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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Physiotherapy, Balneology and Rehabilitation</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Physiotherapy, Balneology and Rehabilitation</journal-title><trans-title-group xml:lang="ru"><trans-title>Физиотерапия, бальнеология и реабилитация</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1681-3456</issn><issn publication-format="electronic">2413-2969</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">676882</article-id><article-id pub-id-type="doi">10.17816/rjpbr676882</article-id><article-id pub-id-type="edn">VJHWLF</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Review</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Apoptosis Regulation in Skeletal Muscles: Effects of Physical Exercise and Bioactive Compounds</article-title><trans-title-group xml:lang="ru"><trans-title>Механизмы регуляции апоптоза в скелетных мышцах: влияние физических нагрузок и биоактивных соединений</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>骨骼肌细胞凋亡的调控机制： 体育锻炼与天然活性化合物的作用</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-5910-8739</contrib-id><name-alternatives><name xml:lang="en"><surname>Marzhanova</surname><given-names>Alina B.</given-names></name><name xml:lang="ru"><surname>Маржанова</surname><given-names>Алина Бекташевна</given-names></name><name xml:lang="zh"><surname>Marzhanova</surname><given-names>Alina B.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>murkudda@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-4535-4184</contrib-id><name-alternatives><name xml:lang="en"><surname>Lapitskaya</surname><given-names>Elizaveta K.</given-names></name><name xml:lang="ru"><surname>Лапицкая</surname><given-names>Елизавета Кирилловна</given-names></name><name xml:lang="zh"><surname>Lapitskaya</surname><given-names>Elizaveta K.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>liza.lapickaya@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-8692-4777</contrib-id><name-alternatives><name xml:lang="en"><surname>Sungurova</surname><given-names>Aminat</given-names></name><name xml:lang="ru"><surname>Сунгурова</surname><given-names>Аминат</given-names></name><name xml:lang="zh"><surname>Sungurova</surname><given-names>Aminat</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>Aammiiinnnkkaa@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4391-0218</contrib-id><contrib-id contrib-id-type="spin">2365-8824</contrib-id><name-alternatives><name xml:lang="en"><surname>Marzoeva</surname><given-names>Marina A.</given-names></name><name xml:lang="ru"><surname>Марзоева</surname><given-names>Марина Аркадиевна</given-names></name><name xml:lang="zh"><surname>Marzoeva</surname><given-names>Marina A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>marzoeva_m99@mail.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-3398-2721</contrib-id><name-alternatives><name xml:lang="en"><surname>Balagutdinova</surname><given-names>Regina I.</given-names></name><name xml:lang="ru"><surname>Балагутдинова</surname><given-names>Регина Илмиратовна</given-names></name><name xml:lang="zh"><surname>Balagutdinova</surname><given-names>Regina I.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>regina.balagutdinova@inbox.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-2164-044X</contrib-id><name-alternatives><name xml:lang="en"><surname>Nasyrova</surname><given-names>Aigul R.</given-names></name><name xml:lang="ru"><surname>Насырова</surname><given-names>Айгуль Равильевна</given-names></name><name xml:lang="zh"><surname>Nasyrova</surname><given-names>Aigul R.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>Shoning228@mail.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-2124-6064</contrib-id><name-alternatives><name xml:lang="en"><surname>Khasukhanova</surname><given-names>Taisa A.</given-names></name><name xml:lang="ru"><surname>Хасуханова</surname><given-names>Таиса Абубакаровна</given-names></name><name xml:lang="zh"><surname>Khasukhanova</surname><given-names>Taisa A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>borealis.k@mail.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-6636-533X</contrib-id><name-alternatives><name xml:lang="en"><surname>Kutlubaev</surname><given-names>Azat I.</given-names></name><name xml:lang="ru"><surname>Кутлубаев</surname><given-names>Азат Ильшатович</given-names></name><name xml:lang="zh"><surname>Kutlubaev</surname><given-names>Azat I.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>kutlubaev_2015@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-6699-3432</contrib-id><name-alternatives><name xml:lang="en"><surname>Ivanova</surname><given-names>Kristina S.</given-names></name><name xml:lang="ru"><surname>Иванова</surname><given-names>Кристина Сергеевна</given-names></name><name xml:lang="zh"><surname>Ivanova</surname><given-names>Kristina S.