Am J Physiol Regul Integr Comp Physiol 285: R727-R732, 2003.
First published June 26, 2003; doi:10.1152/ajpregu.00175.2003
0363-6119/03 $5.00
INFLAMMATION, CYTOKINES, AND TEMPERATURE REGULATION
Macrophages, not neutrophils, infiltrate skeletal muscle in mice deficient in P/E selectins after mechanical reloading
Jéroôme Frenette,1
Nadia Chbinou,1
Charles Godbout,1
David Marsolais,1 and
Paul S. Frenette2
1Department of Rehabilitation, Faculty of
Medicine, Laval University, Ste-Foy, Quebec, Canada G1K 7P4; and
2Divisions of Hematology and Clinical Immunology,
Department of Medicine, Mount Sinai School of Medicine, New York, New York
10029
Submitted 3 April 2003
; accepted in final form 16 June 2003
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ABSTRACT
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Our objective was to test the hypothesis that endothelial selectins, P and
E selectins, are necessary for leukocyte migration after muscle injury from
unloading/reloading. Mice hindlimbs were suspended for 10 days followed by
reloading periods of 6 or 24 h after which the soleus muscle was dissected.
Light microscopic observations showed that macrophages, but not neutrophils,
were able to invade soleus muscles in mice deficient in P/E selectins
(P/E-/-) during reloading periods. The recruitment efficiency of
neutrophils after 6 and 24 h of reloading was minimal in P/E-/-
mice relative to unloaded animals. The recruitment of macrophages in the
soleus muscle was preserved in P/E-/- mice. The concentration of
macrophages increased by 8.1-fold compared with unloaded muscles in
double-mutant mice after 24 h of reloading. The accumulation of macrophages in
reloaded muscles did not lead to fiber necrosis. Together, these findings
indicate that macrophages can invade skeletal muscle through cellular
mechanisms that do not involve P/E selectins during skeletal muscle
reloading.
muscle inflammation; mechanical stress; hindlimb suspension
MODIFICATIONS IN SKELETAL muscle use and muscle injury caused by
direct trauma, thermal or mechanical stresses, or muscle reperfusion after
periods of ischemia can induce an increase in the concentration of
inflammatory cells in muscle
(10,
24,
38). Several investigators
have speculated that these inflammatory cells can increase muscle fiber injury
after modified muscle use (7,
39), which has been supported
by experimental evidence showing that neutrophil depletion before muscle
reperfusion results in less muscle damage
(6,
18). By contrast, macrophages
are expected to play a beneficial role in muscle repair. Macrophages can
induce apoptosis of neutrophils
(30), phagocyte tissue debris
(28), and release factors that
can regulate cell proliferation and myogenesis
(28,
35). Thus the diametrically
opposed roles of these leukocyte subsets give credence to the notion that
inflammatory cells are a double-edged sword in that they are necessary for
efficient tissue healing but responsible for at least part of the secondary
damage.
The recruitment of leukocytes from the vasculature into inflammatory sites
is a multistep process initiated by rolling of leukocytes along the
endothelium, followed by firm adhesion and diapedesis
(4). Members of the selectin
family, including L/P and E selectins, are thought to be largely responsible
for the early rolling of leukocytes in postcapillary venules during the acute
phase of inflammation (22).
The availability of mice genetically deficient for either L/P or E selectin,
as well as mice deficient in two or all selectins, has opened new avenues for
dissecting the specific roles of selectins in the recruitment of leukocytes
into inflammatory sites. For example, mice deficient in P selectin presented a
delay of 2-4 h in the recruitment of leukocytes into inflamed peritoneum, but
ultimately the number of inflammatory cells reached near normal levels
(29). Mice lacking E selectin
displayed a mild phenotype comprising increased leukocyte rolling velocities
and reduced leukocyte stable arrest on cytokine-activated endothelium
(27,
31). However, the phenotype of
animals deficient in both endothelial selectins was much greater than either
single knockouts. Indeed, P/E-/- mice exhibited extreme
leukocytosis, defects in leukocyte rolling on activated endothelium, and
severe reduction in neutrophil accumulation in peritoneum after injection with
proinflammatory agents (3,
13). Similar alterations were
observed in mice lacking all three selectins
(20,
36). Together, these results
clearly demonstrate that both endothelial selectins cooperate to recruit
neutrophils into inflammatory sites.
Because little is known about the mechanisms through which inflammatory
cells invade skeletal muscle and that blocking inflammatory cell invasion may
significantly improve the outcome of several inflammatory pathologies, we
tested the hypothesis that P/E selectins are necessary for inflammatory cell
recruitment in skeletal muscle by modifying mechanical loading to produce
muscle dysfunction (12,
40). In this model, weight
bearing is removed from the mouse hindlimb muscles followed by a period of
normal, weight-bearing ambulation, during which inflammatory cells invade
shortened and weakened soleus muscles. This muscle unloading/reloading
procedure was applied to wild-type and P/E-/- mice, after which the
concentration of invading populations of neutrophils and macrophages and the
percentage of injured fibers were assessed.
