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Körperliches Training bei mitochondrialen Erkrankungen

Exercise in mitochondrial diseases

Zusammenfassung

Körperliches Training gilt bei mitochondrialen Myopathien als einer der vielversprechendsten therapeutischen Ansätze. Effektivität und Sicherheit sind bewiesen. Ausdauer- und Krafttraining haben unterschiedliche Wirkungen auf die Muskulatur von Patienten mit mitochondrialer Myopathie: Als therapeutischer Mechanismus des Krafttrainings gilt das so genannte „gene shifting“, die trainingsinduzierte Verschiebung des Anteils mutierter mitochondrialer DNS (mtDNS) zugunsten von Wildtyp-mtDNS durch Induktion muskulärer Satellitenzellen. Ausdauertraining regt die mitochondriale Biogenese an und hilft somit, den Circulus vitiosus aus verringertem Mitochondriengehalt, verringerter Kapazität der oxidativen Phosphorylierung, Belastungsintoleranz und daraus resultierender fortschreitender muskulärer Dekonditionierung zu durchbrechen. Die Effektivität und die Sicherheit medikamentöser Induktoren der mitochondrialen Biogenese – möglicherweise in Kombination mit Training – könnten Gegenstand künftiger Untersuchungen sein.

Abstract

Exercise is a promising therapeutical option for the treatment of mitochondrial myopathies. Its efficacy and safety have been proven in various studies. In patients with mitochondrial myopathy, resistance training and aerobic exercise training lead to widely diversified effects: resistance training is thought to normalize the mitochondrial DNA (mtDNA) genotype in mature myofibers by enhancing the incorporation of satellite cells and thereby increasing the ratio of wild-type to mutant mtDNA (“gene shifting”). Aerobic exercise training induces mitochondrial biogenesis and helps breaking the vicious circle of low oxidative phosphorylation capacity, exercise intolerance, and progressive muscular deconditioning. Certain drugs act as inductors of mitochondrial biogenesis but their safety and efficacy in patients with mitochondrial myopathy have to be further investigated.

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Literatur

  1. 1.

    Tesch PA (1988) Skeletal muscle adaptations consequent to long-term heavy resistance exercise. Med Sci Sports Exerc 20:132–134

    Article  Google Scholar 

  2. 2.

    Campos GE, Luecke TJ, Wendeln HK et al (2002) Muscular adaptations in response to three different resistance-training regimens: specificity of repetition maximum training zones. Eur J Appl Physiol 88:50–60

    PubMed  Article  Google Scholar 

  3. 3.

    Gettman LR, Ayres JJ, Pollock ML, Jackson A (1978) The effect of circuit weight training on strength, cardiorespiratory function, and body composition of adult men. Med Sci Sports 10:171–176

    PubMed  CAS  Google Scholar 

  4. 4.

    Holloszy JO, Coyle EF (1984) Adaptations of skeletal muscle to endurance exercise and their metabolic consequences. J Appl Physiol 56:831–838

    PubMed  CAS  Google Scholar 

  5. 5.

    Hoppeler H, Howald H, Conley K et al (1985) Endurance training in humans: aerobic capacity and structure of skeletal muscle. J Appl Physiol 59:320–327

    PubMed  CAS  Google Scholar 

  6. 6.

    Fu K, Hartlen R, Johns T et al (1996) A novel heteroplasmic tRNAleu(CUN) mtDNA point mutation in a sporadic patient with mitochondrial encephalomyopathy segregates rapidly in skeletal muscle and suggests an approach to therapy. Hum Mol Genet 5:1835–1840

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Clark KM, Bindoff LA, Lightowlers RN et al (1997) Reversal of a mitochondrial DNA defect in human skeletal muscle. Nat Genet 16:222–224

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Taivassalo T, Fu K, Johns T et al (1999) Gene shifting: a novel therapy for mitochondrial myopathy. Hum Mol Genet 8:1047–1052

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Murphy JL, Blakely EL, Schaefer AM et al (2008) Resistance training in patients with single, large-scale deletions of mitochondrial DNA. Brain 131:2832–2840

    PubMed  Article  Google Scholar 

  10. 10.

    Taivassalo T, Shoubridge EA, Chen J et al (2001) Aerobic conditioning in patients with mitochondrial myopathies: physiological, biochemical, and genetic effects. Ann Neurol 50:133–141

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Taivassalo T, Gardner JL, Taylor RW et al (2006) Endurance training and detraining in mitochondrial myopathies due to single large-scale mtDNA deletions. Brain 129:3391–3401

    PubMed  Article  Google Scholar 

  12. 12.

    Jeppesen TD, Schwartz M, Olsen DB et al (2006) Aerobic training is safe and improves exercise capacity in patients with mitochondrial myopathy. Brain 129:3402–3412

    PubMed  Article  Google Scholar 

  13. 13.

    Jeppesen TD, Duno M, Schwartz M et al (2009) Short- and long-term effects of endurance training in patients with mitochondrial myopathy. Eur J Neurol 16:1336–1339

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Cejudo P, Bautista J, Montemayor T et al (2005) Exercise training in mitochondrial myopathy: a randomized controlled trial. Muscle Nerve 32:342–350

    PubMed  Article  Google Scholar 

  15. 15.

    Wenz T, Diaz F, Hernandez D, Moraes CT (2009) Endurance exercise is protective for mice with mitochondrial myopathy. J Appl Physiol 106:1712–1719

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Lau YS, Patki G, Das-Panja K et al (2011) Neuroprotective effects and mechanisms of exercise in a chronic mouse model of Parkinson’s disease with moderate neurodegeneration. Eur J Neurosci 33:1264–1274

    PubMed  Article  Google Scholar 

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Danksagung

Die Autoren danken dem Schweizerischen Nationalfonds (Beitrags-Nr. 320030_135539).

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Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Correspondence to H.H. Jung.

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Petersen, J., Toigo, M., Frese, S. et al. Körperliches Training bei mitochondrialen Erkrankungen. medgen 24, 200–203 (2012). https://doi.org/10.1007/s11825-012-0345-9

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Schlüsselwörter

  • Myopathien
  • Gen-Shifting
  • Biogenese
  • Ausdauertraining
  • Krafttraining

Keywords

  • Myopathies
  • Gene shifting
  • Biogenesis
  • Aerobic exercise
  • Resistance training