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M.S.

A creatina (Cr) é uma reserva de fosfato de alta energia, sendo a fonte mais rápida de restauração do ATP intracelular. O hormônios tireoideano participa de forma importante na manutenção da taxa metabólica, aumentando a síntese e consumo de ATP, por meio da regulação de diferentes genes-alvo. Neste sentido, avaliamos o efeitos do HT sobre a expressão gênica do transportador de Cr nos músculos esqueléticos e cardíaco de ratos. O tratamento com o hormônio regula estes processos, porém de forma distinta nos diferentes tipos de músculos. / Creatine (Cr) is a high-energy phosphate reservoir and the fastest source for intracellular ATP regeneration. The thyroid hormone plays a key role on the maintenance of basal metabolic rate, increasing the synthesis and the degradation of ATP through regulation of target-genes. In this study, we explore the effects of thyroid hormone on Cr transporter gene expression and regulation of intracellular pool of Cr in skeletal and cardiac muscles in rats. The hormone can regulate these processes in distinct ways in different muscle types.

A creatina (Cr) é uma reserva de fosfato de alta energia, sendo a fonte mais rápida de restauração do ATP intracelular. O hormônios tireoideano participa de forma importante na manutenção da taxa metabólica, aumentando a síntese e consumo de ATP, por meio da regulação de diferentes genes-alvo. Neste sentido, avaliamos o efeitos do HT sobre a expressão gênica do transportador de Cr nos músculos esqueléticos e cardíaco de ratos. O tratamento com o hormônio regula estes processos, porém de forma distinta nos diferentes tipos de músculos. / Creatine (Cr) is a high-energy phosphate reservoir and the fastest source for intracellular ATP regeneration. The thyroid hormone plays a key role on the maintenance of basal metabolic rate, increasing the synthesis and the degradation of ATP through regulation of target-genes. In this study, we explore the effects of thyroid hormone on Cr transporter gene expression and regulation of intracellular pool of Cr in skeletal and cardiac muscles in rats. The hormone can regulate these processes in distinct ways in different muscle types.

Recentemente, foi descrito um grupo de alterações no metabolismo da creatina denominado Síndromes de Deficiência de Creatina. Há três formas da doença geneticamente determinadas que cursam com deficiência de creatina, seja por comprometimento de sua síntese ou por defeito na proteína transportadora. O espectro de apresentação clínica dessa condição é inespecífico e inclui atraso ou estagnação do desenvolvimento neuromotor, hipotonia muscular, movimentos involuntários do tipo coreoatetose, retardo ou ausência do desenvolvimento da fala, retardo mental de grau variável, comportamento autista e epilepsia. Neste trabalho, foi desenvolvida e validada uma alternativa metodológica àquelas disponíveis na literatura, com a utilização de extração por troca catiônica forte e separação e detecção por cromatografia líquida de interação hidrofílica acoplada a espectrometria de massas em tandem em que foram exploradas as características químicas das moléculas de creatina e guanidinoacetato, metabólito intermediário da síntese de creatina. Os valores de referência para o método foram definidos pela sua aplicação a 150 amostras de urina e 197 amostras de soro de indivíduos de ambos os sexos e idades entre 0 e 16 anos. Foram também analisadas amostras de urina, soro e plasma de 54 pacientes com clínica compatível com a síndrome de deficiência de creatina sendo que 3 deles apresentaram perfil bioquímico característico de uma das formas dessa condição / Recently, a new group of inborn errors of metabolism, collectively named as creatine deficiency syndrome, was identified. Three genetically determined presentations are currently known, affecting both creatine synthesis and transport. Clinical presentation spectrum is non-specific and includes developmental delay, hypotonia, involuntary movements as choreoathetosis, delay or lack of speech acquisition, mental retardation of variable severity, autistic behavior, and epilepsy. Herein, we developed and validated an innovative method for determination of creatine and of its metabolic intermediate, guanidinoacetate, based on cation-exchange solid-phase extraction and hydrophilic interaction liquid chromatography coupled to tandem mass spectrometry. Reference values for the method were defined testing 150 urine and 197 serum samples in males and females with age ranging from 0 to 16 years. Urine and serum samples from 54 patients with some clinical features that might be attributable to creatine deficiency were also evaluated, and in three, biochemical profile characteristic of one of the disorders was detected

