Hulmi JJ, Oliveira BM, Silvennoinen M, Hoogaars WM, Pasternack A, Kainulainen H, Ritvos O. Exercise restores decreased physical activity levels and increases markers of autophagy and oxidative capacity in myostatin/activin-blocked mdx mice. Am J Physiol Endocrinol Metab 305: E171-E182, 2013. First published May 14, 2013 doi:10.1152/ajpendo.00065.2013.-The importance of adequate levels of muscle size and function and physical activity is widely recognized. Myostatin/activin blocking increases skeletal muscle mass but may decrease muscle oxidative capacity and can thus be hypothesized to affect voluntary physical activity. Soluble activin receptor IIB (sActRIIB-Fc) was produced to block myostatin/activins. Modestly dystrophic mdx mice were injected with sActRIIB-Fc or PBS with or without voluntary wheel running exercise for 7 wk. Healthy mice served as controls. Running for 7 wk attenuated the sActRIIB-Fc-induced increase in body mass by decreasing fat mass. Running also enhanced/restored the markers of muscle oxidative capacity and autophagy in mdx mice to or above the levels of healthy mice. Voluntary running activity was decreased by sActRIIB-Fc during the first 3-4 wk correlating with increased body mass. Home cage physical activity of mice, quantified from the force plate signal, was decreased by sActRIIB-Fc the whole 7-wk treatment in sedentary mice. To understand what happens during the first weeks after sActRIIB-Fc administration, when mice are less active, healthy mice were injected with sActRIIB-Fc or PBS for 2 wk. During the sActRIIB-Fc-induced rapid 2-wk muscle growth period, oxidative capacity and autophagy were reduced, which may possibly explain the decreased running activity. These results show that increased muscle size and decreased markers of oxidative capacity and autophagy during the first weeks of myostatin/activin blocking are associated with decreased voluntary activity levels. Voluntary exercise in dystrophic mice enhances the markers of oxidative capacity and autophagy to or above the levels of healthy mice. myostatin; activin receptor IIB; exercise; skeletal muscle; hypertrophy ADEQUATE SIZE AND FUNCTION of skeletal muscle are of paramount importance for health (3,11,49,58,60). Duchenne muscular dystrophy (DMD) is a disease characterized by progressive wasting of skeletal muscle (28). Restoration of dystrophin expression in all muscles of the body is difficult, and the effectiveness of such treatment likely depends on the muscle quality of DMD patients. Therefore, approaches aimed at stimulation of muscle growth and function are being developed that may complement dystrophin restoration approaches.Type IIB activin receptors (ActRIIB) are expressed in skeletal muscle (21, 37) and mediate the signaling of myostatin and activins (37, 59). Myostatin and activin are efficiently blocked by systemic injection of a soluble ligand binding domain of ActRIIB fused to the Fc domain of IgG (sActRIIB-Fc) (38). sActRIIB-Fc rapidly increases muscle mass and function and alleviates the disease phenotype...