Stowe, Jessica M.

The diaphragm muscle (DIAm) must be able to generate sufficient forces to sustain ventilatory and non‐ventilatory behaviors throughout the lifespan. Age‐related decreases in DIAm fiber cross‐sectional area and specific force, i.e., sarcopenia, may impair the ability to generate transdiaphragmatic pressures (Pdi) necessary to accomplish expulsive, non‐ventilatory behaviors essential for airway clearance. We examined the effects of aging on DIAm function in both male and female mice at 6 and 24 months of age (n=79). Maximum DIAm specific force was 30% lower in old mice (P蠄0.001) and Pdi generated during non‐ventilatory behaviors was ~40% less in old mice (P蠄0.001). No differences in either DIAm force or Pdi were found between males and females. Collectively, these results indicate that DIAm sarcopenia is present in both sexes and significantly affects the ability to generate Pdi needed for airway clearance in old age. Supported by R01‐AG044615, T32‐HL105355, and the Mayo Clinic.

Respiratory failure is one of the most important complications of cervical spinal cord injury. The level of injury critically determines the severity of the complications. We hypothesized that higher cervical contusion injuries will compromise the motor neuron pool and the descending bulbospinal projections, causing greater functional compromise than contusions at lower levels. Unilateral contusion was performed on adult rats at either the C3 or C5 levels vs. laminectomy. No deficit was seen in ventilatory and non‐ventilatory behaviors as assessed by whole body plethysmography or chronic diaphragm electromyography up to 2 weeks. Contusion injuries at either level resulted in similarly sized cavity formation. Phrenic motor neuron loss differed, with C3 contusion causing a 50% loss of phrenic motor neurons, and C5 contusion only 20% loss compared to the contralateral side. The percent of NMJs that were denervated followed a segmental pattern. Following C3 contusion, ventral regions of the diaphragm displayed denervation of ~30% of NMJs compared to 1‐3% in the C5 contusion and laminectomy groups. In contrast, following C5 contusion, denervation was evident only in dorsal regions (~10%). These results show minimal ventilatory impairment following contusion injuries to the mid‐cervical spinal cord that result in phrenic motor neuron loss and evidence of diaphragm muscle denervation. Grant Funding Source : Supported by NIH grant R01 HL096750 and the Mayo Clinic

We recently determined the presence of sarcopenia in the diaphragm muscle (DIAm), specifically an age‐related reduction in force and muscle fiber cross‐sectional area, the latter being more pronounced at type IIx and/or IIb DIAm fibers. In limb muscles, age‐related changes at neuromuscular junctions (NMJs) include retraction of presynaptic terminals, disaggregation and fragmentation of the motor end‐plate. However, it is presently not clear whether aging impacts the morphology of DIAm NMJs. Adult male mice (n=14) at 6 and 24 months of age, representing survival rates of 100 and 75%, respectively, were used to examine DIAm NMJ structure, pre‐ and post‐synaptic morphology and overlap as measured in 3D by confocal microscopy (643 NMJs). No age related differences were evident in 2D planar area (mean: 328 µm 2 ) or complexity (i.e., fragmentation) of motor end‐plates. Pre‐ and post‐synaptic volumes were also similar across age groups. Evidence of partial or full denervation was present in ~6% of NMJs in both age groups. Thus, these results indicate that by 24 months of age, DIAm sarcopenia is not associated with evidence of ongoing denervation. Examination of earlier age groups will be necessary to rule out the contribution of NMJ denervation to DIAm sarcopenia given the loss of type IIx and/or IIb fibers by 24 months of age. Grant Funding Source : Supported by R01‐AG044615, T32‐HL105355, and the Mayo Clinic.

Neuromuscular dysfunction is common in old age. A hallmark of aging is the aggregation of damaged cytoplasmic structures, especially in post‐mitotic cells like motor neurons. Autophagy flux may be impaired as a result of deficits in the formation of double membrane autophagosomes, the fusion of autophagosomes with lysosomes, or lysosome‐based degradation. Our overarching hypothesis is that autophagy contributes to neuromuscular dysfunction in old age, and that this effect occurs in motor neurons. We evaluated changes in expression levels of core autophagy proteins necessary for the initiation (Beclin1) and elongation (LC3‐I, LC3‐II, ATG7 and ATG5‐ATG12 complex) phases of autophagsome formation, as well as lysosome degradation (assessed by p62 clearance), in adult male and female C57BL/6 mice at 6, 18, and 24 months of age (reflecting 100%, 90% and 75% survival, respectively). Protein expression was analyzed by Western blotting in the cervical spinal cord segments C2–C6. Expression of p62 was reduced in the cervical spinal cord of adult mice at 18 months compared to 24 months, suggesting increased clearance and autophagy flux at 18 months of age. There was no evidence of an effect of age on the expression of the other autophagy markers. In separate animals, immunohistochemical (IHC) analyses of the C2‐C6 segments was used to determine the relative expression of LC3 and p62 in gray and white matter regions. Across all age groups, LC3 and p62 immunoreactivity was evident in the gray matter with minimal expression in the white matter. The ratio of both LC3 and p62 in motor neurons vs. gray matter was compared using a mixed linear model with animal as a random effect. No effect of sex was evident. Increased expression of both LC3 and p62 was evident in choline acetyl transferase (ChAT)‐positive motor neurons (~2–3 fold) compared to the remainder of the gray matter. There was evidence of a difference in relative LC3 and p62 expression in motor neurons across age (F 349,2 =12.5, p<0.001), with a significant increase by 24 months of age (p<0.005). Taken together, these findings suggest that 1) there is an aging effect on autophagy markers in the cervical spinal cord of mice; 2) an increase in autophagy by 18 months of age reflects an increase in autophagosome clearance (reduced p62 expression) not restricted to motor neurons; and, 3) increased motor neuron expression of both LC3 and p62 by 24 months of age reflect autophagsome accumulation and autophagy impairment in motor neurons. These findings are also is in accordance with previous reports suggesting a period of vulnerability between 18 and 24 months of age in mice, where autophagy may play a role in the development of age‐related neuromuscular dysfunction. Support or Funding Information Supported by NIH R01 AG057052.

