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. 2021 Mar;9(5):389.
doi: 10.21037/atm-20-3114.

Muscle damage in response to a single bout of high intensity concentric exercise in patients with Pompe disease

Márk Váczi  1 , Szilvia Anett Nagy  2   3   4   5 , Tamás Kőszegi  6 , Bernadette Misovics  7 , Edina Szabó  8 , Éva Müller  9 , Gábor Perlaki  2   4   5 , Gergely Orsi  2   4   5 , József Pál  10 , Péter Bogner  9 , Zsolt Illes  11   12   13
Affiliations

Muscle damage in response to a single bout of high intensity concentric exercise in patients with Pompe disease

Márk Váczi et al. Ann Transl Med. 2021 Mar.

Abstract

Background: In Pompe disease, resistance exercise could be an effective treatment to delay motor function impairment, however, the acute effects of this exercise modality are unclear.

Methods: In a prospective cohort study, we compared responses to a single bout of resistance exercise by serum markers of muscle damage and quantitative muscle magnetic resonance imaging (MRI) in patients (n=12) and age- and gender-matched healthy controls (n=12). Participants performed 50 maximal effort concentric knee flexions on a dynamometer.

Results: Twenty-four hours after exercise, levels of serum creatine kinase, lactate dehydrogenase and myoglobin increased in controls. In contrast, only myoglobin level increased in patients. All elevated serum markers declined by 48 hours after exercise in both groups. Mild soreness developed at 24 hours, which disappeared at 48 hours in both groups. In controls, MRI R2* relaxation rate reduced immediately and 24 hours after exercise, indicating increased water content and muscle perfusion. In patients, exercise had no effect on R2* values. The resistance exercise did not induce acute strength deficit in patients, rather, patients increased their strength by 24 hours. When serum marker changes were normalized to the magnitude of knee flexor tension developed during exercise, lactate dehydrogenase response was greater in patients.

Conclusions: Late-onset Pompe disease did not exacerbate exercise-induced muscle damage, however, lactate dehydrogenase may be monitored to screen high responders during high intensity resistance exercise interventions.

Keywords: Hamstring muscle; Pompe disease; dynamometer; muscle magnetic resonance imaging (muscle MRI); muscle microinjury.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-3114). SAN reports grants from the New National Excellence Program of the Ministry of Human Capacities (ÚNKP-17-3-III-PTE-315) and a grant from the János Bolyai Research Scholarship of the Hungarian Academy of Sciences. MV reports grants from the Institutional Excellence Program, University of Pécs (17886-4/2018 FEKUTSTRAT) during the conduct of the study. The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
A representative image of muscle MRI (R2* map). Image of the semitendinosus muscle MRI (R2* map) in a patient with LOPD and in a healthy control are shown before and after exercise at different time points. LOPD, late-onset Pompe disease.
Figure 2
Figure 2
Acute effect of concentric hamstring exercise on indirect skeletal muscle damage indicators. Effects on MVC torque, serum biomarkers, muscle soreness and quantitative muscle MRI are shown in patients with LOPD and healthy controls. *, significant difference from baseline (P<0.05). mean ± SEM is shown. IP, immediately post-exercise; 24 h, 24 hours after exercise; MVC, maximal voluntary contraction; CK, serum creatine kinase activity; LDH, lactate dehydrogenase activity; Mb, serum myoglobin concentration; LOPD, late-onset Pompe disease.
Figure 3
Figure 3
Exercise-induced relative changes in serum markers and hamstring soreness. Peak values as percent of the baseline values (mean ± SEM) are shown. *, significant difference between groups (P<0.05).
Figure 4
Figure 4
Exercise-induced changes in serum markers and hamstring soreness normalized to exercise torque. Mean ± SEM are shown. *, significant difference between groups (P<0.05).
See this image and copyright information in PMC

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