The role of Pitx2 and Pitx3 in muscle stem cells gives new insights into P38α MAP kinase and redox regulation of muscle regeneration

Elife. 2018 Aug 14;7:e32991. doi: 10.7554/eLife.32991.


Skeletal muscle regeneration depends on satellite cells. After injury these muscle stem cells exit quiescence, proliferate and differentiate to regenerate damaged fibres. We show that this progression is accompanied by metabolic changes leading to increased production of reactive oxygen species (ROS). Using Pitx2/3 single and double mutant mice that provide genetic models of deregulated redox states, we demonstrate that moderate overproduction of ROS results in premature differentiation of satellite cells while high levels lead to their senescence and regenerative failure. Using the ROS scavenger, N-Acetyl-Cysteine (NAC), in primary cultures we show that a physiological increase in ROS is required for satellite cells to exit the cell cycle and initiate differentiation through the redox activation of p38α MAP kinase. Subjecting cultured satellite cells to transient inhibition of P38α MAP kinase in conjunction with NAC treatment leads to their rapid expansion, with striking improvement of their regenerative potential in grafting experiments.

Keywords: Pitx2/3; cell biology; cell therapy; mouse; muscle stem cell; p38α MAPK; redox state; regeneration; regenerative medicine; stem cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcysteine / administration & dosage
  • Animals
  • Cell Differentiation / genetics
  • Cellular Senescence / genetics
  • Homeodomain Proteins / genetics*
  • Mice
  • Mitogen-Activated Protein Kinase 14 / genetics*
  • Muscle, Skeletal / cytology
  • Mutation
  • Oxidation-Reduction
  • Reactive Oxygen Species
  • Regeneration / genetics*
  • Satellite Cells, Skeletal Muscle
  • Stem Cells / cytology
  • Transcription Factors / genetics*


  • Homeodomain Proteins
  • Reactive Oxygen Species
  • Transcription Factors
  • homeobox protein PITX3
  • homeobox protein PITX2
  • Mitogen-Activated Protein Kinase 14
  • Acetylcysteine