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MATERIALS AND METHODS
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Experimental protocol. P/E-/- mice were generated by
gene targeting (13) and were
backcrossed seven generations into the C57BL/6 background, and wild-type
C57BL/6 (purchased from Charles River, Quebec, Canada) were used for
mechanical unloading and reloading studies. All female mice were aged between
8 and 12 wk and housed at Laval University mouse facility under SPF
conditions. Wild-type and P/E-/- mice were subjected to hindlimb
unloading for 10 days using an apparatus similar to that described by
Morey-Holton and Globus (32).
Mice were removed from the suspension apparatus at the end of the unloading
period and either immediately killed or allowed to reload their hindlimbs
during normal cage activity for periods of 6 or 24 h. Mice were anesthetized
with pentobarbital sodium (10 mg/kg), and soleus muscles were excised with the
intact tendons, frozen and sectioned as described by St.-Pierre and Tidball
(39). All studies and
procedures were approved by the Animal Research Committee at Laval
University.
Immunohistochemistry. Sections were processed for
immunohistochemistry with the following antibodies: 1) F4/80 (rat
anti-mouse IgG; diluted 1:100; Bioproducts for Science), which recognizes a
plasma membrane component on mature macrophages, and 2) Ly-6G (rat
anti-mouse IgG; diluted 1:300; Pharmingen), which binds specifically to
peripheral neutrophils. The sections labeled for macrophages or neutrophils
were then washed in PBS and incubated with biotinylated anti-rat IgG (diluted
1:200; Vector Laboratories) for 1 h. After rinsing in PBS for 30 min, the
sections were incubated with horseradish peroxidase-avidin (1:1,000; Vector
Laboratories).
Some sections were also double-labeled for macrophages and the endothelial
cell marker platelet endothelial cell adhesion molecule-1 (PECAM-1; rat
anti-mouse CD31; diluted 1:100; Pharmingen) to confirm macrophage invasion.
Macrophages were labeled with F4/80 as described above, followed by incubation
with an alkaline phosphatase-avidin (1:1,000; Vector Laboratories) instead of
horseradish peroxidase-conjugated avidin. Sections were then incubated at
37°C and developed with 5-bromo-4-chloro-3-indolyl phosphate and nitroblue
tetrazolium for 30 min. The primary antibody was omitted from control
sections. The concentration of inflammatory cells labeled with each antibody
was measured in duplicate in two mid-belly sections separated by 1 mm from
left and right solei. Therefore, eight sections per mouse were examined by
light microscopy using Nomarski optics. The number of labeled cells in each
section was counted, and the total area of the section was determined manually
by moving methodically the quadrant in each area to cover the whole section.
Intravascular leukocytes, which represented <2% of counted leukocytes, were
excluded during neutrophil and macrophage counting, and the data were
normalized relative to unloaded mouse groups.
Blood collection. Blood was collected by cardiac puncture and
placed in polypropylene tubes containing EDTA. These samples were analyzed in
the Department of Hematology at Centre Hospitalier de
l'Université Laval. Complete blood counts were determined using
an automic cell counter (Beckman Coulter) and differential counts on
Wright-stained smears.
Statistical analysis. All values are reported as means ±
SE. The effect of hindlimb suspension on the number of neutrophils and
macrophages as well as the peripheral blood counts was assessed by one-way
ANOVA to test whether the variation among experimental groups was significant
at P < 0.05. When significant F ratio was obtained, post
hoc multiple comparison testing was done with a Fisher's protected
least-significant differences test to determine where specific differences had
occurred.
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RESULTS
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To evaluate the role of endothelial selectins in the inflammatory response
after muscle reloading, we subjected mice to a 10-day period of hypogravity
followed by a 6- or 24-h reloading challenge. The soleus muscle was dissected,
and mid-belly sections were cut and immunolabeled for neutrophil (Gr-1)- or
macrophage (F4/80)-specific antigens. Reloading under these conditions leads
to the recruitment of inflammatory cells in the challenged skeletal muscles,
which can readily be determined by immunohistochemistry
(Fig. 1).

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Fig. 1. Micrograph of cross sections of soleus muscles from mice deficient in P/E
selectins. A: negative controls (no primary antibody) show no
staining. B: double-immunolabeling of macrophages (black) and
endothelial cells. Soleus muscles were sectioned and labeled with antibodies
specific for macrophages and the endothelial cell marker platelet endothelial
cell adhesion molecule-1. Macrophages accumulated in the interstitial space
between myofibers (arrows). Capillaries were observed around myofibers
(arrowheads). Bars, 50 µm.
