The Role of Exercise in Mitochondrial Remodeling as a Combatant to Muscular Dystrophy: A Literature Review

Abstract

Introduction: Muscular dystrophy (MD) refers to a group of diseases characterized by the progressive degeneration and weakness of skeletal muscle. Mitochondrial dysfunction plays a central role in the pathology of many MD subtypes that arise from various genetic mutations. Elevated oxidative stress induced by MD is a key mechanism driving mitochondrial dysfunction in these conditions. This review explores the role of exercise-induced mitochondrial remodeling and its potential therapeutic implications in MD management.

Methods: This literature review covers a comprehensive scope of studies published between 2018 to 2024 that were found using PubMed and OVID MEDLINE databases. The studies selected for this review focus on the effects of exercise on mitochondrial biogenesis and function in the context of muscular dystrophy.

Results: Exercise and exercise mimetics were found to induce mitochondrial remodeling, improve oxidative metabolism, and reduce cellular oxidative stress in various preclinical MD models and MD patients. Aerobic and resistance training elicited increased mitochondrial mass, protein levels associated with oxidative phosphorylation (OXPHOS), and oxidative muscle fiber composition across different MD subtypes. However, variability in response was observed, suggesting exercise may not be beneficial for all MD patients.

Discussion: Exercise is a potential therapeutic intervention in addressing mitochondrial dysfunction in MD patients. Moderate-intensity aerobic exercise demonstrates benefits in enhancing mitochondrial respiratory complexes thus suggesting it has a key role in improving mitochondrial function. MD models showed increased mitochondrial mass and respiratory complex protein levels in response to resistance exercise which is correlated with improved strength. In combination with pharmaceutical or gene therapies, exercise shows promise in mitigating MD pathology.

Conclusion: Exercise-induced mitochondrial remodeling appears to induce several positive mitochondrial adaptations that play a role in mitigating MD pathology across various subtypes. Exercise prescription should be tailored to specific MD subtypes to optimize mitochondrial responses, and treatment should be focused on preserving muscle function in patients. Further research is required to support the use of a combination of exercise and pharmaceutical therapies as potential intervention for MD patients.