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    <title>Genetic variation of putative myokine signaling is dominated by biological sex and sex
      hormones</title>
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      <article itemscope="" itemtype="http://schema.org/Article" data-itemscope="root">
        <h1 itemprop="headline">Genetic variation of putative myokine signaling is dominated by
          biological sex and sex hormones</h1>
        <meta itemprop="image"
          content="https://via.placeholder.com/1200x714/dbdbdb/4a4a4a.png?text=Genetic%20variation%20of%20putative%20myokine%20signaling%20is%20dominated%20by%20biological%20sex%20and%20sex%20hormones">
        <ol data-itemprop="authors">
          <li itemscope="" itemtype="http://schema.org/Person" itemprop="author">
            <meta itemprop="name" content="Leandro M Velez"><span data-itemprop="givenNames"><span
                itemprop="givenName">Leandro</span><span itemprop="givenName">M</span></span><span
              data-itemprop="familyNames"><span itemprop="familyName">Velez</span></span><span
              data-itemprop="affiliations"><a itemprop="affiliation"
                href="#author-organization-1">1</a><a itemprop="affiliation"
                href="#author-organization-2">2</a></span>
          </li>
          <li itemscope="" itemtype="http://schema.org/Person" itemprop="author">
            <meta itemprop="name" content="Cassandra Van"><span data-itemprop="givenNames"><span
                itemprop="givenName">Cassandra</span></span><span data-itemprop="familyNames"><span
                itemprop="familyName">Van</span></span><span data-itemprop="affiliations"><a
                itemprop="affiliation" href="#author-organization-1">1</a><a itemprop="affiliation"
                href="#author-organization-3">3</a></span>
          </li>
          <li itemscope="" itemtype="http://schema.org/Person" itemprop="author">
            <meta itemprop="name" content="Timothy Moore"><span data-itemprop="givenNames"><span
                itemprop="givenName">Timothy</span></span><span data-itemprop="familyNames"><span
                itemprop="familyName">Moore</span></span><span data-itemprop="affiliations"><a
                itemprop="affiliation" href="#author-organization-4">4</a></span>
          </li>
          <li itemscope="" itemtype="http://schema.org/Person" itemprop="author">
            <meta itemprop="name" content="Zhenqi Zhou"><span data-itemprop="givenNames"><span
                itemprop="givenName">Zhenqi</span></span><span data-itemprop="familyNames"><span
                itemprop="familyName">Zhou</span></span><span data-itemprop="affiliations"><a
                itemprop="affiliation" href="#author-organization-5">5</a></span>
          </li>
          <li itemscope="" itemtype="http://schema.org/Person" itemprop="author">
            <meta itemprop="name" content="Casey Johnson"><span data-itemprop="givenNames"><span
                itemprop="givenName">Casey</span></span><span data-itemprop="familyNames"><span
                itemprop="familyName">Johnson</span></span><span data-itemprop="affiliations"><a
                itemprop="affiliation" href="#author-organization-1">1</a><a itemprop="affiliation"
                href="#author-organization-3">3</a></span>
          </li>
          <li itemscope="" itemtype="http://schema.org/Person" itemprop="author">
            <meta itemprop="name" content="Andrea L Hevener"><span data-itemprop="givenNames"><span
                itemprop="givenName">Andrea</span><span itemprop="givenName">L</span></span><span
              data-itemprop="familyNames"><span itemprop="familyName">Hevener</span></span><span
              data-itemprop="emails"><a itemprop="email"
                href="mailto:ahevener@mednet.ucla.edu">ahevener@mednet.ucla.edu</a></span><span
              data-itemprop="affiliations"><a itemprop="affiliation"
                href="#author-organization-5">5</a><a itemprop="affiliation"
                href="#author-organization-6">6</a></span>
          </li>
          <li itemscope="" itemtype="http://schema.org/Person" itemprop="author">
            <meta itemprop="name" content="Marcus M Seldin"><span data-itemprop="givenNames"><span
                itemprop="givenName">Marcus</span><span itemprop="givenName">M</span></span><span
              data-itemprop="familyNames"><span itemprop="familyName">Seldin</span></span><span
              data-itemprop="emails"><a itemprop="email"
                href="mailto:mseldin@uci.edu">mseldin@uci.edu</a></span><span
              data-itemprop="affiliations"><a itemprop="affiliation"
                href="#author-organization-1">1</a><a itemprop="affiliation"
                href="#author-organization-3">3</a></span>
          </li>
        </ol>
        <ol data-itemprop="affiliations">
          <li itemscope="" itemtype="http://schema.org/Organization" itemid="#author-organization-1"
            id="author-organization-1"><span itemprop="name">Department of Biological Chemistry,
              University of California, Irvine</span><address itemscope=""
              itemtype="http://schema.org/PostalAddress" itemprop="address"><span
                itemprop="addressLocality">Irvine</span><span itemprop="addressCountry">United
                States</span></address></li>
          <li itemscope="" itemtype="http://schema.org/Organization" itemid="#author-organization-2"
            id="author-organization-2"><span itemprop="name">Center for Epigenetics and Metabolism,
              University of California Irvine,</span><address itemscope=""
              itemtype="http://schema.org/PostalAddress" itemprop="address"><span
                itemprop="addressLocality">Irvine</span><span itemprop="addressCountry">United
                States</span></address></li>
          <li itemscope="" itemtype="http://schema.org/Organization" itemid="#author-organization-3"
            id="author-organization-3"><span itemprop="name">Center for Epigenetics and Metabolism,
              University of California Irvine</span><address itemscope=""
              itemtype="http://schema.org/PostalAddress" itemprop="address"><span
                itemprop="addressLocality">Irvine</span><span itemprop="addressCountry">United
                States</span></address></li>
          <li itemscope="" itemtype="http://schema.org/Organization" itemid="#author-organization-4"
            id="author-organization-4"><span itemprop="name">Department of Medicine, Division of
              Cardiology, David Geffen School of Medicine at UCLA</span><address itemscope=""
              itemtype="http://schema.org/PostalAddress" itemprop="address"><span
                itemprop="addressLocality">Los Angeles</span><span itemprop="addressCountry">United
                States</span></address></li>
          <li itemscope="" itemtype="http://schema.org/Organization" itemid="#author-organization-5"
            id="author-organization-5"><span itemprop="name">Department of Medicine, Division of
              Endocrinology, Diabetes and Hypertension, David Geffen School of Medicine at
              UCLA</span><address itemscope="" itemtype="http://schema.org/PostalAddress"
              itemprop="address"><span itemprop="addressLocality">Los Angeles</span><span
                itemprop="addressCountry">United States</span></address></li>
          <li itemscope="" itemtype="http://schema.org/Organization" itemid="#author-organization-6"
            id="author-organization-6"><span itemprop="name">Iris Cantor-UCLA Women’s Health
              Research Center, David Geffen School of Medicine at UCLA</span><address itemscope=""
              itemtype="http://schema.org/PostalAddress" itemprop="address"><span
                itemprop="addressLocality">Los Angeles</span><span itemprop="addressCountry">United
                States</span></address></li>
        </ol><span itemscope="" itemtype="http://schema.org/Organization" itemprop="publisher">
          <meta itemprop="name" content="Unknown"><span itemscope=""
            itemtype="http://schema.org/ImageObject" itemprop="logo">
            <meta itemprop="url"
              content="https://via.placeholder.com/600x60/dbdbdb/4a4a4a.png?text=Unknown">
          </span>
        </span><time itemprop="datePublished" datetime="2022-04-13">2022-04-13</time>
        <ul data-itemprop="genre">
          <li itemprop="genre">Short Report</li>
        </ul>
        <ul data-itemprop="about">
          <li itemscope="" itemtype="http://schema.org/DefinedTerm" itemprop="about"><span
              itemprop="name">Biochemistry and Chemical Biology</span></li>
          <li itemscope="" itemtype="http://schema.org/DefinedTerm" itemprop="about"><span
              itemprop="name">Computational and Systems Biology</span></li>
        </ul>
        <ul data-itemprop="keywords">
          <li itemprop="keywords">myokine</li>
          <li itemprop="keywords">endocrinology</li>
          <li itemprop="keywords">systems genetics</li>
          <li itemprop="keywords">physiology</li>
          <li itemprop="keywords">Human</li>
        </ul>
        <ul data-itemprop="identifiers">
          <li itemscope="" itemtype="http://schema.org/PropertyValue" itemprop="identifier">
            <meta itemprop="propertyID"
              content="https://registry.identifiers.org/registry/publisher-id"><span
              itemprop="name">publisher-id</span><span itemprop="value"
              data-itemtype="http://schema.org/Number">76887</span>