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The number of neutrophils in the soleus muscle of wild-type mice was
increased by 2.7- and 2.4-fold after 6 and 24 h of reloading, respectively,
compared with unloaded animals. In contrast, the number of neutrophils
migrated in the soleus muscle of double-mutant mice after 6 and 24 h of
reloading was similar to those of unloaded animals
(Fig. 2). These results suggest
that the recruitment of neutrophils in skeletal muscle challenged with
reloading is dependent on endothelial selectins.

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Fig. 2. Percent change for neutrophil accumulation in wild-type (WT) and
double-mutant [knockout (KO)] mice from ambulatory controls (AMB) and animals
reloaded (R) for 6 or 24 h. Results were expressed relative to unloaded
animals (UNL); n = 6 for all WT groups, and n = 7 for all KO
groups except for 24-h reloaded (n = 5). Values are means ±
SE. *Significantly different from unloaded control, P <
0.05. #Significantly different from its WT matched group, P <
0.05.
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To evaluate the recruitment of macrophages, sections were stained with the
F4/80 antibody. We found that the concentration of macrophages in the soleus
muscle of wild-type and double-mutant mice decreased during the unloading
period and increased by 4.8- and 8.1-fold, respectively, after 24 h of
reloading (Fig. 3). The
increases of macrophage concentrations in soleus muscles at 24 h of reloading
are consistent with the observation that the concentration of monocytes in
circulation is more important in P/E-/- mice than wild type. In
contrast to the results obtained with neutrophils, the recruitment efficiency
of macrophages was not reduced in P/E-/- mice. The concentration of
macrophages was in fact significantly higher in P/E-/- mice
compared with wild-type after 24 h of reloading, indicating that the
mechanisms mediating macrophage recruitment were preserved and efficient in
soleus muscles lacking both endothelial selectins.

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Fig. 3. Percent change for macrophage accumulation in WT and KO mice from
ambulatory controls and animals reloaded for 6 or 24 h. Results were expressed
relative to unloaded animals; n = 6 for all WT groups, and n
= 7 for all KO groups except 24-h reloaded (n = 5). Values are means
± SE. *Significantly different from unloaded control,
P < 0.05. #Significantly different from its WT matched group,
P < 0.05.
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To ascertain that changes in the concentrations of neutrophils and
macrophages in soleus muscle were not caused by alterations in the number of
circulating leukocytes, blood cell counts were determined at different periods
of unloading and reloading in wild-type and double-mutant mice. These results
corroborate previous observations showing that double-mutant mice exhibit
severe leukocytosis (13).
Importantly, the period of reloading had no impact on leukocyte counts in
either wild-type or P/E -/- mice
(Table 1).
To evaluate the severity of muscle necrosis in wild-type and double-mutant
mice, we counted the number of macrophages that invaded muscle fibers under
different experimental conditions. We found that the proportion of muscle
fibers that were invaded by F4/80 macrophages did not exceed 0.36% of the
total number of fibers (Fig.
4). Modifications in mechanical loading did not significantly
change the number of necrotic fibers in either strains.

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Fig. 4. Percentage of necrotic fibers in WT and KO mice from ambulatory controls
and animals unloaded for 10 days or reloaded for 6 or 24 h; n = 6 for
all WT groups, and n = 7 for all KO groups except for 24-h reloaded
(n = 5). Values are means ± SE. No differences were observed
between any groups.
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DISCUSSION
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The sequence and time course of inflammatory cell invasion are believed to
be similar and well preserved in all damaged tissues. However, recent results
have shown that leukocyte recruitment in skeletal muscle varies depending on
type of insult. For example, eccentric contractions (lengthening contractions)
induce damage and loss in muscle force
(9), but immunohistochemical
and myeloperoxidase data indicate that monocyte recruitment occurs without
extravasation of neutrophils
(25). In contrast, ischemia
and reperfusion in skeletal muscle provokes a massive recruitment of
neutrophils with a mild invasion of macrophages
(23). In addition, hindlimb
suspension and reloading or chemical injury with bupivacain lead to a classic
infiltration of neutrophils followed by macrophages
(11,
12,
33). Several explanations for
these variations in the sequences can be proposed, but the most appealing are
that 1) neutrophils and macrophages use different adhesion molecules
and/or chemokine/chemokine receptors that may be differentially activated for
each type of muscle injury, and 2) the response of neutrophils and
macrophages to cytokines and chemokines differs in these models of muscle
damage. Platelet-derived growth factor is one of the possible cytokines
released by injured skeletal muscle that can chemotactically attract
neutrophils and macrophages
(5). Macrophage inflammatory
protein-1 represents another potential candidate because it is a powerful
chemoattractant molecule for inflammatory cells
(26), and its concentration
increases in circulation after strenuous exercise
(34). However, we cannot
exclude the possibility that nonmuscle cells such as endothelial cells,
adipocytes, or endogenous macrophages may also be a source of leukocyte
chemoattractants during muscle reloading.
