Rodney J. Snow

Creatine and the creatine transporter: A review

The cellular role of creatine (Cr) and Cr phosphate (CrP) has been studied extensively in neural, cardiac and skeletal muscle. Several studies have demonstrated that alterations in the cellular total Cr (Cr + CrP) concentration in these tissues can produce marked functional and/or structural change. The primary aim of this review was to critically evaluate the literature that has examined the regulation of cellular total Cr content. In particular, the review focuses on the regulation of the activity and gene expression of the Cr transporter (CreaT), which is primarily responsible for cellular Cr uptake. Two CreaT genes (CreaT1 and CreaT2) have been identified and their chromosomal location and DNA sequencing have been completed. From these data, putative structures of the CreaT proteins have been formulated. Transcription products of the CreaT2 gene are expressed exclusively in the testes, whereas CreaT1 transcripts are found in a variety of tissues. Recent research has measured the expression of the CreaT1 protein in several tissues including neural, cardiac and skeletal muscle. There is very little information available about the factors regulating CreaT gene expression. There is some evidence that suggests the intracellular Cr concentration may be involved in the regulatory process but there is much more to learn before this process is understood. The activity of the CreaT protein is controlled by many factors. These include substrate concentration, transmembrane Na+ gradients, cellular location, and various hormones. It is also likely that transporter activity is influenced by its phosphorylation state and by its interaction with other plasma membrane proteins. The extent of CreaT protein glycosylation may vary within cells, the functional significance of which remains unclear.

Effects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humans

Most research on creatine has focused on short-term creatine loading and its effect on high-intensity performance capacity. Some studies have investigated the effect of prolonged creatine use during strength training. However, studies on the effects of prolonged creatine supplementation are lacking. In the present study, we have assessed the effects of both creatine loading and prolonged supplementation on muscle creatine content, body composition, muscle and whole-body oxidative capacity, substrate utilization during submaximal exercise, and on repeated supramaximal sprint, as well as endurance-type time-trial performance on a cycle ergometer. Twenty subjects ingested creatine or a placebo during a 5-day loading period (20 g.day(-1)) after which supplementation was continued for up to 6 weeks (2 g.day(-1)). Creatine loading increased muscle free creatine, creatine phosphate (CrP) and total creatine content ( P <0.05). The subsequent use of a 2 g.day(-1) maintenance dose, as suggested by an American College of Sports Medicine Roundtable, resulted in a decline in both the elevated CrP and total creatine content and maintenance of the free creatine concentration. Both short- and long-term creatine supplementation improved performance during repeated supramaximal sprints on a cycle ergometer. However, whole-body and muscle oxidative capacity, substrate utilization and time-trial performance were not affected. The increase in body mass following creatine loading was maintained after 6 weeks of continued supplementation and accounted for by a corresponding increase in fat-free mass. This study provides definite evidence that prolonged creatine supplementation in humans does not increase muscle or whole-body oxidative capacity and, as such, does not influence substrate utilization or performance during endurance cycling exercise. In addition, our findings suggest that prolonged creatine ingestion induces an increase in fat-free mass.

Effect of sodium bicarbonate on muscle metabolism during intense endurance cycling

INTRODUCTION Sodium bicarbonate (NaHCO3) ingestion has been shown to increase both muscle glycogenolysis and glycolysis during brief submaximal exercise. These changes may be detrimental to performance during more prolonged, exhaustive exercise. This study examined the effect of NaHCO3 ingestion on muscle metabolism and performance during intense endurance exercise of approximately 60 min in seven endurance-trained men. METHODS Subjects ingested 0.3 g.kg-1 body mass of either NaHCO3 or CaCO3 (CON) 2 h before performing 30 min of cycling exercise at 77 +/- 1% .VO(2peak) followed by completion of 469 +/- 21 kJ as quickly as possible (approximately 30 min, approximately 80% .VO(2peak)). RESULTS Immediately before, and throughout exercise, arterialized-venous plasma HCO3- concentrations were higher (P < 0.05) whereas plasma and muscle H+ concentrations were lower (P < 0.05) in NaHCO3 compared with CON. Blood lactate concentrations were higher (P < 0.05) during exercise in NaHCO3, but there was no difference between trials in muscle glycogen utilization or muscle lactate content during exercise. Reductions in PCr and ATP and increases in muscle Cr during exercise were also unaffected by NaHCO3 ingestion. Accordingly, exercise performance time was not different between treatments. CONCLUSION NaHCO3 ingestion resulted in a small muscle alkalosis but had no effect on muscle metabolism or intense endurance exercise performance in well-trained men.

