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The Cell

Frank C. Mooren

Cellular Architecture golipids, and sterols. The major membrane lipids

are phospholipids, which form a bilayer matrix with the
The cell represents the smallest unit of a living polar regions facing the hydrophil extracellular fluid
organism and exists either as a free and migrating and the cytosol. The complex lipids like
cell, like blood cells, or as a cell embedded within a phosphosphingolipids are involved in cellular signaling
tissue complex. Despite many contacts with the processes or in identifying cells like gly- cosphingolipids
extracellular matrix or neighboring cells, the single that carry blood group antigens in the erythrocyte
cell functions independently and autonomously membrane. Cholesterol, another complex lipid, is by far
within a certain range. It is surrounded by a cell the most commonly found sterol in membranes. While
membrane that is responsible for perception of its content is high in the. plasma membrane, it is
hormonal information and for controlling the nearly absent in the mitochondrial membrane. The
exchange of ions, substrates, and other substances. reason for this diversity of the chemically distinct lipids
The cell interior is organized and structured by the in any given membrane is largely unknown.
cytoskeleton and consists of the cytosol and various Membrane proteins can be divided into two
membrane-bound organelles. Such a classes: integral and peripheral proteins. This
compartmentalization enables the cell to carry out classification denotes the degree of treatment
numerous functions and processes synchronously required to release the proteins from the membrane.
for instance, energy generation and dissipation, Peripheral proteins that usually associate with lipid
protein synthesis and protein degradation. bilayer in a noncovalently bound form can be
released from the membrane by relatively gentle
Membranes methods like washing of the membranes in buffers
of different ionic strength and pH or in the presence
Membranes coat the entire cell as well as of divalent cation chelators such as EDTA. In
intracellular organelles. This structural homogeneity contrast, integral membrane proteins are partially
of cellular membranes is a prerequisite for vesicular embedded in the bilayer and can be released from
exchange across the cell membrane and between the bilayer only through destruction of its
cellular organelles. All membranes consist of lipids structural integrity using detergents or organic
and proteins as their major components. The solvents. However, this distinction between
relative amounts of proteins and lipids can vary peripheral and integral membrane proteins
significantly between different cell types and emphasizes the relative strength of attachment but
between different organelles. Likewise, the protein does not clearly define the mode of attachment to
content of neuronal myelin membranes is about the bilayer. The attachment might depend on
20% dry weight but Increases to about 80% in the electrostatic or hydrophobic interactions, or the
mitochondrial membrane. The membrane lipids protein might be covalently bound to fatty acids or
belong to different lipid classes such as glycerol- phospholipids that serve as an anchor within the
phospholipids, phosphosphingolipids, glycosphin- lipid bilayer.
4 Mooren
The Cell 5

Integral proteins, which span the entire vesicle movements, which involve endocytosis,
Table 1.1 Classification
membrane, of Actin-Associated
are called transmembrane proteins. TheyProteins
exocytosis, or phagocytosis, but also for cyto-
may have a single transmembrane segment or skeletal interactions with the membrane, which play
multiple transmembrane segments and are a role in determination of asymmetry and
amphiphilic. The portions of the proteins that face stabilization of microdomains as well as plasma
the polar solvents are enriched in amino acid membrane stability (Manno et al. 2002). '
residues with polar and ionized side chains, whereas
the parts of the molecule that are in contact with Cytoskeleton
the lipid bilayer contain primarily nonpolar amino
acid residues. The cytoskeleton is responsible for the cells shape
The concept of the plasma membrane as a fluid and structure. The cytoskeleton is not a solid and
mosaic model describes the plasma membrane as a static framework. Instead, it is highly dynamic and is
highly flexible and mobile structure. For more than involved in a variety of processes such as cellular
three decades it has been known that all movement and locomotion, cell division,
biomembranes display a lateral and transversal phagocytosis, volume regulation, and cell signaling.
asymmetry for both constituents, proteins and Furthermore, it is involved in the organization of
lipids, suggesting that the mobility of molecules is vesicular transport inside the cell and in directing
still somewhat restricted (Bretscher 1972). The vesicular endocytotic and exocytotic processes.
transversal asymmetry of membrane proteins The cytoskeleton consists of three major types of
depends on the way in which the protein is originally filamentous proteins: actin filaments or
inserted into the membrane. Generally the microfilaments, intermediate filaments, and
translocation of proteins across the bilayer is microtubules (Frixione 2000). Actin filaments are
negligible. In contrast, the lateral mobility of proteins small (about 8 nm thick) filaments of polymerized
is much higher, allowing the enhancement of actin, a 43- kDa globular protein. Polymerization is
receptor protein density in specialized areas of the dependent on ATP and cations, most likely
cell or in contact zones to other cells or membranes. potassium and magnesium. There are a number of
Likewise, transversal lipid asymmetry can be actin-associ- ated proteins that are important for the
found in the plasma membrane. While the choline- structure and function of the actin network (table
containing phospholipids, phosphatidylcholine and 1.1); for example, spectrine can serve as a cross-
sphingomyelin, are primarily located in the cells linker of actin filaments. Moreover, it connects the
outer leaflet, the aminophospholipids phos- actin cytoskeleton to several other membrane
phatidylserine and phosphatidylethanolamine are proteins and ion transport systems. The latter
primarily exposed to the intracellular environment. function has also been established for ankyrin,
This property can be used for diagnostic purposes, another actin- associated protein. Interactions
for example to determine apoptotic cells. In apoptotic between ankyrin and the sodium pump, sodium
cells, the membrane phospholipid channels as well as H*-K+ ATPases have been shown
phosphatidylserine is translocated from the inner to (Denker & Barber 2002).
the outer leaflet of the plasma membrane. The The actin cytoskeleton is primarily located in the
dissipation of phospholipid asymmetry is facilitated cell periphery. In polarized cells like epithelial cells,
by calcium-dependent and Mg-ATP-inde- pendent the structure of the actin meshwork differs between
activation of scramblase. The asymmetry of plasma the basolateral and the apical part. Moreover, the
membrane lipids under physiological conditions is actin cytoskeleton builds up the core of cellular
maintained through the activation of two active extensions like microvilli.
transporters, the phospholipid translo- case The structure of the actin cytoskeleton is highly
(floppase) and the aminophospholipid trans- locase dynamic and can rapidly change upon cellular
(flipase) (Diaz & Schroit 1996; Tang et al. 1996; activation or stress. Therefore the actin filament
Bitbol & Devaux 1988). In addition, there is evidence turnover is linked to intracellular signaling processes
for a lateral inhomogeneity of the lipid composition adapting the cytoskeletal network to the
of the plasma membranes resulting in certain lipid physiological demands, for example during cell
microdomains. Furthermore, the cytoskeleton plays activation or motility (Mitchison & Cramer 1996).
an important role in transversal and lateral Important effectors on the actin cytoskeleton are the
distributions of membrane components. This is true PI 3-kinase and small GTPases including Rho, Rac,
not only for the membrane and CDC-42. Each of these has specific inter-

Actin-associated proteins Name Function

Actin monomer binding Profilin, cofilin, Bind monomeric G actin; regulate the
proteins thymosin availability of polymerizable actin; actin
Actin filament capping Geisolin, villin, Regulate monomer addition at the filament
proteins leufactin end
Actin filament nucleating ARP2/3 Generate new filaments
Actin filament binding
proteins Cross-linking Spectrin, fimbrin Connect filaments to form a 3-dimensional
proteins Membrane Tafin, ankyrin, ezrin network Connect filaments to the plasma
anchors Motor proteins Myosin 1, II, V, VI membrane Drive vesicular transport
actions with particular actin-associated proteins cussed so far. Encoded by more than 50 known
inducing the formation of filopodia, lamellipodia, genes, intermediate filaments consist of associated
and stress fibers (Nunoi et al. 2001). tetramers of fibrous proteins and are divided into six
Microtubules are polymers made of tubulin, a well- major classes (Fuchs & Weber 1994). One group
characterized heterodimeric protein. Microtubules encompasses the ceratines, which can be found
originate from the centrosome, an area in the cytoplasm predominantly in epithelial cells. Another group
characterized by the presence of centriols, and require contains vimentin, found predominantly in
cations and GTP for polymerization. The microtubule mesenchymal cells, and desmin, expressed in all
network is located below the actin cytoskeleton muscle cells. Intermediate filaments can be found in
spanning the distance from the plasma membrane to cell-cell contact zones and around the nuclear pores.
the nucleus. Because microtubules are polarized, their A major function of several intermediate filaments is
parallel arrangement within the cell defines the polarity to stabilize cellular architecture against mechanical
of the ceil. The microtubule cytoskel- _. eton can rapidly forces (Coulombe et al. 2000).
assemble into a variety of distinct configurations in
order to carry out different tasks. During mitosis, Cell Organelles
microtubules build up the mitotic spindle responsible
for the chromosomes movement. During interphase, The cytosol contains a number of membrane- bound
microtubules are responsible for the arrangement of structures called cell organelles. Because of their
cellular organelles and play a role in the movement of different sizes and densities, organelles can be
vesicles between organelles and the plasma membrane isolated after cellular homogenization by density
(Allan et al. 2002). gradient centrifugation. Organelles fulfill different
Similar to the situation with the actin functions in cellular metabolism and enable the cell
cytoskeleton, there exist also a number of to separate the multiple biochemical reactions, for
microtubule-associated proteins (MAPs) that serve example synthetic and degradation pathways, or
in stabilization and cross-linking of microtubules. energy-producing and -consuming reactions (figure
Furthermore, MAPs convey signaling molecules 1.1).
such as kinases and phosphatases to the Nucleus
microtubule cytoskeleton (Gundersen & Cook
The cell nucleus is usually the largest cell organelle
1999). Motorproteins of the kinesin and dynein
and is composed of two membranes, forming the
complexes are involved in the directed movement of
nuclear envelope, which is tethered to the
vesicles. While dynein 1 (CD1) drives the cargo
endoplasmic reticulum (figure 1.1a). The nucleus
toward the minus ends of microtubules, most
houses the genetic information of the cell encoded in
members of the kinesin superfamily drive the
the sequence of DNA nucleotides. This information is
vesicle movement in the opposite direction (Allan et
fundamental for cellular homeostasis leading to the
al. 2002; King 2000).
synthesis of proteins that determine structure and
Finally, another group of cytoskeletal filaments,
function of the cell. Usually the DNA is associated
the intermediate filaments, should be mentioned.
with proteins forming a fine network of threads
This group is more heterogeneous than those dis
called chromatin. For cell division, the

The Cell 7

DNA protein aggregates will be condensed, form* ing the ER handles a number of different functions such
the 46 chromosomes of a human cell. as
During the interphase the genetic information is
post-translational modification of proteins,
transcribed into RNA, which has to be translocated
from the nucleus to the cytosol for translation into support of the vesicular transport machinery,
assistance in generating tertiary protein i
an amino acid sequence at the ribosomes.
Additionally, RNA and proteins that build the structures,
ribosomes have to be transferred to the cytosol. This lipid biosynthesis,
macromolecular exchange between the nucleus and calcium storage, and
the cytoplasm takes place through nuclear pores
that result from the fusion of the two membranes of
One can speculate that the apparently
the nuclear envelope. These circular openings are
homogeneous tubular system of the ER consists of
approximately 800 angstroms in diameter and occur
several microdomains and subdomains characterized
at regular intervals along the surface of the nuclear
by specific biochemical markers. Recent
envelope. A supramolecular structure referred to as
investigations of the intracellular traffic between the
the nuclear core complex and of approximately 125
ER and Golgi apparatus describe these organelles as
MDa is an important controlling element for the
highly dynamic in structure, making a precise
import and export of macromolecules (Weis 2003).
definition and description difficult. Likewise,
Finally, the nucleolus can be easily localized within
subdomains such as the transitional elements or the
the nucleus. This filamentous region is responsible
so-called ER-Golgi intermediate compartment
for decoding ribosomal RNA and assembling RNA
(ERGIC) have been defined. It was found that any
and protein components of ribosomal subunits.
part of this secretory pathway has its unique set of
Ribosomes resident or marker proteins that define its structural
Decoding of the genomic information and translating and functional properties. These resident proteins
it into an amino acid sequence are performed - at the either do not enter transport vesicles or - are
ribosomes. Ribosomes are macromolecular _ retrieved from the Golgi apparatus, when they have
complexes consisting of more than 50 different escaped the ER. For this purpose resident proteins
ribosomal proteins and a number of ribosomal RNA possess amino acid sequences like the di- lysin motif
molecules. Typically each ribosome is composed of a targeting a protein to the ER (Teasdale & Jackson
large and a small subunit. The ribosomal subunits 1996).
are assembled in the nucleolus region of the nucleus. The Golgi Apparatus
Ribosomal proteins therefore have to be imported into
The Golgi apparatus consists of about six to eight
the nucleus to associate with RNA. The complete
membrane-bound flattened cisternae arranged in
subunits are'sbA^
then exported through the nuclear pores
parallel order. It is a dynamic organelle that receives,
; v
&^\^3pt?GSrfp. -

into the cytosol, where the subunits form the

post-translationaily modifies, and sorts proteins for
functional ribosome. The ribosomes either are located
delivery to various destinations (figure 1.1c).
free in the cytosol or are attached to the endoplasmic
Functionally, the two sides of the Golgi apparatus
reticulum to produce housekeeping or secretory
behave differently. At one side, the so-called cis-GoIgi
proteins, respectively. For protein synthesis, however,
network (CGN), newly synthesized material from the
a ^fe.
number of additional enzymes, like RNA
ER is imported. At the opposite side, the trans-Golgi i
polymerases, are required.
network (TGN), the material is exported after sorting
Endoplasmic Reticulum and packaging. Between these steps the post-
The endoplasmic reticulum (ER) is a membrane- translational modification of proteins takes place, for
bound organelle that consists of a network of example the linkage of carbohydrates to proteins to
cisternae and tubules stretching throughout the form glycoproteins.
e Morphology and function of the Golgi apparatus i
cytosol (figure 1.16). Morphologically a smooth and I
a rough endoplasmic reticulum can be are highly dependent on intact cytoskeletal
Figure 1.1 Electron micrographs of cellular organelles; (a) Nucleusstructures.
(nu), mitochondria (mi); (b) endoplasmic
Depolarization reticulum
of microtubules (er); (c)
results in
distinguished, the latter being characterized by the
Golgi apparatus (golgi); (d) lysosomes (ly). zymogen granula (zy);a (e) mitochondrium
fragmentation of in a Golgi
the cross-section of human
apparatus skeletal
(Thyberg &
muscle outer of ribosomes.
(om),This apparent structural space (im), matrix (ma), and myofibrils (fi); (f) subsarcolemmat
membrane cristae (cr), intermembrane
Moskalewski 1999). The different organization of 1
simplicity should not obscure the fact that
(ss) and intermyofibrillar (imf) mitochondria of a human muscle fiber. Micrographs a-d were taken from pancreatic acinar
cells, which are an epithelial ceil type. The bar in figures a-d indicated 1 pun.
Micrographs A-D by the courtesy of Dr. M.M. Lerch, Ernst-Moritz-Arndt Universitat Greifswaid; micrographs E-F from H. Hoppeier & M. Fluck, Med.
Sci. Sports Exerc. 35:95-104, 2003, with permission.

