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1 Title Making Mice Mighty: Recent Advances in Translational Models of

2 Load-Induced Muscle Hypertrophy

3 Authors Kevin A. Murach1,2*, John J. McCarthy1,3, Charlotte A. Peterson1,2,3,


4 Cory M. Dungan1,2

1
6 Affiliations The Center for Muscle Biology, University of Kentucky, Lexington,
7 Kentucky 40536
8
2
9 Department of Physical Therapy, College of Health Sciences,
10 University of Kentucky, Lexington, KY 40536
11
3
12 Department of Physiology, College of Medicine, University of
13 Kentucky, Lexington, KY 40536
14
15
16
17 Running Head Making Mice Mighty

18

19 *Correspondence Kevin A. Murach, PhD


20 900 South Limestone Street
21 Room 445 Wethington Building
22 Lexington, KY 40536
23 E-mail: kmu236@g.uky.edu
24 Phone: (859) 218-0872
25

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31 Abstract

32 The ability to genetically manipulate mice allows for gain- and loss-of-function in vivo,
33 making them an ideal model for elucidating mechanisms of skeletal muscle mass
34 regulation. Combining genetic models with mechanical muscle loading enables
35 identification of specific factors involved in the hypertrophic response as well as the
36 ability to test the requirement of those factors for adaptation, thereby informing
37 performance and therapeutic interventions. Until recently, approaches for inducing
38 mechanically-mediated muscle hypertrophy (i.e. resistance-training analogs) have been
39 limited and considered “non-translatable” to humans. This mini-review outlines recent
40 translational advances in loading-mediated strategies for inducing muscle hypertrophy
41 in mice, and highlights the advantages and disadvantages of each method. The skeletal
42 muscle field is poised for new breakthroughs in understanding mechanisms regulating
43 load-induced muscle growth given the numerous murine tools that have very recently
44 been described.

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56 Introduction

57 Key regulators of muscle mass discovered using genetic or pharmacological gain- and
58 loss-of function approaches in mice are often subsequently shown to be altered by
59 loading in humans (i.e. acute resistance exercise and/or training), likely contributing to
60 muscle hypertrophy (5, 12, 38, 39, 48, 49). The development of murine muscle-specific
61 Cre/Lox and Tet-On technologies over the last decade now allows for unprecedented
62 insight into the modifiable factors affecting muscle growth in vivo (24, 37, 40). Moving
63 beyond association and correlation, the utility of mouse models for mechanistically
64 understanding skeletal muscle mass regulation is inarguable and invaluable (55).

65 To identify targets associated with load-mediated muscle hypertrophy, as well as test


66 the requirement of those targets for growth in vivo, a surgical model of overload in mice
67 has historically been the standard (18, 54). This method, termed synergist ablation,
68 involves the excision of one large muscle or a group of muscles to elicit a compensatory
69 growth response from a smaller muscle through ambulation. Most often, the tibialis
70 anterior (dorsiflexor) or gastrocnemius/soleus complex (plantarflexors) are partially or
71 completely removed to overload the extensor digitorum longus or plantaris, respectively.
72 Employed for almost 50 years in mice (26, 50), synergist ablation induces rapid
73 hypertrophy (<2 weeks) and has been leveraged by our laboratory and others to
74 understand cellular and molecular aspects of acute and chronic mechanically-induced
75 muscle hypertrophy (8, 29, 35, 36, 44, 56, 59). While widely adopted, synergist ablation
76 has distinct drawbacks not limited to its invasiveness, tendency to cause
77 damage/degeneration-regeneration and/or muscle fiber splitting, extreme rate and
78 magnitude of growth, isolated functional and metabolic profiles of the muscles being
79 overloaded, continual and irreversible loading stimulus, and ambiguity with respect to
80 the signal that triggers growth (e.g. stretch versus tension) (1, 27, 42, 54). Although the
81 surgical approach has recently been modified to attenuate muscle damage (16, 44, 60),
82 translational models of skeletal muscle hypertrophy that more closely reflect human
83 resistance training are still necessary to obtain an accurate understanding of load-
84 induced adaptations; this has proved challenging since mice are resistant to operant
85 conditioning for exercise.

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86 Very recently, an explosion of alternatives to synergist ablation for enhancing muscle


87 mass through loading have been described for mice. All approaches are comparatively
88 more translatable to human exercise than surgical methods and may have specific
89 clinical implications. Each stimulus is also unique and involves different aspects of load-
90 induced adaptation that could be used in combination to provide a broader view of
91 muscle hypertrophic adaptation. The purpose of this mini-review is to highlight these
92 recent advancements and address the advantages and disadvantages of each method.
93 Our hope is that this information will assist muscle researchers in selecting the optimal
94 loading approach to study muscle hypertrophy, and ultimately facilitate the discovery of
95 genes and therapies that preserve or enhance muscle mass.