Daily training with high carbohydrate availability increases exogenous carbohydrate oxidation during endurance cycling

We determined the effects of varying daily carbohydrate intake by providing or withholding carbohydrate during daily training on endurance performance, whole body rates of substrate oxidation, and selected mitochondrial enzymes. Sixteen endurance-trained cyclists or triathletes were pair matched and randomly allocated to either a high-carbohydrate group (High group; n = 8) or an energy-matched low-carbohydrate group (Low group; n = 8) for 28 days. Immediately before study commencement and during the final 5 days, subjects undertook a 5-day test block in which they completed an exercise trial consisting of a 100 min of steady-state cycling (100SS) followed by a 7-kJ/kg time trial on two occasions separated by 72 h. In a counterbalanced design, subjects consumed either water (water trial) or a 10% glucose solution (glucose trial) throughout the exercise trial. A muscle biopsy was taken from the vastus lateralis muscle on day 1 of the first test block, and rates of substrate oxidation were determined throughout 100SS. Training induced a marked increase in maximal citrate synthase activity after the intervention in the High group (27 vs. 34 micromol x g(-1) x min(-1), P < 0.001). Tracer-derived estimates of exogenous glucose oxidation during 100SS in the glucose trial increased from 54.6 to 63.6 g (P < 0.01) in the High group with no change in the Low group. Cycling performance improved by approximately 6% after training. We conclude that altering total daily carbohydrate intake by providing or withholding carbohydrate during daily training in trained athletes results in differences in selected metabolic adaptations to exercise, including the oxidation of exogenous carbohydrate. However, these metabolic changes do not alter the training-induced magnitude of increase in exercise performance.

Creatine supplementation increases glycogen storage but not GLUT-4 expression in human skeletal muscle

It has been speculated that creatine supplementation affects muscle glucose metabolism in humans by increasing muscle glycogen storage and up-regulating GLUT-4 protein expression. In the present study, we assessed the effects of creatine loading and prolonged supplementation on muscle glycogen storage and GLUT-4 mRNA and protein content in humans. A total of 20 subjects participated in a 6-week supplementation period during which creatine or a placebo was ingested. Muscle biopsies were taken before and after 5 days of creatine loading (20 g.day(-1)) and after 6 weeks of continued supplementation (2 g.day(-1)). Fasting plasma insulin concentrations, muscle creatine, glycogen and GLUT-4 protein content as well as GLUT-4, glycogen synthase-1 (GS-1) and glycogenin-1 (Gln-1) mRNA expression were determined. Creatine loading significantly increased total creatine, free creatine and creatine phosphate content with a concomitant 18 +/- 5% increase in muscle glycogen content (P<0.05). The subsequent use of a 2 g.day(-1) maintenance dose for 37 days did not maintain total creatine, creatine phosphate and glycogen content at the elevated levels. The initial increase in muscle glycogen accumulation could not be explained by an increase in fasting plasma insulin concentration, muscle GLUT-4 mRNA and/or protein content. In addition, neither muscle GS-1 nor Gln-1 mRNA expression was affected. We conclude that creatine ingestion itself stimulates muscle glycogen storage, but does not affect muscle GLUT-4 expression.