s Mooren

..microtubule network in polarized epithelial cells and vations from several different cell types indicate a
in fibroblasts therefore results in different certain spatial distribution of mitochondria within
localizations of the Golgi apparatus (McNiven & the cytosol that results in the modulation of
Marlowe 1999). In addition, maintaining the proper intracellular calcium signals (Tinel et al. 1992).
structure and function of the Golgi apparatus Moreover, mitochondria are involved in the
depends on a number of mechanochemical enzymes initiation of programmed cell death (apoptosis).
like dyneins, kinesins, and myosins, which are Numerous close contacts between mitochondria,
involved in formation and movement of Golgi- the ER, and the cytoskeleton were observed,
derived vesicles (Allan et al. 2002). emphasizing the dynamic interaction between
these structures (Rizzuto et al. 1998). Finally, there
is evidence for a spatial heterogeneity of the
Mitochondria are oval-shaped organelles measuring mitochondria population within a cell. In the
1 to 2 (j,m in length and 0.1 to 0.5 jxm in diameter. skeletal muscle cell, mitochondria from the
Mitochondria are separated from the cytosol by an subsarcolemmal (SS) and the intermyofibrillar
outer membrane while their interior is further (IMF) region can be distinguished that differ with
compartmentalized by a membrane system. The respect to their biochemical properties and their
inner membrane divides the mitochondrias interior adaptation^ response to exercise (see later).
into the intermembrane space and the matrix
(figure l.le). The inner membrane is folded several Vesicular Structures
times, forming sheets or tubules that have been Within the cytosol, at least three different vesicular
named christae mitochondrialis. Novel insights into structures can be defined: peroxisomes, lyso- somes,
the mitochondrial structure owing to recent and endosomes (figure l.ld). These membrane-bound
technical advances revealed that mitochondrias organelles account for about 3% of the total volume.
shape and structure are variable and depend on Peroxisomes contain a number of different enzymes
source and conformational state. The christae that are involved in lipid degradation and
structure can vary from tubular to complex lamellar detoxification. Lysosomes are the final site of
structures. It has been shown that they are degradation and digestion of incorporated
connected to the intermembrane space by tubular extracellular raacromolecules and of obsolete
structures that might have important implications intracellular material. However, there is increasing
on metabolite diffusion and reaction rates (Frey & evidence that lysosomes and their precursor
Manneila 2000). The two mitochondrial membranes structures may have additional functions such as
are different with respect to their ion permeability. cytotoxicity and antigen processing/presentation.
While the outer membrane is highly permeable for Lysosomes are loaded with a number of degrading
molecules up to 5,000 kDa, the inner membrane enzymes like hydrolases and esterases and are
demonstrates low ion permeability comparable to characterized by an acidic pH value (Hunziker &
that of the plasma membranes. Therefore the Geuze 1996).
composition of the inner membrane space is Endosomes represent a heterogeneous
comparable to that of cytosol. While the population of intracellular vesicular structures.
mitochondria matrix contains the enzymes of the Endo- somal compartments can be defined
Krebs cycle, the inner membrane carries the according to various aspects such as function,
enzymes responsible for oxidative phosphorylation morphology, or composition. The definition of the
like cytochrome C. endosomal compartment is sometimes difficult
Mitochondria are the only organelles that contain because there are overlaps with other
separate and semiautonomous genomic information compartments, especially the lysosomal
on the mitochondrial DNA. This DNA codes for compartment. The term early endosorne" reflects an
about 13 different proteins involved in oxidative operational definition for this primary vesicle
phosphorylation and for ribosomal and transfer docking site either for endocytotic vesicles from the
RNAs. plasma membrane or as an acceptor compartment
The role of mitochondria in cell homeostasis, for vesicles from the trans-Golgi network. While early
however, does not seem to be limited to energy endosomes usually are located toward the cell
metabolism. There is evidence for a role of periphery, late endosomes can be found closer to the
mitochondria in intracellular signaling. nucleus (Gruenberg 2001). From the early
Mitochondrias role as a calcium storage and endosomes, material can be directed back to the
buffering organelle is well known (Rutter et al. plasma membrane via the recycling endosorne, as it
1998). Recent obser occurs
10 Mooren
The Cell 9

the cytosol
receptor forrecycling.
degradation Otherby pathways
the proteasome..
are the is Finally, a complex
not present protein machinery
on lysosomal membraneshas been
transfer of & Weissmann
material to the1998). Cargo transport
late endosomes, which described
1998). Finally,that itis has responsible
been observed for membrane
that the
may thefuseER with to iysosomes
the Golgi network
for final is performed and
degradation, via fusion.
material Studies
during the fromtrafficsynaptic
throughvesicle exocytosis
the endosomal
the ER-Golgi across
transcytosis intermediate
the cytosolcompartment.
from one During plasma in neurons have
compartment is moregiven and insight into a protein
more acidified. This iscom-
the cargo passage
membrane domainthrough to the the opposite
Goigi apparatus,domain plex
to theknown
activity as
of athe core complex,
K*-fT-ATPase. The pH which
of theseems
(Katzmann et al.processes are performed early
2002). Morphologically, and operative
in other cell istypes. about After6.0;
cargo is packed again and transported
endosomes tend to be tubular while late endosomes for secre- the first contact between the
endosomes and Iysosomes are characterized by vesicular and target
tion to the
are more plasma(Gruenberg
spherical membrane.2001). Another pathway
It is becoming membrane,
values of about vesicle
5 andand eventarget
below. SNARE
This declinemolecules
in pH
more and digestive enzymes
more apparent thatlikeevery hydrolases and
stage is defined interact
seems to withbeeach other. Synaptobrevin
important for dissociation is the of
by special toward
markers or thecoat lysosomal compartment
proteins. Vesicles coated relevant
incorporated vesicular
receptorSNARE complexes molecule,
as well while
as for thethe
withthe clathrin
endosomalrepresentcompartment. the Tobest- avoid defined
mem- target
shift ofSNARE consists
vesicular marker of proteins
syntoxin (Mukherjee
1 and SNAP-25. et al.
brane depletion pathway,
internalization of the ER and istoused,
which retrieve lost ER
for example, After
1997).the fusion event the core complex is released
proteins, a retrieval pathway
for internalization exists from the
of ligand-occupied Golgi
receptors. by the action of NSF (n-ethylmaleimide-sensitive
apparatus to the ER as well as from
Ligand-receptor coupling induces the exposure of the intermedi- Cytosolic
factor), whichTraffic
is recruited to the membrane by
ate compartment to the ER.
signaling motifs that are recognized by a complex of adaptor proteins called SNAPs (no relation to
In theand
adapter endocytotic route, the The
clathrin molecules. imported
rate of material
clathrin- Cytosolic traffic
SNAP-25). Despite refersthe toprogress
the multiple exchange of
in understanding
directed endocytosis
first to the atendosomal
the plasmacompartment,
membrane is vesicles
the between and
mechanical the intracellular
structural basis organelles as well
of membrane
from which it by
also regulated canrabbe5, transported
a small GTPase. via different
Rab 5 is as with athe
fusion, plasmaofmembrane
number questions (figure
remain1.2). There
also a For marker example,
of the internalized
early endosome receptors can
or sorting exist several
example, how routes
specificityin order to establishfusion
of membrane the
be recycled to
endosome and the is
plasma membrane;
involved material early
in promoting can communication
arises (Rizo & between
Siidhof 1998). organelles and plasma
be sorted for
endosome finalRab
fusion. digestion
11 and in rabthe7 andlysosomes
9 are otheror membrane and to ensure that none of the organelles
can be transferred to the trans-Golgi
small GTPases and marker proteins for the recycling network; and Exercise and the Cell
will be depleted of membrane components. In the
finally material can be transported
and the late endosome, respectively. Another marker from one side synthetic route, proteins are first translocated into
late membrane
endosometo is the the
opposite side.
(ci)-mannose 6- the ERand
Acute where they undergo
chronic exercisefolding
boutsand arematuration.
Such vesicular
phosphate receptor transport
(M6PR). It is found highlyconcentrated ER quality control
dependent on physiological stimuliguarantees
known to that affectonly correctly
aonnumber but The similarity in membrane as
of factors.
late endosomes folded
well proteins
as organare released Acute
structure. to theexercise
cell surface.
structure of the plasma membrane and the intra- ' " especially Otherwise those
proteins are are
that retro-translocated
maximal or supramaxi-
cellular organelles is an important prerequisite mal, often result in structural damage to tissues
for their structural communication via vesicles. followed by a more or less long period of impaired
Budding, movement, and fusion of vesicles are function. Tissue repair leads to an adaptive
moreover dependent on an intact cytoskeletal response, usually making the tissue more resis-
network that arranges the different pathways and tant to subsequent stimuli. Regular and chronic
that, in combination with the cytoskeletal-associ- exercise at a moderate workload is followed by
ated proteins, is necessary for vesicle movement. an adaptive training response that results in an
To address vesicles to a final target, a number of enhanced functional capacity of the organism,
code and marker proteins are used. Various vesicle presenting clinically as an increased maximal
coat proteins like clathrin or COP I and II have been oxygen capacity and enhanced muscular power
described that have different functions in vesicular and fatigue resistance. Both local damage and
transport. Clathrin-c.oated vesicles, the first coated adaptive response have a cellular and molecular
vesicles to be observed (in 1964), are involved in the component, which is discussed in the following
internalization pathway (Roth & Porter 1964). chapters. The present chapter is an overview of
However, some non-clathrin-depen- dent endocytotic current knowledge about the effects of exercise on
events have been identified also. aspects of the cellular structure such as membrane
COP I and COP II vesicles seem to be involved in the composition, cytoskeletal network, and organelle
transport to and from the ER (Allan et al. 2002; function.
Teasdale & Jackson 1996). Moreover, a number of
marker proteins have been characterized, such as Exercise Effects on Plasma
small GTPases (rab 5,11, 7, 9) or special amino acid Membrane Integrity and
motifs like the d-lysine or d-arginine motifs that
characterize the different organelles and vesicles Composition
and drive them to the target (Clague 1998). These Both acute and chronic exercise affect the integ-
marker sequences exist not only for membrane rity and the composition of the plasma membrane.
Figure 1.2 Schematic diagram of the
proteins, but also for soluble proteins of the cytosolic traffic Depending
organization (for detailson
seethe intensity
text). ERGIC, and duration,
endoplasmic acute Golgi
intermediate compartment; EE, early endosome; LE, late endosome; RE, recycling endosome; Lys, lysosome; Q O,
organelles matrix.
organelle/vesicle targeting motifs; / cargo unmodified/modified.
The Cell 11

exercise damages cellular membranes (Temiz et al. by an osmotic shrinkage of lactate-loaded

2000; Overgaard et al. 2002). This effect is either erythrocytes that could be further aggravated by an
delayed or blunted in trained individuals, suggesting exercise-associated fluid shift (Brun 2002).
an adaptational process during chronic exercise that Finally, mechanical stress affects plasma
can at least in part counteract the harmful effects membranes. In endothelial cells, shear stress has
associated with acute exercise (Senturk et al. 2001; been shown to be beneficial because it results in
Vincent et al. 1999; Yalcin et al. 2000; Venditti & Di decreased adhesion of blood cells and therefore
Meo 1997). prevents atherogenesis (Cooke 2003). On the other
In red blood cells, the exercise-induced plasma hand, the mechanical stress in contractile tissue can
membrane damage is indicated by an enhanced result in a decreased cellular integrity. Structural
osmotic fragility and an impaired deformability damage is pronounced after eccentric exercise as
(Senturk et al. 2001; Yalcin et al. 2000). After an indicated by the release of intracellular enzymes and
exercise test, structural alterations of plasma macromolecules like creatine kinase and myosin
membrane of leucocytes have been described, which heavy chains into the blood (Overgaard et al. 2002).
were associated with an increased cellular calcium Exercise-induced structural changes in the
content (Caimi et al. 1997). Azenabor and Hoffman- plasma membrane can be delimited by training
Goetz (2000) reported increased intracellular calcium (Yalcin et al. 2000). One reason might be the up-
levels and calcium influx in mouse thymocytes after regulation of defense mechanisms such as radical
exhaustive exercise. Recently, we could confirm these scavenging and depleting mechanisms (for details see
data in human lymphocytes immediately after an chapter 9) (Vincent et al. 1999). Exercise-induced
exhaustive exercise test at 80% V02max. These cellular hypertrophy is associated with an
alterations were time dependent, since these effects enlargement of the plasma membrane. Cell
were not observed at later time points after the test. capacitance measurements indicate that the cell
The increase in basal calcium was interpreted as an membrane surface area of cardiomyocytes increases
enhanced calcium influx across the plasma under endurance training-induced cardiac growth
membrane due to exercise-associated structural (Mokelke et al. 1997). Furthermore it .could be
damage, because the calcium sequestration was shown that regular exercise alters the lipid
unaffected in these cells (Mooren et al. 2001). composition of both plasma and mitochondrial
A number of factors have been proposed to be membrane (Dohm et al. 1975). In long distance
responsible for plasma membrane structural runners, an increased ratio of phosphatidylcholine to
changes observed during and after exercise. phosphatidylethanolamine and a decreased ratio of
Oxidative stress is one factor that can induce cholesterol to total phospholipids were observed
structural and functional alterations. Since it is (Nakano et al. 2001). This finding was associated
difficult to measure free radicals because of the with an enhanced deformability of the athletes
short life span of these species, scientists focus on erythrocytes. After four weeks of treadmill training, a
determining free radical tissue damage such as lipid change in the structural composition of rat skeletal
peroxidation. Exercise-induced lipid peroxidation has muscle membrane was observed with a decrease in
been demonstrated in a number of studies (Dillard et polyunsaturated fatty acids (Helge et al. 1999). These
al. 1978; Child et al. 1998; Cooper et al. 2002). data were partially confirmed in humans after six-
Moreover, a correlation between lipid oxidation and week exercise training of low intensity (Andersscn et
exercise intensity was reported (Azenabor & al. 1998). Furthermore, a muscle type-specific
Hoffman-Goetz 2000). Markers of free radicals could phospholipid fatty acid pattern was observed. The
be diminished after application of antioxidants and white quadriceps, a muscle dominated by fast-twitch
allopurinol, an inhibitor of xanthine oxidase (see glycolytic fibers, demonstrated a significantly higher
chapter 9) (Senturk et al. 2001; Vina et al. 2000). degree of unsaturated fatty acids than soleus
Other factors that must be considered are muscle, which consists mainly of slow oxidative
metabolic and mechanical stress. Increased plasma fibers, or the red quadriceps muscle, which contains
lactate levels and, subsequently, an enhanced lactate both slow oxidative and oxidative glycolytic fibers.
influx into red blood cells may also affect cell rigidity This might be explained by the contribution of lipids
(Szygula 1990). Red cell deformability decreases with that the fiber type utilizes for fueling oxidative
increasing lactate levels under in vitro conditions. phosphorylation, and emphasizes the impact of
This effect might be mediated metabolism on membrane composition.
1! | E-C coupling j
j' I dysfunction
12 | Mooren