          </li>
          <li itemscope="" itemtype="http://schema.org/PropertyValue" itemprop="identifier">
            <meta itemprop="propertyID" content="https://registry.identifiers.org/registry/doi">
            <span itemprop="name">doi</span><span itemprop="value">10.7554/eLife.76887</span>
          </li>
          <li itemscope="" itemtype="http://schema.org/PropertyValue" itemprop="identifier">
            <meta itemprop="propertyID"
              content="https://registry.identifiers.org/registry/elocation-id"><span
              itemprop="name">elocation-id</span><span itemprop="value">e76887</span>
          </li>
        </ul>
        <section data-itemprop="description">
          <h2 data-itemtype="http://schema.stenci.la/Heading">Abstract</h2>
          <meta itemprop="description"
            content="Skeletal muscle plays an integral role in coordinating physiological homeostasis, where signaling to other tissues via myokines allows for coordination of complex processes. Here, we aimed to leverage natural genetic correlation structure of gene expression both within and across tissues to understand how muscle interacts with metabolic tissues. Specifically, we performed a survey of genetic correlations focused on myokine gene regulation, muscle cell composition, cross-tissue signaling, and interactions with genetic sex in humans. While expression levels of a majority of myokines and cell proportions within skeletal muscle showed little relative differences between males and females, nearly all significant cross-tissue enrichments operated in a sex-specific or hormone-dependent fashion; in particular, with estradiol. These sex- and hormone-specific effects were consistent across key metabolic tissues: liver, pancreas, hypothalamus, intestine, heart, visceral, and subcutaneous adipose tissue. To characterize the role of estradiol receptor signaling on myokine expression, we generated male and female mice which lack estrogen receptor α specifically in skeletal muscle (MERKO) and integrated with human data. These analyses highlighted potential mechanisms of sex-dependent myokine signaling conserved between species, such as myostatin enriched for divergent substrate utilization pathways between sexes. Several other putative sex-dependent mechanisms of myokine signaling were uncovered, such as muscle-derived tumor necrosis factor alpha ( TNFA ) enriched for stronger inflammatory signaling in females compared to males and  GPX3  as a male-specific link between glycolytic fiber abundance and hepatic inflammation. Collectively, we provide a population genetics framework for inferring muscle signaling to metabolic tissues in humans. We further highlight sex and estradiol receptor signaling as critical variables when assaying myokine functions and how changes in cell composition are predicted to impact other metabolic organs.">
          <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Skeletal muscle plays an
            integral role in coordinating physiological homeostasis, where signaling to other
            tissues via myokines allows for coordination of complex processes. Here, we aimed to
            leverage natural genetic correlation structure of gene expression both within and across
            tissues to understand how muscle interacts with metabolic tissues. Specifically, we
            performed a survey of genetic correlations focused on myokine gene regulation, muscle
            cell composition, cross-tissue signaling, and interactions with genetic sex in humans.
            While expression levels of a majority of myokines and cell proportions within skeletal
            muscle showed little relative differences between males and females, nearly all
            significant cross-tissue enrichments operated in a sex-specific or hormone-dependent
            fashion; in particular, with estradiol. These sex- and hormone-specific effects were
            consistent across key metabolic tissues: liver, pancreas, hypothalamus, intestine,
            heart, visceral, and subcutaneous adipose tissue. To characterize the role of estradiol
            receptor signaling on myokine expression, we generated male and female mice which lack
            estrogen receptor α specifically in skeletal muscle (MERKO) and integrated with human
            data. These analyses highlighted potential mechanisms of sex-dependent myokine signaling
            conserved between species, such as myostatin enriched for divergent substrate
            utilization pathways between sexes. Several other putative sex-dependent mechanisms of
            myokine signaling were uncovered, such as muscle-derived tumor necrosis factor alpha
            (<em itemscope="" itemtype="http://schema.stenci.la/Emphasis">TNFA</em>) enriched for
            stronger inflammatory signaling in females compared to males and <em itemscope=""
              itemtype="http://schema.stenci.la/Emphasis">GPX3</em> as a male-specific link between
            glycolytic fiber abundance and hepatic inflammation. Collectively, we provide a
            population genetics framework for inferring muscle signaling to metabolic tissues in
            humans. We further highlight sex and estradiol receptor signaling as critical variables
            when assaying myokine functions and how changes in cell composition are predicted to
            impact other metabolic organs.</p>
        </section>
        <h2 itemscope="" itemtype="http://schema.stenci.la/Heading" id="introduction">Introduction
        </h2>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Proteins secreted from skeletal
          muscle, termed myokines, allow muscle to impact systemic physiology and disease. Myokines
          play critical roles in a variety of processes, including metabolic homeostasis, exercise
          improvements, inflammation, cancer, and cognitive functions <span itemscope=""
            itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a
                href="#bib28"><span>28</span><span>Severinsen and
                  Pedersen</span><span>2020</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a
                href="#bib5"><span>5</span><span>Eckel</span><span>2019</span></a></cite><cite
              itemscope="" itemtype="http://schema.stenci.la/Cite"><a
                href="#bib6"><span>6</span><span>Febbraio and
                  Pedersen</span><span>2020</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib8"><span>8</span><span>Kim et
                  al.</span><span>2019</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib9"><span>9</span><span>Kim et
                  al.</span><span>2021</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib24"><span>24</span><span>Seldin
                  and Wong</span><span>2012</span></a></cite></span>. Several notable examples
          include key peptide hormones such as myostatin and interleukin-6 which exert potent
          actions in regulating autocrine/paracrine muscle physiology <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib10"><span>10</span><span>Kollias
                and McDermott</span><span>2008</span></a></cite> and beneficial exercise-induced
          endocrine signaling <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib28"><span>28</span><span>Severinsen and
                Pedersen</span><span>2020</span></a></cite>, respectively. Despite the clear
          relevance of these factors in mediating a multitude of physiological outcomes, the genetic
          architecture, regulation, and functions of myokines remain inadequately understood. Given
          that genetic sex contributes critically to nearly every physiological outcome, it is
          essential to consider when relating specific mechanisms to complex genetic and metabolic
          interactions. Specifically, many metabolic traits impacted by myokines show striking sex
          differences arising from hormonal <span itemscope=""
            itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a
                href="#bib18"><span>18</span><span>Mauvais-Jarvis et
                  al.</span><span>2017</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a
                href="#bib17"><span>17</span><span>Mauvais-Jarvis</span><span>2015</span></a></cite><cite
              itemscope="" itemtype="http://schema.stenci.la/Cite"><a
                href="#bib3"><span>3</span><span>Clegg and
                  Mauvais-Jarvis</span><span>2018</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib22"><span>22</span><span>Ribas et
                  al.</span><span>2016</span></a></cite></span>, genetic <span itemscope=""
            itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a
                href="#bib18"><span>18</span><span>Mauvais-Jarvis et
                  al.</span><span>2017</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib34"><span>34</span><span>Zore et
                  al.</span><span>2018</span></a></cite></span>, or gene-by-sex interactions <span
            itemscope="" itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib20"><span>20</span><span>Norheim
                  et al.</span><span>2019</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib2"><span>2</span><span>Chella
                  Krishnan et al.</span><span>2021</span></a></cite></span>. In this study, we
          leveraged natural genetic correlation structure of gene expression both within and across
          tissues to understand how muscle interacts with metabolic tissues. Collectively, we
