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Acosta I, Hofer M, Hilton-Jones D, Squier W, Brady S. Treatment resistance in inclusion body myositis: the role of mast cells. Neuromuscul Disord 2024; 41:20-23. [PMID: 38865916 DOI: 10.1016/j.nmd.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/29/2024] [Accepted: 05/02/2024] [Indexed: 06/14/2024]
Abstract
Inclusion body myositis is the commonest acquired myopathy in those over 50 years of age. Although it is classified as an idiopathic inflammatory myopathy and the most frequent finding on muscle biopsy in inclusion body myositis is an endomysial inflammatory infiltrate, it is clinically distinct from other myositis, including a lack of response to immunosuppressive medication. Neurogenic changes are commonly reported in inclusion body myositis and inflammatory changes are observed in muscle following neurogenic injury. The objective of our study was to explore whether neurogenic inflammation plays a role in the pathogenesis of inclusion body myositis, possibly explaining its resistance to immunosuppression. The number of mast cells and presence of neuropeptides, substance P and calcitonin gene-related peptide, were assessed in 48 cases of inclusion body myositis, 11 cases of steroid responsive myositis, two cases of focal myositis associated with neurogenic injury, and ten normal controls. The number of mast cells in inclusion body myositis focal and myositis associated to neurogenic injury were significantly greater than that observed in steroid responsive myositis. Our findings suggest that neurogenic inflammation mediated through mast cells may play a role in the pathogenesis of inclusion body myositis, and focal myositis associated to neurogenic injury, and thus, explain in some part its lack of response to immunosuppressive treatments.
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Affiliation(s)
- I Acosta
- Neuropathology Department, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford OX3 9DU. United Kingdom; Translational neurology and neurophysiology laboratory (NODO lab), Advance clinical research centre (CICA). School of Medicine, Universidad de Chile, Providencia 7500787, Santiago Chile; Neurology and Psychiatry Department, Clínica Alemana Santiago, Vitacura, Santiago 7650568, Santiago Chile.
| | - M Hofer
- Neuropathology Department, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford OX3 9DU. United Kingdom
| | - D Hilton-Jones
- Oxford Muscle Service, Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford OX3 9DU, United Kingdom
| | - W Squier
- Neuropathology Department, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford OX3 9DU. United Kingdom
| | - S Brady
- Oxford Muscle Service, Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford OX3 9DU, United Kingdom
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Mano T, Iguchi N, Iwasa N, Yamada N, Sugie K. Compound muscle action potential of whole-forearm flexors: A clinical biomarker for inclusion body myositis. Clin Neurophysiol Pract 2024; 9:162-167. [PMID: 38707484 PMCID: PMC11066998 DOI: 10.1016/j.cnp.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 05/07/2024] Open
Abstract
Objective This study aimed to investigate the potential of whole-forearm flexor muscle (WFFM) compound muscle action potential (CMAP) as a quantitative biomarker for inclusion body myositis (IBM) pathology. Methods We prospectively enrolled 14 consecutive patients (10 men and 4 women) diagnosed with IBM based on muscle biopsies. We evaluated the baseline-to-peak amplitude of the WFFM CMAP and other quantitative parameters, including grip and pinch strength, Inclusion Body Myositis Functional Rating Scale (IBMFRS) score, and other routine muscle CMAP amplitudes. Results The WFFM CMAP was strongly correlated with disease duration and the IBMFRS score. The WFFM CMAP on the more affected side was lower than that on the less affected side. Furthermore, grip power was strongly correlated with the WFFM CMAP, whereas lateral pinch strength was strongly correlated with the WFFM and first dorsal interosseous CMAPs. The 3-point pinch strength was also correlated with the WFFM CMAP. Conclusions This study demonstrates that the WFFM CMAP may serve as a biomarker of severity in IBM. Significance Identification of this biomarker can support drug development, diagnosis, prognosis, and treatment options for patients with IBM.