In the present study, we tested the hypothesis that P/E selectins are
necessary for leukocyte invasion in a model of muscle dysfunction caused by
hindlimb suspension followed by reloading periods. Here we show that P/E
selectins are not required for macrophage invasion in skeletal muscle,
indicating that other adhesion molecules participate in the recruitment of
this leukocyte subset. The most plausible candidate for bypassing P/E selectin
function is the
4-integrin/vascular cell adhesion molecule-1
pathway, because
4-integrin is highly expressed on
eosinophils and monocytes (7,
16) and can mediate the
rolling and adhesion of these leukocytes under in vitro and in vivo conditions
(1,
19). Interestingly, intravital
microscopy observations in a model of IL-4-induced inflammation of the
cremaster muscle revealed that
4-integrin can initiate
leukocyte-endothelial cell interactions in the absence of selectins in vivo
and that the recruitment of eosinophils and mononuclear cells is preserved
(17). This is also consistent
with the recent observation by Jung and Ley
(21) indicating that mice
lacking all three selectins presented dramatic reductions in leukocyte rolling
and neutrophil recruitment, but monocyte recruitment on the vessel wall was
almost unaffected. Together, these findings provide strong evidence that
neutrophil and monocyte recruitment in muscle and nonmuscle tissues appears to
operate through distinct mechanisms.
Experimental studies on cardiac and skeletal muscles indicate that
neutrophil infiltration plays a significant role in some tissue injury
(15,
24,
42,
43). For example, an injurious
role for inflammatory cells in skeletal muscle has been demonstrated after
ischemia and reperfusion where the extent of muscle injury during reperfusion
is diminished in animals depleted of circulating neutrophils
(6,
18). In addition, the
administration of free radical scavengers prevents muscle damage, suggesting
that free radicals generated by inflammatory cells may cause injury during
reperfusion (37). The present
findings indicate that inflammatory cell invasion does not exacerbate muscle
damage where only 0.36% of the fibers were necrotic after 24 h of reloading.
Previous results have shown that the increase in inflammatory cell
concentration was not associated with any detectable reduction in muscle force
and that the inability to activate the contractile machinery was the primary
mechanism for the loss in force production during the reloading periods
(12). The incubation of soleus
muscles in physiological solution containing caffeine, which acts directly on
Ca2+ release channels of the sarcoplasmic reticulum, revealed that
at least 40% of the reduction in maximal force production originated from a
failure in the excitation-contraction coupling process at a step preceding the
opening of the sarcoplasmic reticulum Ca2+ release channel
(12).
Our results also suggest that endogenous macrophage survival is influenced
by mechanical stress. The absence of mechanical loading leads to significant
reductions of resident macrophage concentration in both wild-type and P/E
selectin-deficient mice. A role for mechanical tension in regulating cell
survival has been demonstrated in other cell types, such as endothelial cells
(8) and fibroblasts
(14). For example, fibroblasts
in mechanically loaded collagen matrices showed little or no apoptosis, but
the release of mechanical conditions led to apoptosis
(14). Whether macrophages also
undergo apoptosis after an unloading period remains to be defined, but recent
observations showed that macrophages can respond to mechanical deformation
with selective augmentation of matrix metalloproteinases and induction of
immediate early genes (41).
Because a phenotypic continuum exists between fibroblasts and macrophages
(2), the possibility that
muscular unloading induces macrophage apoptosis should be the subject of
future studies.
In summary, our results clearly show that P/E selectins were essential for
neutrophils but not required for monocytes to infiltrate reloaded soleus
muscle. These results raise interesting questions regarding the design of
therapies for inflammatory myopathies in which neutrophils can cause secondary
damage. Anti-endothelial selectin therapy may therefore serve a dual purpose
as it blocks neutrophil invasion but permits the recruitment of
monocytes/macrophages, which are likely positive regulators of cell
proliferation and myogenesis.
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DISCLOSURES
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We gratefully acknowledge financial support from the Natural Sciences and
Engineering Research Council in Canada and the Fonds de la Recherche en
Santé du Québec to J. Frenette. This work was also supported by
National Institutes of Health Grant HL-69438 to P. S. Frenette.
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FOOTNOTES
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Address for reprint requests and other correspondence: J. Frenette, CHUL
Research Center, Rm. 9500, 2705 Blvd. Laurier, Ste-Foy, Quebec, G1V 4G2 Canada
(E-mail:
jerome.frenette{at}crchul.ulaval.ca).
The costs of publication of this article were defrayed in part by the
payment of page charges. The article must therefore be hereby marked
"advertisement" in accordance with 18 U.S.C. Section 1734
solely to indicate this fact.
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