Myostatin (MSTN) is a transforming growth factor (TGF)-β superfamily member that acts as a negative regulator of muscle growth and may play a role in cardiac remodeling. We hypothesized that inhibition of activin type II receptors (ACTRII) to reduce MSTN signaling would reduce pathological cardiac remodeling in experimental heart failure (HF). C57BL/6J mice underwent left anterior descending coronary artery ligation under anesthesia to induce myocardial infarction (MI) or no ligation (sham). MI and sham animals were each randomly divided into groups ( n ≥ 10 mice/group) receiving an ACTRII or ACTRII/TGFβ receptor-signaling inhibiting strategy: 1) myo-Fc group (weekly 10 mg/kg Myo-Fc) or 2) Fol + TGFi group (daily 12 µg/kg follistatin plus 2 mg/kg TGFβ receptor inhibitor), versus controls. ACTRII/TGFBR signaling inhibition preserved cardiac function by echocardiography and prevented an increase in brain natriuretic peptide (BNP). ACTRII/TGFBR inhibition resulted in increased phosphorylation (P) of Akt and decreased P-p38 mitogen-activated protein kinase (MAPK) in MI mice. In vitro, Akt contributed to P-SMAD2,3, P-p38, and BNP regulation in cardiomyocytes. ACTRII/TGFBR inhibition increased sarco/endoplasmic reticulum Ca2+-ATPase (SERCA2a) levels and decreased unfolded protein response (UPR) markers in MI mice. ACTRII/TGFBR inhibition was associated with a decrease in cardiac fibrosis and fibrosis markers, connective tissue growth factor (CTGF), type I collagen, fibronectin, α-smooth muscle actin, and matrix metalloproteinase (MMP)-12 in MI mice. MSTN exerted a direct regulation on the UPR marker eukaryotic translation initiation factor-2α (eIf2α) in cardiomyocytes. Our study suggests that ACTRII ligand inhibition has beneficial effects on cardiac signaling and fibrosis after ischemic HF. NEW & NOTEWORTHY Activin type II receptor ligand inhibition resulted in preserved cardiac function, a decrease in cardiac fibrosis, improved SERCA2a levels, and a prevention of the unfolded protein response in mice with myocardial infarction.

Introduction Polyneuropathy is a debilitating condition characterized by distal sensory and motor deficits. Schwann cell dysfunction and axonal loss are integral factors in pathophysiology and disease progression of polyneuropathy. Aims The aim of this study was the assessment of Schwann cell characteristics, nerve fibers and myelination parameters in polyneuropathy patients compared to controls. Methods Nerve tissue was obtained from polyneuropathy patients (n = 10) undergoing diagnostic sural nerve biopsies. Biopsies of healthy peripheral nerves (n = 5) were harvested during elective sural nerve grafting for chronic peripheral nerve lesions. Exclusion criteria for the healthy control group were recent neurological trauma, diabetes, neurological and cardiovascular disease, as well as active malignancies and cytotoxic medication within the last 12 months. The over-all architecture of nerve sections and myelination parameters were histomorphometrically analyzed. Immunofluorescent imaging was used to evaluate Schwann cell phenotypes, senescence markers and myelination parameters. Results Histomorphometric analysis of nerve biopsies showed significant axonal loss in polyneuropathy patients compared to controls, which was in accordance with the neuropathological findings. Immunofluorescent staining of Schwann cells and myelin basic protein indicated a significant impairment of myelination and lower Schwann cell counts compared to controls. Phenotypic alterations and increased numbers of non-myelinating p75-positive Schwann cells were found in polyneuropathy patients. Discussion This study provided quantitative data of axonal loss, reduced myelination and Schwann cell dysfunction of polyneuropathy patients compared to neurologically healthy controls. Phenotypic alterations of Schwann cells were similar to those seen after peripheral nerve injury, highlighting the clinical relevance of Schwann cell dysfunction.

Purpose: Polyneuropathy is a debilitating condition characterized by distal sensory and motoric deficits. Common risk factors in Western countries include diabetes, alcohol abuse, cytostatic drugs and cardiovascular disease. Vascular and neurochemical factors affect cells of the peripheral nervous system. Schwann cell dysfunction and impaired nerve regeneration are important pathophysiological mechanisms that are associated with changes in cellular metabolism, signal transduction and neurotrophic signaling. In experimental models of polyneuropathy, Schwann cell dysfunction and altered myelination were described. Clinically, there is very limited knowledge about Schwann cell characteristics and function in polyneuropathy patients. In this study, we investigated Schwann cell characteristics, nerve fibers and myelination parameters in nerve biopsies obtained from polyneuropathy patients compared to controls. Methods: Nerve tissue was obtained from polyneuropathy patients (n = 10) undergoing diagnostic sural nerve biopsies. Biopsies of healthy peripheral nerves (n = 10) were harvested during reconstructive procedures (e.g. sural nerve grafts, denervation of muscle flaps). Exclusion criteria for the healthy control group included recent neurological trauma, diabetes, neurological and cardiovascular disease, as well as treatment with cytotoxic medication in the previous 12 months. The over-all architecture of nerve sections and myelination parameters were histomorphometrically analyzed. Immunofluorescent imaging was used to evaluate Schwann cell phenotypes, senescence markers and myelination parameters. Immunofluorescent signals were quantified using NIS-Elements imaging software (Nikon Instruments Inc.). Results: The mean age of the included polyneuropathy patients (7 male and 3 female) undergoing diagnostic sural nerve biopsy was 57.3 years (SD 13.04; range 29 - 76 years). Control biopsies were obtained from patients undergoing reconstructive procedures. Three sural nerves, 3 obturator nerves, 2 thoracodorsal nerves, 1 superficial peroneal nerve and 1 medial antebrachial cutaneous nerve were analyzed. In the control group which included 2 male and 8 female patients, the mean age was 46 years (SD 13.384; range 28 - 64 years). Histomorphometric analysis of nerve biopsies showed a significant reduction in axon numbers from 3184 in the control group to 1373.3 in the polyneuropathy group (p = 0.035). Axon density and G-ratio were also significantly lower in polyneuropathy patients (p = 0.001 and p = 0.015, respectively). Immunofluorescent staining concurred with histomorphometric findings, as S-100 (p = 0.0017) and Neurofilament-H (p < 0.0001) signals were significantly reduced compared to controls. Immature p75-positive Schwann cells were identified in nerve biopsies of polyneuropathy patients. Myelin-basic protein was significantly reduced in the polyneuropathy group compared to the control (p < 0.0001). Conclusion: ...