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>christina_ivanova01@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-4863-1957</contrib-id><name-alternatives><name xml:lang="en"><surname>Ispieva</surname><given-names>Diana S.</given-names></name><name xml:lang="ru"><surname>Испиева</surname><given-names>Диана Султановна</given-names></name><name xml:lang="zh"><surname>Ispieva</surname><given-names>Diana S.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ispievadiana@yandex.ru</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-2220-5174</contrib-id><name-alternatives><name xml:lang="en"><surname>Nalivaiko</surname><given-names>Anastasia S.</given-names></name><name xml:lang="ru"><surname>Наливайко</surname><given-names>Анастасия Сергеевна</given-names></name><name xml:lang="zh"><surname>Nalivaiko</surname><given-names>Anastasia S.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>Anastasia.Nalivaiko01@mail.ru</email><xref ref-type="aff" rid="aff6"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-0054-5747</contrib-id><contrib-id contrib-id-type="spin">7667-1390</contrib-id><name-alternatives><name xml:lang="en"><surname>Sukasyan</surname><given-names>Eduard A.</given-names></name><name xml:lang="ru"><surname>Сукасян</surname><given-names>Эдуард Аветисович</given-names></name><name xml:lang="zh"><surname>Sukasyan</surname><given-names>Eduard A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>sukasyan1999@bk.ru</email><xref ref-type="aff" rid="aff6"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-6314-6093</contrib-id><name-alternatives><name xml:lang="en"><surname>Bulgakova</surname><given-names>Polina A.</given-names></name><name xml:lang="ru"><surname>Булгакова</surname><given-names>Полина Александровна</given-names></name><name xml:lang="zh"><surname>Bulgakova</surname><given-names>Polina A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>pbulgakova75@gmail.com</email><xref ref-type="aff" rid="aff6"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-8382-6345</contrib-id><name-alternatives><name xml:lang="en"><surname>Fedotova</surname><given-names>Elizaveta A.</given-names></name><name xml:lang="ru"><surname>Федотова</surname><given-names>Елизавета Александровна</given-names></name><name xml:lang="zh"><surname>Fedotova</surname><given-names>Elizaveta A.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>crosszery2610200143@mail.ru</email><xref ref-type="aff" rid="aff7"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-4784-5997</contrib-id><name-alternatives><name xml:lang="en"><surname>Sattarov</surname><given-names>Danila D.</given-names></name><name xml:lang="ru"><surname>Саттаров</surname><given-names>Данила Дмитриевич</given-names></name><name xml:lang="zh"><surname>Sattarov</surname><given-names>Danila D.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>danila.sattarov@gmail.com</email><xref ref-type="aff" rid="aff5"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Rostov State Medical University</institution></aff><aff><institution xml:lang="ru">Ростовский государственный медицинский университет</institution></aff><aff><institution xml:lang="zh">Rostov State Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Orenburg State Medical University</institution></aff><aff><institution xml:lang="ru">Оренбургский государственный медицинский университет</institution></aff><aff><institution xml:lang="zh">Orenburg State Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">The First Sechenov Moscow State Medical University</institution></aff><aff><institution xml:lang="ru">Первый Московский государственный медицинский университет им. И.М. Сеченова</institution></aff><aff><institution xml:lang="zh">The First Sechenov Moscow State Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Pirogov Russian National Research Medical University</institution></aff><aff><institution xml:lang="ru">Российский национальный исследовательский медицинский университет им. Н.И. Пирогова</institution></aff><aff><institution xml:lang="zh">Pirogov Russian National Research Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">Bashkir State Medical University</institution></aff><aff><institution xml:lang="ru">Башкирский государственный медицинский университет</institution></aff><aff><institution xml:lang="zh">Bashkir State Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff6"><aff><institution xml:lang="en">Vernadsky Crimean Federal University</institution></aff><aff><institution xml:lang="ru">Крымский федеральный университет им. В.