PubMed · 14832874
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K A M TOMORY. 1951. Field training: exercise- hereward.. https://pubmed.ncbi.nlm.nih.gov/14832874/
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The purpose of this review is to summarise the latest literature on the signalling pathways involved in transcriptional modulations of genes that encode contractile and metabolic proteins in response to endurance exercise. A special attention has been paid to the cooperation between signalling pathways and coordinated expression of protein families that establish myofibre phenotype. Calcium acts as a second messenger in skeletal muscle during exercise, conveying neuromuscular activity into changes in the transcription of specific genes. Three main calcium-triggered regulatory pathways acting through calcineurin, Ca(2+)-calmodulin-dependent protein kinases (CaMK) and Ca(2+)-dependent protein kinase C, transduce alterations in cytosolic calcium concentration to target genes. Calcineurin signalling, the most important of these Ca(2+)-dependent pathways, stimulates the activation of many slow-fibre gene expression, including genes encoding proteins involved in contractile process, Ca(2+) uptake and energy metabolism. It involves the interaction between multiple transcription factors and the collaboration of other Ca(2+)-dependent CaMKs. Although members of mitogen-activated protein kinase (MAPK) pathways are activated during exercise, their integration into other signalling pathways remains largely unknown. The peroxisome proliferator-activated receptor gamma (PPARgamma) coactivator-1alpha (PGC-1alpha) constitutes a pivotal factor of the circuitry which coordinates mitochondrial biogenesis and which couples to the expression of contractile and metabolic genes with prolonged exercise.
Increases in both overweight and life expectancy of the population will lead to a larger number of patients with knee problems due to osteoarthritis (OA). Several changes, metabolic as well as functional, link obesity with OA. Randomised controlled trials have shown substantial and clinically relevant disability and symptom relief in obese patients with knee OA following moderate weight loss. While exercises are good for the functional status in general, it is advisable initially to prescribe weight loss as therapy of patients with a combination of obesity and OA.