Indoxyl sulfate inhibits muscle cell differentiation via Myf6/MRF4 and MYH2 downregulation

Stanislas Bataille1,2, Nathalie McKay1, Laetitia Koppe3,4

  • 1Aix Marseille University, INSERM, INRAE, C2VN, Marseille, France.

Abstract

Insights

Indoxyl sulfate (IS), a uremic toxin, impairs muscle cell differentiation by reducing Myf6/MRF4 and MYH2 expression, contributing to muscle atrophy in chronic kidney disease (CKD). This study reveals a novel mechanism of muscle wasting in CKD patients.

Area of Science:

  • Muscle Biology
  • Nephrology
  • Toxicology

Background:

  • Chronic kidney disease (CKD) is linked to reduced muscle strength and mass, potentially due to uremic toxin-induced muscle cell damage.
  • Indoxyl sulfate (IS) is a key indolic uremic toxin implicated in CKD-related complications.

Purpose of the Study:

  • To investigate the in vitro and in vivo effects of indoxyl sulfate (IS) on myoblast proliferation, differentiation, and the expression of myogenic regulatory factors (MRFs).
  • To elucidate the role of the Aryl Hydrocarbon Receptor (AHR) in IS-mediated effects on muscle cells.

Main Methods:

  • C2C12 myoblasts were differentiated in the presence of IS (200 µM).
  • Gene and protein expression of MRFs (MyoD1, Myog, Myf5, Myf6/MRF4) and MYH2 were analyzed.
  • AHR inhibition was employed to assess its role.
  • Studies were conducted in 5/6th nephrectomized mice models.

Main Results:

  • IS exposure resulted in narrower myotubes with fewer nuclei.
  • IS significantly decreased the mRNA and protein expression of Myf6/MRF4 and MYH2.
  • AHR inhibition did not reverse the IS-induced decrease in Myf6/MRF4 expression, suggesting the ARH genomic pathway is not involved.
  • Myf6/MRF4 was downregulated in the muscles of nephrectomized mice.

Conclusions:

  • Indoxyl sulfate inhibits Myf6/MRF4 and MYH2 expression during muscle cell differentiation, potentially impairing myotube structure.
  • These findings suggest a novel mechanism by which IS contributes to muscle atrophy in CKD.

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