程序性坏死在运动性骨骼肌损伤中的作用及调控机制
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作者单位:

1.四川大学体育学院;2.西华大学体育学院;3.山西大同大学体育学院;4.成都体育学院运动医学与健康学院

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G804.5;R685

基金项目:

国家自然科学基金(31900842),四川省自然科学基金(2026NSFSC0497)和中央高校基本科研业务费(2025自研-体育004)资助项目。


Necroptosis in Exercise-induced Skeletal Muscle Damage: Roles and Regulatory Mechanisms
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Affiliation:

1.School of Physical Education,Sichuan University,Chengdu,China;2.School of Physical Education,Xihua University,Chengdu,China;3.School of Physical Education,Datong University,Datong,China;4.School of Sports Medicine and Health,Chengdu Sport University,Chengdu

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This work was supported by grants from The National Natural Science Foundation of China (31900842), Sichuan Natural Science Foundation (2026NSFSC0497) and Fundamental Research Funds for the Central Universities (2025 Self-Research-Sports 004).

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    摘要:

    运动性骨骼肌损伤(EIMD)是大强度或不习惯运动后常见的骨骼肌微损伤现象,可导致肌肉酸痛、力量下降和功能恢复延迟,进而影响运动表现、训练恢复和运动参与,是竞技体育训练优化与大众科学健身实践中需关注的科学问题,其发生机制尚未完全阐明。程序性坏死是由受体相互作用蛋白激酶(receptor-interacting protein kinase,RIPK)1/RIPK3/混合谱系激酶结构域样蛋白(mixed lineage kinase domain-like protein,MLKL)通路精密调控的一种程序性细胞死亡形式,近期研究表明其在组织损伤修复中发挥重要作用。然而,程序性坏死在EIMD进程中究竟是驱动因素、损伤放大机制,还是修复启动必需的适应性反应,目前尚不明确。本文系统梳理程序性坏死在EIMD中的作用及其可能调控机制,提出其可能兼具损伤放大与协调修复的双重作用:通过促进损伤相关分子模式(damage-associated molecular patterns,DAMPs)释放及炎症信号放大,参与EIMD后的继发性炎症反应及损伤进展;可能通过影响坏死组织清除、免疫细胞募集及细胞外基质重塑,间接塑造肌再生微环境,影响损伤骨骼肌的修复与转归。本文为深入理解EIMD的发生机制及探索靶向干预策略提供理论依据。

    Abstract:

    Exercise-induced muscle damage (EIMD) is a frequent form of skeletal muscle microdamage that occurs after high-intensity, prolonged, or unaccustomed exercise, especially exercise dominated by eccentric contractions. It is commonly characterized by delayed-onset muscle soreness, transient loss of muscle strength, local inflammation, structural disruption of myofibers, and delayed functional recovery. Although mild EIMD may serve as a stimulus for training adaptation, excessive or insufficiently recovered muscle damage can impair exercise performance, disturb training continuity, and reduce participation in physical activity. Therefore, clarifying the molecular mechanisms that underlie the initiation, amplification, and resolution of EIMD is important for optimizing athletic training, improving post-exercise recovery, and guiding evidence-based public fitness practice. Necroptosis is a regulated form of programmed cell death mediated primarily by the receptor-interacting protein kinase 1/receptor-interacting protein kinase 3/mixed lineage kinase domain-like protein (RIPK1/RIPK3/MLKL) signaling axis. Recent studies have shown that necroptosis is closely involved in tissue injury, sterile inflammation, and repair remodeling. However, whether necroptosis acts as an initiating driver, a secondary damage amplifier, or an adaptive signal required for repair after EIMD remains unclear. This review aimed to summarize the potential role of necroptosis in EIMD and to establish a mechanistic framework linking regulated cell death, inflammatory amplification, immune regulation, and skeletal muscle repair. Relevant studies concerning EIMD, necroptosis, RIPK1/RIPK3/MLKL signaling, damage-associated molecular patterns (DAMPs), inflammatory responses, immune cell recruitment, extracellular matrix remodeling, and muscle regeneration were reviewed and integrated. On this basis, the possible temporal and functional involvement of necroptosis in different phases of EIMD was analyzed. The main evidence summarized in this review suggests that EIMD is not merely a consequence of primary mechanical disruption. Instead, it develops through a dynamic sequence that includes sarcolemmal instability, calcium overload, mitochondrial dysfunction, oxidative stress, inflammatory mediator production, immune cell infiltration, necrotic tissue clearance, and regeneration-associated remodeling. Necroptosis may participate in this process through at least two interconnected mechanisms. First, in the early or progressive phase of EIMD, activation of the RIPK1/RIPK3/MLKL signaling axis may promote MLKL phosphorylation and plasma membrane permeabilization, leading to the release of DAMPs such as high-mobility group box 1, ATP, mitochondrial DNA, and other intracellular components. These signals may activate innate immune pathways, amplify inflammatory cytokine production, and enhance the recruitment of neutrophils and macrophages, thereby aggravating secondary inflammation and extending muscle fiber injury. Second, during the resolution and repair phases, necroptosis-related signaling may also contribute indirectly to the formation of a regenerative microenvironment. By influencing the clearance of necrotic debris, the recruitment and phenotypic transition of immune cells, and the remodeling of extracellular matrix components, necroptosis may affect satellite cell activation, myogenic repair, and the eventual structural and functional recovery of injured skeletal muscle. Thus, the biological effect of necroptosis in EIMD may be context dependent rather than uniformly harmful. Its outcome may depend on exercise intensity, the extent of tissue damage, the timing of pathway activation, the involved cell types, inflammatory status, training background, age, and metabolic condition. In conclusion, necroptosis may represent an important molecular link between skeletal muscle injury, sterile inflammation, and tissue repair after damaging exercise. It may exert a dual role in EIMD by amplifying secondary damage while also contributing to repair coordination under appropriate temporal and microenvironmental conditions. Future studies should determine the activation pattern of RIPK1/RIPK3/MLKL signaling after different exercise protocols, identify the major cell populations undergoing necroptosis in injured skeletal muscle, and examine whether targeted modulation of necroptosis can reduce excessive inflammation without impairing necessary regenerative responses. This review provides a theoretical basis for understanding the pathogenesis of EIMD and for developing targeted strategies to improve skeletal muscle recovery after exercise-induced injury.

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柯志飞,宋文静,董云峰,尚画雨.程序性坏死在运动性骨骼肌损伤中的作用及调控机制[J].生物化学与生物物理进展,,():

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  • 收稿日期:2026-02-06
  • 最后修改日期:2026-05-29
  • 录用日期:2026-05-31
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