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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Endocrinol.</journal-id>
<journal-title>Frontiers in Endocrinology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Endocrinol.</abbrev-journal-title>
<issn pub-type="epub">1664-2392</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fendo.2017.00330</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Endocrinology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Recombinant Uncarboxylated Osteocalcin <italic>Per Se</italic> Enhances Mouse Skeletal Muscle Glucose Uptake in both Extensor Digitorum Longus and Soleus Muscles</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Lin</surname> <given-names>Xuzhu</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://frontiersin.org/people/u/471289"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Parker</surname> <given-names>Lewan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://frontiersin.org/people/u/362527"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Mclennan</surname> <given-names>Emma</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://frontiersin.org/people/u/491382"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zhang</surname> <given-names>Xinmei</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Hayes</surname> <given-names>Alan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
<uri xlink:href="http://frontiersin.org/people/u/417020"/>
</contrib>
<contrib contrib-type="author">
<name><surname>McConell</surname> <given-names>Glenn</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Brennan-Speranza</surname> <given-names>Tara C.</given-names></name>
<xref ref-type="aff" rid="aff5"><sup>5</sup></xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Levinger</surname> <given-names>Itamar</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
<xref ref-type="corresp" rid="cor1">&#x0002A;</xref>
<uri xlink:href="http://frontiersin.org/people/u/374326"/>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Institute of Sport, Exercise and Active Living (ISEAL), Victoria University</institution>, <addr-line>Melbourne, VIC</addr-line>, <country>Australia</country></aff>
<aff id="aff2"><sup>2</sup><institution>School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University</institution>, <addr-line>Melbourne, VIC</addr-line>, <country>Australia</country></aff>
<aff id="aff3"><sup>3</sup><institution>College of Health and Biomedicine, Victoria University</institution>, <addr-line>Geelong, VIC</addr-line>, <country>Australia</country></aff>
<aff id="aff4"><sup>4</sup><institution>Australian Institute for Musculoskeletal Science, Western Health</institution>, <addr-line>Melbourne, VIC</addr-line>, <country>Australia</country></aff>
<aff id="aff5"><sup>5</sup><institution>Department of Physiology, Bosch Institute for Medical Research, University of Sydney</institution>, <addr-line>Sydney, NSW</addr-line>, <country>Australia</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Chandi C. Mandal, Central University of Rajasthan, India</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Giovanni Lombardi, Istituto Ortopedico Galeazzi (IRCCS), Italy; Graziana Colaianni, University of Bari, Italy</p></fn>
<corresp content-type="corresp" id="cor1">&#x0002A;Correspondence: Itamar Levinger, <email>itamar.levinger&#x00040;vu.edu.au</email></corresp>
<fn fn-type="other" id="fn001"><p>Specialty section: This article was submitted to Bone Research, a section of the journal Frontiers in Endocrinology</p></fn>
</author-notes>
<pub-date pub-type="epub">
<day>22</day>
<month>11</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection">
<year>2017</year>
</pub-date>
<volume>8</volume>
<elocation-id>330</elocation-id>
<history>
<date date-type="received">
<day>26</day>
<month>08</month>
<year>2017</year>
</date>
<date date-type="accepted">
<day>06</day>
<month>11</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2017 Lin, Parker, Mclennan, Zhang, Hayes, McConell, Brennan-Speranza and Levinger.</copyright-statement>
<copyright-year>2017</copyright-year>
<copyright-holder>Lin, Parker, Mclennan, Zhang, Hayes, McConell, Brennan-Speranza and Levinger</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<p>Emerging evidence suggests that undercarboxylated osteocalcin (ucOC) improves muscle glucose uptake in rodents. However, whether ucOC can directly increase glucose uptake in both glycolytic and oxidative muscles and the possible mechanisms of action still need further exploration. We tested the hypothesis that ucOC <italic>per se</italic> stimulates muscle glucose uptake <italic>via</italic> extracellular signal-regulated kinase (ERK), adenosine monophosphate-activated protein kinase (AMPK), and/or the mechanistic target of rapamycin complex 2 (mTORC2)-protein kinase B (AKT)-AKT substrate of 160&#x02009;kDa (AS160) signaling cascade. Extensor digitorum longus (EDL) and soleus muscles from male C57BL/6 mice were isolated, divided into halves, and then incubated with ucOC with or without the pretreatment of ERK inhibitor U0126. ucOC increased muscle glucose uptake in both EDL and soleus. It also enhanced phosphorylation of ERK2 (Thr202/Tyr204) and AS160 (Thr642) in both muscle types and increased mTOR phosphorylation (Ser2481) in EDL only. ucOC had no significant effect on the phosphorylation of AMPK&#x003B1; (Thr172). The inhibition of ucOC-induced ERK phosphorylation had limited effect on ucOC-stimulated glucose uptake and AS160 phosphorylation in both muscle types, but appeared to inhibit the elevation in AKT phosphorylation only in EDL. Taken together, ucOC at the physiological range directly increased glucose uptake in both EDL and soleus muscles in mouse. The molecular mechanisms behind this ucOC effect on muscle glucose uptake seem to be muscle type-specific, involving enhanced phosphorylation of AS160 but limitedly modulated by ERK phosphorylation. Our study suggests that, since ucOC increases muscle glucose uptake without insulin, it could be considered as a potential agent to improve muscle glucose uptake in insulin resistant conditions.</p>
</abstract>
<kwd-group>
<kwd>undercarboxylated osteocalcin</kwd>
<kwd>skeletal muscle</kwd>
<kwd>glucose uptake</kwd>
<kwd>extracellular signal-regulated kinase</kwd>
