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Fournier JE, Mak G, Gordon K, Glogauer J, Fareez F, Provias J, Tarnopolsky MA, Lu JQ. Cylindrical spirals and other concentric structures of skeletal muscle in patients with neurological diseases. J Neurol Sci 2023; 451:120734. [PMID: 37478793 DOI: 10.1016/j.jns.2023.120734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023]
Abstract
Cylindrical spirals (CSs) are ultrastructurally distinct, intracytoplasmic inclusions characterized by concentrically wrapped lamellae, which are rarely found in skeletal muscle biopsies on electron microscopy (EM). CSs are often confused with other EM concentric structures including concentric laminated bodies and mitochondrial concentric cristae (MCC), due to similarities in these ultrastructures. In this study, we found CSs in 9 muscle biopsies from 9 patients, accounting for 0.5% of the biopsies examined routinely by EM. The frequency of CSs in these muscles varied from sparse and segregated to focally frequent and aggregated. CS-associated features included muscle fiber denervation atrophy in all 9 cases, fiber type grouping in 7/8 cases, tubular aggregates in 3/9 cases, and MCC in 2/9 cases. We also compared the concentric structures and highlighted their differences to distinguish CSs from other similar structures. Clinically, 8 out of 9 patients were adults aged 41-74 years and only one patient was 17 month-old. CSs were associated with several neurological diseases including Huntington's disease, amyotrophic lateral sclerosis, Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes, and other complex neurological disorders with neuropathy/encephalopathy, as well as anti-MDA5+ dermatomyositis. Eight of nine patients had genetic findings such as trinucleotide repeat expansion of huntingtin gene, ALS2 variant, MT-TL1 m.3243A > G mutation, and PMP 22 gene deletion. These results suggest that CSs may be highly variable in frequency and likely are under-reported/under-detected; they may be associated with neurogenic myopathy or central/peripheral nervous system disorders including some genetic neurological/neuromuscular diseases. Our findings of more CS-associated neurological diseases and an association of CSs with muscle neurogenic features may contribute to a better understanding of the clinico-pathological significance of CSs.
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Affiliation(s)
- Jeffrey E Fournier
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gloria Mak
- Department of Medicine/Neurology, McMaster University, Hamilton, Ontario, Canada
| | - Katerina Gordon
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Judah Glogauer
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Faiha Fareez
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - John Provias
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mark A Tarnopolsky
- Department of Medicine/Neurology, McMaster University, Hamilton, Ontario, Canada; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jian-Qiang Lu
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
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Xu JW, Liu FC, Li W, Zhao YY, Zhao DD, Luo YB, Lu JQ, Yan CZ. Cylindrical Spirals in Skeletal Muscles Originate From the Longitudinal Sarcoplasmic Reticulum. J Neuropathol Exp Neurol 2016; 75:148-55. [DOI: 10.1093/jnen/nlv013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Malfatti E, Chaves M, Bellance R, Viou MT, Sarrazin E, Fardeau M, Romero NB. Cylindrical spirals associated with severe congenital muscle weakness and epileptic encephalopathy. Muscle Nerve 2015; 52:895-9. [DOI: 10.1002/mus.24699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Edoardo Malfatti
- UPMC Université Paris 06; Institut National de la Santé et de la Recherche Médicale UMR 974, CNRS FRE3617, Center for Research in Myology, GH Pitié-Salpêtrière, Sorbonne Universités; 47 Boulevard de l'Hôpital 75013 Paris France
| | - Marcelo Chaves
- Department of Neurology-Neuromuscular Disorders Centers; Buenos Aires Italian Hospital; Buenos Aires Argentina
| | - Remi Bellance
- Centre de Référence Caribéen des Maladies neuromusculaire et Neurologiques Rares; CHU de Martinique Martinique
| | - Mai Thao Viou
- UPMC Université Paris 06; Institut National de la Santé et de la Recherche Médicale UMR 974, CNRS FRE3617, Center for Research in Myology, GH Pitié-Salpêtrière, Sorbonne Universités; 47 Boulevard de l'Hôpital 75013 Paris France
| | - Elisabeth Sarrazin
- Centre de Référence Caribéen des Maladies neuromusculaire et Neurologiques Rares; CHU de Martinique Martinique