96 Progressive Weighted Wheel Running

97 Mice are highly active creatures with an affinity for wheel-running. With respect to
98 muscle hypertrophy, un-weighted wheel running in mice may or may not elicit muscle
99 and/or fiber type-specific hypertrophy (3, 6, 33). In our hands, at least in the plantaris
100 muscle, eight weeks of voluntary wheel running (8-10 km/night) was insufficient to elicit
101 muscle growth in adult (>4 month old) female mice (25), although we recently reported
102 that 13 months of un-weighted running may ultimately generate hypertrophy (14). Early
103 work from the Edgerton laboratory illustrated how gradually adding weight to a running
104 wheel over 8 weeks can elicit muscle hypertrophy in rats (23). It follows that by adding
105 resistance to a murine running wheel, one can leverage the mouse’s innate drive to run
106 and induce hypertrophy in multiple muscles. Initial attempts yielded some success in
107 generating hypertrophy across various muscles, but the constant loading of the wheel
108 ultimately results in reduced training volume at higher loads, thereby diminishing the
109 efficacy of this approach (7, 22, 31, 47, 52, 57). Our laboratory recently developed a
110 progressive weighted wheel running (PoWeR) strategy that circumvents this issue (13).
111 By loading standard running wheels progressively with 1 gram magnets situated
112 asymmetrically, which encourages repeated bouts of activity as opposed to continuous
113 running, adult female mice run 10-12 km/night for 8 weeks with up to 6 grams on the
114 wheel (~20% of body weight) (13); male mice will run similar volumes but slightly less,
115 while older mice (22-24 months) will run about half as much as younger mice

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116 (unpublished data). Both the plantaris (glycolytic) and soleus (oxidative) muscles grow
117 15-30% according to whole muscle and muscle fiber cross-sectional area measures (13,
118 42), concomitant with a substantial glycolytic-to-oxidative fiber type shift and
119 myonuclear accretion; the gastrocnemius muscle also experiences fiber type-specific
120 growth (unpublished data). Furthermore, weighted wheel running can be adapted to
121 simulate an acute resistance exercise-like stimulus (11).

122 As with all non-surgical methods for inducing hypertrophy, the adaptations can be
123 reversible with detraining, thus allowing for study of the loss of adaptations in addition to
124 the gain of adaptations (13). Other advantages of PoWeR are that it does not involve
125 specialized equipment (only standard running wheels), requires minimal oversight, is
126 high-throughput (i.e. entire cohorts of mice can train at once), and induces robust
127 cardiac adaptations (13). PoWeR involves high volumes of moderate-velocity dynamic
128 contractions, is akin to resistive cycle training or concurrent training in humans (15, 41,
129 43), and simulates an “athlete-like” phenotype in mice (i.e. strength/power production
130 along with fatigue resistance). On balance, PoWeR is not strictly hypertrophic and may
131 not suit the needs of researchers interested in muscle growth alone; specifically, the
132 “hybrid” stimulus that features potentially large alterations in metabolism may
133 complicate the interpretation of results related to growth. The lack of control over
134 training volume may also present an issue; in our hands, female mice will consistently
135 run 10-12 km per night, but this may vary significantly from lab to lab and present
136 challenges for comparison across sex and age. Alternatively, varied running volume
137 within large cohorts can be leveraged to study the effects of training dosage on a
138 desired outcome (14). Collectively, PoWeR is a simple and effective means for inducing
139 hypertrophy across various muscles in mice, but should be used with the understanding
140 that training volume is high and that the stimulus is a combination of resistance and
141 endurance.

142 Weighted-Vest Motorized Wheel Running

143 Graber, Fendray, and Thompson in 2019 developed a method of training specifically to
144 enhance muscle power output (19), since the loss of whole muscle power-producing
145 capacity is a major contributor to age-related muscle dysfunction (46). This approach

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146 involves outfitting mice with a bespoke weighted harness (vest) and locking them into a
147 custom motorized wheel for progressive training over the course of 12 weeks (19). The
148 stimulus involves a controlled dose of high-velocity dynamic contractions, administered
149 in ~60 second bouts to failure, that enhances muscle contractile function in younger
150 adult and aged mice (much like resistance training in humans). This strategy, which can
151 be considered involuntary since the mice are placed into a wheel that is then fastened
152 shut, also induces hypertrophy of the soleus and quadriceps muscles of the younger
153 mice. Advantages of this approach are that resistance (mass of the harness), intensity
154 (velocity of wheel), and frequency (days per week) can be tightly controlled and
155 individualized, making it similar to human resistance training. Aged mice can also
156 perform it (albeit with less hypertrophy than younger mice), and the quadriceps muscle
157 grows, which yields ~200-400 mg of tissue for diverse analyses from the same mouse.
158 The disadvantages are that it requires specialized equipment, is low-throughput, and is
159 only modestly hypertrophic in young plantaris muscles (historically a highly-studied
160 muscle in mice). While a very specialized mode of training, this is an effective approach
161 for inducing muscle hypertrophy (and power output) in the mouse hind limb via bouts of
162 loaded dynamic contraction.