          provide a population genetics framework for inferring muscle signaling to metabolic
          tissues in humans. We further highlight sex and estradiol receptor signaling as critical
          variables when assaying myokine functions and how changes in cell composition are
          predicted to impact other metabolic organs.</p>
        <h2 itemscope="" itemtype="http://schema.stenci.la/Heading" id="results">Results</h2>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="sex-hormone-receptors-are-enriched-with-myokine-expression-independent-of-biological-sex">
          Sex hormone receptors are enriched with myokine expression independent of biological sex
        </h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Our goal was to exploit
          correlation structure of natural genetic variation to investigate how skeletal muscle
          communicates with and impacts metabolic organs. We first assayed regulation of myokines
          and changes in cellular composition, then related these observations to inferred
          cross-tissue signaling mechanisms (<a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1A</a>). Initially, we performed
          differential expression of genes encoding all known secreted proteins (3666 total) in
          skeletal muscle from 210 male and 100 female individuals <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib1"><span>1</span><span>Battle et
                al.</span><span>2017</span></a></cite>. While several notable myokines appeared
          different between sexes (<a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1B</a>), a striking majority of all
          secreted proteins (74%) showed no difference in expression between males and females (<a
            href="#fig1" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 1C</a>, <a
            href="#supp1" itemscope="" itemtype="http://schema.stenci.la/Link">Supplementary file
            1</a>). To understand potential sex effects on the regulation of myokines, gene ontology
          (GO) enrichments were performed on genes which showed the strongest correlation with
          myokines corresponding to each category (male-specific, female-specific, or
          non-sex-specific). Here, the top 10 pathways which persisted in females were also always
          observed to overlap with the non-sex-specific category (<a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1D</a>). In contrast, pathways enriched
          for male-specific myokines were distinct (<a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1D</a>). Notably, the female and shared
          pathways suggested roles in epigenetics and RNA processing, while male-specific myokine
          coregulated processes were more enriched in metabolic pathways (e.g. NADH metabolism) (<a
            href="#fig1" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 1D</a>).
          Further, a majority of myokines showed strong correlation with receptors mediating
          functions of androgens (androgen receptor [AR]), estradiol (estrogen receptor α – ESR1),
          or both, regardless of sex-specific expression (<a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1E</a>). We note that expression of
          hormone receptors themselves were also not significantly different between sexes (<a
            href="#fig1s1" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 1—figure
            supplement 1</a>). To infer causality from hormone receptor regulation, we performed
          RNA-sequencing (RNA-Seq) on mice lacking <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">Esr1</em> in skeletal muscle specifically
          (MERKO) and integrated these analyses with human myokine estimates. While myokines not
          regulated by <em itemscope="" itemtype="http://schema.stenci.la/Emphasis">Esr1</em> showed
          little sex-specific differences in expression, those which were estrogen-dependent showed
          much stronger representation of sex specificity, in particular in males (<a href="#fig1"
            itemscope="" itemtype="http://schema.stenci.la/Link">Figure 1F–G</a>). Among these was
          the master regulator of skeletal muscle differentiation and proliferation, myostatin
          (MSTN), where hormone receptor correlations and gene expression were markedly higher in
          males compared to females (<a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1H</a>). Further, ablation of <em
            itemscope="" itemtype="http://schema.stenci.la/Emphasis">Esr1</em> in mice uniquely
          drove expression changes in males (<a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1H</a>). These data suggest interactions
          between biological sex and ESR1 to tightly regulate <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">MSTN</em> in males, where other factors
          could contribute more in females. Given that, like many bioactive secreted proteins, the
          regulation and sex specificity of myostatin are additionally controlled via
          post-transcriptional mechanisms <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib19"><span>19</span><span>McMahon et
                al.</span><span>2003</span></a></cite>, we next explored gene expression changes at
          the protein level. Immunoblots were performed on skeletal muscle from male and female WT
          or MERKO mice (<a href="#fig1s2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1—figure supplement 2</a>).
          Quantification of the processed form of myostatin showed that, consistent with the RNA-Seq
          in mice and humans, the protein trended toward higher levels in male compared to female
          mice, where ablation of <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">Esr1</em> showed a reduction (<a
            href="#fig1" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 1I</a>).
          Dissimilar to the mouse sequencing data but consistent with human correlations, female
          MERKO mice showed a reduction in processed form of myostatin relative to their WT controls
          (<a href="#fig1" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 1I</a>).
          Related to the sex-specific regulation of myostatin observed at both RNA and protein
          levels, gene expression also showed differences in functional annotations. Here, the most
          highly enriched pathways in males showed GO terms related to glycolytic metabolism (<a
            href="#fig1" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 1J</a>)
          compared to oxidative phosphorylation in females (<a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1K</a>). These observations are
          consistent with previous studies which note myostatin-dependent increases in muscle mass
          in males, but not females <span itemscope=""
            itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib19"><span>19</span><span>McMahon
                  et al.</span><span>2003</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a
                href="#bib21"><span>21</span><span>Reisz-Porszasz et
                  al.</span><span>2003</span></a></cite></span>, where estradiol signaling is
          suggested as a mechanism mediating these differences. These data demonstrate that,
          expression of most myokines are not different between genetic sexes; however, interactions
          between sex and hormone receptors likely play important roles in determining myokine
          regulation and local signaling.</p>
        <figure itemscope="" itemtype="http://schema.stenci.la/Figure" id="fig1" title="Figure 1.">
          <label data-itemprop="label">Figure 1.</label><img src="index.html.media/fig1.jpg" alt=""
            itemscope="" itemtype="http://schema.org/ImageObject">
          <figcaption>
            <h4 itemscope="" itemtype="http://schema.stenci.la/Heading"
              id="sex-and-hormone-effects-on-myokine-regulation">Sex and hormone effects on myokine
              regulation.</h4>
            <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">(<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">A</strong>) Overall study design for
              integration of gene expression from muscle from 310 humans, single-cell RNA-sequencing
              (RNA-seq), muscle-specific deletion of <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">Esr1</em> to infer interorgan
              coregulatory process across major metabolic tissues. (B–C) Differential expression
              analysis for sex was performed on all genes corresponding to secreted proteins in
              skeletal muscle (myokines). The specific genes which showed significant changes in
              each sex are shown as a volcano plot (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">B</strong>) and the relative proportions
              of myokines corresponding to each category at a least-stringent logistic regression
              p-value less than 0.05 (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">C</strong>). (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">D</strong>) For each differential
              expression category based on sex shown in C, myokines were correlated with all other
              muscle genes for pathway enrichment. Then the top 10 enriched pathways in males,
              females, or non-sex specific (by overall significance) were visualized together where
              number of genes corresponding to each category shown as a relative proportion.