<kwd>adenosine monophosphate-activated protein kinase</kwd>
<kwd>mechanistic target of rapamycin complex 2-AKT-AS160 signaling cascade</kwd>
</kwd-group>
<counts>
<fig-count count="6"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="47"/>
<page-count count="11"/>
<word-count count="6618"/>
</counts>
</article-meta>
</front>
<body>
<sec id="S1" sec-type="introduction">
<title>Introduction</title>
<p>The skeleton is an endocrine organ that has been shown, at least in mice, to modulate glucose metabolism (<xref ref-type="bibr" rid="B1">1</xref>&#x02013;<xref ref-type="bibr" rid="B3">3</xref>). One bone-specific hormone that plays a role in this energy regulation is osteocalcin (OC) (<xref ref-type="bibr" rid="B4">4</xref>, <xref ref-type="bibr" rid="B5">5</xref>). Undercarboxylated osteocalcin (ucOC), the biologically active form of OC, regulates glucose metabolism by targeting the pancreas and perhaps several insulin-sensitive organs, including skeletal muscle (<xref ref-type="bibr" rid="B6">6</xref>&#x02013;<xref ref-type="bibr" rid="B8">8</xref>). The effect of ucOC on skeletal muscle may have important clinical implications for whole-body glycemic control as it is the major site for glucose disposal and storage (<xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B10">10</xref>). It has been reported that ucOC increases insulin sensitivity in rodent skeletal muscle (<xref ref-type="bibr" rid="B11">11</xref>&#x02013;<xref ref-type="bibr" rid="B15">15</xref>). Recent evidence also suggests that ucOC may enhance muscle glucose uptake in the absence of insulin. For example, it has been shown that 10&#x02009;ng mL<sup>&#x02212;1</sup> ucOC increases glucose uptake in C2C12 myotubes, and to a lesser extent in <italic>ex vivo</italic> soleus muscle which mainly relies on oxidative metabolism for energy production, but not in <italic>ex vivo</italic> extensor digitorum longus (EDL) muscle, which largely utilize glycolytic metabolism as the energy source (<xref ref-type="bibr" rid="B15">15</xref>). Similarly, in our previous study, we did not observe any effect of ucOC on glucose uptake of non-contracted EDL <italic>ex vivo</italic> (<xref ref-type="bibr" rid="B14">14</xref>). However, since GPRC6A, the presumable receptor for ucOC, is expressed in both EDL and soleus (<xref ref-type="bibr" rid="B14">14</xref>, <xref ref-type="bibr" rid="B15">15</xref>), the regulation on muscle glucose uptake by ucOC in both muscle types is still possible. We hypothesize that the limited direct effects of ucOC that was previously observed on EDL were likely due to the inadequateness of ucOC to access the internal area of intact muscle <italic>in vitro</italic>. Therefore, it is possible that a methodological limitation affected the results and improved techniques such as the application of muscle strips, which was previously performed by Cartee et al. (<xref ref-type="bibr" rid="B16">16</xref>) and others (<xref ref-type="bibr" rid="B17">17</xref>, <xref ref-type="bibr" rid="B18">18</xref>), need to be introduced.</p>
<p>Furthermore, the potential mechanisms behind ucOC <italic>per se</italic> effect on skeletal muscle glucose uptake are still largely unknown. Our previous report exhibited enhanced insulin-stimulated glucose uptake and AS160 phosphorylation at Thr642 by ucOC treatment in EDL muscle post <italic>ex vivo</italic> contraction (<xref ref-type="bibr" rid="B14">14</xref>). Insulin-induced phosphorylation of AS160, and subsequent increases in glucose uptake, requires fully activated AKT <italic>via</italic> the activation of mechanistic target of rapamycin complex 2 (mTORC2), which can be indicated by the phosphorylation of AKT at Ser473 and the phosphorylation of mTOR at Ser 2481 (<xref ref-type="bibr" rid="B19">19</xref>&#x02013;<xref ref-type="bibr" rid="B22">22</xref>). The mTORC2-AKT-AS160 signaling cascade can be stimulated not only by insulin but also other growth factors and stimuli (<xref ref-type="bibr" rid="B23">23</xref>&#x02013;<xref ref-type="bibr" rid="B25">25</xref>). Recent findings indicate that ucOC may also be able to trigger this signaling pathway. In vascular smooth muscle cells, the phosphorylation of AKT was enhanced by the treatment of purified bovine OC (<xref ref-type="bibr" rid="B26">26</xref>). Furthermore, the phosphorylation of AKT at Ser473 was elevated following OC treatment in descending thoracic aortic strips of ApoE-KO mice (<xref ref-type="bibr" rid="B27">27</xref>). In addition, the phosphorylation of AKT (Ser473) was increased in C2C12 myotubes with ucOC exposure during cell differentiation (<xref ref-type="bibr" rid="B13">13</xref>). Nevertheless, the upstream pathway/s that result in the phosphorylation of AKT and AS160 by ucOC are still unclear. It is possible that two previously identified downstream targets of ucOC, extracellular signal-regulated kinase (ERK) and adenosine monophosphate-activated protein kinase (AMPK), may be involved (<xref ref-type="bibr" rid="B28">28</xref>, <xref ref-type="bibr" rid="B29">29</xref>). Indeed, in atrophic rat muscles, lower serum ucOC levels were associated with lower phosphorylation levels of ERK (Thr202/Tyr204) and AMPK (Thr172), and the phosphorylation levels of ERK positively correlated with the phosphorylation levels of AKT (S473) in EDL muscle (<xref ref-type="bibr" rid="B30">30</xref>). In C2C12 myotubes, ucOC-stimulated ERK phosphorylation (Thr202/Tyr204) likely contributed to the increase of AKT phosphorylation at Ser473 (<xref ref-type="bibr" rid="B13">13</xref>). Furthermore, exercise-induced p-AMPK (Thr172) was augmented by ucOC injection in mice tibialis muscle, which could be responsible for ucOC-enhanced exercise-stimulated muscle glucose uptake (<xref ref-type="bibr" rid="B15">15</xref>).</p>
<p>Therefore, the aims of this study were to (a) test the hypothesis that physiological levels of ucOC <italic>per se</italic> increases glucose uptake in both EDL and soleus muscles and (b) explore the mechanisms underlying the effects of ucOC on muscle glucose uptake.</p>
</sec>
<sec id="S2" sec-type="materials|methods">
<title>Materials and Methods</title>
<sec id="S2-1">
<title>Animals</title>