163 High-Intensity Incline Treadmill Running

164 Simultaneous with the publication of PoWeR and weighted vest running to promote
165 hypertrophy in 2019, two laboratories developed involuntary high-intensity interval
166 inclined treadmill running protocols that involve high-velocity dynamic contractions to
167 induce muscle hypertrophy in mice (17, 51). These protocols generally entail increasing
168 speed and grade during 3 separate bouts per week over 8-16 weeks, which results in
169 increased muscle mass in lower extremity dorsi- and plantar-flexors in both young and
170 aged mice. This approach is advantageous because exercise volume, frequency, and
171 intensity can be closely monitored and controlled, and standard rodent treadmills can be
172 employed. Conversely, this method can cause undue stress on the mice (an electric
173 shock grid motivates the mice to run and excessive shocking occurs at higher
174 workloads), is labor-intensive and not high throughput, and is also associated with
175 endurance-type adaptations in addition to hypertrophic adaptations. High-intensity

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176 treadmill running can induce hypertrophy across multiple muscle groups using
177 progressive bouts followed by rest, which is similar to human exercise, but may also be
178 considered a hybrid approach that develops an athlete-like phenotype, similar to
179 PoWeR.

180 Electrical Stimulation

181 A popular technique in rats (4, 58), involuntary electrical stimulation under anesthesia to
182 maximally activate lower-extremity muscles has been employed on a limited basis to
183 induce hypertrophy in mice (2, 21). This technique involves stimulation of the sciatic
184 nerve, causing the plantarflexor and dorsiflexor complexes to contract. The
185 plantarflexors are stronger, so they contract concentrically while the dorsiflexors
186 experience eccentric muscle action. Electrical stimulation generally results in
187 hypertrophy of the dorsiflexors and not the plantarflexors after 7 bouts over 2 weeks
188 (21), but has been reported to induce modest whole-muscle hypertrophy in the
189 gastrocnemius in healthy and cachectic mice after 14 sessions (53). The advantages of
190 this approach are that there is complete control over the training parameters and
191 exercise dosage (making load and work highly quantifiable), it can be modified to study
192 acute responses to eccentric loading (20, 45), it elicits modest but significant
193 hypertrophy in a matter of weeks (i.e. more rapidly than other models discussed here),
194 and can be deployed in unloaded, aged, and diseased populations where voluntary
195 training may not be possible. The disadvantages are that this approach requires
196 specialized equipment and expertise, is relatively labor intensive and low-throughput,
197 involves maximal motor unit recruitment for every contraction (which is unlike traditional
198 resistance training), necessitates frequent exposure of the mice to deep anesthesia,
199 and while a strong hypertrophic stimulus, the eccentric nature has the potential to
200 damage the dorsiflexors. Electrical stimulation is unique from the other training
201 modalities outlined in this review since it is eccentrically-driven and targets the
202 dorsiflexors (as opposed to plantarflexors), so it could be used in combination with other
203 training modes to explore hypertrophy mediated by a novel loading stimulus in muscles
204 of different function.

205

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206 Squat-Like Exercise

207 Another popular technique for inducing hypertrophy in rats that is difficult to execute in
208 mice is squat-like exercise (9, 30, 34, 54). This approach involves operant conditioning
209 of the animal to push voluntarily against an object, often for a food reward. Recently, the
210 Yan lab cleverly and effectively adapted this model for usage in mice (10). Utilizing a
211 specialized cage that is substituted for a normal cage during the dark cycle, mice push
212 off on a ramp to displace a resistance-adjustable lid equipped with a magnetic sensor to
213 record activity. Pushing against the lid involves high volumes of concentric and
214 eccentric muscle actions that provide access to food. The motion required to move the
215 lid and access the food is similar to a squat motion in humans, and over the course of
216 eight weeks while performing ~400 repetitions per night with progressively increased
217 weight, hypertrophy of the soleus, plantaris, and gastrocnemius muscles was reported
218 (10). Importantly, mice did not eat less food nor lose weight during the training, which is
219 sometimes reported in other species using similar training models (9). This method
220 involves specialized equipment and daily replacement of the customized lid, making it
221 modestly labor intensive, and it is unknown whether mice under different conditions (e.g.
222 aged or diseased) can or would perform the squat activity. Otherwise, this model can be
223 adapted for an acute exercise bout (10), can be high-throughput, is primarily
224 hypertrophic (not hybrid), and is perhaps the closest available analog to “traditional”
225 concentric/eccentric resistance training in humans that involves voluntary repetitions
226 followed by rest (albeit at high frequency and volume).