              (<strong itemscope="" itemtype="http://schema.stenci.la/Strong">E</strong>) The same
              analysis as in D, except instead of myokines being correlated with <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">AR, ESR1</em>, both hormone receptors,
              or neither, as compared to correlating with all genes. (F–G) Myokines were binned into
              two categories based on significant differential expression (logistic regression
              adjusted p-value &lt; 0.05) between muscle-specific WT and MERKO mice (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">F</strong>) or those that
              showed no change (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">G</strong>), then visualized as relative
              proportions within each category shown in (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">C</strong>). (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">H</strong>) Midweight bicorrelation
              (bicor) coefficients (color scheme) and corresponding regression p-values (filled
              text) are shown for muscle <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">MSTN</em> ~<em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">ESR1</em> or <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">AR</em> in both sexes (top). Below,
              correlations are shown for differential expression log2FC (color scheme) and
              corresponding logistic regression p-values (text fill) for <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">MSTN</em> between sexes in humans or WT
              vs. MERKO mice. (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">I</strong>) Quantification of processed
              form of myostatin (<a href="#fig1s2" itemscope=""
                itemtype="http://schema.stenci.la/Link">Figure 1—figure supplement 2</a>, bottom
              band) relative to β-actin in WT or MERKO muscle in male or female mice. p-Values
              calculated using a Student’s t-test. (J–K) The top three pathways of genes which
              significantly (p &lt; 1e-4) correlated with muscle <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">MSTN</em> in males (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">J</strong>) or females (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">K</strong>). For human data,
              n = 210 males and n = 100 females. For mouse MERKO vs. WT comparisons, n = 3 mice per
              group per sex. p-Values from midweight bicorrelations were calculated using the
              Student’s p-value from WGCNA and logistic regression p-values were calculated using
              DESeq2.</p>
          </figcaption>
        </figure>
        <figure itemscope="" itemtype="http://schema.stenci.la/Figure" id="fig1s1"
          title="Figure 1—figure supplement 1."><label data-itemprop="label">Figure 1—figure
            supplement 1.</label><img src="index.html.media/fig1-figsupp1.jpg" alt="" itemscope=""
            itemtype="http://schema.org/ImageObject">
          <figcaption>
            <h4 itemscope="" itemtype="http://schema.stenci.la/Heading"
              id="skeletal-muscle-sex-hormone-receptor-expression-between-sexes">Skeletal muscle sex
              hormone receptor expression between sexes.</h4>
            <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Normalized gene expression
              levels for androgen receptor (AR) or estrogen receptor (ESR1) (y-axis) in each sex
              (x-axis). None of the expression levels were significantly different between sexes
              (Student’s t-test).</p>
          </figcaption>
        </figure>
        <figure itemscope="" itemtype="http://schema.stenci.la/Figure" id="fig1s2"
          title="Figure 1—figure supplement 2."><label data-itemprop="label">Figure 1—figure
            supplement 2.</label><img src="index.html.media/fig1-figsupp2.jpg" alt="" itemscope=""
            itemtype="http://schema.org/ImageObject">
          <figcaption>
            <h4 itemscope="" itemtype="http://schema.stenci.la/Heading"
              id="immunoblot-for-myostatin-in-edl-muscle-from-wt-and-merko-male-and-female-mice">
              Immunoblot for myostatin in EDL muscle from WT and MERKO male and female mice.</h4>
            <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Full immunoblots shown for
              skeletal muscle lysate blotted for myostatin (top) or β-actin (bottom) corresponding
              to different C57BL/6J male (left) or female (right) mice in either WT (floxed) or KO
              (floxed-cre) for skeletal muscle <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">Esr1</em>. Band sizes shown to indicate
              either precursor (top band) or processed/LAP form (bottom band) of myostatin.</p>
          </figcaption>
        </figure>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="sex-dominates-cross-tissue-pathways-enriched-for-myokines">Sex dominates cross-tissue
          pathways enriched for myokines</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Given that expression levels of
          most myokines appeared similar between sexes, we next assessed putative functions across
          organs. We applied a statistical method developed to infer cross-tissue signaling which
          occur as a result of genetic variation <span itemscope=""
            itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib25"><span>25</span><span>Seldin
                  et al.</span><span>2018</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib26"><span>26</span><span>Seldin
                  and Lusis</span><span>2019</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib27"><span>27</span><span>Seldin
                  et al.</span><span>2019</span></a></cite></span>. Here, we assayed the
          distribution of midweight bicorrelation coefficients between myokine expression levels and
          global gene expression in key metabolic tissues including hypothalamus, heart, intestine,
          pancreas, liver, subcutaneous, and visceral adipose tissue. Remarkably, nearly all highly
          significant correlations between myokines and target organ genes (putative direct
          interactions) showed sex-specific modes of operation (<a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2A–H</a>). This sex specificity also
          appeared more pronounced for positive correlations between myokines and target tissue
          genes, as compared to negative (<a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2H</a>). Further, among these significant
          cross-tissue circuits, hormone receptor enrichments for these myokines were strongly
          dependent on the category (e.g. significant only in females) rather than target tissue (<a
            href="#fig2" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 2A–H</a>). This
          observation further suggests that hormone receptor levels (ESR1 or AR) in muscle are a
          stronger determinant of myokine expression compared to genetic sex; however, sex is
          suggested to dominate coregulated signaling processes across organs via myokines. To gauge
          the relative impact of muscle steroid hormone receptors across organs, the number of
          significant correlations between <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">ESR1</em>, <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">AR,</em> or both were quantified from muscle
          to each tissue. Here, <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">ESR1</em> showed an order of magnitude
          stronger enrichment across metabolic tissues compared to <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">AR</em> or correlation with both hormone
          receptors (<a href="#fig2" itemscope="" itemtype="http://schema.stenci.la/Link">Figure
            2I–J</a>). Additionally, the number of significantly correlated cross-tissue male <em
            itemscope="" itemtype="http://schema.stenci.la/Emphasis">ESR1</em> genes (<a
            href="#fig2" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 2I</a>) was
          threefold higher than females (<a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2J</a>). Because both sex and ESR1
          signaling appeared to contribute to the regulation and functions of myokines, significant
          cross-tissue enrichments were binned into categories taking into consideration whether
          myokines were driven by ESR1 in muscle, and/or showing a sex-specific mode of cross-organ
          significance. This analysis suggested that a majority of myokines were either driven by
          ESR1 and signaled robustly across sexes (<a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2K</a>, yellow) or signaled differently
          between sexes, but regulated independent of ESR1 (<a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2K</a>, red). These categories appeared
          to a much greater extent compared to a combination of both <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">ESR1</em>-driven myokine and sex-specific
          cross-tissue signaling (<a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2K</a>, beige) or neither (<a
            href="#fig2" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 2K</a>,
          seagreen). One notable example of predicted sex-specific signaling was observed for tumor
          necrosis factor alpha (TNFA). When compared between sexes, muscle <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">TNFA</em> showed markedly different putative
          target tissues (<a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2L</a>, left), as well as underlying
          functional pathways (<a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2L</a>, right). For example, overall
          inflammatory processes engaged by TNFA were stronger in adipose tissue in females;
          however, the same pathways were higher in liver and hypothalamus in males (<a href="#fig2"
            itemscope="" itemtype="http://schema.stenci.la/Link">Figure 2L</a>, left). Collectively,
          these data show that genetic sex and related sex steroid hormones, particularly estradiol,
          exert dominant roles in regulating predicted tissue and pathway engagement by myokines.