Creatine transporters: A reappraisal

Creatine (Cr) plays a key role in cellular energy metabolism and is found at high concentrations in metabolically active cells such as skeletal muscle and neurons. These, and a variety of other cells, take up Cr from the extra cellular fluid by a high affinity Na+/Cl−-dependent creatine transporter (CrT). Mutations in the crt gene, found in several patients, lead to severe retardation of speech and mental development, accompanied by the absence of Cr in the brain.In order to characterize CrT protein(s) on a biochemical level, antibodies were raised against synthetic peptides derived from the N- and C-terminal cDNA sequences of the putative CrT-1 protein. In total homogenates of various tissues, both antibodies, directed against these different epitopes, recognize the same two major polypetides on Western blots with apparent Mr of 70 and 55 kDa. The C-terminal CrT antibody (α-CrTCOOH) immunologically reacts with proteins located at the inner membrane of mitochondria as determined by immuno-electron microscopy, as well as by subfractionation of mitochondria. Cr-uptake experiments with isolated mitochondria showed these organelles were able to transport Cr via a sulfhydryl-reagent-sensitive transporter that could be blocked by anti-CrT antibodies when the outer mitochondrial membrane was permeabilized. We concluded that mitochondria are able to specifically take-up Cr from the cytosol, via a low-affinity CrT, and that the above polypeptides would likely represent mitochondrial CrT(s). However, by mass spectrometry techniques, the immunologically reactive proteins, detected by our anti-CrT antibodies, were identified as E2 components of the α-keto acid dehydrogenase multi enzyme complexes, namely pyruvate dehydrogenase (PDH), branched chain keto acid dehydrogenase (BC-KADH) and α-ketoglutarate dehydrogenase (α-KGDH). The E2 components of PDH are membrane associated, whilst it would be expected that a mitochondrial CrT would be a transmembrane protein. Results of phase partitioning by Triton X-114, as well as washing of mitochondrial membranes at basic pH, support that these immunologically cross-reactive proteins are, as expected for E2 components, membrane associated rather than transmembrane. On the other hand, the fact that mitochondrial Cr uptake into intact mitoplast could be blocked by our α-CrTCOOH antibodies, indicate that our antisera contain antibodies reactive to proteins involved in mitochondrial transport of Cr. The presence of specific antibodies against CrT is also supported by results from plasma membrane vesicles isolated from human and rat skeletal muscle, where both 55 and 70 kDa polypeptides disappeared and a single polypeptide with an apparent electrophoretic mobility of ~ 60 kDa was enriched This latter is most likely representing the genuine plasma membrane CrT.Due to the fact that all anti-CrT antibodies that were independently prepared by several laboratories seem to cross-react with non-CrT polypeptides, specifically with E2 components of mitochondrial dehydrogenases, further research is required to characterise on a biochemical/biophysical level the CrT polypeptides, e.g. to determine whether the ~ 60 kDa polypeptide is indeed a bona-fide CrT and to identify the mitochondrial transporter that is able to facilitate Cr-uptake into these organelles. Therefore, the anti-CrT antibodies available so far should only be used with these precautions in mind. This holds especially true for quantitation of CrT polypeptides by Western blots, e.g. when trying to answer whether CrTs are up- or down-regulated by certain experimental interventions or under pathological conditions.In conclusion, we still hold to the scheme that besides the high-affinity and high-efficiency plasmalemma CrT there exists an additional low affinity high Km Cr uptake mechanism in mitochondria. However, the exact biochemical nature of this mitochondrial creatine transport, still remains elusive. Finally, similar to the creatine kinase (CK) isoenzymes, which are specifically located at different cellular compartments, also the substrates of CK are compartmentalized in cytosolic and mitochondrial pools. This is in line with 14C-Cr-isotope tracer studies and a number of [31P]-NMR magnetization transfer studies, as well as with recent [1H]-NMR spectroscopy data.

UCP3 protein expression is lower in type I, IIa and IIx muscle fiber types of endurance trained compared to untrained subjects

Abstract. Uncoupling protein 3 (UCP3) is a muscle mitochondrial protein believed to uncouple the respiratory chain, producing heat and reducing aerobic ATP production. Our aim was to quantify and compare the UCP3 protein levels in type I, IIa and IIx skeletal muscle fibers of endurance-trained (Tr) and healthy untrained (UTr) individuals. UCP3 protein content was quantified using Western blot and immunofluorescence. Skeletal muscle fiber type was determined by both an enzymatic ATPase stain and immunofluorescence. UCP3 protein expression measured in skeletal muscle biopsies was 46% lower (P=0.01) in the Tr compared to the UTr group. UCP3 protein expression in the different muscle fibers was expressed as follows; IIx>IIa>I in the fibers for both groups (P<0.0167) but was lower in all fiber types of the Tr when compared to the UTr subjects (P<0.001). Our results show that training status did not change the skeletal muscle fiber hierarchical UCP3 protein expression in the different fiber types. However, it affected UCP3 content more in type I and type IIa than in the type IIx muscle fibers. We suggest that this decrease may be in relation to the relative improvement in the antioxidant defense systems of the skeletal muscle fibers and that it might, as a consequence, participate in the training induced improvement in mechanical efficiency.