227 Alternative Approaches

228 There are a few alternative approaches for resistance-training murine skeletal muscle.
229 Weighted ladder climbing, where a weight is attached to a mouse’s tail while it climbs a
230 vertical ladder, may result in modest growth of the plantaris muscle at the whole muscle
231 level, but not according to fiber cross-sectional area (28). A similar approach, unloaded
232 tower climbing, does not result in muscle hypertrophy (47). Being difficult to execute and
233 minimally effective, vertical climbing has not been widely adopted. Another interesting
234 strategy of resistance training in the mouse forelimb is voluntary burrowing through
235 resistant material within a burrowing tube, but this only increased grip strength and

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236 muscle hypertrophy was not reported (47). These alternative approaches may be
237 appropriate for specific applications, but are not the most robust training modality for
238 inducing hypertrophy. One investigation reported on the efficacy of un-weighted vertical
239 hanging from a wire grid in mice as a method of isometric strength training (32). In this
240 model, mice hang from a metal wire grid for 3-minute sets repeated multiple times, 5
241 days per week. Fast-twitch muscle fiber diameter increased in the rectus femoris and
242 gastrocnemius after 10 weeks of training with this strategy, without a shift in muscle
243 fiber type composition (32). While inducing modest fiber type-specific hypertrophy in two
244 muscles, the training does not involve dynamic muscle action, which is a component of
245 traditional strength training in humans, and is very labor-intensive. A curious finding
246 from this investigation was that forced treadmill running 5 days per week was reported
247 to be equally, if not more hypertrophic at the muscle fiber level than the isometric
248 hanging. Introduced in 2013, wire hanging has not yet been widely adopted.

249 Conclusions

250 Selecting the best training modality for inducing hypertrophy in mice is context-specific
251 and highly contingent on the research question. There are clear tradeoffs between the
252 effective translatable strategies for inducing muscle hypertrophy: PoWeR, involuntary
253 weighted wheel running, involuntary incline treadmill running, involuntary electrical
254 stimulation, and voluntary squat-like exercise (summarized in Table 1). Worth
255 mentioning is that most models of murine hypertrophy have focused on muscle
256 adaptation resulting from ankle joint action, but adaptation in every muscle of the lower
257 limb is usually not characterized, nor are upper limb adaptations considered; in other
258 words, muscle and limb-specific adaptations for each modality deserve further
259 investigation. Enhanced translatability to humans, along with the ability to detrain
260 provide the opportunity to study muscle growth and de-loading while minimizing
261 confounding variables associated with a surgical approach, and can be combined with
262 genetically modified mice to provide detailed mechanistic insight into muscle mass
263 regulation.

264

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Non-Standard Volume Fiber-Type
Model Voluntary Throughput Hypertrophied Muscle(s) Fiber Size Refs
Equipment Control Shift
Progressive Plantaris (15%) ↑ (17%) Yes Dungan 2019
Weighted Wheel Yes No No High (oxidative)
Running (8 wks) Soleus (NR) ↑ (22%) NR Murach 2019
Weighted-Vest
Soleus (15%)
Motorized Wheel No Yes Yes Low ↑ (7-10%, Soleus) NR Graber 2019
Quadriceps (22%)
Running (12 wks)
Aged mice: Soleus (29%),
↑ (18%, glycolytic TA) Yes Seldeen 2018
High-Intensity Incline EDL (13%)
Low- (oxidative)
Treadmill Running No Yes Yes
Moderate
(8-16 wks) Gastrocnemius, Quadriceps,
↑ NR Goh 2019
TA, EDL (10-20%)#
TA (7%) ↑ NR Hardee 2016
Electrical Stimulation
No Yes Yes Low
(≤4 wks)
Gastrocnemius (5%) NR NR Tatebayashi 2018
Squat-Like Exercise Soleus, Plantaris,
Yes Yes No High NR NR Cui 2020
(8 wks) Gastrocnemius (10-20%)#
NR – Not Reported, EDL – Extensor Digitorum Longus, TA – Tibialis Anterior
Data from young adult mice are shown in the table (except where noted), and values reported are statistically significant, # estimated from figures

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