        </p>
        <figure itemscope="" itemtype="http://schema.stenci.la/Figure" id="fig2" title="Figure 2.">
          <label data-itemprop="label">Figure 2.</label><img src="index.html.media/fig2.jpg" alt=""
            itemscope="" itemtype="http://schema.org/ImageObject">
          <figcaption>
            <h4 itemscope="" itemtype="http://schema.stenci.la/Heading"
              id="sex-and-hormone-effects-on-myokine-regulation-1">Sex and hormone effects on
              myokine regulation.</h4>
            <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">(<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">A–H</strong>) Key illustrating analysis
              for distribution of midweight bicorrelation coefficients between all myokines in
              skeletal muscle and global transcriptome measures in each target tissue. Coefficients
              are plotted between sexes (left), where proportions for 2SD &gt; mean are subdivided
              into occurrence uniquely in females, males, or shared (middle). The significant (2SD
              &gt; mean) myokines identified in each category were then binned into hormone receptor
              correlations for <em itemscope="" itemtype="http://schema.stenci.la/Emphasis">ESR1,
                AR,</em> both, or neither (right). This analysis was performed on all myokines
              across subcutaneous adipose tissue (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">B</strong>), visceral adipose (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">C</strong>), heart (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">D</strong>), hypothalamus
              (<strong itemscope="" itemtype="http://schema.stenci.la/Strong">E</strong>), small
              intestine (<strong itemscope="" itemtype="http://schema.stenci.la/Strong">F</strong>),
              liver (<strong itemscope="" itemtype="http://schema.stenci.la/Strong">G</strong>), and
              pancreas (<strong itemscope="" itemtype="http://schema.stenci.la/Strong">H</strong>).
              (<strong itemscope="" itemtype="http://schema.stenci.la/Strong">I–J</strong>)
              Significant cross-tissue correlations between muscle <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">ESR1, AR,</em> or both hormone receptors
              are colored by tissue and shown for males (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">I</strong>) or females (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">J</strong>). (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">K</strong>) For each tissue
              (y-axis), the ratio of significant cross-tissue correlations per muscle myokine
              (x-axis) are shown and colored by categories of either the myokine regulated by <em
                itemscope="" itemtype="http://schema.stenci.la/Emphasis">ESR1</em> and/or a
              significant target tissue regression occurring specifically in one sex. (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">L</strong>) Number of
              significant cross-tissue correlations with muscle <em itemscope=""
                itemtype="http://schema.stenci.la/Emphasis">TNFα</em> are shown for each sex and
              colored by tissue as in I–L (left). The −log10(p-value) of significance in an
              overrepresentation test (x-axis) are shown for top significant inter-tissue pathways
              for muscle TNFα in each sex (right).</p>
          </figcaption>
        </figure>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="muscle-cell-proportions-are-similar-between-sexes-but-associated-changes-across-tissues-show-sex-specificity">
          Muscle cell proportions are similar between sexes, but associated changes across tissues
          show sex specificity</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">To determine the potential
          impact of muscle composition on other tissues, we next surveyed muscle cellular
          proportions in the context of genetics and sex. Single-cell sequencing of human skeletal
          muscle <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib23"><span>23</span><span>Rubenstein et
                al.</span><span>2020</span></a></cite> was integrated using cellular deconvolution
          <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib4"><span>4</span><span>Danziger et al.</span><span>2019</span></a></cite> to
          roughly estimate cellular composition in the population (<a href="#fig3" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 3A</a>). Here, a proportion in admixture
          approach <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib12"><span>12</span><span>Langfelder and
                Horvath</span><span>2008</span></a></cite> outperformed other methods (<a
            href="#fig3s1" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 3—figure
            supplement 1</a>) to capture a majority of established cell populations across
          individuals (<a href="#supp2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Supplementary file 2</a>). Similar to myokine
          expression, no notable differences were observed between sexes in terms of cell
          composition, with the exception of modest higher glycolytic fiber in males, compared to
          elevated oxidative fiber levels in females (<a href="#fig3" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 3B</a>). Additionally, no differences
          were observed in the correlations within muscle between compositions (<a href="#fig3s2"
            itemscope="" itemtype="http://schema.stenci.la/Link">Figure 3—figure supplement 2</a>);
          however, nearly every cross-tissue enrichment corresponding to an individual muscle cell
          type differed between sexes (<a href="#fig3" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 3C</a>). Generally, differences in
          skeletal muscle cell abundance was associated with changes in liver and visceral adipose
          tissue pathways in males, compared to pancreas in females (<a href="#fig3" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 3C</a>). In contrast to general myokine
          enrichments, cell proportions showed stronger correlations with <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">AR</em> when compared to <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">ESR1</em> across both sexes where the most
          abundant cell types were significantly enriched for both steroid hormone receptors (<a
            href="#fig3" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 3D</a>). To
          uncover potential direct mechanisms linking changes in cell composition to peripheral
          tissues, we correlated all myokines with cell composition profiles. Again, despite few
          differences between sexes in terms of myokine expression and cell composition, specific
          myokines highly correlating with individual cell types were markedly different between
          males and females with the exception of one, <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">APOD</em> in slow-twitch fibers (<a
            href="#fig3" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 3E</a>). To
          determine if variation in cell compositions corresponding to sex-specific tissue signaling
          via myokines was predicted to be likely, we implemented adjusted regression mediation
          analyses <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib33"><span>33</span><span>Yokota et al.</span><span>2020</span></a></cite>
          for glycolytic fiber composition. Because male glycolytic fiber-type abundance was
          selectively enriched for liver pathways such as immune cell activation and regulated
          exocytosis (<a href="#fig3" itemscope="" itemtype="http://schema.stenci.la/Link">Figure
            3F</a>), the top genes driving these enrichments were used for mediation. The
          top-correlated muscle secreted protein with male glycolytic fiber-type levels was secreted
          glutathione peroxidase 3 (GPX3). Here, adjusting regressions between glycolytic fiber and
          liver pathways on <em itemscope="" itemtype="http://schema.stenci.la/Emphasis">GPX3</em>
          reduced the overall significance across tissues (<a href="#fig3" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 3G</a>), suggesting GPX3 as a potential
          mediator of this communication. These data point to a potential mechanism whereby muscle
          fiber abundance could buffer free radical generation in the liver, thereby feeding back on
          inflammation. This analysis appeared additionally sensitive to inferring non-dependent
          relationships between muscle cell types, top-ranked myokines, and cross-tissue processes.
