The sliding filament theory of muscle contraction is widely accepted as the means by which muscles generate force during activation. Within the constraints of this theory, isometric, steady-state force produced during muscle activation is proportional to the amount of filament overlap. Previous studies from our laboratory demonstrated enhanced titin-based force in myofibrils that were actively stretched to lengths which exceeded filament overlap. This observation cannot be explained by the sliding filament theory. The aim of the present study was to further investigate the enhanced state of titin during active stretch. Specifically, we confirm that this enhanced state of force is observed in a mouse model and quantify the contribution of calcium to this force. Titin-based force was increased by up to four times that of passive force during active stretch of isolated myofibrils. Enhanced titin-based force has now been demonstrated in two distinct animal models, suggesting that modulation of titin-based force during active stretch is an inherent property of skeletal muscle. Our results also demonstrated that 15% of the enhanced state of titin can be attributed to direct calcium effects on the protein, presumably a stiffening of the protein upon calcium binding to the E-rich region of the PEVK segment and selected Ig domain segments. We suggest that the remaining unexplained 85% of this extra force results from titin binding to the thin filament. With this enhanced force confirmed in the mouse model, future studies will aim to elucidate the proposed titin-thin filament interaction in actively stretched sarcomeres.

We propose and examine a three filament model of skeletal muscle force generation, thereby extending classical cross-bridge models by involving titin-actin interaction upon active force production. In regions with optimal actin-myosin overlap, the model does not alter energy and force predictions of cross-bridge models for isometric contractions. However, in contrast to cross-bridge models, the three filament model accurately predicts history-dependent force generation in half sarcomeres for eccentric and concentric contractions, and predicts the activation-dependent forces for stretches beyond actin-myosin filament overlap.

Force enhancement following muscle stretching and force depression following muscle shortening are well-accepted properties of skeletal muscle contraction. However, the factors contributing to force enhancement/depression remain a matter of debate. In addition to factors on the fiber or sarcomere level, fiber length and angle of pennation affect the force during voluntary isometric contractions in whole muscles. Therefore, we hypothesized that differences in fiber lengths and angles of pennation between force-enhanced/depressed and reference states may contribute to force enhancement/depression during voluntary contractions. The purpose of this study was to test this hypothesis. Twelve subjects participated in this study, and force enhancement/depression was measured in human tibialis anterior. Fiber lengths and angles of pennation were quantified using ultrasound imaging. Neither fiber lengths nor angles of pennation were found to differ between the isometric reference contractions and any of the force-enhanced or force-depressed conditions. Therefore, we rejected our hypothesis and concluded that differences in fiber lengths or angles of pennation do not contribute to the observed force enhancement/depression in human tibialis anterior, and speculate that this result is likely true for other muscles too.

Since the 1950s, muscle contraction has been explained using a two-filament system in which actin and myosin exclusively dictate active force in muscle sarcomeres. Decades later, a third filament called titin was discovered. This titin filament has recently been identified as an important regulator of active force, but has yet to be incorporated into contemporary theories of muscle contraction. When sarcomeres are actively stretched, a substantial and rapid increase in force occurs, which has been suggested to arise in part from titin-actin binding that is absent in passively stretched sarcomeres. However, there is currently no direct evidence for such binding within muscle sarcomeres. Therefore, we aimed to determine whether titin binds to actin in actively but not in passively stretched sarcomeres by observing length changes of proximal and distal titin segments in the presence and absence of calcium. We labeled I-band titin with fluorescent F146 antibody in rabbit psoas myofibrils and tracked segmental elongations during passive (no calcium) and active (high calcium) stretch. Without calcium, proximal and distal segments of titin elongated as expected based on their free spring properties. In contrast, active stretch differed statistically from passive stretch, demonstrating that calcium activation increases titin segment stiffness, but not in an actin-dependent manner. The consistent elongation of the proximal segment was contrary to what was expected if titin's proximal segment was attached to actin. This rapid calcium-dependent change in titin stiffness likely contributes to active muscle force regulation in addition to actin and myosin.

The presented correlation of TE with outcome indicates that TE scoring could replace ICM scoring in terms of priority. This would automatically require a rethinking process in terms of blastocyst selection and cryopreservation strategy.

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Altered parathyroid gland biology in patients with chronic kidney disease ( CKD ) is a major contributor to chronic kidney disease‐mineral bone disorder ( CKD ‐ MBD ). This disorder is associated with an increased risk of bone disorders, vascular calcification, and cardiovascular events. Parathyroid hormone ( PTH ) secretion is primarily regulated by the ionized calcium concentration as well as the phosphate concentration in the extracellular fluid and vitamin D. The metabolic disturbances in patients with CKD lead to alterations in the parathyroid gland biology. A hallmark of CKD is secondary hyperparathyroidism, characterized by an increased production and release of PTH , reduced expression of calcium‐sensing and vitamin D receptors on the surface of parathyroid cells, and hyperplasia and hypertrophy of these cells. These alterations happen on different timescales and influence each other, thereby triggering a cascade of negative and positive feedback loops in a highly complex manner. Due to this complexity, mathematical models are a useful tool to break down the patterns of the multidimensional cascade of processes enabling the detailed study of subsystems. Here, we introduce a comprehensive mathematical model that includes the major adaptive mechanisms governing the production, secretion, and degradation of PTH in patients with CKD on hemodialysis. Combined with models for medications targeting the parathyroid gland, it provides a ready‐to‐use tool to explore treatment strategies. While the model is of particular interest for use in hemodialysis patients with secondary hyperparathyroidism, it has the potential to be applicable to other clinical scenarios such as primary hyperparathyroidism or hypo‐ and hypercalcemia.

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