Ageing is characterized by a decline in muscle mass that could be explained by a defect in the regulation of postprandial muscle protein metabolism. Indeed, the stimulatory effect of food intake on protein synthesis and its inhibitory effect on proteolysis is blunted in old muscles from both animals and humans. Recently, low grade inflammation has been suspected to be one of the factors responsible for the decreased sensitivity of muscle protein metabolism to food intake. This study was undertaken to examine the effect of long-term prevention of low grade inflammation on muscle protein metabolism during ageing. Old rats (20 months of age) were separated into two groups: a control group and a group (IBU) in which low grade inflammation had been reduced with a non-steroidal anti inflammatory drug (ibuprofen). After 5 months of treatment, inflammatory markers and cytokine levels were significantly improved in treated old rats when compared with the controls: −22.3% fibrinogen, −54.2% α2-macroglobulin, +12.6% albumin, −59.6% IL 6 and −45.9% IL 1β levels. As expected, food intake had no effect on muscle protein synthesis or muscle proteolysis in controls whereas it significantly increased muscle protein synthesis by 24.8% and significantly decreased proteolysis in IBU rats. The restoration of muscle protein anabolism at the postprandial state by controlling the development of low grade inflammation in old rats significantly decreased muscle mass loss between 20 and 25 months of age. In conclusion, the observations made in this study have identified low grade inflammation as an important target for pharmacological, nutritional and lifestyle interventions that aim to limit sarcopenia and muscle weakness in the rapidly growing elderly population in Europe and North America. Abbreviations COX 2 , cyclo-oxygenase 2; CRP, C reactive protein; 4EBP1, 4E binding protein 1; Foxo3a, forkhead box O3a; IL 6 , interleukin-6; IL 1β , interleukin-1β; MCP 1 , monocyte chemo-attractant protein 1; mTOR, mammalian target of rapamycin; NF-κB, nuclear factor-κB; NSAID, non-steroidal anti-inflammatory drug; PA, post-absorptive; PAI-1, plasminogen activator inhibitor-1; PGE2, prostaglandin-E2; PP, postprandial; S6rp, ribosomal protein S6; S6K1, S6 kinase 1; TNF α , tumor necrosis factor α.

Non-technical summary Immobilization periods increase with age because of decreased mobility and/or because of increased pathological episodes that require bed-rest. Then, sarcopaenia might be partially explained by an impaired recovery of skeletal muscle mass after a catabolic state due to an imbalance of muscle protein metabolism, apoptosis and cellular regeneration. Mechanisms involved during muscle recovery have been little studied and in elderly they remain almost unknown. We show, in rats, that a short immobilization period during ageing initiated muscle atrophy that was indeed not recovered after 40 days. Immobilization was associated with an activation of both the ubiquitin-proteasome and the mitochondria-associated apoptotic pathways and the inflammatory and redox processes, and a decrease of cellular regeneration. We show that the lack of muscle recovery during ageing is not due to a defect in proteolysis or apoptosis down-regulation. These observations lead us to hypothesize that muscle protein synthesis activation after immobilization was altered during ageing.Abstract Immobilization periods increase with age because of decreased mobility and/or increased pathological episodes that require bed-rest. Sarcopaenia might be partially explained by an impaired recovery of skeletal muscle mass after a catabolic state due to an imbalance of muscle protein metabolism, apoptosis and cellular regeneration. Mechanisms involved in muscle recovery have been poorly investigated, and remain almost unknown in the elderly. This study aimed at studying the regulation of the capsase-dependent apoptotic and the ubiquitin-proteasome-dependent proteolytic pathways during immobilization and subsequent recovery during ageing. Old rats (22-24-months old) were subjected to unilateral hindlimb casting for 8 days (I8) and allowed to recover for 10 to 40 days (R10 to R40). Immobilized gastrocnemius muscles atrophied by 21%, and did not recover even at R40. Apoptotic index, amount of polyubiquitinated conjugates, proteasome chymotrypsin-and trypsin-like, apoptosome-linked caspase-9, -3, and -8 activities increased at I8. Conversely, the amount of the myogenic factor myf-5 decreased at I8. These changes paralleled the increase of intramuscular inflammation and oxidative stress. All these parameters normalized as soon as R10. The XIAP/Smac-DIABLO protein ratio decreased by half in immobilized muscles and remained low during recovery. Surprisingly, the non-immobilized leg also atrophied from R20, concomitantly with a decreased XIAP/Smac-DIABLO protein ratio. Altogether, this suggests that the impaired recovery following immobilization in ageing does not result from a lack of normalization of the caspase-dependent * Both authors contributed equally to this work. apoptotic and the ubiquitin-proteasome-dependent pathways, and also that immobilization could induce a general muscle loss and then contribute to the development of sarcopaenia in elderly.(

Key points• During ageing, there is a lack of recovery of muscle mass following immobilization.• We showed, in old rats, an 'anabolic resistance' of muscle protein synthesis to food intake during immobilization and only a slight increase of protein synthesis during the recovery, which explain a poor muscle nitrogen balance that is insufficient to induce a muscle mass gain.• A supplementation with free leucine, an essential amino acid known to stimulate muscle protein metabolism, was efficient in inducing a greater anabolism but failed to induce muscle mass recovery.• This discrepancy was explained by a 'desynchronization' between the leucine signal and amino acids coming from dietary protein digestion.• An induction of a larger increase and a longer availability of amino acids in the postprandial state with rich-protein leucine (i.e. whey) and high protein diets were efficient in inducing a muscle mass recovery after immobilization.Abstract During ageing, immobilization periods increase and are partially responsible of sarcopaenia by inducing a muscle atrophy which is hardly recovered from. Immobilization-induced atrophy is due to an increase of muscle apoptotic and proteolytic processes and decreased protein synthesis. Moreover, previous data suggested that the lack of muscle mass recovery might be due to a defect in protein synthesis response during rehabilitation. This study was conducted to explore protein synthesis during reloading and leucine supplementation effect as a nutritional strategy for muscle recovery. Old rats (22-24 months old) were subjected to unilateral hindlimb casting for 8 days (I8) and allowed to recover for 10-40 days (R10-R40). They were fed a casein (±leucine) diet during the recovery. Immobilized gastrocnemius muscles atrophied by 20%, and did not recover even at R40. Amount of polyubiquitinated conjugates and chymotrypsin-and trypsin-like activities of the 26S proteasome increased. These changes paralleled an 'anabolic resistance' of the protein synthesis at the postprandial state (decrease of protein synthesis, P-S6 and P-4E-BP1). During the recovery, proteasome activities remained elevated until R10 before complete normalization and protein synthesis was slightly increased. With free leucine supplementation during recovery, if proteasome activities were normalized earlier and protein synthesis was higher during the whole recovery, it nevertheless failed in muscle mass gain. This discrepancy could be due to a 'desynchronization' between the leucine signal and the availability of amino acids coming from casein digestion. Thus, when