<p>Eight-week-old male C57BL/6J mice (<italic>N</italic>&#x02009;&#x0003D;&#x02009;55) were purchased from Animal Resources Centre (WA, Australia). All mice were group housed with a 12-h light/12-h dark cycle and fed standard laboratory chow [Specialty Feeds mouse food cubes (Glen Forrest, WA, Australia) containing 20% protein, 4.8% fat, and the rest carbohydrate and fiber] and water <italic>ad libitum</italic> until 9&#x02013;12&#x02009;weeks old. The study was approved by the Animal Experimentation Ethics Committee of Victoria University (AEC14/009) and conformed to the Australian National Code of Practice for the Care and Use of Animals for Scientific Purposes. The mice for each group in this study were randomly allocated.</p>
</sec>
<sec id="S2-2">
<title>Muscle Dissection</title>
<p>Mice were fasted for 4&#x02009;h before deep anaesthetization with 60&#x02009;mg kg<sup>&#x02212;1</sup> intraperitoneal pentobarbital. Left and right EDL and soleus muscles were excised within 30&#x02009;min of anesthesia. Isolated muscles were bathed in carbogenated Krebs&#x02013;Henseleit buffer (KHB) (119&#x02009;mM NaCl, 4.7&#x02009;mM KCl, 2.5&#x02009;mM CaCl<sub>2</sub>, 1.2&#x02009;mM MgSO<sub>4</sub>, 1.2&#x02009;mM KH<sub>2</sub>PO<sub>4</sub>, 25&#x02009;mM NaHCO<sub>3</sub>, pH 7.4) and evenly divided into halves longitudinally. After muscle dissection, mice were euthanized <italic>via</italic> cervical dislocation under anesthesia.</p>
</sec>
<sec id="S2-3">
<title>ucOC Stimulation</title>
<p>Muscles were evenly divided longitudinally into halves to improve the effusion of ucOC into muscle fiber <italic>ex vivo</italic>, similar to what has been performed in rat muscle in previous studies (<xref ref-type="bibr" rid="B16">16</xref>&#x02013;<xref ref-type="bibr" rid="B18">18</xref>). The whole ucOC stimulation process is shown in Figure <xref ref-type="supplementary-material" rid="SM1">S1</xref> in Supplementary Material. In experiments without the ERK inhibitor U0126, muscle samples were preincubated in 30&#x000B0;C baths containing carbogenated KHB buffer for 1&#x02009;h. In experiments with U0126 (<italic>N</italic>&#x02009;&#x0003D;&#x02009;5), after 30&#x02009;min preincubation, muscle samples were exposed to the ERK inhibitor U0126 (1&#x02009;&#x000B5;M) (Cell Signaling, MA, USA) or dimethyl sulfoxide (DMSO) vehicle (Sigma-Aldrich, MO, USA) for 30&#x02009;min. Then, muscle samples were stimulated for 90&#x02009;min with increasing doses [0&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;6), 0.3&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;10), 3&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;10), 10&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;14), or 30&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;10)] of recombinant ucOC (Bachem, Bubendorf, Switzerland). These doses of ucOC were chosen because they are within the physiological range in mice (<xref ref-type="bibr" rid="B7">7</xref>, <xref ref-type="bibr" rid="B31">31</xref>). In experiments without U0126, muscle halves from the same mouse were treated with KHB buffer control or ucOC. In experiments with U0126, muscle halves from the same mouse were treated with DMSO, DMSO with ucOC, U0126, and U0126 with ucOC, respectively.</p>
</sec>
<sec id="S2-4">
<title>2-Deoxyglucose Uptake Measurement and Sample Homogenization</title>
<p>The method to assess 2-Deoxy-D-glucose (2-DG) uptake has been described previously (<xref ref-type="bibr" rid="B14">14</xref>). Briefly, after the 90&#x02009;min ucOC treatment, muscles were transferred to chambers containing KHB&#x02009;&#x0002B;&#x02009;0.1% bovine serum albumin (Sigma-Aldrich)&#x02009;&#x0002B;&#x02009;2&#x02009;mM 2-Deoxy-<sc>d</sc>-[1,2-<sup>3</sup>H]-glucose (PerkinElmer, MA, USA) and 16&#x02009;mM <sc>d</sc>-[1-<sup>14</sup>C] mannitol (PerkinElmer) with or without U0126/Vehicle or ucOC. After 10&#x02009;min, muscles were rapidly rinsed with ice cold KHB buffer, then immediately frozen in liquid nitrogen. On the day of sample processing, muscle samples were lysed in ice-cold radioimmunoprecipitation assay (RIPA) buffer (60&#x02009;&#x000B5;L RIPA for 1&#x02009;mg sample) (Cell Signaling) with Inhibitor Cocktail (Cell Signaling) and 100&#x02009;mM dithiothreitol (Sigma-Aldrich) using TissueLyser II (QIAGEN, Hilden, Germany) followed by gentle rocking at 4&#x000B0;C for 1&#x02009;h. Half of the lysate was pipetted into vials with scintillation cocktail for scintillation counting (&#x003B2;-counter) with Tri-Carb 2910TR Liquid Scintillation Analyzer (PerkinElmer) and the other half was used in western blotting.</p>
</sec>
<sec id="S2-5">
<title>Western Blotting</title>
<p>After muscle samples were homogenized using RIPA buffer, protein concentrations in the lysate were determined by Bio-Rad Protein Assay (Bio-Rad, CA, USA). Equal amounts of protein were subjected to electrophoresis on Criterion stain-free precast gels (10%; Bio-Rad) and then transferred electrophoretically using Trans-Blot Turbo Transfer System (Bio-Rad) onto a polyvinylidene fluoride membrane (Bio-Rad). Then, a stain-free blot image was taken using ChemiDoc Imaging System (Bio-Rad) for total protein measurement in each sample lane. Immunoblotting was performed at optimum conditions for each antibody. Bands were identified using ChemiDoc Imaging System, using SuperSignal West Femto Maximum Sensitivity Substrate (Thermo, MA, USA). Band densities of both stain-free blot and immunoblotting were measured using Image Lab Software (Bio-Rad). Values of immunoblotting bands were normalized using total protein values. p-ERK (Thr202/Tyr204), ERK, p-AMPK&#x003B1; (Thr172), AMPK&#x003B1;, p-mTOR (Ser2481), mTOR, p-AKT (Ser473), AKT, p-AS160 (Thr642), AS160, and p-PKC&#x003B4;/&#x003B8; (Ser643/676) antibodies were purchased from Cell Signaling.</p>
<p>Two data points for AMPK&#x003B1; phosphorylation assessment were excluded due to western blot imaging artifacts. However, their exclusion did not alter the statistical outcome, interpretation, or conclusions of the results.</p>
</sec>
<sec id="S2-6">
<title>Statistical Analysis</title>
<p>Fold-changes for western blotting data were calculated by normalization to control groups within the same animals. 3&#x02009;ng mL<sup>&#x02212;1</sup> group and 30&#x02009;ng mL<sup>&#x02212;1</sup> group were chosen for western blotting and correlation analysis as representatives of low and high doses of ucOC.</p>