          For example, female glycolytic fibers were strongly enriched for pancreatic protein
          synthesis pathways; however, when adjusted for the top-ranked myokine <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">CES4A</em>, no changes in regression
          significance were observed (<a href="#fig3" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 3F–G</a>). These analyses suggest that
          male GPX3 is a potential mechanism whereby fast-twitch muscle signals to liver; however,
          the same cell type in females are predicted to drive pancreas protein synthesis
          independent of CES4A. In summary, we show that cell composition is strongly conserved
          between sexes, but putative cross-tissue signaling of altered composition differs
          entirely. We further suggest putative myokines and mechanisms, as well as highlight the
          key regulatory roles of estrodiol in both sexes.</p>
        <figure itemscope="" itemtype="http://schema.stenci.la/Figure" id="fig3" title="Figure 3.">
          <label data-itemprop="label">Figure 3.</label><img src="index.html.media/fig3.jpg" alt=""
            itemscope="" itemtype="http://schema.org/ImageObject">
          <figcaption>
            <h4 itemscope="" itemtype="http://schema.stenci.la/Heading"
              id="genetic-variation-of-muscle-cell-proportions-and-coregulated-cross-tissue-processes">
              Genetic variation of muscle cell proportions and coregulated cross-tissue processes.
            </h4>
            <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">(<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">A</strong>) Uniform Manifold Approximation
              and Projection (UMAP) for skeletal muscle single-cell sequencing used to deconvolute
              proportions. (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">B</strong>) Mean relative proportions of
              pseudo-single-cell muscle cell compositions (denoted by color) between sexes. (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">C</strong>) Number of
              significant cross-tissue correlations (y-axis) corresponding to each skeletal muscle
              type in each sex (x-axis). Target tissues are distinguished by color, where NS (male
              platelets) denotes that no significant cross-tissue correlations were observed.
              (<strong itemscope="" itemtype="http://schema.stenci.la/Strong">D</strong>) Heatmap
              showing significance of correlations between skeletal muscle hormone receptors and
              cell proportions, * = p &lt; 0.01. (<strong itemscope=""
                itemtype="http://schema.stenci.la/Strong">E</strong>) The strongest enriched
              myokines are plotted for each myokine (y-axis, −log10 p-value of myokine ~ cell
              composition) are shown for each muscle proportion for each sex (x-axis). Gene symbols
              for myokines are shown above each line, where red lines indicate positive correlations
              between myokine and cell type and blue shows inverse relationships. (<strong
                itemscope="" itemtype="http://schema.stenci.la/Strong">F</strong>) Significant
              cross-tissue correlated genes in liver (blue) and pancreas (purple) for muscle
              fast-twitch glycolytic fibers (p &lt; 1e-6) were used for overrepresentation tests
              where enrichment ratio of significance (x-axis) is shown for each pathway and sex
              (y-axis). (<strong itemscope="" itemtype="http://schema.stenci.la/Strong">G</strong>)
              Heatmap showing the regression significance of the top five genes corresponding to
              inflammation (liver), exocytosis (liver), and protein synthesis (pancreas) for
              proportions of fast-twitch fiber type (un-adj). Below each correlation between
              fast-twitch fiber and liver or pancreas gene, the same regressions were performed
              while adjusting for abundance of select myokines in each sex. * = p &lt; 1e-6.</p>
          </figcaption>
        </figure>
        <figure itemscope="" itemtype="http://schema.stenci.la/Figure" id="fig3s1"
          title="Figure 3—figure supplement 1."><label data-itemprop="label">Figure 3—figure
            supplement 1.</label><img src="index.html.media/fig3-figsupp1.jpg" alt="" itemscope=""
            itemtype="http://schema.org/ImageObject">
          <figcaption>
            <h4 itemscope="" itemtype="http://schema.stenci.la/Heading"
              id="comparisons-of-deconvolution-methods">Comparisons of deconvolution methods.</h4>
            <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Cell proportions were
              estimated from skeletal muscle sequencing across the 310 individuals in GTEx.</p>
            <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Here, comparisons of the
              three most common methods (DCQ, NNLS, and porportionsInAdmixture) were plotted for
              each pseudo-sc-proportion, where proportionsInAdmixture method captured the largest
              relative number of cell types.</p>
          </figcaption>
        </figure>
        <figure itemscope="" itemtype="http://schema.stenci.la/Figure" id="fig3s2"
          title="Figure 3—figure supplement 2."><label data-itemprop="label">Figure 3—figure
            supplement 2.</label><img src="index.html.media/fig3-figsupp2.jpg" alt="" itemscope=""
            itemtype="http://schema.org/ImageObject">
          <figcaption>
            <h4 itemscope="" itemtype="http://schema.stenci.la/Heading"
              id="cell-composition-correlations-within-each-sex">Cell composition correlations
              within each sex.</h4>
            <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Heatmaps showing
              regressions for cell proportions in males (left) or females (right), * = regression
              p-value &lt; 0.01.</p>
          </figcaption>
        </figure>
        <h2 itemscope="" itemtype="http://schema.stenci.la/Heading" id="discussion">Discussion</h2>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Here, we provide a population
          survey of skeletal muscle myokine regulation and putative functions using genetic
          variation and multi-tissue gene expression data. We find that in general, expression of
          myokines do not significantly differ between sexes; however, inferred signaling mechanisms
          across tissues using regressions show strong sex specificity. Steroid hormone receptors,
          in particular <em itemscope="" itemtype="http://schema.stenci.la/Emphasis">ESR1</em>, is
          highlighted as a key regulator of myokines and potentially interacting with biological sex
          for proteins such as myostatin. Further integration with loss-of-function mouse models of
          <em itemscope="" itemtype="http://schema.stenci.la/Emphasis">Esr1</em> highlighted the key
          roles of estradiol signaling in muscle in terms of myokine regulation and signaling across
          both sexes. Generation of pseudo-single-cell maps of muscle composition showed that, like
          myokines, muscle proportions are conserved between sexes, but inferred interorgan
          consequences differ substantially. When interpreting these findings, several
          considerations should be taken. While inter-tissue regression analyses have been
          informative to dissect mechanisms of endocrinology <span itemscope=""
            itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib25"><span>25</span><span>Seldin
                  et al.</span><span>2018</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib26"><span>26</span><span>Seldin
                  and Lusis</span><span>2019</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib27"><span>27</span><span>Seldin
                  et al.</span><span>2019</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib13"><span>13</span><span>Li and
                  Auwerx</span><span>2020</span></a></cite></span>, observations can be subjected to
          spurious or latent relationships in the data. While causality for inter-organ signaling
          can be inferred statistically using approaches such as mediation as in <a href="#fig3"
            itemscope="" itemtype="http://schema.stenci.la/Link">Figure 3H</a>, the only methods to
          provide definitive validation for new mechanisms are in experimental settings. Further,
          our current analyses rely on gene expression to guide functions of proteins which are
          typically strongly regulated by post-transcriptional processes. As shown for myostatin (<a
            href="#fig1" itemscope="" itemtype="http://schema.stenci.la/Link">Figure 1</a>), gene
          expression analyses can miss key functional aspects of proteins, where follow-up studies
          and resources focused on protein and subsequent modification levels could heavily improve
          predictions. In addition, we anticipate that estimates for ESR1 effects on myokines in
          this study likely represent an underestimated number of all human ESR1-driven myokines.
