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Individual transcriptomic response to strength training for patients with myotonic dystrophy type 1
Emily E. Davey, Cécilia Légaré, Lori Planco, Sharon Shaughnessy, Claudia D. Lennon, Marie-Pier Roussel, Hannah K. Shorrock, Man Hung, John Douglas Cleary, Elise Duchesne, J. Andrew Berglund
Emily E. Davey, Cécilia Légaré, Lori Planco, Sharon Shaughnessy, Claudia D. Lennon, Marie-Pier Roussel, Hannah K. Shorrock, Man Hung, John Douglas Cleary, Elise Duchesne, J. Andrew Berglund
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Research Article Muscle biology Therapeutics

Individual transcriptomic response to strength training for patients with myotonic dystrophy type 1

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Abstract

Myotonic dystrophy type 1 (DM1), the most common form of adult-onset muscular dystrophy, is caused by a CTG expansion resulting in significant transcriptomic dysregulation that leads to muscle weakness and wasting. While strength training is clinically beneficial in DM1, molecular effects had not been studied. To determine whether training rescued transcriptomic defects, RNA-Seq was performed on vastus lateralis samples from 9 male patients with DM1 before and after a 12-week strength-training program and 6 male controls who did not undergo training. Differential gene expression and alternative splicing analysis were correlated with the one-repetition maximum strength evaluation method (leg extension, leg press, hip abduction, and squat). While training program–induced improvements in splicing were similar among most individuals, rescued splicing events varied considerably between individuals. Gene expression improvements were highly varied between individuals, and the percentage of differentially expressed genes rescued after training were strongly correlated with strength improvements. Evaluating transcriptome changes individually revealed responses to the training not evident from grouped analysis, likely due to disease heterogeneity and individual exercise response differences. Our analyses indicate that transcriptomic changes are associated with clinical outcomes in patients with DM1 undergoing training and that these changes are often specific to the individual and should be analyzed accordingly.

Authors

Emily E. Davey, Cécilia Légaré, Lori Planco, Sharon Shaughnessy, Claudia D. Lennon, Marie-Pier Roussel, Hannah K. Shorrock, Man Hung, John Douglas Cleary, Elise Duchesne, J. Andrew Berglund

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Figure 2

Individual improvement at the level of alternative splicing after strength training.

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Individual improvement at the level of alternative splicing after streng...
(A) Number of significant skipped exon events (ΔPSI > 0.2 and FDR < 0.05) of each participant for rescued, overrescued, or misrescued events. Rescued (purple), 10% < PSI < 110%; overrescued (red), PSI ≥ 110% control; and misrescued (green), PSI < –10% opposite direction of control. Rescued events unique to each individual are indicated with light purple. (B) Range of percent rescue values, calculated as: (ΔPSI Pre-Post/ΔPSI Pre-Control) × 100, for all significant skipped exon events for each participant. (C) The overlap of shared rescued events between participants, expressed as total shared events between n individuals, no. of individual shared events within that total, and which individuals between whom those events are shared (connected dots). There are no shared events between 6 or more individuals. (D) Individual (black/gray) and grouped (red/pink) pretraining and posttraining splicing dysregulation scores. Splicing dysregulation scores are quantified as the average absolute ΔPSI of all events significantly misspliced prior to the strength-training program. (E) Heatmap of a panel of 46 skipped exon events that are good predictors of [MBNL]inferred levels (28) for individual with the largest number of rescued events (participant 1791), and greatest (participant 523) and least (participant 2002) clinical improvement. See Supplemental Table 2 for all individual data. Statistically (blue shading) and not statistically (gray shading) significant events illustrated. X boxes in table indicate no reads present for the splicing event. Pre, pretraining sample; post, posttraining sample.

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