И. Вернадского</institution></aff><aff><institution xml:lang="zh">Vernadsky Crimean Federal University</institution></aff></aff-alternatives><aff-alternatives id="aff7"><aff><institution xml:lang="en">Volgograd State Medical University</institution></aff><aff><institution xml:lang="ru">Волгоградский государственный медицинский университет</institution></aff><aff><institution xml:lang="zh">Volgograd State Medical University</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2025-05-19" publication-format="electronic"><day>19</day><month>05</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2025-08-16" publication-format="electronic"><day>16</day><month>08</month><year>2025</year></pub-date><volume>24</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><issue-title xml:lang="zh"/><fpage>220</fpage><lpage>234</lpage><history><date date-type="received" iso-8601-date="2025-03-05"><day>05</day><month>03</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-03-24"><day>24</day><month>03</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2025,</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://eco-vector.com/for_authors.php#07</ali:license_ref></license></permissions><self-uri xlink:href="https://rjpbr.com/1681-3456/article/view/676882">https://rjpbr.com/1681-3456/article/view/676882</self-uri><abstract xml:lang="en"><p>Apoptosis is crucial for maintaining tissue homeostasis in skeletal muscles. However, its dysregulation due to obesity, type 2 diabetes mellitus, or aging can result in increased muscle degeneration, decreased functional capacity, and metabolic disorders. This article reviews the regulatory mechanisms of apoptosis in skeletal muscles and examines the effects of two key factors: physical exercise and natural bioactive compounds. Scientific data analysis confirms that both physical activity and bioactive compounds such as resveratrol, curcumin, and quercetin exert a pronounced anti-apoptotic effect by reducing oxidative stress, improving mitochondrial function, and modulating signaling pathways such as Bcl-2 and AMPK/SIRT1. When combined, these interventions demonstrate a synergistic effect, offering a promising approach to the prevention and treatment of sarcopenia, obesity, and associated metabolic diseases. Despite encouraging experimental findings, further clinical trials are needed to optimize physical activity protocols and identify the most effective combinations of natural compounds for preventing muscle atrophy and improving patients’ metabolic status.</p></abstract><trans-abstract xml:lang="ru"><p>Апоптоз играет важную роль в поддержании тканевого гомеостаза скелетных мышц. Однако при ожирении, сахарном диабете 2 типа и возрастных изменениях его дисрегуляция приводит к усиленной дегенерации мышц, снижению их функциональности и развитию метаболических нарушений. В данной статье рассмотрены механизмы регуляции апоптоза в скелетных мышцах и влияние на него двух ключевых факторов — физических упражнений и натуральных биологически активных соединений. Анализ научных данных подтверждает, что как физическая активность, так и биоактивные соединения, такие как ресвератрол, куркумин и кверцетин, оказывают выраженный антиапоптотический эффект за счёт снижения окислительного стресса, улучшения функции митохондрий и модуляции сигнальных путей Bcl-2 и AMPK/SIRT1. В сочетании эти вмешательства демонстрируют синергетическое воздействие, что делает их перспективным подходом к профилактике и лечению саркопении, ожирения и ассоциированных с ним метаболических заболеваний. Несмотря на многообещающие результаты экспериментальных исследований, требуется проведение дальнейших клинических испытаний для оптимизации протоколов физической активности и подбора наиболее эффективных комбинаций натуральных соединений с целью предотвращения мышечной атрофии и улучшения метаболического статуса пациентов.</p></trans-abstract><trans-abstract xml:lang="zh"><p>细胞凋亡在维持骨骼肌组织稳态中发挥着关键作用。然而，在肥胖、2型糖尿病及年龄相关变化的背景下，其调控机制可能发生紊乱，导致肌肉加速退化、功能减退以及代谢障碍的发展。本文综述了骨骼肌细胞凋亡的调控机制，重点探讨了两大关键因素——体育锻炼与天然生物活性化合物的影响。科学研究证实，体育锻炼以及白藜芦醇、姜黄素、槲皮素等天然活性化合物具有显著的抗细胞凋亡作用，其机制包括减轻氧化应激、改善线粒体功能和调控Bcl-2及AMPK/SIRT1信号通路。二者联用具有协同作用，是预防和治疗肌少症、肥胖及其相关代谢性疾病的有前景策略。尽管实验研究结果显示出良好前景，仍需进一步开展临床试验，以优化体育活动方案并筛选出最优天然活性化合物组合，以期预防肌肉萎缩并改善患者的代谢状况。</p></trans-abstract><kwd-group xml:lang="en"><kwd>apoptosis</kwd><kwd>skeletal muscles</kwd><kwd>physical exercise</kwd><kwd>natural compounds</kwd><kwd>resveratrol</kwd><kwd>curcumin</kwd><kwd>oxidative stress</kwd><kwd>mitochondria</kwd><kwd>obesity</kwd><kwd>type 2 diabetes mellitus</kwd><kwd>AMPK</kwd><kwd>SIRT1</kwd><kwd>Bcl-2</kwd><kwd>sarcopenia</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>апоптоз</kwd><kwd>скелетные мышцы</kwd><kwd>физические упражнения</kwd><kwd>натуральные соединения</kwd><kwd>ресвератрол</kwd><kwd>куркумин</kwd><kwd>окислительный стресс</kwd><kwd>митохондрии</kwd><kwd>ожирение</kwd><kwd>сахарный диабет 2 типа</kwd><kwd>AMPK</kwd><kwd>SIRT1</kwd><kwd>Bcl-2</kwd><kwd>саркопения</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>细胞凋亡</kwd><kwd>骨骼肌</kwd><kwd>体育锻炼</kwd><kwd>天然化合物</kwd><kwd>白藜芦醇</kwd><kwd>姜黄素</kwd><kwd>氧化应激</kwd><kwd>线粒体</kwd><kwd>肥胖</kwd><kwd>2型糖尿病</kwd><kwd>AMPK</kwd><kwd>SIRT1</kwd><kwd>Bcl-2</kwd><kwd>肌少症</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Dedov II, Shestakova MV, Melnichenko GA, et al. 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