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Muscle cell regeneration: the role of satellite cells and their metabolism

Satellite cells and muscle regeneration

Muscle regeneration is a complex process involving multiple cellular and molecular events, including the proliferation and differentiation of specific stem cells, known as satellite cells. Satellite cells are resident stem cells in skeletal muscle tissue, essential for repairing muscle damage and maintaining tissue homeostasis over time. They were first identified in the 1960s by Mauro, located between the basement membrane and the sarcolemma of muscle fibers. Under normal conditions, these cells are in a quiescent state, but in response to damage or stress, they are activated to enter the cell cycle. Once activated, satellite cells undergo clonal expansion, differentiate into myoblasts, and fuse with existing muscle fibers or form new fibers to repair damaged tissue. Satellite cells express specific markers such as Pax7 (a key transcription factor for maintaining quiescence and satellite cell activation) and MyoD, another transcription factor that drives differentiation. The dynamics between these two pathways is crucial: Pax7 inhibits premature differentiation, while MyoD promotes the differentiation process.

Energy metabolism in muscle regeneration

The energy metabolism of satellite cells is a crucial factor influencing their expansion and differentiation. Quiescent satellite cells mainly use oxidative phosphorylation, an aerobic process, as their main source of energy. During activation and proliferation, there is a change in the metabolic profile, with a switch to anaerobic glycolysis, which rapidly provides ATP to support cell expansion. This transition is crucial for effective muscle proliferation and repair. Quiescent satellite cells predominantly use oxidative phosphorylation in the mitochondria, which is an efficient but slow pathway in terms of ATP production. This helps maintain a quiescent state and protects cells from oxidative stress. During clonal expansion after activation, satellite cell metabolism switches towards glycolysis, which allows rapid energy production even under conditions of low oxygen availability. Glycolysis is regulated by key enzymes such as phosphofructokinase and pyruvate kinase. This switch is associated with the activation of signaling pathways such as mTOR and HIF-1α, which modulate mitochondrial biogenesis and energy balance.

Two signaling pathways that are crucial for satellite cell energy metabolism are mTOR (mammalian Target Of Rapamycin) and AMPK (AMP-activated protein kinase). mTOR is a key regulator of cell growth and protein synthesis. It is activated under nutrient-rich conditions and promotes protein synthesis and cell proliferation. It is crucial for muscle regeneration, as it supports protein synthesis during myogenic differentiation and myoblast fusion. The protein kinase AMPK, in contrast, is activated under energy stress, such as during intense exercise or nutrient starvation. It inhibits satellite cell proliferation under energy-limited conditions to conserve ATP, while promoting fat oxidation and maintenance of quiescence. The balance between mTOR and AMPK is essential for regulating muscle regeneration. Activation of AMPK during periods of low energy may promote regeneration by improving mitochondrial efficiency and reducing oxidative stress, while mTOR stimulates muscle proliferation and growth under nutrient-adequate conditions.

Lipid metabolism in satellite cells

During muscle regeneration, satellite cells are activated, proliferate, and differentiate into myocytes to repair damaged muscle fibers. These cells, initially quiescent, enter a cycle of rapid proliferation in response to local and systemic signals, which requires an adequate energy supply. Satellite cells have been observed to utilize beta-oxidation of fatty acids as an energy source to support their proliferation and differentiation. Beta-oxidation is the process by which fatty acids are broken down in the mitochondria to produce acetyl-CoA, which then enters the citric acid cycle to generate energy in the form of ATP. During muscle regeneration, this process is intensified to support satellite cells and the entire regenerative process.

Fatty acids are stored in the muscle in the form of triglycerides, which can be hydrolyzed to produce free fatty acids. These fatty acids are transported into the mitochondria and undergo beta-oxidation to generate ATP, NADH, and FADH2, which are used to fuel protein synthesis and cell proliferation. During the muscle regeneration phase, energy demands increase significantly, and beta-oxidation becomes critical to support activated satellite cells. This is especially important because fatty acid oxidation is more energy efficient than glycolysis, producing more ATP molecules per substrate molecule.