Effect of training status and relative exercise intensity on physiological responses in men

PURPOSE This study examined the effect of training status and relative exercise intensity on physiological responses to endurance exercise in humans. METHODS Seven endurance trained (TR: peak oxygen uptake [VO2peak] = 65.8 +/- 2.4 mL x kg(-1) min(-1)) and six untrained (UT: VO2peak = 46.2 +/- 1.9 mL x kg(-1) x min(-1)) men cycled for 60 min, either at a work rate corresponding to approximately 70% VO2peak or approximately 95% lactate threshold (LT). RESULTS The work rate and relative exercise intensity (i.e., % VO2peak) for UT 95% LT were lower (P < 0.01) than for all of the other trials. Although the work rate for UT 70% VO2peak was lower (P < 0.001) than for TR 70% VO2peak and TR 95% LT, average heart rate (HR) for the trial was higher (P < 0.01) throughout exercise in UT 70% VO2peak compared with all of the other trials. Plasma lactate and ammonia concentrations were greater (P < 0.01) during exercise in UT 70% VO2peak compared with all of the other trials. There was a tendency (P = 0.077) for plasma hypoxanthine to be greater at 60 min in UT 70% VO2peak compared with the other trials. At no time were any of the plasma metabolite concentrations different between the UT 95% LT, TR 95% LT and TR 70% VO2peak trials. CONCLUSIONS These data demonstrate that HR and plasma markers of metabolic stress were greater in UT compared with TR when exercise was performed at 70% VO2peak but were similar during exercise at 95% LT.

Blunting the rise in body temperature reduces muscle glycogenolysis during exercise in humans

To examine the effect of blunting the rise in body temperature on exercise metabolism, seven endurance‐trained men cycled for 40 min at 65% of maximal oxygen consumption (VO2,max) in an environmental chamber at either 20 degrees C and 20% relative humidity (RH) (T20) or 3 degrees C and approximately 50% RH (T3). The trials were conducted in random order at least 1 week apart. Mean oxygen consumption (VO2) during exercise was not different when comparing the two trials. In contrast, the mean respiratory exchange ratio (RER) was lower (P < 0.05) at T20 compared with T3. Heart rate, rectal temperature and plasma catecholamines were higher (P < 0.05) during exercise at T20 compared with T3, as was post‐exercise muscle temperature (P < 0.01). Muscle and blood lactate and blood glucose concentrations were not significantly different when comparing T20 with T3. Net muscle glycogen utilization was greater (P < 0.05) at T20 compared with T3. These results suggest that glycogenolysis in contracting skeletal muscle is reduced during exercise when the rise in body core temperature is attenuated. These changes in carbohydrate metabolism appear to be influenced by alterations in muscle temperature and/or sympatho‐adrenal activity.

Intense exercise up-regulates Na+,K+-ATPase isoform mRNA, but not protein expression in human skeletal muscle.

Characterization of expression of, and consequently also the acute exercise effects on, Na+,K+‐ATPase isoforms in human skeletal muscle remains incomplete and was therefore investigated. Fifteen healthy subjects (eight males, seven females) performed fatiguing, knee extensor exercise at ∼40% of their maximal work output per contraction. A vastus lateralis muscle biopsy was taken at rest, fatigue and 3 and 24 h postexercise, and analysed for Na+,K+‐ATPase α1, α2, α3, β1, β2 and β3 mRNA and crude homogenate protein expression, using Real‐Time RT‐PCR and immunoblotting, respectively. Each individual expressed gene transcripts and protein bands for each Na+,K+‐ATPase isoform. Each isoform was also expressed in a primary human skeletal muscle cell culture. Intense exercise (352 ± 69 s; mean ±s.e.m.) immediately increased α3 and β2 mRNA by 2.4‐ and 1.7‐fold, respectively (P < 0.05), whilst α1 and α2 mRNA were increased by 2.5‐ and 3.5‐fold at 24 h and 3 h postexercise, respectively (P < 0.05). No significant change occurred for β1 and β3 mRNA, reflecting variable time‐dependent responses. When the average postexercise value was contrasted to rest, mRNA increased for α1, α2, α3, β1, β2 and β3 isoforms, by 1.4‐, 2.2‐, 1.4‐, 1.1‐, 1.0‐ and 1.0‐fold, respectively (P < 0.05). However, exercise did not alter the protein abundance of the α1–α3 and β1–β3 isoforms. Thus, human skeletal muscle expresses each of the Na+,K+‐ATPase α1, α2, α3, β1, β2 and β3 isoforms, evidenced at both transcription and protein levels. Whilst brief exercise increased Na+,K+‐ATPase isoform mRNA expression, there was no effect on isoform protein expression, suggesting that the exercise challenge was insufficient for muscle Na+,K+‐ATPase up‐regulation.