

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

Spinal cord injury (SCI) disrupts nerve connections to muscles, leading to muscle atrophy, which is worsened by factors like reduced activity, hormone changes, inflammation, and oxidative stress. This atrophy involves muscle cell death, protein breakdown, and fat buildup, hindering motor function recovery and affecting overall health. Research shows inflammation and oxidative stress are key drivers of muscle atrophy after SCI, involving multiple molecular pathways. While these pathways could be targets for clinical intervention, most studies are in early research stages. Current treatments mainly focus on rehabilitation training. This review examines the mechanisms of muscle atrophy after SCI, summarizing related cytokines and signaling pathways from recent studies, aiming to suggest new treatment ideas for clinical application.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5, Narrative Review

Key Findings

1
Inflammation and oxidative stress are major mechanisms driving skeletal muscle atrophy after spinal cord injury.
2
Several cytokines, including TNF-α, TWEAK, IL-1β, and IL-6, are associated with skeletal muscle atrophy after SCI.
3
Signaling pathways such as MAPK, NF-κB, PI3K/Akt/mTOR, and the ubiquitin-proteasome system play critical roles in the process of skeletal muscle atrophy following SCI.

Research Summary

This review summarizes the pathophysiological changes of skeletal muscle atrophy after SCI, analyzes the related factors and atrophy mechanisms, providing a theoretical basis and research direction for future clinical treatment. Current prevention and treatment methods are mostly exercise and hormone therapy, both demonstrating therapeutic effects through various molecular pathways. Appropriate dietary treatment and nutritional therapy are necessary to compensate for some of the drawbacks of medication and exercise training, and to improve the physical function of SCI patients.

Practical Implications

Targeted Therapies

Future therapeutic modalities may be explored and investigated at the cellular and molecular levels to optimize current clinical treatment options and improve the therapeutic effect of skeletal muscle atrophy after SCI, thus effectively promoting functional recovery after SCI.

Nutritional Interventions

A good nutritional intervention program may improve the treatment effect of SCI skeletal muscle atrophy and optimize the treatment plan. Glycine therapy may be a safe, effective and promising dietary treatment.

Combination Therapies

Combining exercise training with adjuvant therapies such as non-invasive transcutaneous spinal cord stimulation (tSCS), N-3 unsaturated fatty acids, and testosterone and androgen therapy can provide a better outcome.

Study Limitations

1
Some relevant literature may have been overlooked.
2
Some ongoing studies and recent results may not have been included.
3
The relationship and influence between various regulatory factors also need to be further explored.

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