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Affiliation(s)
- Tomoo Mano
- Department of Neurology, Nara Medical University, Kashihara, Japan
- Department of Rehabilitation Medicine, Nara Prefecture General Medical Center, Nara, Japan
| | - Naohiko Iguchi
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Naoki Iwasa
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Nanami Yamada
- Department of Neurology, Nara Medical University, Kashihara, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, Kashihara, Japan
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Elmansy M, Morrow JM, Shah S, Fischmann A, Wastling S, Reilly MM, Hanna MG, Helmy EM, El-Essawy SS, Thornton JS, Yousry TA. Evidence of nerve hypertrophy in patients with inclusion body myositis on lower limb MRI. Muscle Nerve 2022; 66:744-749. [PMID: 36151728 DOI: 10.1002/mus.27728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION/AIMS Inclusion body myositis (IBM) is a myopathic condition but in some patients has been associated with an axonal length-dependent polyneuropathy. In this study, we quantified the cross-sectional area of the sciatic and tibial nerves in patients with IBM comparing with Charcot-Marie-Tooth disease type 1A (CMT1A) and healthy controls using magnetic resonance neurography (MRN). METHODS MRN of the sciatic and tibial nerves was performed at 3T using MPRAGE and Dixon acquisitions. Nerve cross-sectional area (CSA) was measured at the mid-thigh and upper third calf regions by an observer blinded to the diagnosis. Correlations were performed between these measurements and clinical data. RESULTS A total of 20 patients with IBM, 20 CMT1A and 29 healthy controls (age- and sex-matched) were studied. Sciatic nerve CSA was significantly enlarged in patients with IBM and CMT1A compared to controls (sciatic nerve mean CSA 62.3 ± 22.9 mm2 (IBM) vs. 35.5 ± 9.9 mm2 (controls), p < 0.001; and 96.9 ± 35.5 mm2 (CMT1A) vs. 35.5 ± 9.9 mm2 (controls); p < 0.001). Tibial nerve CSA was also enlarged in IBM and CMT1 patients compared to controls. DISCUSSION MRN reveals significant hypertrophy of the sciatic and tibial nerves in patients with IBM and CMT1A compared to controls. Further studies are needed to correlate with neurophysiological measures and assess whether this finding is useful diagnostically.
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Affiliation(s)
- Mostafa Elmansy
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK.,Department of Radiology, Mansoura University Hospitals, Mansoura, Egypt
| | - Jasper M Morrow
- Queen Square Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Sachit Shah
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK
| | - Arne Fischmann
- Institute of Radiology and Nuclear Medicine and Breast Center St. Anna, Hirslanden Klinik St. Anna, Lucerne, Switzerland
| | - Stephen Wastling
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK
| | - Mary M Reilly
- Queen Square Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Michael G Hanna
- Queen Square Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | | | | | - John S Thornton
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK.,Queen Square Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
| | - Tarek A Yousry
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK.,Queen Square Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK
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Naddaf E, Shelly S, Mandrekar J, Chamberlain AM, Hoffman EM, Ernste FC, Liewluck T. Survival and associated comorbidities in inclusion body myositis. Rheumatology (Oxford) 2022; 61:2016-2024. [PMID: 34534271 PMCID: PMC9071572 DOI: 10.1093/rheumatology/keab716] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/11/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate survival and associated comorbidities in inclusion body myositis (IBM) in a population-based, case-control study. METHODS We utilized the expanded Rochester Epidemiology Project medical records-linkage system, including 27 counties in Minnesota and Wisconsin, to identify patients with IBM, other inflammatory myopathies (IIM), and age/sex-matched population-controls. We compared the frequency of various comorbidities and survival among groups. RESULTS We identified 50 IBM patients, 65 IIM controls and 294 population controls. Dysphagia was most common in IBM (64%) patients. The frequency of neurodegenerative disorders (dementia/parkinsonism) and solid cancers was not different between groups. Rheumatoid arthritis was the most common rheumatic disease in all groups. A total of 36% of IBM patients had a peripheral neuropathy, 6% had Sjögren's syndrome and 10% had a haematologic malignancy. T-cell large granular lymphocytic leukaemia was only observed in the IBM group. None of the IBM patients had hepatitis B or C, or HIV. IBM patients were 2.7 times more likely to have peripheral neuropathy, 6.2 times more likely to have Sjögren's syndrome and 3.9 times more likely to have a haematologic malignancy than population controls. IBM was associated with increased mortality, with a 10-year survival of 36% from index, compared with 67% in IIM and 59% in population controls. Respiratory failure or pneumonia (44%) was the most common cause of death. CONCLUSIONS IBM is associated with lower survival, and higher frequency of peripheral neuropathy, Sjögren's syndrome and haematologic malignancies than the general population. Close monitoring of IBM-related complications is warranted.