Mechanical Stress and Cytoskeleton (figure 1.4; Friden & Lieber 2001). Whether these
events are solely responses to the mechanical
Mechanical stress is an important effector and
stimulus or the effect of activated intracellular
modulator of the cytoskeletons structure and
proteases remains unclear. Several studies have
organization. Cytoskeletal alterations depend on the
demonstrated an increase in basal intracellular
intensity of the stimulus. Submaximal stimuli
calcium concentrations in muscle fibers after
usually result in a reorganization of the structure,
exercise, which can activate calcium-dependent
while supramaximal stimuli often disrupt the
proteases such as calpain. Belcastro (1993) reported
cytoskeletal network followed by regenerating and
both an increased calcium affinity of calpain and an
remodeling processes. Examples of both responses
increased calpain activity in hindlimb muscles after
are given here while a distinction is made between
exercise. Interestingly, calpain preferentially affects
muscle and non-muscle cells.
cytoskeletal proteins while it interferes less with the
Exercise may damage fibers in the active
myofilaments. Another proposed pathway involves
muscles, especially when the exercise is relatively
calcium-dependent activation of phospholipase A2,
intense, is of long duration, and includes eccentric
known to damage cell membranes by cracking
contractions. Clinically this presents as muscular
membrane lipids (Armstrong 1990). While
discomfort and pain in the stressed muscles that
pharmacological inhibition of phospholipase A2 was
peak 24 to 48 h after exercise, known as delayed-
effective in attenuating the stimulus-induced
onset muscle soreness (DOMS; Friden & Lieber
membrane damage in skeletal muscle, it was not
2001). DOMS is directly related to the eccentric
responsible for myofibrillar disruption (Jackson et
component of exercise, a form of exercise
al. 1984; Duncan 1988).
characterized by forcible lengthening of a
The other hypothesis focuses on a primary sar-
contracting muscle. This type of exercise generates
colemmal damage. This should result in both
higher tension than any other form of contraction
disintegration of the lipid bilayer and disconnection
(Proske & Morgan 2001).
of the calcium release units (feet structure), which
Which is the primary event of muscle injury after
consists of membranous (voltage-dependent Ca2+
exercise is still controversial (figure 1.3). One
channel; dihydropyridine receptor, DHPR) and
hypothesis claims a primary intracellular event in
submembranous components (intracellular Ca2*
which overstretched and disrupted sarcomere's
channel; ryanodine receptor, Ryr) together with
represent the initial damage. Cytoskeletal
cytoskeletal elements. A disturbance of ion
disruption, especially of the desmin intermediate
homeostasis and of the excitation-contraction (EC)
filament network, has been shown to occur early
coupling follows (Warren et al. 2001). Supporting
after eccentric exercise. Subsequently,
evidence comes from studies in mouse muscle.
morphological studies show sarcomeres out of
Exercise-induced tension deficit was reversible after
register with one another and Z-disc streaming and
application of caffeine, known to

Loss of
(e.g force

Ryr/DHPR Ca-
re!ease unit (feet
B Ca-dependent
1 protease activation

Figure 1.3 Postulated sequences of events leading from mechanical load to muscular loss of function.
Adapted from U. Proske & D.L. Morgan, 2001, J. Physiol. 537.2:333-345.
14 Mooien
The Cell 13

proteins, membrane lipids, and ion channels (Ali & biogenesis.

and should helpMoreover,
the muscle a to number
withstand of further
Schumacker 2002). Some ion channels have been physiological
stress. Other and pathophysiological
hypotheses focus onconditions have
an increased
identified that change their open probability upon been shown
resistance to enhance
against stress ofmitochondrial
the cytoskeleton biogenesis,
and the
membrane stretching, leading to a subsequent influx such
cell as electrical
membrane (Gibalastimulation,
et al. 1995).creatine depletion,
of calcium concomitant with an activation of hyperthyroidism,
Currently there isand
no information respiratory
calcium-dependent intracellular signaling pathways deficiency.
about the effect of exercise on the cytoskeleton of
(Sachs & Sokabe 1990). Mitochondrial
non-muscle biogenesis
cells. However, oneiscan
a complex process
find analogies In
other various
areas steps
such such
as hemodynamics events
as signaling and
Mechanical Stimuli and leading to research.
cardiovascular transcriptionA numberof nuclear and
of interesting
mitochondrialhavegenes, protein
made and lipid about
Membrane Traffic observations been recently the
proteinof import
effect into mitochondria,
shear stress on the endothelial and theircell
Mechanical stimuli including shear stress, osmotic
assembly into The
cytoskeleton. the enzyme
blood complexes (figure 1.5).
flow constantly exposes
pressures, and the like apply forces to the plasma
membrane resulting in alterations of membrane endothelial cells in Mechanisms
Initial Signaling vivo to hemodynamic forces that
tension, one intrinsic variable of plasma change with the onset of exercise and depend on the
Muscle contraction is activated by and associated
membranes. A rough approximation of plasma type and intensity of exercise. The shape and the
with numerous intracellular signaling events, one of
membrane tension is given by LaPlaces law. Other cytoskeletal organization of the endothelial cells
which is increases in cytosolic calcium. Calcium is
contributing factors are the attachment of depend on the Intensity of the shear stress applied.
known to be an important second messenger.
cytoskeleton and hydrostatic pressure across the In regions of the aortic tree exposed to low shear
Voltage-induced calcium influx releases calcium
membrane (Dai &Sheetz 1999). Usually cells stress, the cells are polygonal and have only a few
from the sarcoplasmic reticulum. Besides facilitating
respond to increases in membrane tension with an stress fibers. In contrast, in regions of high shear
actin/myosin cross-bridging, calcium serves as an
enhanced exocytosis rate, leading to an enhanced stress, the cells are more elongated and contain
activator of a number of kinases and phosphatases.
cell surface as indicated by capacitance numerous stress fibers. These findings could be
The differential activation of transcription factors by
measurements. This mechanism is used as a trigger confirmed by in vitro experiments using flow
distinct calcium signaling patterns seems to be
for secretory cells, for example the release of atrial chambers (Barakat 1999; Galbraith et al. 1998).
responsible for myosin isoform expression, thereby
natriuretic factor (ANF) and angiotensin II from Morphologically, enhanced shear stress results in
modulating the muscle phenotype (Chin et al. 1998;
stretched cardiac myocytes (Sadoshima & Izumo more stress fibers and a rearrangement of the
Wu et al. 2001; Allen & Leinwand 2002; Chin et al.
1997). In contrast, a decrease in membrane tension cytoskeleton. This includes thicker intercellular
2003) (see chapter 13). For a long time it was
is followed by an enhanced endocytosis rate junctions, more apical microfilaments, and more
unclear whether increases in cytosolic calcium
Figure 1.4inElectron
a recovery of membrane
micrograph tension.damaged
of eccentrically Several microtubule organizing centers (Galbraith et al,
would be propagated into intracellular organelles.
human skeletal
exceptions muscle.
to these rulesNotecanthebe lack
found,of registry
leading ofto 1998).
Using the recombinant calcium-sensitive photo-
the myofibrils, that
assumption the Z-disc
and Several mechano-sensors have been identified in
dissipation, and the sarcomeric disruption. protein aequorin, modified by addition of a
predominantly affect the rate of membrane turnover the cell membrane. On the luminal side of
Micrograph courtesy of Dr. J. Friden, Department of Hand Surgery, mitochondrial target in the sequence, the calcium
(Apodaca endothelial cells, vascular endothelial growth factor
Sahlgrenska 2002). Exocytosis
University and endocytosis
Hospital, SE-413 45, Goteborg, seem to
Sweden. concentration within the mitochondrial matrix of
be coupled
Reprinted, processes
by permission, from J.leading
Friden. to a continuous receptor (a receptor tyrosine kinase) can serve as a
living cells could be determined (Rizzuto etal. 1992;
replacement of the cell surface. Membrane tension mechano-sensor. Similarly, integrins work on the
Rutter et al. 1998). This approach revealed that
therefore can be adjusted depending on which abluminal side (Fisher et al. 2001; Shyy &Chien
upon physiological stimulation, the cytosolic calcium
release the
process sarcoplasmic calcium pool and thereby
predominates. 2002). Dynamic interaction between mechano-sen-
increase was accompanied by an increase of the
Cellular the voltage-dependent
mechano-sensors include calcium-induced
integrins, ion sitive integrins and extracellular matrix proteins
mitochondrial matrix calcium concentration, which
calcium release
channels, (Warren
and the et al. 1993;
cytoskeleton, Balnave
while & Allen
downstream results in the activation of many downstream
reached levels sufficiently high to activate matrix
signaling pathways involve intracellular messengers signaling molecules. This includes activation of
dehydrogenases. Another calcium-dependent
like While the exact
calcium, cyclicseries
AMP,of andinitialthe
events leading of
activation to serine/threonine and tyrosine kinases located in the
pathway was demonstrated by Wu et al. (2002) using
muscle damage remains open, there
phosphorylation/dephosphorylation are obvious
cascades. For a cell membrane and focal adhesions and induction of
a transgenic mouse approach. The authors could
signs detailed
more of impaired cellular the
description integrity
referred byto phosphorylation cascades of signaling molecules;
show that a downstream effector kinase of the
the release
some excellentof recent
reviews molecules such as
(Hamill & Martinac examples are the Ras-MEKK-JNK signaling pathway
calcium signaling pathway, the calcium/calmodulin-
2001; kinase,
Davies 1995;lactate
Morris dehydrogenase
& Homann 2001). (LDH), or and members of the Rho small GTPase family such
dependent protein kinase, augmented mitochondrial
myosin heavy chains. Subsequently, an as RhoA, which is functionally linked to MAPK
DNA replication and mitochondrial biogenesis as
inflammatory response Biogenesis starts with deposits of signaling, cell migration, and the organization of
well as up-regulation of mitochondrial enzymes. This
fibronectin and the invasion of leucocytes, leading to theactin-based cytoskeleton (Shyy & Chien 2002).
effect is induced by expression of the peroxisome
Chronic stimulationand
tissue remodeling of skeletal
adaptation muscle
of theresults in
muscle Shear stress-induced formation of stress fibers and
proliferator-activated receptor y coactivator-1 (PGC-
fibers. A second andboutfunctional adaptations
of eccentric exercise, of
repeated cell elongation and alignment could be inhibited by
mitochondria. With respect to exercise,
within days or weeks, produces much less damage. endurance RhoN19, a dominant negative mutant of RhoA (Li et
There is evidence, however, that the calcium
The structuralis the basismost
of thispowerful
adaptational stimulus
processfor is al. 1996). Other endothelial cell shear stress
increase alone is not sufficient for induction
proposed to be the formation of extra sarcomeres, mechano-sensors that have been proposed include
which should improve the muscles working range G-proteins, intercellular junction
16 Mooren
The Cell 15

induce mitochondrial biogenesis as well. This could increased in the triceps muscle about 18 h after the
be an indication that in addition to the role of exercise. Likewise, NRF-1 and NRF-2 were detected
depleted energy pools, the turnover rate of energetic between 12 and 18 h after exercise (Baar et al.
phosphates can induce mitochondrial biogenesis 2002). Additional transcription factors involved in
(Hood 2002). |t ATP I Activation of mitochondrial biogenesis are activator protein-1 (AP-
mRNA : Protein
The role turnover
of intracellular kinases
| kinases and and 1) and peroxisome proliferator-activated receptor a
expression /expression |
phosphatases for induction of mitochondrial
l phosphatases and y (PPARa/y). The latter factor appears to be
of genes and
biogenesis ist [Ca
far2+from clear. Although there is much responsible for the |transcriptional
| encoding assembly of
, Altered wof
] in |e.g., protein,
evidence that contractile
cytosol and factivity activates a number enzymes involved in mitochondrial
mitochondrial I multisubunit j betaphenotype;
| kinase C,
of Acute
different kinases, for example protein kinase C
mitochondria; (figure|1.6) (Hoppeler & Fluck
proteins 2003).
respiratory metabolic
exercise | AMP kinase,
and ERK and MAP kinases (for details chapter 13), 4 I complexes adaptation to
I MAP kinases Regulation of20
[e.g., Tom Cellular mRNA Levels
their roles in mitochondrial
It Electron biogenesis have to be exercise
determined. transport Protein cytochrome
expressionc,l depends
e.g., on
COX, the amount of mRNA
available within
I COX III a cell, which
| importin turn depends on the
and one hand on the transcriptional
l machineryactivity and on the
Mitochondrial Genes other hand on mRNA stability. For mitochondrial
Although there are only a few Minutes
mitochondrial gene biosynthesis both processes seem to be important.
Seconds Minutes-hours Hours-days Days-weeks Weeks
products (two ribosomal proteins, 22 transfer RNAs,Time Recent experiments by Freyssenet et al. (1999)
and 13 polypeptides), they are nonetheless indicated that the postexercise levels of mRNA
important for establishing complete oxidative increased initially due to an increase mRNA stability
Figure 1.5 Established
capacity. sequence ofby
This is supported exercise-induced
the fact that events
the leading to mitochondrial
followed biogenesis.transcriptional
by an enhanced Mitochondrial biogenesis is a
complex process depending on aDNA sequence of signaling andinanabolic eventsresults
These with different time prior
confirmed constants (for details that
experiments see text).
number of mitochondrial copies changes
Reprinted, by permission, from D. Hood, 2001, "Plasticity in skeletal, cardiac, and smooth muscle: Invited review: Contractile activity- induced,"
response to endurance training, suggesting a role at shown an increase of cytochrome oxidase activity
Journal of Applied Physiology 90:1137-1157.
the pretranscriptional level (Murakami et al. 1994; that was higher than the increase in its mRNA
iwai et al. 2003). The presence of two genomes (Flood et al. 1989).
responsible for mitochondrial biosynthesis makes
- Mitochondrial Protein Synthesis
of mitochondrial between the Cellular
biogenesis. transcription calcium of increase
both factor (see later) (Lai & Booth 1990; Freyssenet et al.
Besides amino acid sequence coding regions,
subsequent necessary. In chronically
to application of a calcium stimulated rat
ionophore 1994; Bergeron et al. 2001). An important
regions coding for ribosomal RNA and tRNA can be
resulted tibialis muscle, Hood
in the expression of only et aal.
few(1989)nuclear could
genes downstream effector molecule that is activated by
found on the mitochondrial genome, suggesting an
demonstrate a similar time
encoding mitochondria! course in
proteins, mRNAothers
- while levels that
of decreases in ATP and phosphocreatine is the AMP-
autonomous translational regulation of protein
the cytochrome oxidase subunit HI, which is
would be critical to mitochondrial biogenesis were not activated protein kinase (AMPK). AMPK activity is
synthesis. This is supported by measurements in
affected. Therefore encoded,otherand IV, whichseem
co-stimuli is nucle-
to be increased, during exercise in the skeletal muscle.
skeletal muscle that revealed different rates of
arly encoded,
necessary in relation tobiogenesis,
for mitochondrial cytochrome one oxidase
of which However, recent observations indicate that this
protein synthesis and different adaptations to
is the cellular pool of high-energy phosphate bonds. response depends on the muscle type. Endurance
exercise between the two populations of
During the last
Interestingly, decade et
Jouaville a number
al. (1999) of transcription
found that training caused an enhanced expression of a
mitochondria, IMF and S3 mitochondria. Under
factors have been
mitochondrial calciumdiscovered,
levels such correlate as nuclear
with an subunit of AMPK in rat red quadriceps muscle but
nonadaptive steady state conditions, rates of protein
enhancement factor 1 and 2 (NRF-1,
in mitochondrial NRF-2), that
ATP concentration. not in soleus or white quadriceps (Durante et al.
synthesis were found to be higher in IMF than in SS
activate several nuclear genes encoding for 2002). Activation of AMPK by administration of 5-
mitochondrial and ATP
enzymes. Turnover
However, these transcription
mitochondria. Acute exercise resulted in a decrease
amino- imidazole-4-carboxamide ribofuranoside
Cellular areenergy status is reflected by the ATP/AMP of protein synthesis in both fractions, but with
factors also involved in the coordinated (A1CAR) increases expression of some mitochondrial
ratio and phosphocreatine content, different time constants. In contrast, chronic
transcription of the nuclear and and appears as
mitochondrial enzymes like citrate synthase and cytochrome C
a central stimulator of mitochondrial biogenesis. In exercise reduces protein synthesis only in the IMF
genomes, since NRF-1 sites exist in the promoter (Oj'uka et al. 2000; Winder et al. 2000). On the other
addition to the physiological stimuli such subpopulations, but without any impairment in the
region of the mitochondrial transcription factor as A hand, expression of fatty acid synthase and the
endurance training, numerousmitochondrial
recent experimental chronic contractile activity-induced cytochrome C
(TFAM), which stimulates DNA pyruvate kinase gene is inhibited (Foretz et al. 1998).
conditions leading to a disturbance in energy oxidase activity increase (Connor et al. 2000). There
transcription and replication. With the discovery of In addition to its role in mitochondrial biogenesis,
metabolism increased the mitochondrial content of is evidence from a number of studies that the
PGC-1 (PPARy-coactivator-1), an important enhanced AMPK activity was associated with
skeletal muscles. Depletion of seems cellular endurance training-induced increase in
coactivator of mitochondrial biogenesis to increases in GLUT4 protein content.
phosphocreatine and ATP pools by chronic feeding mitochondrial oxidase capacity is more pronounced
have been identified (Wu et al. 1999). PGC-1 Interrupting ATP production by pharmacological
of [3-guanidinopropionic acid was followed by an in SS than in IMF mitochondria (Krieger et al. 1980;
coactivates NRF-1 and is involved in the stimulation dissipation of the electrochemical gradient using
increase Hoppeler et al. 1973). Recent observations revealed
of GLUT4ofexpression.
mitochondrial oxidative
Recent studies capacity
suggest of fast-
that mitochondrial uncoupling agents is another way to
twitch skeletal muscles due to an enhanced activity a more differentiated regulation, since single
single bouts of exercise induced the expression of activate gene transcription important for
of mitochondrial enzyme activities in both subpopuiations seem to
these transcription enzymes, an up-regulation
factors (Pilegaard et al. 2003). of mitochondrial biogenesis. However, mitochondrial
cytochrome C mRNA,PGC-1 and activation of the nuclear respond independently to the training stimulus
After 3-h swimming, mRNA was detected in biogenesis can be activated without substantial
respiratory (Bizeau et al. 1998). Furthermore, high-intensity
red muscles factor-1 (NRF-1)
while PGC-1 transcription
protein was changes in cellular ATP level as indicated by the fact
interval training
that exercise of moderate intensity can
18 The Cell
Mooren 17

