Muscle energetics and ageing in the context of RYR1 variants.

In aged muscle, from humans and mice, the ryanodine receptor (RyR1) is leaky, leading to increased levels of resting Ca2+ in the myoplasm. This is also a feature of skeletal muscle disorders caused by variants in RyR1 such as malignant hyperthermia (MH), central core disease (CCD), exertional heat illness (EHI) and late-onset axial myopathy (LOAM). Elevated Ca2+ is damaging to mitochondria, leading to production of reactive oxygen and nitrogen species associated with MH susceptibility to inhalational anaesthetics. Mice with Ryr1 variants show premature muscle ageing and highlight the cycle of inefficient calcium handling and oxidative damage to mitochondria that impairs skeletal muscle energetics. Caenorhabditis elegans models of MH CCD EHI and LOAM variants, both homozygous and heterozygous forms, showed increased sensitivity to halothane. Altered caffeine sensitivity was evident in MH and CCD models, and at very high concentrations in EHI models. Strains with RyR1 variants exhibit age-related accelerated myosin disorganisation. Whole genome Affymetrix arrays revealed genes and pathways correlated with skeletal muscle ageing and MH. Of additional genes of interest investigated UNC13, CASQ1, ORAI1, MCU and MICU1 showed altered expression with age. Array data from blood has been used to identify a signature for MH susceptibility. There is loss of mitochondrial membrane integrity and alteration in mitochondrial number in MH. New apparatus, capable of quantifying heat produced during muscle contraction, has enabled calculation of skeletal muscle efficiency. Preliminary data indicates that there was loss of skeletal muscle efficiency in aged muscle from wild type mice. This work provides new information on the role of RYR1 variants in skeletal muscle ageing and the importance of calcium handling in muscle energetics.