Mechanical Signaling in the Pathophysiology of Critical Illness Myopathy.
Mechanical Signaling in the Pathophysiology of Critical Illness Myopathy.
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DOI：
10.3389/fphys.2016.00023
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发表时间：
2016
影响因子：
4
通讯作者：
Larsson L
中科院分区：
文献类型：
--
作者：
Kalamgi RC;Larsson L
骨骼肌的机械刺激完全丧失，即，与负重相关的外部应变和与肌肉细胞收缩相关的内部应变的损失在瘫痪或深度镇静的机械通气的重症监护病房（ICU）患者中唯一观察到。肢体和躯干肌肉中肌球蛋白和肌球蛋白相关蛋白的优先丢失是危重病肌病（CIM）的显著特征，其将CIM与ICU患者中其他类型的获得性肌无力区分开。机械消声是触发CIM的重要因素。微重力或地面微重力模型是研究肌肉卸载-再加载效应的基础，但其机制和效应可能与ICU条件不同。为了了解机械张力如何调节肌肉质量，了解肌肉如何感知机械信息并将刺激转化为细胞内生化作用和基因表达变化是至关重要的，这一过程称为细胞机械转导。在成人骨骼肌和肌纤维中，这一过程可能不同，相同的刺激可以引起不同的反应，相同的纤维类型可能在不同的肌肉中发生相反的变化。骨骼肌包含多种类型的机械传感器和许多结构，这些结构可以受到不同的影响，因此在不同的肌肉中做出不同的反应。
The complete loss of mechanical stimuli of skeletal muscles, i.e., the loss of external strain, related to weight bearing, and internal strain, related to the contraction of muscle cells, is uniquely observed in pharmacologically paralyzed or deeply sedated mechanically ventilated intensive care unit (ICU) patients. The preferential loss of myosin and myosin associated proteins in limb and trunk muscles is a significant characteristic of critical illness myopathy (CIM) which separates CIM from other types of acquired muscle weaknesses in ICU patients. Mechanical silencing is an important factor triggering CIM. Microgravity or ground based microgravity models form the basis of research on the effect of muscle unloading-reloading, but the mechanisms and effects may differ from the ICU conditions. In order to understand how mechanical tension regulates muscle mass, it is critical to know how muscles sense mechanical information and convert stimulus to intracellular biochemical actions and changes in gene expression, a process called cellular mechanotransduction. In adult skeletal muscles and muscle fibers, this process may differ, the same stimulus can cause divergent response and the same fiber type may undergo opposite changes in different muscles. Skeletal muscle contains multiple types of mechano-sensors and numerous structures that can be affected differently and hence respond differently in distinct muscles.