<p>Paired <italic>t</italic>-tests were used to analyze the effects of ucOC, for each individual concentration, on muscle glucose uptake, protein phosphorylation, protein abundance, and phospho/total ratio compared to paired control samples. This paired comparison was used to exclude individual variances.</p>
<p>To analyze the dose&#x02013;response effects of ucOC on muscle glucose uptake, basal glucose uptake data from all groups were combined, then one-way ANOVA with Tukey <italic>post hoc</italic> test was applied.</p>
<p>Spearman&#x02019;s correlation was performed between the variables from 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC treatment group. Rule of thumb for interpreting the size of a correlation coefficient will be applied to measure the strength of correlation between two variables (<xref ref-type="bibr" rid="B32">32</xref>). According to standard practice thresholds, the <italic>r</italic> ranges for negligible positive, low positive, moderate positive, high positive, and very high positive correlations are defined as 0.00&#x02009;&#x0003C;&#x02009;<italic>r</italic>&#x02009;&#x0003C;&#x02009;0.30, 0.30&#x02009;&#x02264;&#x02009;<italic>r</italic>&#x02009;&#x0003C;&#x02009;0.50, 0.50&#x02009;&#x02264;&#x02009;<italic>r</italic>&#x02009;&#x0003C;&#x02009;0.70, 0.70&#x02009;&#x02264;&#x02009;<italic>r</italic>&#x02009;&#x0003C;&#x02009;0.90, and 0.90&#x02009;&#x02264;&#x02009;<italic>r</italic>&#x02009;&#x02264;&#x02009;1.00, respectively.</p>
<p>All figures and analyses were performed using GraphPad 6 (GraphPad Software, La Jolla, CA, USA).</p>
<p>All data are reported as mean&#x02009;&#x000B1;&#x02009;SEM.</p>
</sec>
</sec>
<sec id="S3">
<title>Results</title>
<sec id="S3-1">
<title>ucOC Increased Glucose Uptake in both EDL and Soleus Muscles</title>
<p>Compared with paired controls, muscle glucose uptake was significantly higher following the treatment of ucOC at doses of 10&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05) and 30&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.01) in EDL, and 0.3&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.01) and 30&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.01) in soleus (Figures <xref ref-type="fig" rid="F1">1</xref>A,B). When data were analyzed for ucOC dose&#x02013;response effects, ucOC significantly enhanced glucose uptake at doses equal or larger than 3&#x02009;ng mL<sup>&#x02212;1</sup> in EDL and at a dose of 30&#x02009;ng mL<sup>&#x02212;1</sup> in soleus (Figures <xref ref-type="fig" rid="F1">1</xref>C,D; <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, ANOVA <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.01), from 2.91 to 4.32&#x02009;&#x003BC;mol g<sup>&#x02212;1</sup>&#x02009;h<sup>&#x02212;1</sup> and from 3.12 to 4.16&#x02009;&#x003BC;mol g<sup>&#x02212;1</sup>&#x02009;h<sup>&#x02212;1</sup>, respectively.</p>
<fig id="F1" position="float">
<label>Figure 1</label>
<caption><p>Undercarboxylated osteocalcin (ucOC) effects on and insulin-stimulated glucose uptake in extensor digitorum longus (EDL) and soleus. <bold>(A,B)</bold> glucose uptake of EDL and soleus muscle samples treated with Krebs&#x02013;Henseleit buffer control and ucOC [0&#x02009;ng mL<sup>&#x02212;1</sup> (mice <italic>N</italic>&#x02009;&#x0003D;&#x02009;6), 0.3&#x02009;ng mL<sup>&#x02212;1</sup> (mice <italic>N</italic>&#x02009;&#x0003D;&#x02009;10), 3&#x02009;ng mL<sup>&#x02212;1</sup> (mice <italic>N</italic>&#x02009;&#x0003D;&#x02009;10), 10&#x02009;ng mL<sup>&#x02212;1</sup> (mice <italic>N</italic>&#x02009;&#x0003D;&#x02009;14), or 30&#x02009;ng mL<sup>&#x02212;1</sup> (mice <italic>N</italic>&#x02009;&#x0003D;&#x02009;10)] was detected. &#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.05 and &#x0002A;&#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.01 between paired samples (paired <italic>t</italic>-test); <bold>(C,D)</bold> glucose uptake of EDL and soleus samples was analyzed for dose-response effect of ucOC with combined basal levels. Samples sizes for groups treated with 0, 0.3, 3, 10, or 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC are 56, 10, 10, 14, or 10, respectively. &#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.05 and &#x0002A;&#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.01 in Tukey&#x02019;s <italic>post hoc</italic> test (compared with 0&#x02009;ng mL<sup>&#x02212;1</sup> ucOC samples) of one-way ANOVA analysis.</p></caption>
<graphic xlink:href="fendo-08-00330-g001.tif"/>
</fig>
</sec>
<sec id="S3-2">
<title>ucOC Stimulated the Phosphorylation of mTOR, AKT, and AS160</title>
<p>In EDL, ucOC treatment at 30&#x02009;ng mL<sup>&#x02212;1</sup> significantly increased p-mTOR (1.37-fold, <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, Figure <xref ref-type="fig" rid="F2">2</xref>A) and p-mTOR/tmTOR ratio (1.40-fold, <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, Figure <xref ref-type="fig" rid="F2">2</xref>A), and only tended to increase p-AKT (1.25-fold, <italic>P</italic>&#x02009;&#x0003D;&#x02009;0.074, Figure <xref ref-type="fig" rid="F2">2</xref>C) but not p-AKT/tAKT ratio. Neither of these signaling molecules was affected in the soleus (Figures <xref ref-type="fig" rid="F2">2</xref>B,D). In both EDL and soleus, both p-AS160 and p-AS160/tAS160 ratio were considerably elevated 1.4-fold to 1.8-fold following ucOC treatments at 3&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05 and <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, Figure <xref ref-type="fig" rid="F2">2</xref>E; <italic>P</italic>&#x02009;&#x0003D;&#x02009;0.059 and <italic>P</italic>&#x02009;&#x0003D;&#x02009;0.056, Figure <xref ref-type="fig" rid="F2">2</xref>F) and 30&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.01 and <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, Figure <xref ref-type="fig" rid="F2">2</xref>E; <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.01 and <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.001, Figure <xref ref-type="fig" rid="F2">2</xref>F). Total AS160 expression was also increased by 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC in EDL (1.13-fold, <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, Figure <xref ref-type="fig" rid="F2">2</xref>E). Blots of phosphorylated proteins and total expression of proteins are shown as Figure <xref ref-type="supplementary-material" rid="SM2">S2</xref> in Supplementary Material.</p>