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Affiliation(s)
| | | | | | | | | | - Floranne C Ernste
- Division of Rheumatology, Department of Medicine, Mayo Clinic,
Rochester, MN, USA
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Jordan A, Nagaraj A, Hoyle JC, Stino AM, Arnold WD, Elsheikh B. Elevated Creatinine Kinase in Peripheral Neuropathy Is Associated With Muscle Cramping. Front Neurol 2021; 12:613599. [PMID: 33633669 PMCID: PMC7902013 DOI: 10.3389/fneur.2021.613599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/11/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction: Serum Creatinine Kinase (CK) is a non-specific marker of muscle damage. There has been limited investigation of the association between peripheral neuropathy and CK elevation (hyperCKemia). Methods: We performed a chart review to investigate the CK level in peripheral neuropathies. Demographics, clinical history, physical exam, electrodiagnostic data, CK level, statin use, etiology of neuropathy, and concomitant neuromuscular disorders were recorded. HyperCKemia was defined using our laboratory cutoff values of >180 U/L (women) and >220 U/L (men). Results: We identified 450 patients with peripheral neuropathy who had CK testing, 92 (20.4%) of whom had hyperCKemia. Sixty-one of those patients (13.5% of the total figure) had a concomitant etiology that could explain the CK elevation. Thirty-one patients (6.9%) had no other identifiable etiology for their hyperCKemia beyond the neuropathy. The average CK level in the latter cohort with hyperCKemia was 376 U/L (women: 312 U/L; men: 444 U/L). The frequency of cramping was greater in patients with elevated vs. normal CK (p < 0.0001). Discussion: HyperCKemia can occur in patients with peripheral neuropathy and appears to associate with cramping.
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Affiliation(s)
- Allison Jordan
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Arun Nagaraj
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - J Chad Hoyle
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Amro Maher Stino
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - W David Arnold
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Bakri Elsheikh
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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Neuropathy in sporadic inclusion body myositis: A multi-modality neurophysiological study. Clin Neurophysiol 2020; 131:2766-2776. [PMID: 32928695 DOI: 10.1016/j.clinph.2020.07.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 07/09/2020] [Accepted: 07/22/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Sporadic inclusion body myositis (sIBM) has been associated with neuropathy. This study employs nerve excitability studies to re-examine this association and attempt to understand underlying pathophysiological mechanisms. METHODS Twenty patients with sIBM underwent median nerve motor and sensory excitability studies, clinical assessments, conventional nerve conduction testing (NCS) and quantitative thermal threshold studies. These results were compared to established normal controls, or results from a normal cohort of older control individuals. RESULTS Seven sIBM patients (35%) demonstrated abnormalities in conventional NCS, with ten patients (50%) demonstrating abnormalities in thermal thresholds. Median nerve motor and sensory excitability differed significantly in sIBM patients when compared to normal controls. None of these neurophysiological markers correlated significantly with clinical markers of sIBM severity. CONCLUSION A concurrent neuropathy exists in a significant proportion of sIBM patients, with nerve excitability studies revealing changes possibly consistent with axolemmal depolarization or concurrent neuronal adaptation to myopathy. Neuropathy in sIBM does not correlate with muscle disease severity and may reflect a differing tissue response to a common pathogenic factor. SIGNIFICANCE This study affirms the presence of a concurrent neuropathy in a large proportion of sIBM patients that appears independent of the severity of myopathy.
