Molecular mechanisms activating muscle protein degradation in chronic kidney disease and other catabolic conditions

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Abstract
Muscle atrophy is a prominent feature of chronic kidney disease (CKD) and is frequent in other catabolic conditions. Results from animal models of these conditions as well as patients indicate that atrophy is mainly owing to accelerated muscle proteolysis in the ubiquitin‐proteasome (Ub‐P'some) proteolytic system. The Ub‐P'some system, however, rapidly degrades actin or myosin but cannot breakdown actomyosin or myofibrils. Consequently, another protease must initially cleave the complex structure of muscle. We identified caspase‐3 as an initial and potentially rate‐limiting proteolytic step that cleaves actomyosin/myofibrils to produce substrates degraded by the Ub‐P'some system. In rodent models of CKD and other catabolic conditions, we find that caspase‐3 is activated and cleaves actomyosin to actin, myosin and their fragments. This initial proteolytic step in muscle leaves a characteristic footprint, a 14‐kDa actin band, providing a potential diagnostic tool to detect muscle catabolism. We also found that stimulation of caspase‐3 activity depends on inhibition of IRS‐1‐associated phosphatidylinositol 3‐kinase (PI3K) activity; inhibiting PI3K in muscle cells also leads to expression of a critical E3‐ubiquitin‐conjugating enzyme involved in muscle protein breakdown: atrogin‐1/MAFbx. Thus, protein breakdown by caspase‐3 and the ubiquitin‐proteasome system in muscle are stimulated by the same signal: a low PI3K activity. These responses could yield therapeutic strategies to block muscle atrophy.