<fig id="F2" position="float">
<label>Figure 2</label>
<caption><p>Undercarboxylated osteocalcin (ucOC) effects on the phosphorylation of mTOR, AKT, and AS160. The phosphorylation levels, total expression levels, and phospho/total ratio levels of mTOR <bold>(A,B)</bold>, AKT <bold>(C,D)</bold>, and AS160 <bold>(E,F)</bold> of Extensor digitorum longus (EDL) and soleus samples treated with Krebs&#x02013;Henseleit buffer control and ucOC (3 and 30&#x02009;ng mL<sup>&#x02212;1</sup>, <italic>N</italic>&#x02009;&#x0003D;&#x02009;10 for each dose) were examined. &#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.05, &#x0002A;&#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.01, and &#x0002A;&#x0002A;&#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.001 paired samples from the same animal (<italic>t</italic>-test).</p></caption>
<graphic xlink:href="fendo-08-00330-g002.tif"/>
</fig>
</sec>
<sec id="S3-3">
<title>ucOC Stimulated the Phosphorylation of ERK but Not AMPK</title>
<p>p-ERK2, but not p-ERK2/tERK2 ratio, was increased by the treatment of 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC (1.14-fold, <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, Figure <xref ref-type="fig" rid="F3">3</xref>A) in EDL, and by both 3 and 30&#x02009;ng mL<sup>&#x02212;1</sup> of ucOC in soleus (1.24-fold and 1.17-fold, <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05 and <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.01, Figure <xref ref-type="fig" rid="F3">3</xref>B). ucOC at 3 or 30&#x02009;ng mL<sup>&#x02212;1</sup> had limited effects on AMPK&#x003B1; phosphorylation in both EDL and soleus (Figures <xref ref-type="fig" rid="F3">3</xref>C,D). However, soleus total AMPK&#x003B1; levels were increased by the treatment of 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC (1.30-fold, <italic>P</italic>&#x02009;&#x0003C;&#x02009;0.01, Figure <xref ref-type="fig" rid="F3">3</xref>D). Blots of phosphorylated proteins and total expression of proteins are shown as Figure <xref ref-type="supplementary-material" rid="SM3">S3</xref> in Supplementary Material.</p>
<fig id="F3" position="float">
<label>Figure 3</label>
<caption><p>Undercarboxylated osteocalcin (ucOC) effects on the phosphorylation of ERK2 and AMPK&#x003B1;. The phosphorylation levels, total expression levels, and phospho/total ratio levels of ERK2 <bold>(A,B)</bold> and AMPK&#x003B1; <bold>(C,D)</bold> of Extensor digitorum longus (EDL) and soleus samples treated with Krebs&#x02013;Henseleit buffer control and ucOC (3 and 30&#x02009;ng mL<sup>&#x02212;1</sup>, <italic>N</italic>&#x02009;&#x0003D;&#x02009;9&#x02013;10 for each dose) were examined. &#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.05 and &#x0002A;&#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.01 paired samples from the same animal (<italic>t</italic>-test).</p></caption>
<graphic xlink:href="fendo-08-00330-g003.tif"/>
</fig>
<p>Treatment with 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC had limited effects on phosphorylated protein kinase C &#x003B4;/&#x003B8; (PKC&#x003B4;/&#x003B8;) in both EDL and soleus muscles (Figure <xref ref-type="supplementary-material" rid="SM4">S4</xref> in Supplementary Material).</p>
</sec>
<sec id="S3-4">
<title>The Phosphorylation Levels of ERK2 Correlated with the Phosphorylation Levels of AKT and AS160</title>
<p>p-ERK2 levels were not associated with glucose uptake levels (Figures <xref ref-type="fig" rid="F4">4</xref>A,B) or p-mTOR levels (Figures <xref ref-type="fig" rid="F4">4</xref>C,D), in either EDL or soleus. Higher levels of p-ERK2 were associated with higher levels of p-AKT in EDL (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, Figure <xref ref-type="fig" rid="F4">4</xref>E) with a low positive correlation (<italic>r</italic>&#x02009;&#x0003D;&#x02009;0.48), but not in soleus (Figure <xref ref-type="fig" rid="F4">4</xref>F). In both EDL (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.05, Figure <xref ref-type="fig" rid="F4">4</xref>G) and soleus (<italic>P</italic>&#x02009;&#x0003C;&#x02009;0.001, Figure <xref ref-type="fig" rid="F4">4</xref>H), higher p-ERK2 levels were associated with higher levels of p-AS160, with a low positive correlation (<italic>r</italic>&#x02009;&#x0003D;&#x02009;0.48) and a high positive correlation (<italic>r</italic>&#x02009;&#x0003D;&#x02009;0.85), respectively.</p>
<fig id="F4" position="float">
<label>Figure 4</label>
<caption><p>The correlations between the levels of p-ERK2 and the levels of glucose uptake, p-mTOR, p-AKT, and p-AS160. In extensor digitorum longus (EDL) and soleus samples, the correlations between the levels p-ERK2 fold-change and the levels of glucose uptake <bold>(A,B)</bold>, p-mTOR fold-change <bold>(C,D)</bold>, p-AKT fold-change <bold>(E,F)</bold>, and p-AS160 fold-change <bold>(G,H)</bold> were analyzed among samples from 30&#x02009;ng mL<sup>&#x02212;1</sup> undercarboxylated osteocalcin (ucOC) treatment group; &#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.05 and &#x0002A;&#x0002A;&#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.001.</p></caption>
<graphic xlink:href="fendo-08-00330-g004.tif"/>
</fig>
<p>p-AMPK&#x003B1; levels were not associated with glucose uptake or any signaling protein phosphorylation levels in either muscle type (data not shown).</p>
</sec>
<sec id="S3-5">
<title>The Prevention of ucOC-Induced ERK Phosphorylation Had Limited Effect on ucOC-Stimulated Muscle Glucose Uptake</title>
<p>Preincubation with 1&#x02009;&#x000B5;M U0126 blocked ucOC (30&#x02009;ng mL<sup>&#x02212;1</sup>)-induced increases in ERK2 phosphorylation in both EDL and soleus (Figures <xref ref-type="fig" rid="F5">5</xref>A,B). However, the addition of inhibitor did not significantly affect ucOC-stimulated muscle glucose uptake (Figures <xref ref-type="fig" rid="F5">5</xref>C,D).</p>
<fig id="F5" position="float">
<label>Figure 5</label>