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Nicolau S, Liewluck T, Milone M. Myopathies with finger flexor weakness: Not only inclusion-body myositis. Muscle Nerve 2020; 62:445-454. [PMID: 32478919 DOI: 10.1002/mus.26914] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/29/2020] [Accepted: 05/03/2020] [Indexed: 12/11/2022]
Abstract
Muscle disorders are characterized by differential involvement of various muscle groups. Among these, weakness predominantly affecting finger flexors is an uncommon pattern, most frequently found in sporadic inclusion-body myositis. This finding is particularly significant when the full range of histopathological findings of inclusion-body myositis is not found on muscle biopsy. Prominent finger flexor weakness, however, is also observed in other myopathies. It occurs commonly in myotonic dystrophy types 1 and 2. In addition, individual reports and small case series have documented finger flexor weakness in sarcoid and amyloid myopathy, and in inherited myopathies caused by ACTA1, CRYAB, DMD, DYSF, FLNC, GAA, GNE, HNRNPDL, LAMA2, MYH7, and VCP mutations. Therefore, the finding of finger flexor weakness requires consideration of clinical, myopathological, genetic, electrodiagnostic, and sometimes muscle imaging findings to establish a diagnosis.
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Affiliation(s)
- Stefan Nicolau
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
| | - Teerin Liewluck
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
| | - Margherita Milone
- Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, Minnesota, 55905, USA
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Haczkiewicz K, Sebastian A, Piotrowska A, Misterska-Skóra M, Hałoń A, Skoczyńska M, Sebastian M, Wiland P, Dzięgiel P, Podhorska-Okołów M. Immunohistochemical and ultrastructural analysis of sporadic inclusion body myositis: a case series. Rheumatol Int 2018; 39:1291-1301. [PMID: 30535925 DOI: 10.1007/s00296-018-4221-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 12/04/2018] [Indexed: 12/18/2022]
Abstract
Sporadic inclusion body myositis (s-IBM) is a progressive, skeletal muscle disease with poor prognosis. However, establishing the final diagnosis is difficult because of the lack of clear biomarkers in the blood serum and very slow development of clinical symptoms. Moreover, most other organs function normally without any disturbance. Here, in patients with this untreatable disease, we have underlined the importance of immunohistochemical and ultrastructural assessment of skeletal muscle in patients diagnosed with s-IBM. The goal of this study was to identify the distribution of specific antigens and to determine morphological features in order to localize pathological protein aggregates, rimmed vacuoles, and loss of myofibrils, which are key elements in the diagnosis of s-IBM. All studied patients were between 48 and 83 years of age and were hospitalized in the Department of Rheumatology and Internal Medicine between 2011 and 2016. Anamneses revealed an accelerated progression of muscle atrophy, weakness of limb muscles, and difficulties with climbing stairs. Based on histopathology and transmission electron microscopy examination, inflammatory infiltrations consisting of mononuclear cells, severe atrophy and focal necrosis of myofibers, splitting of myofilaments, myelinoid bodies and rimmed vacuoles were observed. Primary antibodies directed against CD3, CD8, CD68, cN1A, beta-amyloid, Tau protein and apolipoprotein B made it possible to identify types of cells within infiltrations as well as the protein deposits within myofibers. Using a combination of immunohistochemistry and electron microscopy methods, we were able to establish the correct final diagnosis and to implement a specific treatment to inhibit disease progression.
