Cytosolic 5'-nucleotidase 1A autoantibody profile and clinical characteristics in inclusion body myositis

OBJECTIVES

Autoantibodies directed against cytosolic 5'-nucleotidase 1A have been identified in many patients with inclusion body myositis. This retrospective study investigated the association between anticytosolic 5'-nucleotidase 1A antibody status and clinical, serological and histopathological features to explore the utility of this antibody to identify inclusion body myositis subgroups and to predict prognosis.

MATERIALS AND METHODS

Data from various European inclusion body myositis registries were pooled. Anticytosolic 5'-nucleotidase 1A status was determined by an established ELISA technique. Cases were stratified according to antibody status and comparisons made. Survival and mobility aid requirement analyses were performed using Kaplan-Meier curves and Cox proportional hazards regression.

RESULTS

Data from 311 patients were available for analysis; 102 (33%) had anticytosolic 5'-nucleotidase 1A antibodies. Antibody-positive patients had a higher adjusted mortality risk (HR 1.89, 95% CI 1.11 to 3.21, p=0.019), lower frequency of proximal upper limb weakness at disease onset (8% vs 23%, adjusted OR 0.29, 95% CI 0.12 to 0.68, p=0.005) and an increased prevalence of excess of cytochrome oxidase deficient fibres on muscle biopsy analysis (87% vs 72%, adjusted OR 2.80, 95% CI 1.17 to 6.66, p=0.020), compared with antibody-negative patients.

INTERPRETATION

Differences were observed in clinical and histopathological features between anticytosolic 5'-nucleotidase 1A antibody positive and negative patients with inclusion body myositis, and antibody-positive patients had a higher adjusted mortality risk. Stratification of inclusion body myositis by anticytosolic 5'-nucleotidase 1A antibody status may be useful, potentially highlighting a distinct inclusion body myositis subtype with a more severe phenotype.

Use of cloned and expressed human liver UDP-glucuronosyltransferases for analysis of drug glucuronide formation and assessment of drug toxicity

Five cloned human hepatic UDP-glucuronosyltransferase (UGT) cDNAs were stably expressed in tissue culture cell lines. More than 100 drugs and xenobiotics were used as substrates for glucuronidation catalyzed by the cloned human transferases to determine the chemical structures accepted as substrates. UGT-HP1 exhibited a limited substrate specificity for planar phenolic compounds, whereas UGT-HP4 was more accepting of nonplanar phenols, anthraquinones, flavones, alphatic alcohols, aromatic carboxylic acids, steroids and many drugs of varied structure. UGT-HP3 (bilirubin UGT) catalyzed the glucuronidation of ethinylestradiol. UGT-H6 and UGT-H25 (steroid/bile acid UGTs) also catalyzed the glucuronidation of some xenobiotics. Levels of UGT-HP4 activity towards some substrates were sufficient to allow determination of kinetic parameters for the enzyme reaction. Further, metabolism of drugs could be studied by addition to the recombinant cell lines in culture and extraction of the media allowed analysis of glucuronide formation. The protection afforded against cytotoxic drugs was observed. The data presented here demonstrate the potential of using these recombinant cell lines for investigation of phase II metabolism by human UGTs and subtle differences in protein structure which affect their specificity.

The retrotransposon copia regulates Drosophila gene expression both positively and negatively

The D. melanogaster transposable element copia is structurally similar to retroviral proviruses. We have asked whether copia encodes regulatory functions which have been observed in certain other proviruses. We have introduced reporter constructs based on the copia promoter and other Drosophila promoters into Drosophila cells and asked if copia has any affect on their expression. We find that, whilst copia negatively regulates expression from its own promoter, it also positively regulates expression from the larval serum protein 1 promoter. Analysis of RNA suggests that both regulatory functions occur by post-transcriptional mechanisms.

The retrotransposon copia controls the relative levels of its gene products post-transcriptionally by differential expression from its two major mRNAs

All retroviruses and retrotransposons studied to date regulate the relative levels of gag and pol/int gene products post-transcriptionally from a single mRNA. In these genetic elements the production of protein encoded by the pol and int genes is attenuated by a translational stop or frameshift in the reading frame preceding their coding regions in the mRNA. We show here that the Drosophila retrotransposon copia also produces lower amounts of gene products from its int/pol region than gag region but this is achieved by a mechanism which is novel for this class of genetic element. We show by the use of gene fusion constructs that the subgenomic 2 kilobase copia RNA, encoding gag products, is expressed as protein in cultured cells at least ten-fold more efficiently than the full genome length RNA, which additionally contains the pol and int open reading frames.

The termini of extrachromosomal linear copia elements

Extrachromosomal linear copia elements were isolated and cloned from cultured Drosophila melanogaster cells. Four full length copia recombinants were characterised. Each contains a full sized copy of copia bounded by its direct repeats. The sequences of the ends of the copia inserts were determined. All of the termini are identical to those of genomic copias except for a single base deletion from one end of one clone. These results suggest that the priming for initiation of copia reverse transcription differs from normal retroviral models. Southern blot analysis of uncloned full length copia circles shows that approximately 50% correspond to the predicted circularisation product of such linears. We propose that this class of circles and the linear DNAs described here are precursors to integrated genomic copia elements.