the-inner membrane (Koehler 2000). Again this membrane system. Lipid synthesis is performed in
translocase consists of several subunits closely the ER, followed by transport and sorting of the
assembled with mitochondrial HSP70 and the lipids to the outer and inner mitochondrial
nucleotide exchange factor MGRP E, which function membranes. In contrast, cardiolipin, which is
as an ATP-dependent translocation motor. TIM-22 is involved in the translocation process of the TIM-23
also associated with a number of proteins (TIM-18, complex, is synthesized at the inner mitochondrial
TIM-54). With the help of a family of small proteins membrane (Schiame & Haidar 1993).
in the mitochondrial intermembrane space, proteins Endurance training is followed by a significant
are guided to the TIM-22 complex. Insertion of the increase of mitochondrial lipid synthesis. The ratio
precursor into the inner membrane is dependent on of protein to lipid plus protein content of
membrane potential. Therefore dissipation of the ion mitochondria, however, remains stable during
gradient by uncoupling agents reduces the protein endurance training, suggesting a correlation
import into the inner mitochondrial membrane. between protein and lipid synthesis (Davies et al.
In chronically stimulated skeletal muscles, an 1981). Measurements of Hood and colleagues,
adaptation of members of the protein import however, indicated a different time constant of
machinery (e.g., MSF, cytosolic and mitochondrial protein and lipid synthesis, the latter being faster
HSP70, TOM 20) has been shown (Takahashi et al. (Hood et al. 1994; Takahashi &Hood 1993).
1998). Twenty-week treadmill training increased the
HSP60 expression in rat muscle (Samelman et al.
2000). A differential regulation of mitochondrial
protein import has been shown for the
The development of novel techniques has enabled
mitochondrial membranes and for the mitochondrial
fascinating insights into the cells structure and
subpopulations. The rate of protein import is higher
function. Its description as a steady state, a term
in IMF mitochondria than in SS mitochondria
generally used for biochemical reactions, seems
(Takahashi & Hood 1996).
applicable for the structural components of a cell as
Mitochondrial Phospholipid Synthesis well. Under resting conditions, and even more under
As indicated in the preceding discussion, the activated conditions, dynamic, interactions and
s (INK; p38)
structural basis of mitochondria is formed by a transitions between various cellular components
double membrane system. Therefore expansion of exist and allow rapid and extensive adaptations!
Figure 1.6 Signaling and transport pathways leading to mitochondrial biogenesis. TOM/TIM, translocase of the outer/ inner
the mitochondrial reticulum during mitochondrial responses. The following chapters give an overview of
membrane; JNK, c-Jun NH2-terminal kinase; AMPK, AMP-activated protein kinase; PPAR, peroxisome proliferator- activated
biogenesis requires the enhanced synthesis of our 1;current
kinase; p38, mitogen activated protein kinase; AP-1, activator protein knowledge
NRF, nuclear respiratoryregarding
factor. how cells and
various phospholipids as components of the subcellular structures face and respond to the
exercise challenge.

in comparison to continuous endurance training into mitochondria is to attach a targeting sequence

was shown to be more effective in stimulating fatty to the amino terminus. Next, the protein can bind to
acid oxidation in IMF than in SS mitochondria, the translocation complex TOM (which stands for
suggesting a differential effect of the training translocase in the outer mitochondria! membrane),
regimes on the biogenesis of mitochondrial which consis ts of several subunits responsible for
subpopulations (Chilibeck et al. 1998, 2002). recognition, binding, and translocation of the protein
(figure 1.6; Lithgow 2000).
Mitochondrial Protein Assembly A number of cytosolic chaperones guide the
An optima! oxidative phosphorylation capacity precursor proteins to the transiocases and prevent
requires the structural assembly and interaction of their misfolding and aggregation. Examples of these
both nuclear- and mitochondrial-encoded proteins. chaperones are cytosolic HSP70 and mitochondrial
Therefore biogenesis of mitochondria depends on an import stimulating factor (MSF).
effective transfer system responsible for the import After passing the TOM complex, proteins targeted
of precursor proteins from the cytosol as well as for for the mitochondrial inner membrane and for the
the export of mitochondrially coded proteins. For matrix have to pass another translocase system
this purpose, mitochondria! membranes contain named TIM (translocase of inner membrane). TIM
several protein transiocases along with a number of consists of two different complexes, the TIM-23
chaperones and processing enzymes for assistance complex responsible for transport of proteins into
in the translocation process. The first step for the matrix and the TIM-22 complex responsible for
translocation of a protein mediating protein insertion into
Chapter 2 fiSIB

Cellular Life Span

Laurie Hoffman-Goetz, Joe Quadriiatero, and Harshna Patel

Research supported by a grant from the

Natural Sciences and Engineering Research Council of Canada

Cell Cycle and Tissue Turnover Growth factors accomplish this by interacting with
specific receptors. Steroid hormones, such as
fn order for proper growth to occur and life to be testosterone, estrogen, and cortisol, influence
sustained, cell renewal and reproduction are cellular growth and differentiation by penetrating
required (Singh et al. 2000). Tissue turnover and the plasma membrane and acting on nuclear
homeostasis are dependent on the relationship receptors, thereby exerting direct effects on genomic
between cellular proliferation, differentiation, and regulatory mechanisms. Polypeptide growth factors,
death and are essential for the generation and such as epithelial growth factor (EGF), insulin-like
maintenance of complex tissue architecture. growth factor-1 (TGF-1), and interleu- kin-2 (IL-2),
Alterations in the balance between the signals that cannot penetrate the cell membrane and instead act
lead to cell death and cell renewal can lead to on specific plasma membrane receptors. These cell
undesired tissue atrophy or tissue growth (King & surface receptors include enzyme-linked receptors,
Cidlowski 1998; Pucci et al. 2000). The cell cycle is such as tyrosine kinase and serine/threonine kinase
an integral factor controlling cellular proliferation receptors, receptors associated with cytoplasmic
and tissue turnover. The cel! cycle is a highly ordered kinases, and the seven transmembrane domain
and tightly regulated process that assesses both the receptors (Martinez Arias & Stewart 2002).
intracellular and extracellular environments, Steroid hormone receptors are located in the
including factors such as extracellular growth cytoplasm of the cell or nucleus and include the
signals, cell size, and DNA integrity, at multiple receptors for androgens, estrogens, glucocorticoids
checkpoints. Progression through the cell cycle and mineralocorticoids, thyroid hormone, retinoids,
ultimately results in the replication and distribution and vitamin D. Ligand-receptor binding results in an
of genetic material from one ceil generation to the allosteric change that leads to heat shock protein
next (Ho & Dowdy 2002; Israels & Israels 2001; dissociation, receptor dimerization, the binding of
Schafer 1998). the receptor to specific DNA elements, and gene
transcriptional activities (Kumar & Thompson 1999;
Cell Proliferation Sheppard 2002; Weigel 1996). Tyrosine kinases are a
Extracellular signals (such as growth factors, family of enzymes that phos- phorylate or transfer a
hormones, and mitogens) play an important role in phosphate group from ATP to tyrosine residues on
cell proliferation, development, differentiation, and specific cellular proteins, upon binding of ligand or
survival (Talapatra & Thompson 2001). growth factor. Tyrosine

20 Hoffman-Goetz, Quadrilatero, and Patel
Cellular Life Span 21

kinases can be divided into two categories, receptor ..Upon appropriate growth stimulation, G0 cells
Table 2.1 Mammalian Cyclins, Associated cdks, Cell Cycle Stage of Involvement, and
(e.g., epithelial growth factor receptor, fibroblast can enter the cell cycle at early G,; similarly, G 1 cells
Function During
growth factor Cell insulin-like
receptor, Cycle Regulation
growth factor-1 deprived of external growth stimulation can exit into
receptor) and nonreceptor (e.g., src, fgr, ctk, abl, and G0. Although growth factor stimulation is needed for
fak) tyrosine kinases. The activity of tyrosine-specific a cell to enter into G, and proliferate, this stimulus
protein kinases is known to be associated with is essential only in the first two-thirds of the G,
various oncogenes that alter cellular growth (Cross phase. This point between the early and late G 1
& Dexter 1991; Goel et al. 2002; Haluska & Adjei represents an irreversible commitment to undergo
2001; Hubbard 1999; Hubbard &TiU 2000). one cell division and is termed the restriction point
Growth factors stimulate the cell to enter the cell (Ho & Dowdy 2002). This restriction point divides
cycle; however, absence or early withdrawal of the cell cycle into a growth factor-dependent phase
growth factors will result in the cells returning to a (early GJ) and growth factor-independent phase (late
quiescent state (Schafer 1998). Growth factors G, to M). Therefore, following initial stimulation, cells
prevent cell death through various signaling can complete the remainder of the growth cycle
pathways, including the Jak/STAT, PJ3K/Akt, and through mitosis in the absence of further exposure
Ras/ MAPK pathways (Talapatra & Thompson to growth factors or mitogens (Jones & Kazlauskas
2001). However, lack of growth factor availability 2001; Lundberg & Weinberg 1999).
results in the loss of mitochondrial function and Normal cells do not progress from one phase to
leads to cell death (Talapatra & Thompson 2001). the next unless the events of the preceding phase
have been correctly completed. Progression of cells
Cell Cycle and Mitosis through the cell cycle is controlled at specific stages,
particularly at the G, to S and G2 to M transitions.
The cell cycle is divided into the G0, G,, S, G2, and M These transition stages are referred to as cell cycle
phases. The G0 phase is a quiescent nonproliferating checkpoints (Poster et al. 2001; Sherr 1996).
state. The G, and G2 are gap phases during which Specifically, cyclins are the major regulators of the
required cellular components such as RNA, proteins, cell cycle because of thejr association with cyclin-
and enzymes are synthesized and accumulated for dependent kinases (cdks). Cdks belong to a family of
use in the subsequent stage. During the S or serine and threonine protein kinases and are
synthesis phase DNA replication occurs, while M dependent on the presence of cyclins for activation
phase or mitosis involves the division of nuclear and (Pucci et al. 2000). Normally, cdks are inactive, but
cellular components (Zafonte et al. 2000). The G,, S, once bound to their cyclin counterpart they form
and G2 phases can be grouped into the interphase active cyclin- cdk complexes. These complexes
whereas the M phase can be further delineated as phosphorylate critical serine and threonine sites on
six distinct subphases each with specific the target cells, which ultimately stimulate gene
morphological characteristics. These include expression of transcription factors and critical cell
prophase, prometaphase, metaphase, anaphase, cycle components (Foster et al. 2001; Lundberg &
telophase, and cytokinesis. During prophase, Weinberg 1999; Zafonte et al. 2000). A variety of
nuclear chromatin begins to condense and cyclin-cdk complexes are formed during distinct
centrosomes separate to form the mitotic spindles. phases of the cell cycle and are responsible for the
During prometaphase, the nuclear envelope is phosphorylation of a particular set of target proteins
broken down, which allows the chromosomes to (Lundberg & Weinberg 1999). Currently, 16 cyclins
associate with the spindle fibers. Metaphase is (cyclin A, B,, B2, C, D,, D2, D3, E, F, G,, G2, H, I, K,
characterized by the lining up of the chromosomes T,, and T2) as well as 9 cdks (cdk 1-9) have been
at the equator of the cell and disappearance of the identified in mammalian cells. Table 2.1 summarizes
nuclear membrane. During anaphase, the selected mammalian cyclins, their associated cdks,
centromeres split, allowing the sister chromatids to cell cycle stage of involvement, and defined functions
separate and move toward opposite poles of the (Johnson & Walker 1999; Kong et al. 2000; Leclerc
cells. At telophase, the nucleolus reappears and & Leopold 1996).
there is a formation of a new nuclear membrane. During the G, phase there is an increased
The final result, known as cytokinesis, culminates expression of cyclin D (D,, D2, D() as well as cdk4
with the formation of two genetically identical and cdk6. Progression through late G, is coupled
daughter cells (Boisover et al. 1997; Singh et al. with an increased expression of cyclin E and cdk2
2000; Van De Graaff & Fox 1995).

Cyclins Associated cdk Cycle phases Function

A cdk1(cdc2), S Participates as a negative feedback loop for E2F
cdk2 regulation
B,.Ba cdkl C2toM Regulation of cyclin degradation during mitotic exit
C cdk8 G0tS Phosphoryiates RNA polymerase II
Phosphorylates Rb and Ri>-related proteins that
^2' ^3 cdk4, cdk6 G0toS regulate the activity of transcription factors (e.g., E2F
E cdk2 G, to 5 Maintains Rb in a hyperphosphorylated state therefore
acting as a positive feedback loop for E2F
F ? G, to M Regulates cyclin B, localization to the nucleus
and is required for transition from G, to S phase. Telomere DNA usually consists of double-
Binding of cyclin A with cdk2 allows DNA synthesis stranded sequences, with a single G-rich strand that
to occur during the S phase. Cyclin A associates protrudes at the 3N end and forms a singlestrand
with cdkl later on in S phase, and increased overhang (Price 1999). In mammalian cells, the
expression of cyclin A and B with cdkl propels the length of the double-strand repeat (TTAGGG/
cell to exit G2 and complete mitosis (Israels & Israels CCCTAA)n ranges from a few to tens of kbp, whereas
2001). These cyclin-cdk complexes are regulated by the length of the single-strand overhang (TTAGGG)n
the varying expression of cyclins and cdk inhibitors. is usually no more than a few hundred nucleotides
Two families of cdk inhibitors are involved in cell (Coljins 2000). The number of telomeric repeats
cycle control. The Cip/Kip family includes p21 and differs from one organism to another. Telomeric
p27, which function at various points of the cell length also varies in different mammalian tissues as
cycle. In particular, these cdk inhibitors target cdk2, well as from one chromosome to another
-4, and -6. The second family includes the inhibitors (Buchkovich 1996). Friedrich et al. (2000) found that
of cyclin-dependent kinase 4 (INK4) genes, plG* telomere length was significantly shorter in
and pi 9^ (Israels & Israels 2001). Figure 2.1 shows leukocytes compared to skin (fibroblasts) and
a schematic representation of the cell cycle and synovial tissue (fibrocytes) of the same patient and
various regulator components affecting progression was consistent with the faster replicating properties
through the various stages. of leukocytes compared to the other tissues.
During DNA replication, a gradual shortening of
Telomeres the telomere occurs. Because DNA polymerases
work only in the 5N to 3N direction and require
Telomeres are DNA-protein structures found at the short oligonucleotides as primers, shortening of the
ends of all linear eukaryotic chromosomes. This telomeric DNA is expected during each cell cycle
cap protects the chromosome ends from (Buchkovich 1996). Telomere terminal transferase or
degradation that would normally occur during telomerase is a telomeric-specific ribonucleoprotein
double DNA strand breaks. Telomeres also function reverse transcriptase that is important in telomere
to prevent illegitimate recombination of chromosome maintenance. Telomerase is composed of a
ends, which would lead to unstable chromosome structural RNA and two proteins, telomeric repeat
forms. Therefore, telomeres are critical for the binding factor 1 (TRF1) and TRF2. Telomerase
proper function, integrity, and stability of the utilizes an integral RNA component as a template for
chromosome and ultimately establish a stable linear de novo synthesis and adds single- stranded
chromosome end. In addition, it has been proposed telomeric repeats to the chromosomes 3N end. Both
that telomeres have a central role in determining the TNF1 and -2 have been hypothesized to aid in the
number of times a cell can divide (Blackburn 1991; docking and holding of the enzyme to the telomeric
Perrem & Reddel 2000). DNA (Collins 2000; Counter 1996; Perrem & Reddel
24 Hoffman-Goetz,
Cellular Ouadrilatero.
Hoffman-Goetz, Quadrilatero,
Life Span and
Patel 23