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Affiliation(s)
- Katarzyna Haczkiewicz
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Chałubińskiego Street 6a, 50-368, Wrocław, Poland.
| | - Agata Sebastian
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556, Wrocław, Poland
| | - Aleksandra Piotrowska
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Chałubińskiego Street 6a, 50-368, Wrocław, Poland
| | - Maria Misterska-Skóra
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556, Wrocław, Poland
| | - Agnieszka Hałoń
- Department of Pathomorphology, Wroclaw Medical University, Borowska Street 213, 50-556, Wrocław, Poland
| | - Marta Skoczyńska
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556, Wrocław, Poland
| | - Maciej Sebastian
- Department of Minimally Invasive Surgery and Proctology, Wroclaw Medical University, Borowska Street 213, 50-556, Wrocław, Poland
| | - Piotr Wiland
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556, Wrocław, Poland
| | - Piotr Dzięgiel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Chałubińskiego Street 6a, 50-368, Wrocław, Poland
| | - Marzenna Podhorska-Okołów
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Chałubińskiego Street 6a, 50-368, Wrocław, Poland
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10
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Inclusion Body Myositis: Diagnosis, Pathogenesis, and Treatment Options. Rheum Dis Clin North Am 2011; 37:173-83, v. [DOI: 10.1016/j.rdc.2011.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Mitsui T, Kunishige M, Kuroda Y, Kaji R. Heterogeneous Muscular Involvement in Inclusion Body Myositis. Lab Med 2010. [DOI: 10.1309/lm4y47nlhqvhsupx] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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King J, LeCouteur RA, Aleman M, Williams DC, Moore PF, Guo LT, Mizisin AP, Shelton GD. Vacuolar myopathy in a dog resembling human sporadic inclusion body myositis. Acta Neuropathol 2009; 118:711-7. [PMID: 19718499 PMCID: PMC2773121 DOI: 10.1007/s00401-009-0588-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2009] [Revised: 08/18/2009] [Accepted: 08/19/2009] [Indexed: 12/05/2022]
Abstract
Sporadic inclusion body myositis (sIBM) is the most common myopathy in people over the age of 50 years. While immune-mediated inflammatory myopathies are well documented in dogs, sIBM has not been described. An 11-year-old dog with chronic and progressive neuromuscular dysfunction was evaluated for evidence of sIBM using current pathologic, immunohistochemical and electron microscopic diagnostic criteria. Vacuoles and congophilic intracellular inclusions were identified in cryostat sections of multiple muscle biopsies and immunostained with antibodies against amyloid-β peptide, amyloid-β precursor protein, and proteosome 20S of the ubiquitin–proteosome system. Cellular infiltration and increased expression of MHC Class I antigen were observed. Cytoplasmic filamentous inclusions, membranous structures, and myeloid bodies were identified ultrastructurally. These observations constitute the first evidence that both the inflammatory and degenerative features of human sIBM can occur in a non-human species.
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Affiliation(s)
- Jason King
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA USA
| | - Richard A. LeCouteur
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA USA
| | - Monica Aleman
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA USA
| | - D. Colette Williams
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA USA
| | - Peter F. Moore
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA USA
| | - Ling T. Guo
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA 92093-0709 USA
| | - Andrew P. Mizisin
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA 92093-0709 USA
| | - G. Diane Shelton
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA 92093-0709 USA
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Strazielle C, Dumont M, Fukuchi K, Lalonde R. Transgenic mice expressing the human C99 terminal fragment of betaAPP: effects on cytochrome oxidase activity in skeletal muscle and brain. J Chem Neuroanat 2004; 27:237-46. [PMID: 15261330 DOI: 10.1016/j.jchemneu.2004.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2003] [Revised: 09/09/2003] [Accepted: 03/28/2004] [Indexed: 11/15/2022]
Abstract
In order to furnish a combined model of relevance to human inclusion-body myopathy and Alzheimer's disease, transgenic mice expressing human betaAPP-C99 in skeletal muscle and brain under the control of the cytomegalovirus/beta-actin promoter were produced (Tg13592). These transgenic mice develop Abeta deposits in muscles but not in brain. Cell metabolic activity was analyzed in brain regions and muscle by cytochrome oxidase (CO) histochemistry, the terminal enzyme of the electron transport chain. By comparison to age-matched controls of the C57BL/6 strain, CO activity was selectively increased in dark skeletal muscle fibers of Tg13592 mice. In addition, only increases in CO activity were obtained in those brain regions where a significant difference appeared. The CO activity of Tg13592 mice was elevated in several thalamic nuclei, including laterodorsal, ventromedial, and midline as well as submedial, intralaminar, and reticular. In contrast, the groups did not differ in most cortical regions, except for prefrontal, secondary motor, and auditory cortices, and in most brainstem regions, except for cerebellar (fastigial and interpositus) nuclei and related areas (red and lateral vestibular nuclei). No variation in cell density and surface area appeared in conjunction with these enzymatic alterations. The overproduction of betaAPP-C99 fragments in brain without (amyloidosis did not appear to affect the metabolic activity of structures particularly vulnerable in Alzheimer's disease.
