Advances on Exercise-mediated Regulation of Programmed Cell Death in the Management of Sarcopenia
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2025.0503
- VernacularTitle:运动调控程序性细胞死亡在肌少症防治中的研究进展
- Author:
Xueke SHI
1
;
Xiaodong FENG
1
Author Information
1. The First Affiliated Hospital of Henan University of Chinese Medicine， Zhengzhou 450000， China
- Publication Type:Journal Article
- Keywords:
sarcopenia;
programmed cell death;
exercise intervention;
apoptosis;
autophagy;
pyroptosis;
ferroptosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(5):737-746
- CountryChina
- Language:Chinese
-
Abstract:
With the acceleration of global population aging， sarcopenia， characterized by a progressive loss of skeletal muscle mass， strength， and physical function， has become a major public health issue that seriously threatens the health and quality of life in older adults. The development and progression of sarcopenia involve complex， multi-level， and cross-system cellular and molecular mechanisms. Recent studies have highlighted the central role of programmed cell death （PCD） in maintaining skeletal muscle homeostasis， regulating metabolism， and mediating tissue repair. The classic forms of PCD-apoptosis， autophagy， pyroptosis， and ferroptosis-interact through critical nodes such as reactive oxygen species（ROS） accumulation， mitochondrial dysfunction， and iron homeostasis disruption， ultimately driving muscle fiber loss， functional decline， and chronic inflammation. These processes underpin the pathology of sarcopenia. Exercise， the most effective non-pharmacological intervention to date， has been shown to precisely regulate multiple PCD pathways. It improves muscle mass， strength， and metabolic stability， and delays the progression of sarcopenia. Specifically， appropriate exercise could inhibit excessive apoptosis， activate protective autophagy， alleviate NLRP3 inflammasome-mediated pyroptosis， and suppress ferroptosis by enhancing antioxidant defenses and maintaining iron homeostasis. This review systematically summarizes the roles and mechanisms of apoptosis， autophagy， pyroptosis， and ferroptosis in sarcopenia. It particularly focuses on the molecular targets and physiological effects of exercise-mediated PCD regulation. The aim is to provide theoretical and practical support for developing personalized and precision exercise interventions targeting PCD pathways for the prevention and management of sarcopenia.