<caption><p>The effects of the removal of p-ERK2 enhancement by U0126 on undercarboxylated osteocalcin (ucOC)-stimulated muscle glucose uptake. <bold>(A,B)</bold> The phosphorylation levels, total expression levels, and phospho/total ratio levels of ERK2 in samples treated with dimethyl sulfoxide (DMSO) vehicle, vehicle plus 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC, U0126 (1&#x02009;&#x003BC;M), and U0126 plus ucOC were assessed in Extensor digitorum longus (EDL) and soleus muscles; <bold>(C,D)</bold> the glucose uptake of samples treated with DMSO vehicle, vehicle plus ucOC (30&#x02009;ng mL<sup>&#x02212;1</sup>), U0126 (1&#x02009;&#x003BC;M), or U0126 plus ucOC were examined in EDL and soleus muscles. &#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.05 and &#x0002A;&#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.01 between paired samples (<italic>t</italic>-test).</p></caption>
<graphic xlink:href="fendo-08-00330-g005.tif"/>
</fig>
</sec>
<sec id="S3-6">
<title>The Removal of ucOC-Induced ERK Phosphorylation Prevents ucOC-Stimulated AKT Phosphorylation in EDL, but Has Limited Effect on the Phosphorylation of mTOR and AS160 in Both Muscle Types</title>
<p>U0126 (1&#x02009;&#x000B5;M) had limited effect on p-mTOR following ucOC treatment in either EDL or soleus (Figures <xref ref-type="fig" rid="F6">6</xref>A,B). However, it somewhat prevented the ucOC-mediated AKT activation in EDL with a change close to significant observed in phosphorylation levels (<italic>P</italic>&#x02009;&#x0003D;&#x02009;0.06), but not in soleus (Figures <xref ref-type="fig" rid="F6">6</xref>C,D). Although AS160 phosphorylation shared similar patterns of modulation with those of AKT following the treatments, ucOC-stimulated AS160 phosphorylation levels were only marginally decreased by U0126 addition in both muscle types (<italic>P</italic>&#x02009;&#x0003E;&#x02009;0.1; Figures <xref ref-type="fig" rid="F6">6</xref>E,F).</p>
<fig id="F6" position="float">
<label>Figure 6</label>
<caption><p>The effects of the removal of p-ERK2 enhancement by U0126 on undercarboxylated osteocalcin (ucOC)-stimulated p-mTOR, p-AKT, and p-AS160. The phosphorylation levels, total expression levels, and phospho/total ratio levels of mTOR <bold>(A,B)</bold>, AKT <bold>(C,D)</bold>, and AS160 <bold>(E,F)</bold> of samples treated with dimethyl sulfoxide vehicle, vehicle plus 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC, 1&#x02009;&#x003BC;M U0126, and U0126 plus ucOC were assessed in extensor digitorum longus (EDL) and soleus muscles (<italic>N</italic>&#x02009;&#x0003D;&#x02009;5). &#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.05 and &#x0002A;&#x0002A;<italic>P</italic>&#x02009;&#x02264;&#x02009;0.01 between paired samples from the same animal (<italic>t</italic>-test).</p></caption>
<graphic xlink:href="fendo-08-00330-g006.tif"/>
</fig>
</sec>
</sec>
<sec id="S4" sec-type="discussion">
<title>Discussion</title>
<p>We report that physiological levels of ucOC <italic>per se</italic> increased muscle glucose uptake <italic>ex vivo</italic> in both EDL (glycolytic muscle) and soleus (oxidative muscle) muscles. Furthermore, ucOC increased the phosphorylation of ERK2, mTOR, and AS160 in EDL and enhanced the phosphorylation of ERK2 and AS160 in soleus muscle. It appears that ERK phosphorylation was not directly involved in ucOC-stimulated glucose uptake and AS160 phosphorylation in both muscle types.</p>
<p>We, and others, have previously reported that ucOC had no significant effect on resting EDL muscle glucose uptake, indicating that ucOC <italic>per se</italic> probably only upregulates muscle glucose metabolism in oxidative muscle fibers (<xref ref-type="bibr" rid="B14">14</xref>, <xref ref-type="bibr" rid="B15">15</xref>). However, since the expression of GPRC6A, which is reported as the plausible receptor of ucOC, has been found in both muscle types (<xref ref-type="bibr" rid="B14">14</xref>, <xref ref-type="bibr" rid="B15">15</xref>), we suggested that the results of these studies were affected by a potential methodological limitation that the usage of intact whole muscles may prevent adequate ucOC exposure to all muscle fibers. <italic>In vivo</italic>, muscle fibers are closely fed by capillaries that penetrate the epimysium and bifurcate throughout the muscle, primarily within perimysium (<xref ref-type="bibr" rid="B33">33</xref>). Since both epimysium and perimysium belong to robust collagenous connective tissue networks, without the help of blood vessels, ucOC in external solution may have limited direct contact with fibers of intact muscles during <italic>ex vivo</italic> incubation. By utilizing the method of splitting muscles longitudinally into halves (<xref ref-type="bibr" rid="B16">16</xref>&#x02013;<xref ref-type="bibr" rid="B18">18</xref>), in order to increase the ucOC saturation during treatment, we report that ucOC can increase muscle glucose uptake in the absence of insulin in both glycolytic (EDL) and oxidative (soleus) muscles, suggesting the effect of ucOC on skeletal muscle glucose uptake is likely universal rather than muscle-type specific. It also seems that, compared with EDL, higher doses of ucOC are required for observing this effect on the glucose uptake of soleus (Figures <xref ref-type="fig" rid="F1">1</xref>C,D). Although there was a significant increase in soleus treated with 0.3&#x02009;ng mL<sup>&#x02212;1</sup> ucOC using paired comparison method (Figure <xref ref-type="fig" rid="F1">1</xref>B), this increase could not be observed when data were analyzed using one-way ANOVA. Thus, it was likely that this increase was merely resulted from an abnormally low control levels in that specific group. Since skeletal muscle is the major site of glucose disposal and utilization in the postprandial state (<xref ref-type="bibr" rid="B9">9</xref>), these findings implicate ucOC as a possible therapeutic agent to improve muscle glucose transport even without insulin.</p>
<p>However, it should be noted that even though we introduced muscle splits in this study to enhance the interaction between ucOC and interior muscle myotubes beneath muscle surface, some limitations, which might result in enhanced biological variations, such as different ucOC saturation percentages due to different muscle dimensions, and different basal glucose uptake levels of different individuals, still cannot be ruled out. Therefore, future studies should explore the effect of ucOC in primary myotubes from animals and human, to avoid these limitations.</p>