Midcervical contusion injuries disrupt descending ipsilateral excitatory bulbospinal projections to phrenic motoneurons, compromising ventilation. We hypothesized that a unilateral contusion injury at C3 versus C5 would differentially impact phrenic activity reflecting more prominent disruption of ipsilateral descending excitatory drive to more caudal segments of the phrenic motor pool with more cranial injuries. Phrenic motoneuron counts and evidence of diaphragm muscle denervation at individual neuromuscular junctions (NMJ) were evaluated at 14 days post-injury after unilateral contusion injury (100 kDynes). Whole body plethysmography and chronic diaphragm EMG were measured before the injury and at 3, 7, and 14 days post-injury. Contusion injuries at either level resulted in a similarly sized cavity. C3 contusion resulted in loss of 39 ± 13% of ipsilateral phrenic motoneurons compared with 13 ± 21% after C5 contusion ( p = 0.003). Cervical contusion injuries resulted in diaphragm muscle denervation (C3 contusion: 17 ± 4%; C5 contusion: 7 ± 4%; p = 0.047). The pattern of denervation revealed segmental innervation of the diaphragm muscle, with greater denervation ventrally after C3 contusion and dorsally after C5 contusion. Overall, diaphragm root mean square electromyography activity did not change ipsilaterally after C3 or C5 contusion, but increased contralaterally (∼11%) after C3 contusion only on the first day post-injury ( p = 0.026). Similarly, there were no significant changes in breathing parameters during eupnea or exposure to hypoxia (10% O 2 ) – hypercapnia (5% CO 2 ) at any time post-injury. Unilateral midcervical contusions minimally impair ventilatory behaviors despite phrenic motoneuron loss and diaphragm muscle denervation.

To perform a range of ventilatory and nonventilatory behaviors, the diaphragm muscle (DIAm) must be able to generate sufficient forces throughout the lifespan. We hypothesized that sarcopenia impacts DIAm force generation and thus limits performance of expulsive, higher force, nonventilatory behaviors. Male and female mice ( n = 79) at 6 and 24 mo of age (100 vs. 70–75% survival, respectively) were used to examine transdiaphragmatic pressure (Pdi) generation across motor behaviors in vivo and in vitro DIAm specific force. We found a significant effect of age on maximum Pdi (20–41% decline during tracheal occlusion and bilateral phrenic nerve stimulation), maximum DIAm specific force (30% decline), and DIAm fatigue resistance (15% increase). There were no differences between sexes in these age effects on DIAm performance. These results support our hypothesis that sarcopenia primarily impacts higher force, nonventilatory motor behaviors of the DIAm. Such functional limitations may have negative implications in the ability of the DIAm to generate forces needed for airway clearance in old age and thereby contribute to age-related respiratory complications.

Activation of the tropomyosin-related kinase receptor B (TrkB) by brain-derived neurotrophic factor acutely regulates synaptic transmission at adult neuromuscular junctions (NMJs). The role of TrkB kinase activity in the maintenance of NMJ function and structure at diaphragm muscle NMJs was explored using a chemical-genetic approach that permits reversible inactivation of TrkB kinase activity in TrkB F616A mice by 1NMPP1. Inhibiting TrkB kinase activity for 7 days resulted in significant, yet reversible, impairments in neuromuscular transmission at diaphragm NMJs. Neuromuscular transmission failure following 2 min of repetitive phrenic nerve stimulation increased from 42% in control to 59% in 1NMPP1-treated TrkB F616A mice ( P = 0.010). Recovery of TrkB kinase activity following withdrawal of 1NMPP1 treatment improved neuromuscular transmission ( P = 0.006). Electrophysiological measurements at individual diaphragm NMJs documented lack of differences in quantal content in control and 1NMPP1-treated mice ( P = 0.845). Morphological changes at diaphragm NMJs were modest following inhibition and recovery of TrkB kinase activity. Three-dimensional reconstructions of diaphragm NMJs revealed no differences in volume at motor end plates (labeled by α-bungarotoxin; P = 0.982) or presynaptic terminals (labeled by synaptophysin; P = 0.515). Inhibition of TrkB kinase activity by 1NMPP1 resulted in more compact NMJs, with increased apposition of presynaptic terminals and motor end plates ( P = 0.017) and reduced fragmentation of motor end plates ( P = 0.005). Recovery of TrkB kinase activity following withdrawal of 1NMPP1 treatment resulted in postsynaptic remodeling likely reflecting increased gutter depth ( P = 0.007), without significant presynaptic changes. These results support an essential role for TrkB kinase activity in maintaining synaptic function and structural integrity at NMJs in the adult mouse diaphragm muscle.