Recentemente, foi descrito um grupo de alterações no metabolismo da creatina denominado Síndromes de Deficiência de Creatina. Há três formas da doença geneticamente determinadas que cursam com deficiência de creatina, seja por comprometimento de sua síntese ou por defeito na proteína transportadora. O espectro de apresentação clínica dessa condição é inespecífico e inclui atraso ou estagnação do desenvolvimento neuromotor, hipotonia muscular, movimentos involuntários do tipo coreoatetose, retardo ou ausência do desenvolvimento da fala, retardo mental de grau variável, comportamento autista e epilepsia. Neste trabalho, foi desenvolvida e validada uma alternativa metodológica àquelas disponíveis na literatura, com a utilização de extração por troca catiônica forte e separação e detecção por cromatografia líquida de interação hidrofílica acoplada a espectrometria de massas em tandem em que foram exploradas as características químicas das moléculas de creatina e guanidinoacetato, metabólito intermediário da síntese de creatina. Os valores de referência para o método foram definidos pela sua aplicação a 150 amostras de urina e 197 amostras de soro de indivíduos de ambos os sexos e idades entre 0 e 16 anos. Foram também analisadas amostras de urina, soro e plasma de 54 pacientes com clínica compatível com a síndrome de deficiência de creatina sendo que 3 deles apresentaram perfil bioquímico característico de uma das formas dessa condição / Recently, a new group of inborn errors of metabolism, collectively named as creatine deficiency syndrome, was identified. Three genetically determined presentations are currently known, affecting both creatine synthesis and transport. Clinical presentation spectrum is non-specific and includes developmental delay, hypotonia, involuntary movements as choreoathetosis, delay or lack of speech acquisition, mental retardation of variable severity, autistic behavior, and epilepsy. Herein, we developed and validated an innovative method for determination of creatine and of its metabolic intermediate, guanidinoacetate, based on cation-exchange solid-phase extraction and hydrophilic interaction liquid chromatography coupled to tandem mass spectrometry. Reference values for the method were defined testing 150 urine and 197 serum samples in males and females with age ranging from 0 to 16 years. Urine and serum samples from 54 patients with some clinical features that might be attributable to creatine deficiency were also evaluated, and in three, biochemical profile characteristic of one of the disorders was detected

Thesis (MPhil (Physiological Sciences))--University of Stellenbosch, 2006. / Background. Creatine monohydrate is widely used for its purported ergogenic and anabolic properties. The mechanism by which creatine supplementation enhances muscle growth is not understood. This study was undertaken to determine whether creatine monohydrate supplementation increases the conversion rate of testosterone to dihydrotestosterone. An increase in dihydrotestosterone could partly explain the beneficial effect of creatine monohydrate on muscle hypertrophy. Methods. Subcommittee C of the research committee of the University of Stellenbosch approved the study. Project number 2001/ C045. The study was designed as a double blind crossover with subjects (n = 20) in each leg of the study. Group 1 (n = 10) taking creatine monohydrate and group 2 (n = 10) glucose during the first leg of the study. In accordance with crossover study design the groups were reversed in the second leg of the study. Gelatin capsules were filled with 5g of either creatine monohydrate or 5g of glucose. Subjects taking creatine monohydrate also took 25g of glucose to improve absorption of creatine. Subjects took creatine monohydrate 25g plus 25g of glucose (ten capsules in all) or glucose ten capsules per day for seven days in the loading phase. In the maintenance phase they took 5g of creatine monohydrate plus 25g of glucose (six capsules in all) per day or six capsules of glucose, for 14 days. The groups were reversed after a six-week washout period and the dosages repeated as per crossover study design. Blood samples were taken on day zero of the study as baseline measurements, repeated on day 7, (after the loading phase), and again on day 21, (after the maintenance phase). These were again repeated in the second leg of the study as per crossover design. Serum was separated within one hour of collection and stored at minus 70 oC. Testosterone and dihydrotestosterone concentrations were determined using a radio-immunoassay kit by an accredited university laboratory. The percentage conversion of testosterone to dihydrotestosterone was calculated. The results were statistically analyzed: A paired t - tests at the beginning of each leg of the study and repeated measure analysis of variance, for the pooled data for each condition over the whole study. Results. The difference in blood levels of testosterone and dihydrotestosterone on both days 0, were not statistically significant. This made the pooling of the data possible. The difference in the percentage conversion of testosterone to dihydrotestosterone over the study period between the creatine monohydrate condition and the glucose condition, was however significant (p < 0.0001). In this small study highly significant statistical results were obtained. The answer to how creatine taken as a supplement exerts its effect may lie in the increased rate of conversion of testosterone to dihydrotestosterone. Conclusion. With the known greater androgenic effect of dihydrotestosterone as opposed to testosterone, the increase in testosterone conversion to dihydrotestosterone could explain how creatine supplementation exerts its anabolic effect in susceptible individuals. A larger study should be done to confirm these results and answer the questions arising from the findings.

