High Intensity Training May Reverse the Fiber Type Specific Decline in Myogenic Stem Cells in Multiple Sclerosis Patients

Abstract

Multiple sclerosis (MS) is associated with loss of skeletal muscle mass and function. The myogenic stem cells (satellite cells—SCs) are instrumental to accretion of myonuclei, but remain to be investigated in MS. The present study aimed to compare the SC and myonuclei content between MS patients (n = 23) and age matched healthy controls (HC, n = 18). Furthermore, the effects of 12 weeks of high intensity training on SC and myonuclei content were explored in MS. Muscle biopsies were obtained from m. Vastus Lateralis at baseline (MS and HC) and following 12 weeks of training (MS only). Frozen biopsies were sectioned followed by immunohistochemical analysis for fiber type specific SCs (Pax7+), myonuclei (MN) and central nuclei content and fiber cross-sectional area (fCSA) was quantified using ATPase histochemistry. At baseline the SCs per fiber was lower in type II compared to type I fibers in both MS (119%, p < 0.01) and HC (69%, p < 0.05), whereas the SCs per fCSA was lower in type II fibers compared to type I only in MS (72%, p < 0.05). No differences were observed in MN or central nuclei between MS and HC. Following training the type II fiber SCs per fiber and per fCSA in MS patients increased by 165% (p < 0.05) and 135% (p < 0.05), respectively. Furthermore, the type II fiber MN content tended (p = 0.06) to be increased by 35% following training. In conclusion, the SC content is lower in type II compared to type I fibers in both MS and HC. Furthermore, high intensity training was observed to selectively increase the SC and myonuclei content in type II fibers in MS patients.

High intensity interval training for people with multiple sclerosis: A systematic review

“…Eleven articles, which described seven studies, were included in this review. Of the included articles four were RCTs) (described by seven articles) Collett et al, 2011;Farup et al, 2016;Feltham et al, 2013;Skjerbaek et al, 2014;Wens et al, 2015;Wens et al, 2017;Zimmer et al, 2017), one was a randomised crossover trial (Collett et al, 2017) and two were cohort studies (Keytsman et al, 2017; Zaenker et al, 2016). Full-text articles assessed for eligibility (n = 38)…”

“…PEDro scores ranged from three to eight out of ten (Table 2). Eight articles were regarded to be of high quality with a score of seven (Bansi et al, 2017;Feltham et al, 2013;Skjerbaek et al, 2014;Wens et al, 2015;Wens et al, 2017) or eight (Collett et al, 2011;Farup et al, 2016;Zimmer et al, 2017). Points were commonly lost due to a lack of blinding of participants and therapists.…”

“…Three of the studies, reported by seven articles, provided a power calculation and had a sample size large enough to be powered (Collett et al, 2011;Farup et al, 2016;Feltham et al, 2013;Wens et al, 2015;Wens et al, 2017;Zimmer et al, 2017). The other four studies did not report on power (Bansi et al, 2017;Collett et al, 2017;Keytsman et al, 2017;Skjerbaek et al, 2014;Zaenker et al, 2016).…”

“…Sample sizes ranged from 11 (Skjerbaek et al, 2014) to 61 (Collett et al, 2011) with a total number of 249 participants. Five studies included participants that were predominantly mildly disabled (EDSS < 4.0) (Collett et al, 2011;Collett et al, 2017;Farup et al, 2016;Feltham et al, 2013;Keytsman et al, 2017;Wens et al, 2015;Wens et al, 2017;Zaenker et al, 2016) one study recruited a predominantly moderately disabled group (EDSS 4.0-6.0) (Bansi et al, 2017;Zimmer et al, 2017) and one study recruited participants who were more severely disabled (EDSS 6.0-8.0) (Skjerbaek et al, 2014) (Table 3). Five studies included participants with both relapsing remitting MS and progressive MS (Bansi et al, 2017;Collett et al, 2011;Collett et al, 2017;Farup et al, 2016;Feltham et al, 2013;Wens et al, 2015;Wens et al, 2017;Zimmer et al, 2017), one study only included participants with progressive MS (Skjerbaek et al, 2014), and one study did not report on MS type (Keytsman et al, 2017).…”

“…All studies conducted HIIT, in a supervised setting, on a cycle ergometer apart from Skjerbaek et al 2014who used upper limb ergometry. Four studies (eight articles) compared HIIT to a form of continuous training (Bansi et al, 2017;Collett et al, 2011;Collett et al, 2017;Farup et al, 2016;Feltham et al, 2013;Wens et al, 2015;Wens et al, 2017;Zimmer et al, 2017), one study compared HIIT and in-patient rehabilitation to just in-patient rehabilitation (Skjerbaek et al, 2014), and two studies did not have a comparator group (Keytsman et al, 2017;Zaenker et al, 2016) (Table 3). Inclusion and exclusion criteria of all studies were standard compared to other exercise interventions in…”