be stimulating
+ 0.1 kbendothelial
longer thancell migration.
those of memory However, cells tion
the basement
interact to. membrane
produce by activated
proteases, TGF-P (3)
both processes can be inhibited
from the same donors and were independent of age. by angiogenesis endothelial
that furthercell induces
migration changes and inproliferation,
the pericytes andand (4)
These such suggest
findings as angiostatin
that cell anddivision
endostatin (Nie &
is ongoing maturation
myofibroblasts. of the neovasculature.
TGF-j3 is a homodymeric
Honn 2002). the life span and that memory cells
throughout polypeptide
Angiogenesis thatisisinitiated
strongly in response
expressedtoin hypoxic
sites or of
undergo more cells have the
extensive cellintrinsic
thanto naiveform ischemic
tissue morphogenesis
conditions that (Robertsresultet al.
in 1986).
the release of
cells. structures
A later studyafter endothelial
by Weng cell proliferation
and colleagues (1997) cytokines
from variousis controlled
a balance & between
and migration
showed that meanthrough TRF lengths extracellular matrix.
were significantly 2000).
and angiostatic
of the blood factors.
vesselSomeis a prerequisite
greater cells elongate
in germinal centerand align to form compared
B-lymphocytes a sprout, for
act directly
cells toby enter
the angiogenic
cells to cascade.
to the lumen
and memoryis formedcells. by a Differentiation
curvature within fromeacha This
is mediated
or form abyvessel, nitricwhereas
oxide others (NO), can an
naive to a cell (Qian etcenter
germinal al. 1997). Individual
lymphocyte sprouts
results in endothelium-derived
indirectly activate host relaxingcellsfactor
(EDRF), and mastby
elongate andlengthening
significant eventually join, of forming loops through
the telomere, while up-regulation
cells, lymphocytes) of fibroblast
to release growth endothelial
factor-2 (FGF-2)
which blood begins
subsequent to flow. However,
differentiation to ain ordermemory to form B- factors.&The
(Ziche Morbidelli
direct-acting2000). factors
VEGFincludeis then acidic
ableand to
a stable vasculature
lymphocyte results and in prevent
significantceil deathtelomeric by stimulate
basic fibroblastic
vasodilation growth andfactors
the permeability
and bFGF),
apoptosis, endothelial
shortening that may cells must interact
be controlled by with mural
telomerase and
VEGF, vascular
and angiopoietin
tone via (Nie endothelial
& Honn 2002).NO production
cells such as pericytes in small vessels and smooth
activity. (Griffioen
acting factors& Molemainclude 2000;
tumor Ziche
& Morbidelli
factor-a 2000).
muscle cells within large vessels (Griffieon & The
a), TGF-j3,
increaseandin platelet- microvascularderived permeability
endothelial cell to
Molema 2000). This can be achieved through the proteins
growth is factor/thymidine
a crucial step in angiogenesis.phosphorylase Leakage (PD-of
production of platelet-derived growth factor (PDGF), plasma
ECGF/TP). proteins
These factorsand the are briefly
formation describedof an in
which acts as athe formation
mitogen of new capillary PDGF
and chemoattractant. blood extravascular
table 2.2. However, fibrin gel angiogenesis
are sufficient inhibitors
for endothelial
exist to
induces from preexisting
differentiation of thevasculature,
mural cells involves
into cell
growth (Folk-the man effects
1997). of the
VEGF angiogenic
can also factors.
or smooth muscle among endothelial
via cell-to-cellcells, matrix
contact- the
factors include
of proteases
and receptorsinterferon,that are
dependentand soluble factors,
processes. Transforming leadinggrowth
to endothelial
factor-P crucial
tissue for inhibitors
tissue remodeling
of MMP and (TIMP),
of cell
cell proliferation, migration,
(TGF- (3) is found on both mural cells and vessel formation. and death
in endothelialand cells platelet
(Farrara factor-4
2001). and are
endothelial tissue growth is characterized by dependence summarized
For endothelialin table cells
2.3. to enter into new areas of the
on new vessel formation for the supply of oxygen and body, they must detach from the basement
nutrients as well as removal of waste products (Ziche membrane via proteolysis. Matrix metalloprotein-
Table 2.2 Angiogenesis
& Morbidelli 2000). However, Growth
regardless Factors
of the cause, ases (MMP) are endopeptidases that are secreted,
new vessels always grow out of preexisting vessels. activated, and then degraded in the extracellular
A schematicvessels representation
in the body of norma!
functionceil cycle
as a and selected regulatory elements involved in cellular progression.
matrix. MMP facilitate the invasion of endothelial
Following growth factor stimulation, normal cells progress through the stages of the cell cycle with the aid of various
transport compartment for the blood and play a cells through the basement membrane andavailability
regulatory factors. Cycle progression is positively influenced by growth factor (e.g., insulin-like growth factor-1)
major role in maintaining homeostasis in various into avascular
(prior to the restriction point), cydins (e.g., cyciin D), cyclin-dependent kinases (e.g.,tissuecdk4), andin oncogenes
response (e.g., to angiogenic
c-myc) and
ways. Thebyblood
is inhibited directly contacts
tumor suppressor genes (e.g., thep53)endothelial stimuli (e.g.,
as well as cdk inhibitors (Stelterp21).Stevenson 1999). MMP are secreted
cells on the vessels composed of pericytes, smooth by a number of cells including fibroblasts,
muscle cells, fibroblasts, basement membranes, and inflammatory cells, epithelial cells, and endothelial
an Progressive
matrix within the subendothelium
of chromosome ends is telomerase activity is low or absent in replicating
intimately&coupledMolema with 2000). The endothelial
cellular division ofcells normalform cells, telomere lengths
As endothelial ceils leave of their
the original
chromosome will
sites, they
monolayercells and and are actively
results in the involved in several
so-called end- gradually decrease
proliferate and can (Goynsinvade&Laveryboth2000).vascular and
replication processes
problem. This in istheattributable
body including to the Immune
avascular tissues.response
Angiogenic is factors
dependent such as on VEGF the
inability of the DNA polymerasesintegrity
and metabolism. Tissue to complete and . expression
and bFGF and can differentiation
directly stimulate of specific responsive
endothelial cell
replication ofare theregulated
3N end by duea to balance between cell
their requirement cells following
proliferation viaancGMP-mediated
antigenic challenge. Stimuli
activation of that
for an upstream and cellRNAdeath.primer, Modulation
angiogenic in result in the proliferation
mitogen-activated protein kinaseand expansion
(MAPK) family of normal(Nie
the shrinking is achieved through regulation
of the chromosome ends withof each the &lymphocytes
Honn 2002).should However, alsoinresult
order infor the induction
endothelial of
successive of endothelial
cell cycle. cellsThis
during vessel cell
affects repaircycle and telomerase
to activity. This
create a network, they mustwould migrate
serve to maintain
toward and
reproductive whereby capacity unnecessary,
(McEachern et newlyal. formed
2000; telomere
within length tissue.
the vascular and reproductive potential.
As the cells proliferate,
vessels undergo regression
Wynford-Thomas 1996). and apoptosis
Cessation of (Nor
cell Hathcock et is
plasminogen al. converted
(1998) found to that
plasmin unstimulated
by the
proliferation 1999).is indicative of cellular aging and mouse T-lymphocytes
plasminogen activators expressed
u-PA andlowt-PA. to virtually
The senescence.
cellular adult vasculature Normaliscells usually quiescent.
in culture possess In undetectable
degrades levels laminin,
fibronectin, of telomerase
and the proteinactivitycore butof
response to angiogenic stimuli,
a maximum number of cellular divisions called the such as vascular expressed significant
proteoglycans. Plasmin telomerase activity after
is considered the inmost
Hayflick limit growth factor (VEGF)
(Perrem &Reddeland basic Telomeric
2000). fibroblast antigen stimulation.
important protease for Weng et al. (1995)
mobilization found from
of FGF-2 that
length isfactor (bFGF),
predictive endothelial
of replication cells undergo
capacity in normala as donor age increased, from
the heparin sulfate proteoglycans in the extracellular24 to 75 years,
cells in ofvitrotightly
(Allsopp controlled
et al. 1992; events
Harley toet form
al. 1990), new terminal
matrix poolrestriction
(Griffioen & fragment
Molema (TRF) 2000). length
Aside from (an
capillary vessels. activity
and telomerase These steps include
is either (1) initiation
absent or at very of estimate of cell
stimulating telomere size) decreased
proliferation, VEGF and inbFGF
both play
low angiogenic
levels in many response, adult(2)somatic
dissolu cells (Chiu et al. and memory CD4+ lymphocytes. Furthermore, TRF
1996; Hiyama et al. 1995). Moreover, if lengths of naive CD4+ lymphocytes were found to

Factor Function Receptor

Basic fibroblast growth factor Endothelial mitogen, survival factor, FGFR-4
(bFGF/FGF-2) angiogenesis inducer; inducer of Flk-1
Acidic fibroblast growth factor Endothelial mitogen and angiogenesis FGFR-4
(aFGF/FGF-1) inducer
Vascular endothelial growth Endothelial mitogen, survival factor, and Flk-1
factor/Vascular permeability factor permeability inducer Flt-1
In vivo-acting angiogenesis inducer with Angiogenin
RNase activity receptor
Epidermal growth factor EGFR "
Weak endothelial mitogen, inducer of VEGF
Tumor necrosis factor-a (TNF-a) In vivo-acting angiogenesis inducer; TNFR-55
endothelial mitogen (low concentrations) or
inhibitor (high concentrations); inducer of
VEGF expression
Platelet-derived growth factor (PDGF) Mitogen and motility factor for endothelial PDGFR
cells and fibroblasts; in vivo angiogenesis
Thymidine phosphorylase (TP)/Piatelet- Receptor
derived endothelial cell growth factor In vivo-acting angiogenesis factor unknown
Transforming growth factor-p (TGF-p) in vivo-acting angiogenesis Inducer or
endothelial growth inhibitor; inducer of Ml
VEGF expression

inhibitors Function
Plasminogen fragment; systemically acting
Cellular Life Spanangiogenesis inhibitor. 25
Angiostatin Inhibits endothelial ceil proliferation by unknown mechanism.
Endostatin Proteolytic fragment of collagen XVIII. Systemically acting angiogenesis
Table 2.3 Inhibitors of Angiogenesis
inhibitor. Inhibits endothelial cell proliferation and angiogenesis by
unknown mechanism.
Thrombospondin-1 Binds to CD36 on endothelial cells and inhibits angiogenesis by
(TSP-1) unknown mechanism.
Tissue inhibitors of Blocks breakdown of extracellular matrix and endothelial cell invasion
metalloproteinases by inhibiting MMPs.
Platelet factor 4 (PF4) Inhibits angiogenesis by interfering with bFGFR.

Prolactin Inhibits angiogenesis by bFGF and VEGF-Induced proliferation to

endothelial cell (S phase arrest).
inhibits EGF and laminin-dependent endothelial cell motility and
EGF fragment angiogenesis.
Interferon-a (IFN-a) Inhibits angiogenesis by antimigratory and antimitotic effect on
endothelial cells; blocks bFGF production by parenchymal cells.
Interferon-p (IFN-p) Inhibits endothelial cell proliferation and migration.
interferon-7 (IFN-7) Inhibits endothelial cell proliferation and migration.
lnter!eukin-12 (IL-12) Inhibits angiogenesis by stimulating IFN-7-
26 Hoffman-Goetz, Quadrilatero, and Patel

