Effects of Glutamine Supplementation on Muscle Function in a Mouse Model of Spinal Cord Injury Abstract: Spinal cord injury (SCI) results in loss of muscle function due to the rapid breakdown of muscle contractile proteins and high incidence of inflammation that directly hinder rehabilitation. Glutamine is an amino acid that plays a critical role in muscle integrity and in reducing inflammation, however, impaired glutamine synthesis occurs under stressful conditions. Glutamine supplementation can improve clinical outcomes from acute infection to sepsis, but its effects on skeletal muscle function in the early stages after a SCI are unknown. Based on glutamine’s benefits and clinical applicability these experiments tested the hypothesis that glutamine treatment can preserve muscle mass, strength, and fatigue resistance in a mouse model of SCI. Changes in muscle mass, maximal isometric force, and fatigability will be measured 7 days after sham or spinal cord transection (ST) surgery in mice receiving either placebo or glutamine (n=3-5/group). ST significantly reduced gastrocnemius mass independent of saline or glutamine treatment. Maximal isometric force normalized to body or muscle mass was not different among groups. Fatigue resistance was reduced with ST + saline, however, glutamine supplementation prevented the loss of fatigue resistance (38±9 vs. 57±5% of max force, respectively). Preliminary results suggest that 7 days after a SCI significant reductions in muscle fatigue resistance can be reversed by glutamine supplementation. Additional studies can continue to establish the protective effects of glutamine on muscle endurance with SCI, underscoring the importance of glutamine as a therapeutic intervention to accelerate the recovery of muscle function after a SCI. BACKGROUND AND HYPOTHESIS Spinal Cord Transection (ST) is a well-established rodent model for studying the effects of spinal cord injury. Glutamine supplementation can improve clinical outcomes under stressful conditions (Novak et al.), but its direct influence on skeletal muscle function after a spinal cord injury are unknown. Glutamine was shown to prevent muscle force loss following an acute inflammatory insult (Meador and Huey) Skeletal muscle is the largest contributor to plasma glutamine levels (Darmaun et al.), therefore providing an exogenous source of glutamine may reduce the necessity for muscle protein breakdown to maintain adequate levels of this essential amino acid. Compared to non-injured subjects, plasma glutamine levels were reduced 54% in spinal cord injury patients (Rogeri and Costa Rosa) Accelerated recovery from glutamine supplementation has been directly related to increase in expression of protective heat shock proteins (Wischmeyer et al.). Primary Hypothesis: These experiments will test the hypothesis that glutamine supplementation can attenuate losses of muscle force and endurance in a mouse model of spinal cord injury. Carissa Chamney, Ethan Garrigan, Kimberly Huey Drake University, College of Pharmacy and Health Sciences METHODS Adult C57 mice were divided into 4 groups (n=35/group): 1) Placebo/Sham 2) Glutamine/Sham 3) Placebo/Spinal Cord Transection 4) Glutamine/Spinal Cord Transection Complete spinal cord transection or sham surgery was performed and followed by daily glutamine or placebo (saline) supplementation for 7 days. Glutamine groups received intraperitoneal injections of 1g/kg glutamine in saline suspension and placebo groups received saline alone. Maximal isometric plantar flexor force and fatigability was measured at 7 days post-injury in anesthetized mice with a dual-mode footplate system. 10 contractions were evoked every 5 seconds by sciatic nerve stimulation Fatigue calculated as % maximum force after 10th repetition Figure 1. Dual mode footplate system to measure in vivo muscle force production. Isometric Force Table 1. Initial and Final Body Weights (BW) in Sham and Spinal Transected Mice Receiving Daily Saline or Glutamine Initial BW (g) Final BW (g) Sham Saline Glutamine 24.3 ± 0.8 24.2 ± 0.6 24.3 ± 1.1 24.5 ± 0.4 Spinal Transection Saline Glutamine 22.7 ± 1.8 23.7 ± 1.4 20.0 ± 1.5 20.8 ± 0.8 Values are mean ± SE 3-5/group Muscle Mass Figure 3. Muscle force production significantly reduced seven days aft cord injury (SCI). Average maximal isom relative to body weight in sham and supplemented with glutamine or saline. M n=3-5/group. Fatigue Resistance Figure 2. Muscle mass is decreased seven days after spinal cord injury (SCI). Average right gastrocnemius mass (mg) for sham and SCI groups supplemented with glutamine or saline. Means ± SE, * significantly less than sham (p<0.05) KEY FINDINGS Glutamine prevented decreases in muscle fatigue resistance after spinal cord injury. Maximal isometric force production relative to body weight is not reduced seven days following spinal cord injury. Physiological Implications: These results help establish the effectiveness of a safe, clinical intervention for humans in a mouse model of spinal cord injury. Simple dietary intervention with glutamine may help preserve muscle integrity and endurance in spinal cord injury patients, thereby reducing early loss of muscle function and accelerating recovery. Future Studies: Quantify Hsp25 and Hsp70 protein expression in muscle Heat shock proteins protect muscle from numerous stressors including inflammation, oxidative stress, and muscle wasting. 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Glutamine prevents decre muscle fatigue resistance after spinal co (SCI). Fatigue calculated as % max force repetition in sham and SCI mice suppleme glutamine or saline. (n = 3-5/group, Me *significant effect of glutamine (p<0.05)