Involvement of epigenetic mechanisms

In addition to energy metabolism, epigenetic mechanisms, such as histone methylation and acetylation, play an important role in muscle regeneration. For example, EZH2, a histone methyltransferase, negatively regulates satellite cell differentiation by maintaining them in a proliferative state. However, during the final phase of regeneration, inhibition of EZH2 promotes differentiation. Inhibiting EZH2 activity in the early stages of regeneration can impair satellite cell proliferation, while its persistence in the final stages can inhibit differentiation. This balance between activating and repressive histone methylation is crucial for effective muscle regeneration. The interplay between metabolic signals and epigenetic modifications guides satellite cell fate and influences their regenerative capacity. Histone acetylation is generally associated with more open chromatin, favoring access to transcription factors and increased gene expression.

This process is catalyzed by histone acetyltransferases (HATs), while the opposite, deacetylation, is regulated by histone deacetylases (HDACs). The acetylating agent of HATs is acetyl-Coenzyme A, derived from glycolysis and oxidative phosphorylation, so the integration of these processes with energy metabolism is evident. Acetylation is crucial during muscle regeneration because it promotes the expression of genes involved in satellite cell proliferation and differentiation. An important example is the regulation of the expression of the transcription factor MyoD, which in satellite cells is dynamically acetylated during their activation, thus promoting their differentiation. Furthermore, class II HDACs (such as HDAC4 and HDAC5) play a fundamental role in maintaining satellite cell quiescence by repressing MyoD expression.

Therapeutic implications

Recent studies have shown that modulating metabolism through the supplementation of nutrients or drugs that regulate glycolysis or oxidative phosphorylation can improve muscle regeneration in pathological conditions. Valproate and trichostatin A act as histone deacetylase inhibitors and their use has been associated with increased muscle regeneration capacity in animal models. Resveratrol and Metformin: These compounds activate the AMPK pathway; AMPK improves the metabolic efficiency of satellite cells and promotes mitochondrial biogenesis, thereby improving muscle regeneration capacity. In addition, AMPK promotes fatty acid oxidation, providing additional energy to satellite cells during the regenerative process.

In addition to small molecules, bioactive peptides and protein-derived drugs are also emerging as potential stimulators of muscle regeneration. These compounds can interact with specific receptors or signaling pathways on satellite cells to modulate their activity: among them are the fragment of the growth factor IGF1 (IGF-1Ec) and fragments derived from the cleavage of the extracellular matrix, including those derived from collagen or laminin. The use of chemical compounds to stimulate muscle regeneration through satellite cells represents a promising therapeutic approach to improve muscle repair following injury or in pathological conditions such as muscular dystrophies.

  • Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Farup J, Kjølhede T. (2016). J Appl Physiol 121(4), 937

Vainshtein A, Hood DA. (2016). J Appl Physiol, 120(6), 664-73.

Ryall JG, Cliff T et al. (2015). Cell Stem Cell, 17(6), 651-662.

Wan X et al. (2012). Nature Rev Mol Cell Biol, 13(2), 127-133.

Cheung TH et al. (2013). Nature Rev Mol Cell Biol, 14(6), 329.

Mauro A. (1961). J Biophys Biochem Cytol, 9(2), 493-495.

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Dott. Gianfrancesco Cormaci
Dott. Gianfrancesco Cormaci
Laurea in Medicina e Chirurgia nel 1998; specialista in Biochimica Clinica dal 2002; dottorato in Neurobiologia nel 2006; Ex-ricercatore, ha trascorso 5 anni negli USA (2004-2008) alle dipendenze dell' NIH/NIDA e poi della Johns Hopkins University. Guardia medica presso la casa di Cura Sant'Agata a Catania. Medico penitenziario presso CC.SR. Cavadonna (SR) Si occupa di Medicina Preventiva personalizzata e intolleranze alimentari. Detentore di un brevetto per la fabbricazione di sfarinati gluten-free a partire da regolare farina di grano. Responsabile della sezione R&D della CoFood s.r.l. per la ricerca e sviluppo di nuovi prodotti alimentari, inclusi quelli a fini medici speciali.

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