Apoptosis -~ and execute the apoptotic program through cleavage

of several vital proteins (caspase 3, caspase 6,
Apoptosis is a highly regulated, evolutionarily
caspase 7). Three pathways result in caspase
conserved pathway that is essential for normal
activation and subsequent apoptosis. Figure 2.2 is a
embryonic development, regulation of the immune
simplified illustration of the pathways to apoptosis
system, hormone-dependent atrophy, chemically
and necrosis.
induced cell death, and tissue homeostasis (Cohen
In the first pathway, cell death is associated with
1997; Phaneuf & Leewenburgh 2001; Sjostrom &
mitochondria permeability changes. This is known
Bergh 2001). Apoptosis can also be induced by a
as the death-by-neglect pathway because it involves
number of deleterious stimuli or stressors including
deprivation of cells of necessary survival stimuli
DNA damage, heat, hormonal triggering, anticancer
(e.g., growth factors or co-stimulators), which then
drugs, and physical stress. Since apoptosis does not
leads to the rapid increase in the permeability of
result in the release of intracellular material into the
mitochondria membranes and the release of
extracellular space, it usually does not lead to an
cytochrome C (Budd 2001). Various factors,
inflammatory response. Apoptosis is an active
including irradiation, glucocorticoids (GC), nitrogen
process that requires participation of the dying cell
monoxide, reactive oxygen species (ROS), and certain
and changes in cellular biochemistry and
chemotherapeutic drugs, induce apoptosis by this
morphology, leading to DNA cleavage, nuclear
biochemical mechanism. Cytochrome C, localized on
condensation and fragmentation, and changes in
the outside of the inner mitochondrial membrane
membrane lipid distribution (Bidere & Senik 2001).
and intermembrane space (Hirsch et al. 1997),
Apoptotic cells are rapidly endocytosized by
functions as a cofactor with a protein known as
neighboring healthy cells or phagocytosized by
apoptosis activating factor-1 (Apaf-1) to stimulate
professional phagocytes that recognize a number of
caspase 9 and initiate the apoptosis pathway.
signals on the surface of condemned cells, such as
Cytochrome C is released into the cytosol, binds to
phosphatidyiserine residues that pass through the
Apaf-1, and forms a complex known as dATP. This
plasma membrane. Apoptosis results in the
complex then activates procaspase 9 to caspase 9
irreversible, internucleosomal fragmentation.of
and eventually results in the activation of caspase 3
genomic DNA and the fragmentation of the cell into
Angiogenesis and Telomeres (van Cruchten &Cell van Death
den Broeck 2002). This
membrane-bound apoptotic bodies (Los et al. 2001;
pathway seems to be controlled by a group of
Phaneuf & Leewenburgh
The relationship 2001). The
between angiogenesis and complex
telomere proteins that regulate
The processes of cell apoptosis.
death, cell These proteins (e.g.,
proliferation, and
sequential process of
length/telomerase apoptosis
activity has involves an effector
been investigated. Bcl-2,
the ceilBax, and are
cycle Bcl-x) are codedlinked
inexorably for by (Evan
the genes of
et al.
Franco aetpointal. of no return,
(2002) a degradation
indicated phase,
that telomerase- the Bcl-2
1995). Two(B-cell
terms lymphoma)
have been family
usedandto may function
describe the
and a clearance phase. In the effector
deficient mice (Terc have shorter telomere lengths phase,
to regulate
process of cellmitochondrial
death, necrosis and permeability via the
apoptosis. Necrosis,
endonucleases and cellular caspases
and impaired angiogenic potential, Mean TRF are activated
a term introduced permeability
by Virchowtransition
in the 19th pore, with
and mitochondrial
lengths were founddysregulation
to be shorter occurs (Salvesen
in endothelial &
cells consequent
refers to a release
passiveof process
cytochrome C intoby
induced thecatabolic,
Dixit 1999). At the point of no return,
from the iliac arteries (a site of higher hemodynamic cells are
Theor second
toxic, pathological pathway
et al.involves
stress and to cell
die. turnover)
Reorganization of thetocytoskeleton
compared iliac veins. triggering
Recently, itbyhas binding of ligandsthat
been suggested to death-inducing
necrosis is not
and nuclear chromatin
Furthermore, telomeric breakdown
DNA loss was characterize
greater in thethe membrane
a mechanism receptors
of cell (Newton
death at& all Strasser
but is 2001).
rather This
degradation phase. Finally,
iliac artery compared to thethe removal
internal of apoptotic
thoracic artery pathway
collectionis ofknown as the receptor-ligand-
morphological changes occurring mediated in
cells byofmacrophages
(a site low hemodynamic and other
normallyas part
free pathway of apoptosis.
cells postmortem (MajnoTwo& important
Joris 1995). ligands in this
Necrotic cell
of the clearance phase (Aigner 2002).
from atherosclerotic plaques), and was more pathway
death isareassociated
Fas ligandwith (FasL), which inflammatory
specific binds to the
The effector phase of apoptosis involves the
dramatic with increasing donor age (Chang & Harley Fas receptor,
changes and TNF-a
in dying (an inflammatory
and adjacent cells. In cytokine),
activation of cytosolic enzymes known as caspases.
1995). Of clinical importance is the finding that which binds
apoptosis to the
refers TNFR1
to the set receptor. Fas events
of cell death and TNFR1with
Caspases are cysteine proteases that cleave the
human telomerase reverse transcriptase (hTERT) have corresponding
particular morphologicalcytoplasmic regions known
characteristics such as
carboxy terminal of aspartic acid (Asp) residues
mRNA is expressed by vascular endothelial cells of conserved
blebbing and death domain
nuclear (DD) responsible
fragmentation (Kerr 1971; for
(e.g., cysteine aspartases). Caspases are present in
astrocytic tumors but is absent in normal brain signaling
Kerr et al. transduction
1972). Wyllie and in apoptosis. Transduction
colleagues (1980) linked
an inactive form in the cytoplasm in virtually every
(Pallini et al. 2001); hTERT mRNA was related to the occurs through the
the observation binding of patterns
of stereotyped the Fas-associated
of induced
cell (Newton & Strasser 2001; Villa et al. 1997). To
histological grade of the tumor. Collectively, these death domain with procaspase
DNA fragmentation 8, the activation
in gel electrophoresis with the of
date, 14 caspases have been identified and
studies suggest that telomere length and telomerase caspase 8, andFurthermore,
term apoptosis. the eventual conversion
apoptosis describes of
implicated in cell death. Caspases cleave precursors
activity play a key role in angiogenic potential and procaspase
an active cell3 into
process 3. that occurs under both
to produce mature cytokines (caspase 1, caspase
may have implications for tumor therapy and age- Not surprisingly,
normal physiological lymphocytes
and express Fas. FasL
11), initiate the propagation of apoptotic death
associated vascular diseases, such as is mainly expressed
conditions. by T-lymphocytes
These processes after in further
are described
signals (caspase 8, caspase 9),
arteriosclerosis. detail in the sections that follow.

28 Cellular Quadrilatero,
Hoffman-Goetz, Life Span and Patel 27

independent .p{,the receptor-ligand pathway and the (SODD), another cytoplasmic protein, may be
mitochondrial pathway. involved in limiting apoptosis signaling by death
The commitment to cell death is based on a receptors since it also has a death domain and
number of factors. For example, receptor clustering interacts with Fas (Musci et al. 1997).
results in caspase activation to generate the first Regardless of the pathway through which
proteolytic signal. Commitment to other pathways is apoptosis occurs (i.e., through death by neglect or
dependent on whether the extent of damage death by triggering of death receptors), certain
outweighs the ability of the cell to repair itself, which morphological changes occur in the dying cell
is in itself dependent on the ratio of proteins that (Hacker 2000). These morphological consequences of
initiate apoptosis (e.g., Fas, p53) to the proteins that apoptosis are (1) loss of attachment of the apoptotic
inhibit or block apoptosis (e.g., Bcl-2) (Phaneuf & cell to other cells and the extracellular matrix, (2)
Leewenburgh 2001). Low levels of damage beyond the occurrence of protrusions from the plasma
ability of the cell to repair itself result in postmitotic membrane (blebs), (3) condensation of the nucleus
arrest and cell survival. More severe damage leads to and fragmentation of genomic DNA, (4) dilation of the
the activation of apostat, induction of death signals, endoplasmic reticulum and release of ribosomes, and
and the downstream activation of executioner (5) disintegration of the cell into apoptotic bodies that
caspases. are membrane- bound vesicles varying in size and
As noted earlier, several factors trigger apoptosis, composition (Hacker 2000). Apoptotic bodies are
including growth factor deprivation, cytokines, engulfed by neighboring ceils, especially
members of the TNF family, TGF-3, GC, retinoids, macrophages. Under some circumstances apoptotic
cytotoxic chemicals, and many more. Apoptosis can cells that are not phagocytosized show features of
also be induced by cell injury resulting from toxicity, necrosis without inflammation (van Cruchten & van
ischemia and reperfusion injury, oxidative stress, den Broeck 2002).
inflammation, and irradiation (Fellstrom & Zezina
2001). The apoptotic pathway in lymphocytes can be Necrosis
prevented by various activating stimuli, including
specific antigen recognition;" provision of essential The term necrosis means the irreversible and
growth factors (such as IL-2), and engagement of co- dramatic changes that are visible by microscopy after
stimulators (such as CD28 on T-cells by B7 cell death (Majno & Joris 1995). Most pathology
molecules on antigen-presenting cells). In response to textbooks define necrosis based on whether the
apoptotic stimuli, inhibitory genes may be up- morphological changes are due to enzymatic
regulated, leading to the synthesis of apoptosis digestion of ceils (e.g., Iiquefactive necrosis) or due to
inhibitory proteins. representation
One of the best denaturation of proteins (e.g., coagulative necrosis).
Figure 2.2 Schematic of thecharacterized
pathways to apoptosis and necrosis, (a) Ligation of death receptors with
apoptosis inhibitory protein Necrosis is characterized by osmotic swelling,
cytokines, such as FasL and TNF-a,isleads
Bcl-2, which blocks
to activation of death receptors (e.g., Fas, TNFR1, TNFR2, TRAIL), activation of the
caspase cascade,C release (b) Stress to the
from mitochondria,
and apoptosis, binds Apaf-ROS,rupture
cell (e.g., GC, and of the plasma
growth membrane,
factor withdrawal) and
leads the release
to MPT formationof
andand inhibitsC release
cytochrome activation of cytosol,
into the caspasewhich is in part &
9 (Newton cytosolic
regulated by thecontents
expressioninto theand
of Bd-2 extracellular environment.
Bax. The formation of the
dAPT complex
Strasser initiates
2001). the activation
Bcl-2 insertsof theintocaspase outer andNecrotic
the cascade cells retain
leads to apoptosis, the toshape
(c) Stress of the reticulum
the endoplasmic nucleus,
(ER) may lead tomembrane
mitochondrial cellular apoptosis via activation
and maintains the of caspase 12.although
integrity chromatin of stress
(d) Greater magnitudes condensation,
will bypass thelate DNA
pathway and lead to necrosis, (e) Sustained
of the mitochondria by allowing the export of H ions accumulations
+ of degradation,
intracellular and
calcium pyknosis
(Ca 2
*) can (nuclear
activate shrinkage
calpains, leadingand
necrosis, (f) Decreased intracellular ATP availability can lead to cell basophilia) can
death via necrosis. occur (Chautan et al. 1999;
through ion channels (Budd 2001). A family of
proteins that contain the Bci-2 homology domain 3 Schweichel & Merker 1973). Moreover, necrosis is
region (e.g.,by Bax, Bad,and Bim, characterized_y/_ by the relatively slow disintegration of
activation antigens theBid) counteracts
cytokine IL-2. When the caspase 12 transgenic knockout (KO) mice
actions of Bci-2. Apoptosis signaling by death ligands the cell in which the plasma membrane integrity
mature T-lymphocytes are repeatedly stimulated by (Nakagawa et al. 2000). The basis for this pathway
also regulated breaks down and the cellular contents are
Fas andinFasL a number of ways. In Cytotoxic
are co-expressed. humans is the finding that when mice are challenged with
and a T-lymphocytes
variety of animal enzymatically degraded and released (Hacker 2000).
(CD8*) have a species,
specialized secreted
form of Fas- and the ER-stressing agents, tunicamycin and thap-
membrane-anchored decoy receptors The end result of necrosis is pathological
Fas ligand-mediated apoptosis. In CDS* preventT-cells, sigargin, apoptosis occurs in fibroblasts from
apoptosis inflammation. Whereas apoptosis is considered
binding ofsignaling
Fas-FasL by neutralizing
leads to the releaseFasLofand TNF-
perforins heterozygous (caspase 12+/~) mice but not in
related immunologically silent, a hallmark of necrotic death
at the apoptosis-inducing ligandand (TRAIL)
the (Newton & :
target cell membrane release of caspase \2~ ~ animals. In contrast, when
Strasser is the involvement of inflammatory cells. The
granzyme2001).B intoMoreover,
the targetincytosol
and inductiondeliveryof homozygous knockouts were given Fas-specific
of FasL to (Martin
the cell&surface involvement of these inflammatory cells (especially
apoptosis Green is under
1995; vanstrict control.
Cruchten & antibodies or synthetic GC (which activate the
FasL is stored in lytic granules, and degranulation in macrophages and neutrophils) and the release of
van den Broeck 2002). receptor ligand pathway and the mitochondrial
response to pathway
target cellforrecognition chemoattractants to Simulate neutrophil emigration
A third apoptosis leads to thetermed
has been rapid pathway of apoptosis, respectively), no differences
delivery of FasL to the cell surface. Silencer of death distinguish necrosis from
the endoplasmic reticulum (ER)-mediated were found in apoptosis. Thus, it has been
mechanism and has been identified by studies in suggested that an ER-mediated mechanism of
apoptosis must be
30 CellularOuadrilatero,
Hoffman-Goetz, Life Span and Patel 29

It is apparentHowever,
approach to this
that identifydistinction
although apoptotic may
the mechanisms cells be using
and For example,
target-cells and various
through calpain
the inhibitorsangiogenesis
mitochondrial have been
apparent than
flurochrome-labeled real. When
Annexin apoptosis
the circumstances of cell death vary, the end result V, which occursbinds on a
to shown
within to protect
mature against apoptosis
(cytochrome C and Apaf-1) as weli as through in lymphoid
tissue. cells
Exercise the
large scale,
phosphatidylserine for example
(PS) that
is always the same: the disappearance of cells. Theis during
externalized embryonic
on the (Sarin et al. 1995; Squier et al.
receptor-mediated ligand mechanism, resultingthe
enhances 0 2 transport 1994;
conductance Wang 2000
between ). in
impact of cell largefornumbers
of death
damaged or apoptotic
tissues, of phagocytic
organs, cells (Vermes
systems, ceils
andet Whatactivation
factors trigger
caspase and cells to respond
& Freathy 2001).andwith necro-
TGF-Pj also,
al. 1995).although
organisms dependsitbecause
However, is unclear
upon theAnnexinwhether
biological V binds these
contextto are
in sis compared
.the number
suppresses pRb to
and apoptosis? Although
size of mitochondria
expression (Fan et al.many of the
in skeletal
1996), and
which it within
occurs. phagocytes
In somecells, or
cases, simply
thiscell neighboring
death is may a same
experiments and trigger both
the activity
with cell
of death
pAb-deficient enzymes pathways,
mice controlling the
normal up physiologicalcells that
both apoptotic take
and up thecells.
consequence ofcellular debris
To provide
development more toxicmetabolism.
widespread the stressor,
apoptosis in the
Skeletal more
a varietymuscle likely it is sues,
tis-... that
and bodies)
differentiation (Majno
during& embryogenesis.
in distinguishing Joris 1995).from In
apoptotic necrotic
other necrosis
including will
by an
increase which
in capillary
(Zachsenhaus et cell death
al. density,
cases, Unlike the apoptosis,
cell use occurs
death of necrotic as acellpathophysiological
propidium death
iodide does (PI) not is pathway (apoptosisratio,
capillary-to-fiber or necrosis)
or both, occurs reflectsfollowing
a vital
involve activation
response to injury sinceof
or caspases.
PI enters
toxic insult. However,
necrotic the cellsabsence
but is Detection
injury depends
adaptation of Apoptosis
to upon
exercisethe intensity
and allows of the forinjury
improved and
of caspase
excluded activity ones.
from apoptotic does PInot is a eliminate
DNA stain and the the level capacity
aerobic of intracellular ATP available
(02 transport, (Leist et and
conductance, al.
Apoptosis and Cell Cycle
can therefore of
be other
used enzyme
both for cascades
cell cycle involved
analysis andin There
1997; are
extraction) many
of et techniques
skeletal 1998).
muscles for
(Amaralthe detection
et al. factors,
2001). of
to differentiate Calpains
necrotic (suchfrom as apoptotic
calpain p)cells. have Table
been apoptosis
These changes in cells,
short or
occur each
after withaerobic advantages
opening of the
endurance and
2.4 described
summarizes inearlier, the cell
cell approaches
death cycleused
(Wang consists
2000), of
tosince the G0
measure limitations.
mitochondrial The major
training characterized approaches
by low-resistance for the detection
transition and high- pore of
or rest phase,
inactivate in
apoptosis the
caspases G or protein synthesis
cells. t(Chua et al. 2000) and shift cells phase, the apoptosis
(Kowaitowski are via
et al. 2001),
repetition contractile morphological
the concentration
activity changes
(Amaral et al.of2001; by
or DNA an replication
apoptotic phenotypephase, the to G2 a phase extending
necrotic one. microscopy,
Gustafsson to Western
et al. 1999). blotting, gel electrophoresis
Angiogenesis (Denecker
is the result et
Calpains the canend be of activated
DNA replication
physiologicallyto eventual
by stimuli cell identify
2001), characteristic
and the DNA
prolonged imbalances between the metabolic patterns,
of histo-
oxidative chemical
that induce
and the of
M or
mitosis phase.
onof The
Ca2+ control
in the of techniques,
requirements ELISA,
1999), of and flow tissue
the cytometric
the decision andanalysis. point of
the Proliferation and Cell Death
cytosol. cycle
The is through
endogenous the action
inhibitor,of cyclin proteins
calpastatin, deathMorphological
of the changes
or death
vasculature inby condensed
(Gavin et (see
al. DNAfigureof
protects A, B,against
D, E) and by cdks.
caipain- Cyclin necrotic
mediated and cdksdeath. form apoptotic
2.2). cells
The decision
Therefore, can tobeoxygenation
decreased detected
commit by microscopy.
to apoptosis,
resulting necrosis,
from this For
Nonetheless, andthe
has by
distinction the to concentration
betweenmodulate and
caspase-cell example,
or cellularstaining
imbalance stasis
causes isofshown
cells tissues
the with hematoxylin
to becomeand
diagrammaticaily eosin
mediated of apoptosis
and complexes,
and death cell division
calpain-mediated can be
necrosis orand
2.3.with acridinea orange
produces variety or Hoeschst can
of metabolites be used in
implicated to
hormones, or stopped,
is far from absolute. or
factors, cells
and can
metabolicbe induced
pathways. to identify apoptotic cells but
vessel growth, including adenosine, ADP, lactic acid, requires careful
Some of these apoptosis.
factors have The been relationship between
well characterized interpretation and technical
nicotinamide derivatives, experience, since
and prostaglandins of the.
in exercise andmodels,
the cell cyclesuch isasbest VEGF illustrated
and NO by the in apoptotic and necrotic ceils
E series. The mechanisms underlying capillary may not be easily
p53 tumor
vascular suppressor
endothelial gene. This
responses gene others,
whereas encodes suchfor distinguished
proliferation remain (van Cruchtenunknown, & van butden it isBroeck
likely that 2002).a
the p53 protein,
as "expression of whose
and telomeraseis increased in The molecular
number of biology
factors technique
are required of Western to blotting
lymphocytes, ing DNAhave damage not (e.g., been following oxidative
systematically using antibodies
physiological angiogenesisagainst caspase to exercise.
in response substrates,
investigated.or irradiation)
The following(Mathieu section briefly et al.describes apoptosis-related
1999). - However, it is suggested proteins, that cyclins,
these factors and act tumorin
Expression of the p53 protein induces
exercise effects on angiogenesis, proliferation, and the expression suppressor genes can be used
concert to increase vascularity to promote oxygento identify apoptosis in
of the in
death p21 gene, muscle
skeletal which blocksand immune cyclin-cdk cells.complexes ceil populations. Limitations of
delivery to the tissue cells by increasing the capii- this method have
and ultimately leads to Gj to S phase cell cycle arrest been reviewedsurface
lary-to-fiber by McCarthyarea interfaceand Evan and (1998).
increasing Gel
(Stew r
art & Pietenpoi 2001). This interaction is electrophoresis
maximal blood flow. to demonstrate a characteristic DNA
further strengthened by the findings that mutations ladderDuring patternexercise, of localinternu-
muscle cleosomaloxygen tension DNA
The which
formation are of newseencapillaries is an essential fragmentation detects
to pi6, often in tumors, result in a falls; and exercise, under apoptotic
conditions cells. of restricted DNA
of activityresponse
by the of skeletal
p53 tumor muscle to repeated
suppressor gene. fragmentation
blood flow, further as reduces
demonstrated the oxygen in tension.
situ byA the
The loss in p53 activity cripples the cells ability to technique known as TUNEL (terminal
mobilize p21 for inducing senescence and to mobilize deoxynucleotidyl transferase mediated dUTP nick end
pro-apoptotic proteins such as Bax to induce labeling) has been used as the gold standard. The
Table 2.4 Commonly Used Methods to Detect the Occurrence of Apoptosis in Cells
apoptosis (Lundberg & Weinberg 1999). Elevated TUNEL method has been used to detect the early
levels of the p53 protein induce the expression of Bax stages of cell death that cannot be visualized by
proteins, which induce greater apoptosis (Kamesaki routine histologic staining with hematoxylin- eosin.
1998). DNA fragmentation also occurs in necrotic cells;
Other genes, including the retinoblastoma, Rb hence the specificity of this method is problematic
gene, regulate the cell cycle and influence apoptosis (Saikumar et al. 1999; van Cruchten & van den
(Evan et al. 1995; van Cruchten & van den Broeck Broeck 2002). Enzyme-linked immunosorbant assay
2002). The Rb gene and its protein products (ELISA) methods can be used to measure caspase
(pRb/pl05, pRb2/pl30 and pl07) have growth- activity in apoptosis. Although caspase activity is
suppressive properties in that they inactivate indicative of apoptosis, limitations are similar to
transcription factors and negatively control the cell those of Western blotting: measurement of apoptosis
cycle between the Gs and S phases (Tonini et al. in cell populations but not in individual cells. Flow
Figure pRb
2002). 2.3 Schematic
also functions representation of celt progression
as an antiapoptotic necrosis or apoptosis.
cytometry techniques Followingare triggering
a by extracellular (e.g.,
growth factors and antigens)
For example, TGF-pj induces apoptosis in and/or intracellular factors (e.g., pro- vs. antiapoptotic proteins), ceils commit to cycle
progression, to maintenance (stasis), or to a death pathway (involving necrosis or apoptosis). MTP = mitochondrial
permeability transition pore; ATP = adenosine triphosphate.