<p>We report that ucOC treatment activated the mTORC2-AKT-AS160 signaling cascade in skeletal muscle, in a muscle type-specific manner. Importantly, ucOC elicited significant increases in AS160 phosphorylation (Thr642) despite relatively modest increases in AKT phosphorylation (Ser473) (<italic>P</italic>&#x02009;&#x0003D;&#x02009;0.074). Therefore, ucOC may enhance AS160 phosphorylation <italic>via</italic> AKT independent mechanisms, which may be the major mechanisms underlying the ucOC-induced enhancement of glucose uptake and AS160 phosphorylation. Indeed, several other signaling proteins are also able to increase AS160 phosphorylation, including AMPK and conventional/novel (c/n) protein kinase C (PKC) (<xref ref-type="bibr" rid="B34">34</xref>).</p>
<p>Along with ERK, previous studies have suggested that AMPK is a potential downstream target of the ucOC signaling in skeletal muscle (<xref ref-type="bibr" rid="B13">13</xref>, <xref ref-type="bibr" rid="B15">15</xref>). Our data shows that following 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC treatment, there is a significant increase in phosphorylated ERK2 (Thr202/Yyr204) in both EDL and soleus muscles. However, there was limited change in AMPK&#x003B1; phosphorylation at Thr172, a phosphorylation site that has widely been reported as an indicator of AMPK activity (<xref ref-type="bibr" rid="B35">35</xref>&#x02013;<xref ref-type="bibr" rid="B37">37</xref>). Similarly, it has been reported that AMPK&#x003B1; Thr172 phosphorylation was not increased following ucOC treatment in C2C12 cells (<xref ref-type="bibr" rid="B13">13</xref>). A recent paper reported that intraperitoneal injection of osteocalcin increased AMPK phosphorylation in mouse muscles during exercise (<xref ref-type="bibr" rid="B15">15</xref>). Given that AMPK Thr172 phosphorylation is increased in skeletal muscle after acute exercise alone, without ucOC (<xref ref-type="bibr" rid="B38">38</xref>, <xref ref-type="bibr" rid="B39">39</xref>), it is possible that ucOC treatment merely has an additive effect on exercise-enhanced phosphorylation of AMPK, but is unable to increase its phosphorylation level <italic>per se</italic>. However, it should be noted that until now no studies have shown ucOC-induced change of AMPK phosphorylation over the course of time. Thus, a transient increase of AMPK phosphorylation after ucOC treatment still cannot be ruled out.</p>
<p>We neither observed any significant increases in the phosphorylation in PKC&#x003B4;/&#x003B8;, two important members in novel PKC family, in both muscle types (Figure <xref ref-type="supplementary-material" rid="SM4">S4</xref> in Supplementary Material). This finding suggests a limited role of PKC&#x003B4;/&#x003B8; in the modulation of muscle glucose uptake by ucOC. However, the involvement of other types of PKC in the mechanisms behind this ucOC effect is still possible, which warrants further investigation.</p>
<p>We reported that p-AKT in EDL and p-ERK2 in both EDL and soleus were enhanced following ucOC treatment with no significant changes in phospho/total ratio (Figures <xref ref-type="fig" rid="F2">2</xref>C and <xref ref-type="fig" rid="F3">3</xref>A,B). This discrepancy may be attributed to an ucOC-induced modest increase in total protein expression (Figures <xref ref-type="fig" rid="F2">2</xref>E and <xref ref-type="fig" rid="F3">3</xref>D), in addition to its effect on protein phosphorylation. Consistent with our finding, protein synthesis has recently been reported to increase in mouse myotubes following 1&#x02013;2&#x02009;h of ucOC treatment (<xref ref-type="bibr" rid="B40">40</xref>, <xref ref-type="bibr" rid="B41">41</xref>). It is possible that ucOC regulates kinase activity by both enhancing protein phosphorylation, and, to a lesser extent, increasing protein abundance.</p>
<p>We report a low positive correlation between p-ERK2 levels and p-AKT levels as well as a high positive correlation between p-ERK2 levels and p-AS160 levels in EDL, which was consistent with our previous findings showing that lower p-ERK levels were associated with lower p-AKT levels in rat EDL muscle (<xref ref-type="bibr" rid="B30">30</xref>). In soleus, p-ERK2 levels were associated with p-AS160 levels, with a low positive correlation. As such, we investigated whether the removal of ucOC-mediated ERK phosphorylation leads to the suppression of the effect of ucOC on skeletal muscles. Pretreatment with 1&#x02009;&#x000B5;M U0126 blocked ucOC-stimulated increases in ERK phosphorylation in both muscle types. In EDL, it seems that the inhibition of p-ERK2 blocked ucOC-stimulated AKT phosphorylation (<italic>P</italic>&#x02009;&#x0003D;&#x02009;0.06). Consistently, a previous finding also suggested that partial ERK inhibition dampened ucOC-stimulated AKT phosphorylation in C2C12 myotubes (<xref ref-type="bibr" rid="B13">13</xref>). In contrast, in response to the loss of ucOC-induced ERK phosphorylation, ucOC-stimulated glucose uptake and AS160 phosphorylation was not compromised. Similarly, in soleus, the inhibition of p-ERK2 had limited effects on ucOC-stimulated glucose uptake and the phosphorylation of signaling proteins. These findings suggest that mechanisms underlying ucOC stimulation in skeletal muscle are probably muscle type-specific, but converging at AS160 phosphorylation, both resulting in the enhancement of glucose uptake. The ucOC-stimulated mTOR phosphorylation was also not modulated by U0126 pretreatment in both muscle types. Thus, whether ERK signaling modulates AKT phosphorylation through mTORC2 needs further investigations.</p>