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Affiliation(s)
- C Strazielle
- Laboratoire de Pathologie Moléculaire et Cellulaire en Nutrition (EMI-INSERM 0014) and Service de Microscopie Electronique, Faculté de Médecine, Université Henri Poincaré, Nancy I, France.
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Arnardottir S, Svanborg E, Borg K. Inclusion body myositis--sensory dysfunction revealed with quantitative determination of somatosensory thresholds. Acta Neurol Scand 2003; 108:22-7. [PMID: 12807389 DOI: 10.1034/j.1600-0404.2003.00087.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In order to evaluate sensory function in inclusion body myositis (IBM), nine patients were subjected to sensibility screening and quantitative determination of somatosensory thresholds. Data were compared with results from electrophysiological examination and muscle biopsy. On sensibility screening all but one of the IBM patients had abnormal findings in hands and/or feet mostly affecting thermal sensibility. Vibratory thresholds were abnormal in five and thermal thresholds in four of the patients. Mean vibratory thresholds were significantly (P < 0.05) higher in the IBM patients when compared with the controls. Significantly increased heat pain thresholds were found in hands and feet when compared with the controls while thermal thresholds were normal. Nerve conduction velocities were decreased in three patients, EMG showed both myopathic and neuropathic abnormalities in six patients. Eight patients had neuropathic abnormalities on muscle biopsy. The sensory dysfunction found suggests an affection of peripheral nerves in IBM mainly affecting large diameter myelinated nerve fibres corroborating earlier findings of a peripheral neuropathy in IBM.
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Affiliation(s)
- S Arnardottir
- Department of Clinical Neuroscience, division of Neurology, Karolinska Hospital, Stockholm, Sweden
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Simmons Z, Towfighi J. Sporadic inclusion body myositis and hereditary inclusion body myopathy. J Clin Neuromuscul Dis 2002; 3:122-132. [PMID: 19078666 DOI: 10.1097/00131402-200203000-00005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Sporadic inclusion body myositis (s-IBM) is a common but under-recognized myopathy in individuals over 50 years of age. An awareness of the clinical phenotype and of the electrodiagnostic and histopathologic features should lead to improved recognition, and should minimize confusion with polymyositis, motor neuron disease, and other neuromuscular disorders. Treatment efficacy has been difficult to judge because of the insidious progression of the disease over many years, but immunomodulating therapy is generally less effective than in polymyositis and dermatomyositis, and may not be effective at all in many patients. The hereditary inclusion body myopathies (h-IBM) are a heterogeneous group of recessively and dominantly inherited vacuolar myopathies that share some histologic features with s-IBM. Oxidative stress may play a role in the pathogenesis of both s-IBM and h-IBM.
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Affiliation(s)
- Zachary Simmons
- Salt Lake City, UT From the *Division of Neurology and the daggerDepartment of Pathology, Penn State College of Medicine, Hershey, Pennsylvania
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