The mechanisms and treatments for sarcopenia: could exosomes be a perspective research strategy in the future?

Abstract

The age-related loss of muscle mass and muscle function known as sarcopenia is a primary contributor to the problems faced by the old people. Sarcopenia has been a major public health problem with high prevalence in many countries. The related underlying molecular mechanisms of sarcopenia are not completely understood. This review is focused on the potential mechanisms and current research strategies for sarcopenia with the aim of facilitating the recognition and treatment of age-related sarcopenia. Previous studies suggested that protein synthesis and degradation, autophagy, impaired satellite cell activation, mitochondria dysfunction, and other factors associated with muscle weakness and muscle degeneration may be potential molecular pathophysiology of sarcopenia. Importantly, we also prospectively highlight that exosomes (small vesicles) as carriers can regulate muscle regeneration and protein synthesis according to recent researches. Dietary strategies and exercise represent the interventions that can also alleviate the progression of sarcopenia. At last, building on recent studies pointing to exosomes with the roles in increasing muscle regeneration, mediating the beneficial effects of exercise, and serving as messengers of intercellular communication and as carriers for research strategies of many diseases, we propose that exosomes could be a potential research direction or strategies of sarcopenia in the future.

Apitherapy for Age-Related Skeletal Muscle Dysfunction (Sarcopenia): A Review on the Effects of Royal Jelly, Propolis, and Bee Pollen

“…Imbalance between muscle protein synthesis and degradation is associated with low protein intake and altered efficiency of the GI tract in old age, which triggers skeletal muscle loss and poor physical performance [ 36 , 40 ], given that proteins are the main building blocks of muscle myofibers. Moreover, transmembrane proteins and micro-peptides (e.g., myomixer and myomaker/Tmem8c) contribute to the formation of myofibers by promoting myoblast fusion via a mechanism that involves appropriate localization of Tmem8c at the plasma membrane of myoblasts allowing trafficking related to palmitoylation of C-terminal cysteine residues and C-terminal leucine [ 17 ]. Amino acid supplements (e.g., leucine, a master dietary regulator of muscle protein turnover, and its metabolite β-hydroxy β-methylbutyrate) and early refeeding with high protein diet (especially fast digestive proteins) can preserve muscle mass and function, revert sarcopenia, and enhance mobility and quality of life (QoL) by correcting age-related nutritional deficiencies, muscle protein turnover, and immune dysregulation—these effects are even greater when combined with other nutrients like vitamin D or omega 3 fatty acids as well as with physical exercise [ 6 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 ].…”

“…Given its high prevalence in the general population, which ranges between 5 and 40% in western countries and increases up to 50% in advanced age, sarcopenia is considered a public health problem [ 4 , 15 ]. It causes progressive decline of functional capacity, contributes to frailty, increases the risk of falls and hospitalization in old people [ 16 , 17 ], and leads to poor outcomes in patients with COVID-19 [ 18 ]. A large number of pharmacological agents are being tested as anti-sarcopenic agents such as bimagrumab (BYM338), enobasarm (GTx-024), trevogrumab (REGN1033), and sarconeos (BIO101).…”

MIF Facilitates the Therapeutic Efficacy of Mesenchymal Stem Cells Derived Exosomes in Acute Myocardial Infarction Through Up-regulating miR-133a-3p

“…However, more extensive testing and validation of exosomes therapeutics are needed to assure its safety and e cacy. 28 In this study, we proved that exosomes of MIF-MSCs were embellished with anti-apoptotic and angiogenesis miRNA, which inhibit apoptosis and promote angiogenesis, thus protect the cardiac function. Exosomes are extracellular vesicles containing miRNAs et al, and they are absorbed by target cells.…”

Advance in Drug Delivery for Ageing Skeletal Muscle

“…EVs can be administered via intravenous (IV) and intranasal routes to reach the target location, depending on the therapeutic purpose. Due to these characteristics, EVs are considered ideal natural systems for drug delivery (Vader et al, 2016;Skotland et al, 2020;Rong et al, 2020).…”

“…proposed a prospect that extracellular vesicles (EVs), including exosomes, may also be ideal drug carriers which could regulate muscle regeneration and protein synthesis. EV-based delivery systems may be potential strategies of age-related muscle loss in the future ( Rong et al., 2020 ).…”