| | - Michel Fardeau
- UPMC Université Paris 06; Institut National de la Santé et de la Recherche Médicale UMR 974, CNRS FRE3617, Center for Research in Myology, GH Pitié-Salpêtrière, Sorbonne Universités; 47 Boulevard de l'Hôpital 75013 Paris France
| | - Norma B. Romero
- UPMC Université Paris 06; Institut National de la Santé et de la Recherche Médicale UMR 974, CNRS FRE3617, Center for Research in Myology, GH Pitié-Salpêtrière, Sorbonne Universités; 47 Boulevard de l'Hôpital 75013 Paris France
- Centre de Référence de Pathologie Neuromusculaire Paris-Est, Institut de Myologie, GHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris; Paris France
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Abstract
Few medical disciplines have benefited so enormously from the molecular revolution as myology. Whereas the congenital myopathies have flourished from enzyme histochemistry and electron microscopy, defining individual congenital myopathies by structural abnormalities, genetic research has only recently focused on congenital myopathies. However, a number of congenital myopathies have been molecularly elucidated: central and multiminicore diseases, nemaline myopathy, myotubular myopathy, and congenital myopathy marked by aggregation of proteins, giving rise to the concept of protein aggregate myopathies, to which now desminopathies, alpha-B crystallinopathies, selenoproteinopathy, myotilinopathy, actinopathies, and myosinopathies belong. Based on recent identification of mutations in respective genes, the principle "from morphology, that is, immunohistochemistry, to molecular analysis" through recognition of certain accrued proteins within muscle fibers and subsequent analysis of their respective genes has resulted in a wealth of genetic data and in reconsidering classification and nosologic interpretation of certain congenital myopathies. This heuristic principle needs to be further applied to other genetically still obscure congenital myopathies.
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Affiliation(s)
- Hans H Goebel
- Department of Neuropathology, Johannes Gutenberg University, Mainz, Germany.
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Abstract
Certain muscular dystrophies are marked by absence or reduction of mutant proteins, foremost dystrophinopathies and sarcoglycanopathies. Conversely, other sporadic and familial neuromuscular conditions are marked by a surplus of proteins present in a granular or filamentous form, such as desmin-related myopathies, actinopathy and, perhaps, hyaline body myopathy. This emerging group of congenital myopathies is clinically, immunohistochemically, and genetically diverse. Clinically, early- and late-onset diseases with variable courses are described. Immunohistochemically, mutant gene-related and other proteins have been identified by immunohistochemistry. Mutations in the desmin and alpha-B crystallin genes have been discovered in desminopathies. Mutations in the actin gene, but in no other genes have been revealed in actinopathy. Surplus sarcoplasmic and/or intranuclear nemaline bodies have been related to mutant tropomyosin-3, actin and nebulin genes. This emerging concept of surplus protein myopathies will require substantial investigation to further interpret the results of present and future studies.
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Affiliation(s)
- H H Goebel
- Department of Neuropathology, Johannes Gutenberg University Medical Center, Langenbeckstrasse 1, D-55131, Mainz, Germany.
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Wolfe GI, Burns DK, Krampitz D, Barohn RJ. Cylindrical spirals of myofilamentous origin associated with exertional cramps and rhabdomyolysis. Neuromuscul Disord 1997; 7:536-8. [PMID: 9447613 DOI: 10.1016/s0960-8966(97)00101-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We describe the presence of cylindrical spirals on muscle biopsy from a 31-year-old man who developed rhabodomyolysis following a long run. He had a prior history of exertional cramps and myoglobinuria. His maternal grandfather had similar symptoms. Transmission electron micrographs demonstrated continuity between the lamellae of the cylindrical spirals and native myofilaments. Whether these unusual structures confer a derangement in myofilament function is uncertain.
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Affiliation(s)
- G I Wolfe
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas 75235-8897, USA
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