Thesis (MSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The aim of this study was to investigate the powerful muscle regulator, myostatin, and its regulators in response to an acute bout of plyometric training. The participants were recruited and screened by characterization by means of isometric force production tests, baseline blood creatine kinase levels and VO2 max results. The selected individuals (n=15) were subjected to a baseline muscle biopsy for comparative purposes. The study made use of plyometric jumping, as source of eccentric exercise, to serve as an exercise intervention after which muscle biopsies (4 hours post and 24 hours post) and blood draw (4 hours post, 24 hours post and 48 hours post) samples were taken. Maximal voluntary isometric contractions of the knee extensors were also measured immediately after the exercise protocol and after 1 week recovery. Creatine kinase (CK) analysis on the serum samples was used to conclude muscle damage. The muscle biopsy samples were used for protein quantification (Western blot) and gene expression assessment (semi-quantitative and real-time PCR). The results showed decreased force production immediately after eccentric exercise (p < 0.05), while returning back to baseline values at 1 week post exercise and CK results showed a significant increases at 4 hours (p<0.05), 24 hours (p<0.001) and 48 hours (p<0.01) after exercise. There were no significant differences in myostatin precursor protein (43 kDa), phosphorylated Smad2,3, Smad7 or activin receptor IIb in response to eccentric exercise. However, the follistatin protein was increased at both 4 hours and 24 hours after exercise (p<0.01). RNA analysis of the extracellular matrix (ECM) protein, decorin, revealed the existence of the splice variants A1 and A2 in human skeletal muscle. The RT-PCR analysis (n=4) of these variants showed no significant difference when comparing pre- to post-exercise. The decorin core protein was also investigated by means of antibody probing and results revealed the need for ABC chondroitinase enzyme treatment before immunoblotting of human skeletal muscle samples. The results concerning knee extensor force reduction and circulating creatine kinase showed the effectiveness of plyometric jumping in producing skeletal muscle damage in the lower limbs of unfit individuals, unaccustomed to eccentric exercise. In conclusion, myostatin, and its associated signalling cascade, are not activated in early muscle regeneration, but follistatin is increased during this phase possibly aiding and initiating the muscle repair process. Future studies: Variants of decorin are expressed in human skeletal muscle, increasing the complexity that should be taken into account in studies concerning the regulation of decorin in a human model. Investigation into myostatin protein at different post-translational levels needs more clarification. Published methods and materials used in different laboratories are not consistent and investigators should attempt to standardise protocols in order to compare results between studies more effectively. Of importance, these results show that the myostatin at protein level report different results compared to mRNA analysis and that more investigation into myostatin regulatory factors, with special reference to follistatin and decorin, is needed in future human models. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die kragtige spiere reguleerder, miostatin, en sy reguleerders in reaksie op 'n akute aanval van pliometriese spronge te ondersoek. Die deelnemers is gewerf en gekeur deur karakterisering deur middel van isometriese krag produksie toetse, basislyn bloed kreatien kinase vlakke en VO2maks resultate. Die geselekteerde individue (N = 15) is onderhewig aan 'n basislyn spierbiopsie vir vergelykende doeleindes. Die studie het gebruik gemaak van pliometriese spronge (essentriese spier aksie) as die oefening intervensie waarna spierbiopsie (4 uur na en 24 uur na) en bloed (4 uur na, 24 uur na en 48 uur na) monsters geneem is. Isometriese kontraksies van die knieverlengers is ook gemeet onmiddellik na die oefening protokol en na 1 week se herstel. Kreatine kinase (KK) ontleding van die serum monsters is gebruik om spierskade aftelei. Die spierbiopsie monsters was gebruik vir proteïen kwantifisering (Western klad) en die assessering van geen uitdrukking (semi-kwantitatiewe en real-time PCR). Die resultate het gewys dat krag produksie afgeneem het onmiddellik na essentriese oefening (p <0.05), terwyl dit terugkeer na die oorspronklike waardes 1 week na oefening en KK resultate toon 'n beduidende toename by 4 uur (p <0,05), 24 uur (p <0,001) en 48 uur (p <0,01) na oefening. Daar was geen betekenisvolle verskille in Miostatien voorloper proteïen (43 kDa), gefosforileerde Smad2,3, Smad7 of Activin reseptoor IIb in reaksie op essentriese oefening. Dit is egter die follistatien proteïen wat verhoog by beide 4 uur en 24 uur na oefening (p <0,01). RNS ontleding van die ekstrasellulêre matriks (ESM) proteïen, decorin, het die bestaan van die splitsing variante A1 en A2 in menslike skeletspier, aan die lig gebring. Die RT-PCR analise (n = 4) van hierdie variante het geen betekenisvolle verskille getoon wanneer voor met na-oefening vergelyk is. Die decorin kern proteïen is ook ondersoek deur middel van teenliggaam afhanklike metodes en resultate het die behoefte aan ABC chondroitinase ensiem behandeling voor immunokladding van menslike skeletspier monsters gesteun. Die resultate aangaande knieverlenger krag vermindering en sirkuleerende kreatien kinase het die doeltreffendheid van pliometriese spronge in die vervaardiging van skeletspier skade in die onderste ledemate van individue ongewoond aan essentriese oefening verseker. Ten slotte, Miostatien, en sy verwante sein kaskade, is nie geaktiveer vroeg in spier herstelling, maar follistatien is tydens hierdie fase verhoog en help moontlik met die aanvang van die spier herstel. Toekomstige studies: variante van decorin word uitgedruk in menslike skeletspier, wat die kompleksiteit aangaande decorin verhoog en dit is iets wat in ag geneem moet word in studies wat handel oor die regulering van decorin in mens modelle. Ondersoek na miostatien proteïen op verskillende na-translasie vlakke moet meer duidelikheid verkry. Gepubliseer metodes en materiaal wat gebruik word in verskillende laboratoriums is nie konsekwent en ondersoekbeamptes moet probeer om protokolle te standaardiseer sodat resultate van studies meer effektief kan vergelyk word. Van belang is, die resultate wys dat miostatien op proteïen vlak verskillende resultate vertoon in vergelyking met boodskapper-RNS ontleding en dat meer ondersoek na miostatien regulerende faktore, met spesiale verwysing na follistatien en decorin, nodig is in toekomstige menslike modelle.