          One limitation here includes that annotation of known orthologous mouse-human genes <cite
            itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib29"><span>29</span><span>The Alliance of Genome Resources
                Consortium</span><span>2020</span></a></cite> remains somewhat limited. Furthermore,
          cell composition estimates from single-cell sequencing data are inferred from gene
          expression, where histological or flow cytometry-based methods can provide much more
          accurate direct quantifications. Clearly, morphological and structural differences between
          sexes have been observed in humans <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib7"><span>7</span><span>Haizlip et
                al.</span><span>2015</span></a></cite> which, if not apparent in deconvoluted gene
          expression, would be missed in this analysis. Future studies addressing these points will
          help to clarify context- and mechanism-relevant muscle-derived endocrine communication
          axes. In summary, this study highlights the key contributions of sex and sex steroid
          hormones in mediating myokine functions.</p>
        <h2 itemscope="" itemtype="http://schema.stenci.la/Heading" id="materials-and-methods">
          Materials and methods</h2>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">All datasets used, R scripts
          implemented for analyses, and detailed walkthrough guide is available via: <a
            href="https://github.com/Leandromvelez/myokine-signaling" itemscope=""
            itemtype="http://schema.stenci.la/Link">https://github.com/Leandromvelez/myokine-signaling</a>,
          (copy archived at <a
            href="https://archive.softwareheritage.org/swh:1:dir:f85e39fc6a9e5925b66376dc77f748cfc76489b2;origin=https://github.com/Leandromvelez/myokine-signaling;visit=swh:1:snp:2a361a2495b23946ffe3e2d9eb10c9db3e371db2;anchor=swh:1:rev:530dc39df1c586ad67eab36688fa2c1936b06354"
            itemscope=""
            itemtype="http://schema.stenci.la/Link">swh:1:rev:530dc39df1c586ad67eab36688fa2c1936b06354</a>;
          <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib31"><span>31</span><span>Velez and
                Seldin</span><span>2022</span></a></cite>).</p>
        <table id="keyresource" itemscope="" itemtype="http://schema.org/Table">
          <caption><label data-itemprop="label">Key resources table</label></caption>
          <thead>
            <tr itemscope="" itemtype="http://schema.stenci.la/TableRow">
              <th itemscope="" itemtype="http://schema.stenci.la/TableCell">Reagent type (species)
                or resource</th>
              <th itemscope="" itemtype="http://schema.stenci.la/TableCell">Designation</th>
              <th itemscope="" itemtype="http://schema.stenci.la/TableCell">Source or reference</th>
              <th itemscope="" itemtype="http://schema.stenci.la/TableCell">Identifiers</th>
              <th itemscope="" itemtype="http://schema.stenci.la/TableCell">Additional information
              </th>
            </tr>
          </thead>
          <tbody>
            <tr itemscope="" itemtype="http://schema.stenci.la/TableRow">
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">Antibody</td>
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">Anti-MSTN(Goat
                polyclonal)</td>
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">R&amp;D</td>
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">AF788</td>
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">(1:1000)</td>
            </tr>
            <tr itemscope="" itemtype="http://schema.stenci.la/TableRow">
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">Antibody</td>
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">Rabbit
                anti-βactin(Rabbit polyclonal)</td>
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">Genetex</td>
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">GTX109639</td>
              <td itemscope="" itemtype="http://schema.stenci.la/TableCell">(1:1000)</td>
            </tr>
          </tbody>
        </table>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading" id="animals">Animals</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">All mice used in this study
          were approved by the University of California Los Angeles (UCLA) Animal Care and Use
          Committee, in accordance with Public Health Service guidelines with reference #92-169.</p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="data-sources-and-availability">Data sources and availability</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">All data used in this study can
          be immediately accessed via GitHub to facilitate analysis. Human skeletal muscle and
          metabolic tissue data were accessed through GTEx V8 downloads portal on August 18, 2021,
          and previously described <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib1"><span>1</span><span>Battle et al.</span><span>2017</span></a></cite>. To
          enable sufficient integration and cross-tissue analyses, these data were filtered to
          retain genes which were detected across tissues where individuals were required to show
          counts &gt;0 in 1.2e6 gene-tissue combinations across all data. Given that our goal was to
          look across tissues at enrichments, this was done to limit spurious influence of genes
          only expressed in specific tissues in specific individuals. Post-filtering consists of 310
          individuals and 1.8e7 gene-tissue combinations. Single-cell sequencing from skeletal
          muscle used for deconvolution was obtained from <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib23"><span>23</span><span>Rubenstein
                et al.</span><span>2020</span></a></cite>. <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">Esr1</em> WT and KO mouse differential
          expression results are available on GitHub as well, where raw sequencing data has been
          deposited in NIH sequence read archive (SRA) under the project accession: PRJNA785746.</p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="selection-of-secreted-proteins">Selection of secreted proteins</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">To determine which genes encode
          proteins known to be secreted as myokines, gene lists were accessed from the Universal
          Protein Resource which has compiled literature annotations terms for secretion <cite
            itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib30"><span>30</span><span>The UniProt
                Consortium</span><span>2021</span></a></cite>. Specifically, the query terms to
          access these lists were: locations:(location:&quot;Secreted [SL-0243]&quot;
          type:component) AND organism:&quot;<em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">Homo sapiens</em> (Human) <span itemscope=""
            itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib9"><span>9</span><span>Kim et
                  al.</span><span>2021</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a
                href="#ref606">ref606</a></cite></span>&quot; where 3666 total entries were found.