<p>The administration of U0126 as an ERK inhibitor has limitations. One limitation derives from the influence of vehicle DMSO, which is widely used as the solvent for U0126. DMSO has been shown to exert some impact on skeletal muscle, such as depressing muscle contractility and accelerating muscle injury (<xref ref-type="bibr" rid="B42">42</xref>, <xref ref-type="bibr" rid="B43">43</xref>). In our study, by comparing the results shown in Figure <xref ref-type="fig" rid="F2">2</xref> with those in Figure <xref ref-type="fig" rid="F6">6</xref>, it is suggested that even the presence of a low concentration of DMSO (0.1%) may have slightly altered the ucOC effect on the phosphorylation of mTOR in EDL and AKT in soleus. However, since DMSO was universally added to all samples in experiments involving the prevention of ucOC-induced ERK phosphorylation, the conclusions drawn from comparisons between these samples are unlikely to be affected by DMSO addition. The other limitation of U0126 administration in this study is the capability of U0126 to enhance glucose uptake and AKT phosphorylation by itself (<xref ref-type="bibr" rid="B44">44</xref>&#x02013;<xref ref-type="bibr" rid="B46">46</xref>). It has been suggested that this effect is due to the elevation of AMPK activity that is independent of ERK inhibition (<xref ref-type="bibr" rid="B47">47</xref>). In the current study, the application of low dose (1&#x02009;&#x003BC;M) of U0126 had a limited effect on AMPK phosphorylation in both muscle types (Figure <xref ref-type="supplementary-material" rid="SM6">S6</xref> in Supplementary Material), and glucose uptake and phosphorylation of most other signaling proteins were also minimally or not at all affected. Nevertheless, other inhibitors or methodologies for ERK inhibition should be investigated in future studies to confirm the involvement of ERK in the regulation of AKT phosphorylation.</p>
<p>In conclusion, ucOC increases glucose uptake in both glycolytic and oxidative muscles in the absence of insulin, <italic>via</italic> mechanisms involving enhanced AS160 phosphorylation. Therefore, ucOC should be considered as a potential agent to improve muscle glucose uptake in insulin resistant conditions including type 2 diabetes.</p>
</sec>
<sec id="S5">
<title>Ethics Statement</title>
<p>The study was approved by the Animal Experimentation Ethics Committee of Victoria University (AEC14/009) and conformed to the Australian National Code of Practice for the Care and Use of Animals for Scientific Purposes.</p>
</sec>
<sec id="S6" sec-type="author-contributor">
<title>Author Contributions</title>
<p>XL, XZ, TB-S, and IL design the study. XL, LP, and EM performed experiments and data collection. XL and LP did the data analysis. XL wrote the paper. XL, LP, XZ, AH, GM, TB-S, and IL substantially contributed to manuscript revision and approved the final version.</p>
</sec>
<sec id="S7">
<title>Conflict of Interest Statement</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
</body>
<back>
<fn-group>
<fn fn-type="financial-disclosure">
<p><bold>Funding.</bold> IL is a Future Leader Fellow of Australian Heart Foundation (ID: 100040).</p></fn>
</fn-group>
<sec id="S8" sec-type="supplementary-material">
<title>Supplementary Material</title>
<p>The Supplementary Material for this article can be found online at <uri xlink:href="http://www.frontiersin.org/article/10.3389/fendo.2017.00330/full&#x00023;supplementary-material">http://www.frontiersin.org/article/10.3389/fendo.2017.00330/full&#x00023;supplementary-material</uri>.</p>
<supplementary-material xlink:href="Image_1.tif" id="SM1" mimetype="applicationn/tif" xmlns:xlink="http://www.w3.org/1999/xlink">
<label>Figure S1</label>
<caption><p>Flow-chart of the protocol used in this study.</p></caption>
</supplementary-material>
<supplementary-material xlink:href="Image_2.tif" id="SM2" mimetype="applicationn/tif" xmlns:xlink="http://www.w3.org/1999/xlink">
<label>Figure S2</label>
<caption><p>Blots of all samples in western blot analysis for p-mTOR, p-AKT, and p-AS160. Blots of p-mTOR at Ser2481 in Extensor digitorum longus (EDL) <bold>(A)</bold> and soleus <bold>(B)</bold> samples, p-AKT at Ser473 in EDL <bold>(C)</bold> and soleus <bold>(D)</bold> samples, and p-AS160 at Thr642 in EDL <bold>(E)</bold> and soleus <bold>(F)</bold> samples from 3&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;10) and 30&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;10) groups are exhibited.</p></caption>
</supplementary-material>
<supplementary-material xlink:href="Image_3.tif" id="SM3" mimetype="applicationn/tif" xmlns:xlink="http://www.w3.org/1999/xlink">
<label>Figure S3</label>
<caption><p>Blots of all samples in western blot analysis for p-ERK2 and p-AMPK&#x003B1;. Blots of p-ERK2 at Thr202/Tyr204 in Extensor digitorum longus (EDL) <bold>(A)</bold> and soleus <bold>(B)</bold> samples as well as p-AMPK&#x003B1; at Thr172 in EDL <bold>(C)</bold> and soleus <bold>(D)</bold> samples from 3&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;9&#x02013;10) and 30&#x02009;ng mL<sup>&#x02212;1</sup> (<italic>N</italic>&#x02009;&#x0003D;&#x02009;9&#x02013;10) groups are exhibited.</p></caption>
</supplementary-material>
<supplementary-material xlink:href="Image_4.tif" id="SM4" mimetype="applicationn/tif" xmlns:xlink="http://www.w3.org/1999/xlink">
<label>Figure S4</label>
<caption><p>The phosphorylation levels of protein kinase C (PKC)&#x003B4;/&#x003B8; in Extensor digitorum longus and soleus samples treated with Krebs&#x02013;Henseleit buffer buffer control and 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC were examined (<italic>N</italic>&#x02009;&#x0003D;&#x02009;10).</p></caption>
</supplementary-material>
<supplementary-material xlink:href="Image_5.tif" id="SM5" mimetype="applicationn/tif" xmlns:xlink="http://www.w3.org/1999/xlink">
<label>Figure S5</label>
<caption><p>Blots of all samples in western blot analysis for p-ERK2, p-mTOR, p-AKT, and p-AS160 in ERK inhibition experiments. Blots of p-ERK2 at Thr202/Tyr204 in Extensor digitorum longus (EDL) <bold>(A)</bold> and soleus <bold>(B)</bold> samples, p-mTOR at Ser2481 in EDL <bold>(C)</bold> and soleus <bold>(D)</bold> samples, p-AKT at Ser473 in EDL <bold>(E)</bold> and soleus <bold>(F)</bold> samples, and p-AS160 at Thr642 in EDL <bold>(G)</bold> and soleus <bold>(H)</bold> samples in ERK inhibition experiments are exhibited (<italic>N</italic>&#x02009;&#x0003D;&#x02009;5).</p></caption>
</supplementary-material>
<supplementary-material xlink:href="Image_6.tif" id="SM6" mimetype="applicationn/tif" xmlns:xlink="http://www.w3.org/1999/xlink">
<label>Figure S6</label>
<caption><p>The phosphorylation levels of AMPK&#x003B1; at Thr172 in Extensor digitorum longus (EDL) and soleus samples treated with treated with dimethyl sulfoxide vehicle, vehicle plus 30&#x02009;ng mL<sup>&#x02212;1</sup> ucOC, 1&#x02009;&#x003BC;M U0126, and U0126 plus ucOC were examined (<italic>N</italic>&#x02009;&#x0003D;&#x02009;5).</p></caption>
</supplementary-material>
</sec>
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