Method to detect
apoptosis Strengths Limitations
Morphological Technique well validated; uses Difficulty in identifying apoptotic
microscopy common histological dyes; most versus necrotic celis.
labs have access to microscopy
TUNEL-gel Considered "gold standard" for Difficulty in identifying apoptotic
electrophoresis verification of DNA laddering. versus necrotic cells.
Caspases-ELISA Caspase(s) activity definitive Application to cel! populations and
indication of apoptosis. not single ceils; requires
micropiate reader which may be
expensive; wiii not detect caspase-
independent apoptosis.
Phosphatidylserine (PS) Useful for detecting early May pick up PS in necrotic cells;
externalization-flow apoptotic cells. requires expensive flow cytometry
cytometry equipment.
32 Hoffman-Goetz, Quadrilatero, and Patel

possible mechanism that mediates angiogenesis is Flk-1 in response to exercise suggests that differ- -
muscle hypoxia during exercise. Breen et al. (1996) ences exist in their functions. Flk-1 is critical for
showed that VEGF mRNA is increased fourfold after embryonic endothelial cell differentiation and
a single treadmill run in rat muscle and is increased vasculogenesis. Flt-1 is important in the organization
further when exercise is performed under of the developing vasculature. However, both
hypoxemia. It was also demonstrated that FGF-2 receptors may be needed in angiogenesis since Flt-1
mRNA was increased with exercise under hypoxemia and Flk-2 gene expression can be induced by hypoxia
and that bFGF and TGF-P were increased after 1 h of (Sandner et al. 1997). Unfortunately, the exact
exercise. Similar findings were also obtained in mechanisms of action of both receptors are not clear
human muscle biopsies taken after 40 to 60 min of yet and need to be further elucidated.
knee extensor exercise (Richardson et al. 1999). In addition, constitutive VEGF protein expression
Chronic nerve stimulation has also been shown to was confirmed in muscle fibers, vascular smooth
increase VEGF mRNA levels in skeletal muscles after muscle (VSM) of larger vessels, interstitial fibroblasts,
one and three days (Breen et al. 1996; Hang et al. and other cell types (Brown et al. 2001). Expression
1995). This increase in VEGF gene expression is also of VEGF in VSM of arterial vessels in exercise-
correlated with increase in hypoxia-inducible factor induced angiogenesis is hypothesized to be due to
(H1F) mRNA in working muscles after 30 to 45 min adenosine availability, which helps produce MMP
of knee extensions (Gustafson et al. 1999). However, from VSM. The MMP mobilize VEGF or encourage
change in mRNA is not necessarily followed by an migration of mesenchymal cells participating in the
increase in protein, but VEGF protein is increased arteriolization of capillaries. Endothelial cell-
almost threefold after three days of chronic electrical stimulating angiogenic factor (ESAF) is linked with
nerve stimulation (Annex et al. 1998). Asano and capillary growth in stimulated muscles; this activates
colleagues (1998) also showed that serum levels of the pro-forms of metalloproteinase gelatinase A,
VEGF were increased during high-altitude swim collagenase, and streptolysin, which are implicated in
training in humans. VEGF has been considered a capillary growth (Hansen-Smith et al. 1998).
potent angiogenic factor since it is up-regulated after Hypoxia-inducible factor 1 (HIF-1) has been
both exercise and electrical stimulation. Thus, shown to be required for the hypoxia-induced
increased VEGF protein levels should provide an increase in VEGF (Forsythe et al. 1996). Both HIF- la
important stimulus for angiogenesis, especially and HIF-1 p mRNA levels increase in vivo along with
during the early phase of the training program. At increases in VEGF, However, a cause-effect
present there is only one study that shows both relationship cannot be established, since a similar
increased VEGF and vessel density with training stimulus or mechanism affects the transcription or
(Amaral et al. 2001). Lloyd et al. (2002) did not detect stabilization, or both, of VEGF and HIF-1 mRNA
increased muscle capillarity during the early time (Gavin et al. 2000b).
period of training when the VEGF mRNA changes Nitric oxide (NO) also appears to be an important
were most apparent. However, increase in capillarity regulator of endothelial cell growth and angiogenesis.
was observed beginning at day 12 of training. Since It is known to be important in blood flow regulation
angiogenesis has been observed as early as five days during exercise and is a cellular signal regulating
after the onset of chronic muscle stimulation, it is mitochondrial respiration (Gavin et al. 2000b). As
likely that the angiogenic process was already mentioned previously, hypoxic exercise produces a
ongoing at earlier time points, during the dominant greater increase in VEGF mRNA levels than does
phase of the VEGF response. However, a sustained exercise alone. However, NO has been shown to
exercise stimulus, occurring over a number of days, inhibit VEGF up-regulation through inhibition of
may be necessary in order for the development of HIF-1 in aortic smooth muscle cells (Liu et al. 1995).
angiogenesis to be fully manifested. Therefore, since NO is important for vasodilation, it is
Furthermore, inhibition of VEGF with a expected that NO should increase VEGF levels rather
neutralizing antibody completely blocked than cause a decrease. Nonetheless, NO may regulate
angiogenesis induced by exercise, further supporting VEGF gene expression differentially depending on the
the relationship between exercise, VEGF, and specific tissue. NO increases VEGF mRNA levels via
angiogenesis. The angiogenesis-promoting factor guanylate cyclase activity in human A-l 72
action of VEGF is produced primarily through VEGF glioblastoma cells and human Hep G2 hepatocellular
binding to its two receptors, Flk-1 and Fit-1 (Gavin et carcinoma cells. NO stimulates soluble guanylate
al. 2000a). Early gene expression of Flt-1 and not
Cellular Life Span 33

cyclase, which converts GTP to the intracellular Although hypoxia is a known regulator of VEGF
second messenger cGMP (Pilz et al. 1995). Thus, mRNA, its role in the exercise response has been
VEGF does not function alone in exercise-induced questioned. Breen et al. (1996) showed that VEGF
angiogenesis in skeletal muscle. Capillary growth in mRNA was unregulated in aerobic and hypoxic
stimulated muscles can be suppressed by treatment exercise conditions. This suggests that other signals
with inhibitors of either nitric oxide synthase (NOS) associated with muscle contraction are sufficient to
or prostaglandin production (Brown et ai. 2001). increase VEGF mRNA levels. These signals could be
Inhibition of NOS attenuates the exercise- induced produced in response to flow-dependent stimuli,
increases in VEGF mRNA (Gavin et al. 2000b). mechanical changes induced by load bearing within
However, the evidence is still preliminary and further the muscle during exercise, or both. Increased
investigation is needed to elucidate the effects of shear stress during exercise may play an important
exercise on VEGF and VEGF receptor expression. role in modulating angiogenic factor gene
Although the presence of VEGF appears to be expression. Shear stress increases NO levels, and
essential to initiate and facilitate angiogenesis, its Noris et al. (1995) found that NO activates HIF-1, a
actions are not sufficient as the sole agent to major regulator of VEGF expression, in the absence
complete the process. The angiopoietins are essential of hypoxia. In addition, increased stretch has been
for normal vascular remodeling. Both angiopoietins shown to increase VEGF mRNA expression in
(Angl, Ang2) bind to the Tie-2 receptor and thus skeletal muscle (Rivilis et al. 2002). Although shear
compete with each other. Angl functions to ensure stress, hypoxia, and mechanical stimuli are all
vessel stability while Ang2 has the opposite effect potential stimulators of VEGF gene expression in
(Maisonpierre et al. 1997). Therefore, the Ang2: Angl response to exercise, it is presently unknown which
ratio is thought to determine whether the net effect of these stimuli actually account for the higher
of the angiopoietins is to stabilize or destabilize the concentrations of this important angiogenic growth
vasculature. An increase in the Ang2:Angl ratio factor.
(destabilization) is indicative of being proangiogenic. Differential effects of angiogenesis factors on
For example, Ang2 is up-regulated at the leading various tissue sites play an important role in exer-
edge of new vessel growth (Maisonpierre et al. 1997). ciserinduced angiogenesis. For example, the lungs -
Preliminary evidence indicates that exercise, respond to hypoxia with vasoconstriction of the
particularly ischemic exercise, leads to a shift in .vasculature whereas in skeletal muscle, hypoxia
Ang2:Angl mRNA expression ratio that would causes vasodilation of the vasculature. In addition,
support destabilization of the vasculature. Further, capillary growth following exercise takes several weeks
studies in transgenic mouse myocardium show that to appear, making it difficult to ascertain the effects of
Ang2 has a synergistic effect with VEGF on capillary angiogenic factors in the long term.
growth, while Angl antagonizes VEGF action
(Visconti et al. 2002). In the model proposed by Proliferation in Skeletal Muscle
Lloyd and colleagues (2002), the Ang2:Angl mRNA
ratio was elevated after a single day of exercise, Satellite cells are undifferentiated mononuclear
thereby suggesting that destabilization of existing precursor muscle cells that are located between the
muscle vasculature is an early event in exercise- sarcolemma and basal lamina of the fiber (Bodine-
induced angiogenesis. In accordance with VEGF Fowier 1994). Evidence suggests that muscular
mRNA expression profiles, the up-regulation of activity can stimulate satellite cells to advance from
angiopoietin receptor (Tie-2) mRNA was delayed their initial quiescent state (Yan 2000). This has led
relative to the up-regulation of ligand mRNA. several authors to investigate the effect of various
However, the initial increase in the Ang2:Angl mRNA exercise protocols on muscle satellite cell activity.
ratio coincided with the up-regulation of VEGF Smith et al. (2001) found that 30 min of decline
mRNA (Lloyd et al. 2002). The wprk by Lloyd and running (-16 grade, 15 m/min) significantly
colleagues is the first to show that a coordinated increased soieus muscle satellite ceil proliferation
activation of VEGF and the angiopoietin system (1.0 0.2% of fibers) compared to that in
occurs during physiological angiogenesis in skeletal nonexercise control rats (0.4 0.2% of fibers)
muscle. Thus, a balance among these three factors following two but not one, four, or seven bouts of
appears to be necessary for normal vessel growth. the same task. McCormick and Thomas (1992)
found that progressive treadmill training for 10
weeks resulted in an increase in soieus satellite cell
mitotic activity from 0.52 0.13 nuclei/mm2
34 Hoffman-Goetz, Quadrilatero, and Patel