        </p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="differential-expression-of-myokines-dependent-on-sex">Differential expression of
          myokines dependent on sex</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Gene expression counts matrices
          were isolated from the rest of the tissues, where individual genes were retained if the
          total number of counts exceeded 10 in 50 individuals. Next, only genes encoding secreted
          proteins (above) were retained, where logistic regression contrasted on sex was performed
          using DESeq2. Differential expression summary statistics were used for downstream binning
          of sex specificity based on an empirical logistic regression p-value &lt; 0.05. This
          threshold was used to reflect a least stringent cutoff where, despite potential false
          positive influence, genes which nominally trended toward sex-specific expression could be
          included in those categories. Given that the general conclusions supported very few
          proportions of myokines showing sex-specific patterns of expression, this conclusion would
          only be further exaggerated if the differential expression threshold were made more
          stringent and lessened the number of myokines in each category.</p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="regression-analyses-across-tissues">Regression analyses across tissues</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Regression coefficients and
          corresponding p-values across tissues were generated using WGCNA bicorandpvalue() function
          <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib12"><span>12</span><span>Langfelder and
                Horvath</span><span>2008</span></a></cite>. Myokine-target gene pairs were
          considered significant (e.g. <a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2A–H</a>) at a threshold of abs(bicor)
          &gt; 2 standard deviations beyond the average coefficient for the given target tissue of
          interest. In previous studies, this threshold of 2 standard deviations reflects adaptive
          permutation testing p-values &lt; 0.01 <span itemscope=""
            itemtype="http://schema.stenci.la/CiteGroup"><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib25"><span>25</span><span>Seldin
                  et al.</span><span>2018</span></a></cite><cite itemscope=""
              itemtype="http://schema.stenci.la/Cite"><a href="#bib26"><span>26</span><span>Seldin
                  and Lusis</span><span>2019</span></a></cite></span>. For analyses estimating
          cumulative patterns of concordance across tissues (e.g. <a href="#fig2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 2I–L</a>), empirical regression p-values
          (Student’s p-value from bicor coefficients) of 0.01 (corresponding to abs(bicor) &gt; 0.1)
          were used to assay global patterns. While usage of empirical p-values are clearly
          subjected to false positives, these were used for several analyses to capture broad
          visualization of both potential direct interactions which would show significance across
          multiple FDR thresholds (e.g. myokine-target gene), as well as coregulated indirect
          processes across organs. Thus, assessing cumulative changes as a result of larger
          physiologic shifts. It is important to note that we exclusively rely on these empirical
          p-values when surveying broad correlation structures, whereas much more stringent and
          appropriate thresholds (e.g. p &lt; 1e-6 for <a href="#fig3" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 3G</a>) were applied when inferring
          direct interactions.</p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="pathway-enrichment-analyses">Pathway enrichment analyses</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">For <a href="#fig1"
            itemscope="" itemtype="http://schema.stenci.la/Link">Figures 1I</a> and <a href="#fig3"
            itemscope="" itemtype="http://schema.stenci.la/Link">3G</a>, genes corresponding to
          p-value cutoffs were visualized using Webgestalt <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib15"><span>15</span><span>Liao et
                al.</span><span>2019</span></a></cite> to enable streamline analysis. This tool
          enabled simultaneous overrepresentation testing of GO:BP (non-redundant), KEGG, and
          Panther databases. For <a href="#fig1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 1D</a>, the top 1000 (by regression
          p-value) significant genes from myokines to all muscle bicorrelation analysis in females,
          males, or non-sex specific datasets were assessed for enrichment in GO Biological Process
          terms using ClusterProfiler v4.0.2 in R <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib32"><span>32</span><span>Wu et
                al.</span><span>2021</span></a></cite>. The resulting top 10 GO terms in each
          dataset were integrated and plotted against the relative proportion of the p-adjusted
          value and visualized in the same graph using ggplot2.</p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="deconvolution-of-skeletal-muscle">Deconvolution of skeletal muscle</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Raw single-cell RNA-sequencing
          from skeletal muscle was obtained from <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib23"><span>23</span><span>Rubenstein
                et al.</span><span>2020</span></a></cite>. These raw counts were analyzed in Seurat
          where cluster analyses identified variable cell compositions. Cell type annotations were
          assigned based on the top 30 genes (<a href="#supp2" itemscope=""
            itemtype="http://schema.stenci.la/Link">Supplementary file 2</a>) assigned to each
          Uniform Manifold Approximation and Projection (UMAP) cluster through manual inspection and
          ENRICHR <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib11"><span>11</span><span>Kuleshov et al.</span><span>2016</span></a></cite>.
          Finally, a normalized matrix of gene:cells was exported from Seurat and used to run
          deconvolution on skeletal muscle bulk sequencing. Using the ADAPTS pipeline <cite
            itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib4"><span>4</span><span>Danziger et al.</span><span>2019</span></a></cite>,
          three deconvolution methods (nnls, dcq, or proportions in admixture) were compared based
          on ability to robustly capture cell proportions (<a href="#fig3s1" itemscope=""
            itemtype="http://schema.stenci.la/Link">Figure 3—figure supplement 1</a>), where
          proportion in admixture showed the best performance and subsequently applied to bulk
          sequencing.</p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="esr1-muscle-ko-generation-rna-seq-and-integration-with-human-data">ESR1 muscle KO
          generation, RNA-Seq, and integration with human data</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Muscle-specific Esr1 deletion
          was generated and characterized as previously described <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib22"><span>22</span><span>Ribas et
                al.</span><span>2016</span></a></cite>. Whole quadriceps was pulverized at the
          temperature of liquid nitrogen. Tissue was homogenized in Trizol (Invitrogen, Carlsbad,
          CA), RNA was isolated using the RNeasy Isolation Kit (Qiagen, Hilden, Germany), and then
          tested for concentration and quality with samples where RIN &gt; 7.0 used in downstream
          applications. Libraries were prepared using KAPA mRNA HyperPrep Kits and KAPA Dual Index
          Adapters (Roche, Basel, Switzerland) per manufacturer’s instructions. A total of 800–1000
          ng of RNA was used for library preparation with settings 200–300 bp and 12 PCR cycles. The
          resultant libraries were tested for quality. Individual libraries were pooled and
          sequenced using a HiSeq 3000 at the UCLA Technology Center for Genomics and Bioinformatics
          (TCGB) following in-house established protocols. Raw RNA-Seq reads were inspected for
          quality using FastQC v0.11.9 (Barbraham Institute, Barbraham, England). Reads were aligned
          and counted using the Rsubread v2.0.0 <cite itemscope=""
            itemtype="http://schema.stenci.la/Cite"><a href="#bib14"><span>14</span><span>Liao et
                al.</span><span>2019</span></a></cite> package in R v3.6 against the Ensembl mouse
          transcriptome (v97) to obtain counts. Lowly expressed genes (&gt;80% samples with 0 count
          for particular gene) were removed. Samples were analyzed for differential expression using
          DeSeq2 v1.28.0 <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib16"><span>16</span><span>Love et al.</span><span>2014</span></a></cite>.</p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading"
          id="conservation-of-gene-between-mice-and-humans">Conservation of gene between mice and
          humans</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">To find which myokines and
          pathways were conserved between mice and humans, all orthologous genes were accessed from
          MGI vertebrate homology datasets, which have been compiled from the Alliance for Genome
          Resources <cite itemscope="" itemtype="http://schema.stenci.la/Cite"><a
              href="#bib29"><span>29</span><span>The Alliance of Genome Resources
                Consortium</span><span>2020</span></a></cite> and intersected at the gene level
          (roughly 18,000 genes).</p>
        <h3 itemscope="" itemtype="http://schema.stenci.la/Heading" id="immunoblotting-procedures">
          Immunoblotting procedures</h3>
        <p itemscope="" itemtype="http://schema.stenci.la/Paragraph">Muscle tissue was homogenized
          in the TissueLyser II (Qiagen) at 4 °C in RIPA lysis buffer supplemented with protease
          inhibitors. The homogenate was centrifuged at 4 °C for 10  min at 10,000 <em itemscope=""
            itemtype="http://schema.stenci.la/Emphasis">g</em>, and the protein concentrations in
          the supernatant were measured by the BCA assay (Bio-Rad). After boiling protein samples
          for 5  min, 20 μg of protein from each sample were applied on an SDS-polyacrylamide gel
          (10%) and electrophoresis was performed at 100  V for 1.5  hr. The separated proteins were
          transferred to nitrocellulose membranes and membranes were blocked for 1.5  hr in TBS (4
           mM Tris-HCl, pH 7.5, and 100  mM NaCl) containing 5% skim milk plus Tween 20, at room
          temperature. Goat polyclonal anti-GDF8 (Myostatin) (R&amp;D, catalog number AF788) at
          1/1000 dilution were applied overnight as primary antibody. After washings, membranes were
          incubated with Goat IgG HRP-conjugated Antibody (R&amp;D HAF017) at 1/10,000 for 2 hr, and
          bound HRP activity was detected with an enhanced chemiluminescence method (Clarity Western
          ECL, Bio-Rad), by means of a chemiluminescence detection system (ChemiDoc System,
          Bio-Rad). The intensities of the resulting bands were quantified by densitometry (ImageJ
          free software). Membranes were immersed in a stripping solution for 10 min (Restore PLUS
          Western Blot, Thermo Fisher), and then the process repeated with a rabbit polyclonal
          anti-β-actin (GeneTex GTX109639) at 1/1000 dilution as loading control to assess
          uniformity of loading.</p>
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