Cardiovascular magnetic resonance imaging (MRI) is a well established technique in clinical cardiology. Different MRI sequences are routinely used to assess cardiac anatomy, function, viability and other parameters that aid diagnosing cardiac disease. Conversely, cardiac magnetic resonance spectroscopy (MRS), the only available method for a non-invasive study of human cardiac metabolism, has not evolved into a clinical tool yet. The combination of both techniques holds great potential to gain insight into the causality of cardiomyopathy diseases or other medical conditions with high cardiovascular risk profile, like diabetes or obesity and improve the clinical management of cardiac diseases. Nowadays, high field clinical MR systems have the great potential of improving the low spatial and temporal resolution and reproducibility of MRS. The aim of this thesis was to develop and implement a cardiac 1H-MRS method at 3 T that can be applied in clinical routine for the assessment of creatine and lipid levels in the human myocardium. The methodological developments to advance cardiac MRS are presented first. A robust 1H-MRS method comprising an optimized single-voxel technique, phased-array coil combination routine, optimized water suppression, breath-hold averaging and post-processing methods were developed. First, reproducibility and feasibility of the method were validated in vivo by acquiring 1H-MRS of the liver in almost one hundred healthy subjects. Subsequently, myocardial lipids levels were obtained in healthy volunteers by single breath-hold 1H-MRS triggered to mid-diastole, showing good reproducibility in an acquisition time less than 12 s. The good spectral resolution achieved using this method was demonstrated by the ability to differentiate for the first time two pools of myocardial lipids in spectra from the septum of patients with suspected myocardial lipid excess. Finally, creatine levels for healthy volunteers were investigated using multiple breath-hold acquisitions. Thus, this study shows the practicality and feasibility to incorporate this rapid cardiac 1H-MRS method into clinical studies of the human myocardium.