to. ,1.28 0.33 nuclei/mm2 in exercised rats. to pinpoint specific regulatory components (e.g.,
Furthermore, Tamaki et al. (2000) found that a cyclin-cdks).
single bout of heavy hindlimb weightlifting
significantly increased muscle mitotic activity in Telomeres and Telomerase Activity
young (14-20 weeks) but not in old (>120 weeks)
rats. It is currently unclear whether and how The proliferation of satellite cells following muscle
exercise affects cell cycle-specific components. injury plays a critical role in muscle recovery (Smith
et al. 2001). In skeletal muscle degenerative
Proliferation in Immune Cells conditions such as muscular dystrophy, satellite cells
are forced to undergo repeated bouts of cellular
Following mitogenic and antigenic stimulation, proliferation to repair continuous skeletal muscle
quiescent immune cells (Gg) progress through the damage. This leads to satellite cell exhaustion due to
cell cycle and are governed by the same molecules repeated cycles of regeneration and telomeric loss.
as other cell lineages. However, some cell cycle Indeed, muscular dystrophy is associated with a 14-
components interact with lymphocytes in a unique fold greater rate (187 bp/year vs. 13 bp/ year) of
manner and therefore play a critical role in immune telomeric loss than that in healthy controls (Pecary
function. For example, T-lymphocytes do not express et al. 2000; Di Donna et al. 2000). Exercise also
cyclin Dr Therefore proliferation through the G, causes muscle to undergo repeated bouts of
phase is dependent on cyclins D 2 and D3 as well as regeneration that could potentially affect telomeric
cdk4 and cdk6. Furthermore, p27 is constitutively length. Moreover, exercise affects lymphocyte and
present in quiescent T-lympho- cytes and down- satellite cell proliferation, and these relationships
regulated in the Gj phase following stimulation have led some authors to suggest a possible link with
(Balomenos & Martinez-A 2000; Chitko-McKown & alterations in telomere length and telomerase activity
Modiano 1997). in these tissues with exercise.
Exercise has been shown to modulate many Two recent studies have addressed the effect of
aspects of immune function, including cell exercise on telomere length or telomerase activity.
proliferation (Pedersen & Hoffman-Goetz 2000). Radak et al. (2001) found that 60 min of swimming
Several investigators have examined the role of five times per week for eight weeks (moderate
physical activity on lymphocyte proliferation. Here exercise), or a gradual increase in swimming
we describe some representative findings rather duration by 30 min/week (from 60 min during the
than providing a comprehensive and exhaustive first week to 270 min by the last week), did not alter
review of the area. Nieman et al. (1994) found that skeletal muscle telomerase activity in Wistar rats.
45 min of high (80% V0 2max)-intensity treadmill Furthermore, BDF1 mice implanted with the S-l 80
running was associated with a 21% decrease in sarcoma and exposed to various exercise conditions
concanavalin A-stimulated lymphocyte proliferation did not have any differences in liver telomerase
1 and 2 h postexercise compared to baseline values activity. Bruunsgaard et al. (1999) found that mean
following correction for changes in CD3* TRF length in blood mononuclear cell (BMNC), CD4*,
lymphocytes. However, moderate (50% V02max)- and CD8+ lymphocytes was significantly shorter in
intensity running had no effect on lymphocyte elderly (median age 78) compared to younger (median
proliferation. Short-duration (20 min) submaximal age 23) subjects. Furthermore, TRF lengths were
cycling at 50% peak work capacity significantly significantly decreased in BMNC and CDS'
increased lymphocyte proliferation in young (26 3 lymphocytes of younger subjects and CD4
years) but not elderly (69 5 years) subjects (Mazzeo lymphocytes of elderly subjects following maximal
et al. 1998). A recent study (Green et al. 2002) bicycle exercise lasting 17 to 20 min. Further
showed that 60 min of running at 95% ventilatory research is warranted given the limited data on
threshold significantly decreased exercise-induced alterations in telomere length and
phytohemagglutinin-induced peripheral blood telomerase activity.
mononuclear cells (PBMC) proliferation but had no
effect on NK-depleted PBMC or PBMC adjusted for Apoptosis in Heart
CD3+ percentage. Although studies that measure
and Skeletal Muscle
lymphocyte proliferation, as determined by 3H-
thymidine incorporation (or other radionucleotides), Cardiomyocytes undergo apoptosis in response to
are suggestive of changes in the cell cycle with ischemia and reperfusion injury. Gottlieb et al.
exercise, further research is needed (1994) were among the first to demonstrate
Cellular Life Span 35

apoptosis in rabbit myocardium subjected to increased expression of Fas (Cheng et al. 1995).
metabolic inhibition and recovery. Others have However, cardiac adaptation totreadmill training in
shown increased Fas mRNA undergoing hypoxia- rats is not associated with increased apoptosis of
induced myocyte death in rats (Tanaka et al. 1994), myocytes (Jin et al. 2000).
as well as ultrastructural changes (e.g., DNA Cell death occurs in immature skeletal muscle in
fragmentation, membrane blebbing) indicative of response to a variety of injurious stimuli. Some have
apoptosis that were especially pronounced during suggested that whether the response is apoptosis or
reperfusion (restoration of oxygen, serum, and necrosis depends upon the maturity of the muscle
glucose following a designated period of deprivation) cell. Carraro and Franceschi (1997) hypothesized
compared with the initial ischemia (deprivation of that the normal response to injury by immature
oxygen, serum, and glucose) (Umansky et al. 1995). muscle cells is apoptosis whereas the typical
Expression of Bcl-2, Bax, and Fas proteins in rat response in adult muscle fibers to the same
myocytes has been reported post-ischemia (Kajstura inducing stimulus is necrosis. Evidence that age and
et al. 1996). As noted earlier, Fas and Bax are potent development influence apoptosis or necrosis
cell death triggers whereas Bcl-2 functions to pathways comes from studies in neonatal rat
increase cell survival. While it is clear that ischemia skeletal muscle (Kaminska & Fidzianska 1996) and
can lead to cardiac apoptosis and necrosis, what from observations of human embryos at different
accounts for apoptotic injury to myocytes during stages of development (Carraro & Franceschi 1997).
reperfusion? Reperfusion of ischemic tissue is Apoptosis has been demonstrated under non-
associated with the generation of oxygen free radicals pathological conditions that stress muscle cells,
and acute leukocyte activation (Kloner et al. 1989; such as eccentric exercise, or conditions of atrophy,
Sussman & Bulkley 1990). ROS are generated such as prolonged traction and limb unweighting. As
through a variety of mechanisms, including the a rule, damage to skeletal muscle is greater with
repeated contractions in which the muscle
metabolism of arachidonic acid and respiratory burst
undergoes lengthening (eccentric exercise) than with
activity from leukocytes (which generates superoxide
activity involving shortening (concentric) or isometric
anion, singlet oxygen, hypochlorous acid, and other
contractions. Biral and colleagues (2000) used a
reactive species). ROS can damage DNA by oxidation
model of sustained eccentric exercise, with repeated
of purine and pyrimidine bases, most especially
contractions while the muscle was extended. With
guanine (Loft & Poulsen 1996), leading to apoptosis
use of the TUNEL method to detect apoptosis in rat
of the injured cell.
soleus and extensor digitorum longus, the
Ca2+ also plays a role in cell death during
disappearance of the dystrophin-based membrane
reperfusion injury. Following reperfusion, a large
skeleton and an elevated expression of Bax and
increase in intracellular Ca2+ occurs with resultant
caspase 3 in individual muscle fibers were
mitochondria Ca2+ accumulation. These events lead
demonstrated. Thus, apoptosis occurs in normal,
to decreased ATP production and MTP formation,
mature skeletal muscle fibers in response to extreme
which can lead to cell death (Suleiman et al. 2001;
functional demands.
Xu et al. 2001; Wang et al. 2002). Narayan et al.
Is there any evidence for apoptosis of skeletal
(2001) found that rat ventricular myocytes subjected muscle fibers with less extreme workload demands?
to simulated ischemia and reperfusion showed Although tentative, evidence of apoptosis in adult
increased apoptosis (Annexin V staining), but not C57BL/6 mouse tibialis anterior muscle following 12
when exposed to simulated ischemia alone. Following h of voluntary wheel running has been reported,
simulated reperfusion, free Ca2+ concentrations with myofiber content of Bax, Fas, and ubiquitin
within the mitochondria increased from 111 14 nM correlated with the appearance of apoptotic
during baseline to 214 22 nM and 382 22 nM in myonuclei (Podhorska-Okolow et al. 1998). Apoptosis
Annexin-negative and Annexin-positive cells, results in the elimination of myonuclei or satellite
respectively. Furthermore, calcium preconditioning ceils, or both, from atrophying rat muscle fibers with
of myocytes maintains mitochondria Ca2+ hindlimb unweighting (Allen et al. 1997).
homeostasis, preventing MPT formation and
apoptosis (Xu et al. 2001). However, ischemia- Apoptosis of Immune Cells
reperfusion injury is not the only trigger for non-
necrotic cell death of cardio- myocytes. An area of increasing research is the effect of
Overstretching results in apoptosis in rat myocytes exercise on apoptosis of immune cells. Strenuous
and non-myocytes, together with exercise regulates several factors that alter
36 Hoffman-Goetz. Ouadrilatero, and Patel

lymphocyte apoptosis in a number of ways. Eor~. is activated depends on the whether the exercise
example, increased GC secretion, growth factor triggers a hormonal response involving ACTH and
withdrawal, ROS generation, and increased plasma cortisol/corticosterone release, a metabolic response
TNF-a are some of the signals that induce apoptosis involving ROS generation, or generation of
in immune cells (Phaneuf & Leewenburgh 2001); and inflammatory cytokines such as TNF-a. In an
some of these factors (GC, TNF-a) are notably elevated exercise bout of longer duration (e.g., 60-120 min)
after strenuous, prolonged, or muscle-damaging and moderate intensity (e.g., <75% of VOzmax)
exercise. Apoptotic loss could contribute to the well- associated with activation of the hypothalamic-
documented decrease in the number and function of pituitary-adrenal (HPA) axis (Ronsen et al. 2001),
lymphocytes postexercise (Hoffman-Goetz & corticosterone release will trigger the mitochondrial
Quadrilatero 2003; Pedersen & Hoffman-Goetz 2000). pathway of apoptosis, activating procaspase 8 and,
The effect of high-intensity exercise on the ultimately, caspase 3. In an exercise bout of high
induction of lymphocyte apoptosis has been intensity (e.g., >75% of V02max) and shorter duration
repeatedly demonstrated. One of the earliest studies (e.g., <30 min), respiratory oxidant stress will occur
to address this was that of Concordet and Ferry (Raidai et al. 2000), also leading to induction of
(1993), who found DNA fragmentation (using the mitochondrial damage and cytochrome C release and
TUNEL assay) of thymus following two treadmill triggering of the caspase pathways. The type of
runs to exhaustion (separated by a 24-h rest) in exercise also modifies the apoptotic pathway that
rats. Thymocyte apoptosis could be blocked by ensues once the minimum intensity and duration
administration of a GC receptor antagonist, RU-486 thresholds have been exceeded. For example,
(mifepristone). In vitro studies indicate that exercise that involves muscle damage (e.g., downhill
corticosterone exposure (at levels observed after running) leads to the release of inflammatory
exercise) is associated with increased expression of cytokines (e.g., TNF-a) and the induction of the
Annexin V-positive thymocytes (Hoffman-Goetz receptor-ligand mechanism of cell death. In contrast,
&Zajchowski 1999). Increased oxygen consumption intense exercise that occurs without muscle damage
and hyperventilation with exhaustive exercise lead could induce apoptosis in lymphocytes primarily
to the generation of ROS; ROS contribute to through the mitochondrial pathway (see figure 2.4).
thymocyte cell death as measured by lipid peroxides According to this model, short-duration sub-
and the influx of Ca2* ion into thymocytes (Azenabor maximal treadmill exercise (Hoffman-Goetz et al.
& Hoffman-Goetz 1999, 2000). Antioxidant 1999) should not induce significant apoptosis in
supplementation inhibits exercise-induced thymocytes or other susceptible lymphocytes.
leukocyte DNA damage (Hartmann et al. 1995) and Similarly, high-volume exercise of very low intensity,
thymocyte apoptosis (Lin et al. 1999). Increased cas- which occurs with wheel running, would also not
pase 3 activity was demonstrated in developing induce apoptosis in lymphocytes (Hoffman-Goetz &
thymocytes (but not mature splenocytes) after a Fietsch 2002). Thus, variation in findings of
single intensive bout of exercise in mice (Patel & apoptosis effects among exercise studies may be due
Hoffman-Goetz 2002), providing evidence that to exercise intensity and duration continuum;
apoptosis occurs in GC-sensitive lymphoid tissues exercise that fails to lead to either an elevation in GC
via caspase-dependent mechanisms. Lagranha et al. or the generation of ROS or the release of
(2004) found that a single bout of intense treadmill inflammatory cytokines will not be associated with
running significantly increased Bax and Bcl-x s (pro- apoptotic events in lymphocytes. Moreover,
apoptotic) gene expression while at the same time differences in the sensitivity of lymphocytes to these
decreasing Bcl-x, (anti-apoptotic) gene expression apoptotic-inducing factors will also influence the
and mitochondrial membrane potential in extent of cell death. For example, the primary
neutrophils from mature rats. lymphoid compartments (thymus and bone marrow)
What is the mechanism for the apoptosis of contain many double positive (004X08 ") and double
thymocytes in rats or mice after strenuous exercise? negative (CD4XD8") lymphocytes compared with
We hypothesize that intense exercise leads to secondary lymphoid compartments (spleen, nodes,
apoptosis through both receptor-ligand signaling blood), which have primarily single positive cells
and mitochondrial pathways (shown (CD4+ or CD8*)- Characterization of the sensitiv-
diagrammatically in figure 2.2). Which pathway
Cellular Life Span 37

Low Low

s w Inflammatory-Receptor
Metabolic-Mitochondria o' o O
cytochrome c pathway
s ligand pathway

Low s. High Low

Figure 2.4 Model of exercise-induced lymphocyte apoptosis. Model predicts general exercise conditions under which apoptosis
will occur. Reactive oxygen species (ROS) and glucocorticoids (GC), released in response to high-intensity or long- duration
exercise or both, trigger the mitochondrial-cytochrome C pathway of apoptosis in lymphocytes. Other hormonal triggers (e.g.,
catecholamines) may be involved. Tumor necrosis factor-ot (TNF-a), released during muscle damage or exercise associated
with inflammatory events, triggers the receptor-ligand pathway of apoptosis in lymphocytes. Below some intensity and
duration threshold, exercise-induced apoptosis of lymphocytes does not occur because of absence of physiological triggers.

ity of these different subpopulations to ROS, GC, Conclusion

and other apoptotic stimuli may help to explain the
differential apoptosis in lymphocyte compartments Diverse factors (cytokines, growth factors, cell cycle
after exercise. components) regulate cell proliferation. An equally
There are limited data from human studies on diverse and often bewildering group of intracellular
the effects of exercise on the induction of apoptosis and extracellular factors are involved in the
in lymphocytes. Treadmill exercise to exhaustion signaling of cell apoptosis. How these factors
(Mars et al. 1998; Niess et al. 1996), treadmill converge to trigger the physical processes of cellular
exercise above the aerobic-anaerobic threshold replication, cellular stasis, or cellular apoptosis has
(Hartmann et al. 1994), and treadmill exercise (80% been the object of intense scientific research in the
of V02max) to exhaustion (~30 min) (Mooren et al. past 20 years. Better understanding of the
2002) were associated with induction of apoptosis in relationship between level of expression of
human lymphocytes. In exercise of lower intensity oncoproteins such as c-myc and p53, survival
(60% of V02max) for a short duration (~30 min), no proteins such as the products of Bcl-2, and
apoptosis was observed in human lymphocytes. components of the cell cycle (cyclins-cdks) will be
Steensberg et al. (2002) found an increase in the important for understanding how apoptotic
resistance develops in cancer cells and how cellular
percentage (but not absolute numbers) of human
senescence occurs. It is clear that with appropriate
blood lymphocytes expressing early markers of
signals, cardiac and skeletal muscle cells, as well as
apoptosis after exercise at 75% of V0 2max for 2.5 h.
lymphocytes, undergo apoptosis. The decision to
Since an increase in both plasma cortisol and
commit to the cellular apoptosis program in
plasma isoprostanes (a measure of oxidative stress)
response to an exercise challenge will ultimately
was observed, it is likely that the mitochondrial
reflect a combination of extracellular influences
pathway was activated, leading to the percentage
(e.g., glucocorticoids, generation of ROS, presence of
increase in apoptotic lymphocytes. Further, Hsu et
inflammatory cytokines) and intracellular influences
al. (2002) found decreased mitochondrial membrane
(e.g., ATP availability, short or prolonged opening of
potential and increased DNAfragmentation in
the mitochondrial permeability transition pore,
peripheral blood leukocytes from subjects who
concentration of pro-apoptotic to antiapoptotic
performed consecutive bouts of aerobic exercise at
proteins, activation of oncogenes) acting upon
60% and 85% but not 35% VO,max.
muscle and immune cells.